The Annals of thoracic surgery
-
Comparative Study
Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure.
Anatomic sublobar resection is currently being assessed as an alternative to lobectomy for primary lung cancers less than 2 cm in size. Open segmentectomy is a proven oncologic procedure for patients with reduced cardiopulmonary reserve and significant comorbidities. With the increased use of thoracoscopy, a video-assisted thoracoscopic surgery (VATS) segmentectomy may be as safe and effective as an open segmentectomy. ⋯ Video-assisted thoracoscopic surgery segmentectomy is a safe procedure which has fewer complications and a reduced hospital stay when compared with an open segmentectomy. This approach may be the ideal oncologic procedure for patients with small lung cancers (<2 cm) and (or) limited cardiopulmonary reserve and significant comorbidities.
-
Randomized Controlled Trial Comparative Study
Cell saver for on-pump coronary operations reduces systemic inflammatory markers: a randomized trial.
This study investigated whether intraoperative use of a cell saver reduces the systemic inflammatory response after coronary operations using cardiopulmonary bypass (CPB). ⋯ The cell saver reduced the systemic levels of the proinflammatory markers IL-6 and IL-8 at 6 hours after CPB. The role of the anti-inflammatory molecules IL-10 and soluble tumor necrosis factor receptors is undefined in this setting.
-
Comparative Study
Video-assisted thoracoscopic versus open thoracotomy lobectomy in a cohort of 13,619 patients.
Video-assisted thoracoscopic surgery (VATS) is becoming increasingly popular for lung resection in some centers. However, the issue of whether VATS or open thoracotomy is better remains controversial. We compared outcomes of open and VATS lobectomy in a national database. ⋯ Patients who underwent VATS lobectomy were 1.6 times more likely to have intraoperative complications than patients who underwent open lobectomy. However, short-term mortality, lengths of stay, and hospitalization costs were similar between the two groups of patients. There seems to be a socioeconomic disparity between VATS and open thoracotomy patients.
-
Biventricular repair of double-outlet right ventricle (DORV) with noncommitted ventricular septal defect (VSD) or subpulmonary VSD, associated with pulmonary stenosis, remains controversial. The usual technique, Rastelli or réparation à l'étage ventriculaire (REV) procedure, may not meet a perfect biventricular outflow tract reconstruction in terms of hemodynamic performance and long-term outcome. Here we present an early result of an alternative solution for these anomalies by double-root translocation technique. ⋯ The early results showed an optimized solution for DORV with noncommitted VSD or DORV with subpulmonary VSD, associated with pulmonary stenosis. Long-term benefits need to be evaluated with a larger number of patients and longer follow-up.
-
Tracheomalacia complicates the clinical course of congenital heart disease among infants; however, the surgical treatment of tracheomalacia in conjunction with open heart operations is rarely reported. We report an infant with ventricular septal defect and severe tracheomalacia. The patient was treated with simultaneous intracardiac repair, and the tracheomalacia was relieved by aortopexy for anterior wall collapse and a new technique to fix the posterior wall bulging.