The Annals of thoracic surgery
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Pulsatile versus nonpulsatile cardiopulmonary bypass (CPB) perfusion remains debated. Beneficial effects on tissue perfusion, inflammation, and microvascular fluid exchange have been linked to pulsatile perfusion by some investigators and denied by others. This study evaluated fluid extravasation and tissue perfusion during nonpulsatile or pulsatile roller pump-induced CPB perfusion. ⋯ No important differences were found between pulsatile and nonpulsatile CPB perfusion for microvascular fluid balance and tissue perfusion.
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Trocars used during video-assisted thoracic surgery (VATS) present some technical disadvantages due to their rigid structure. We propose the use of an extra-small wound retractor system, designed for general surgery, as alternative to rigid trocar for camera port during VATS. In our experience the wound retractor presents 5 objective advantages: reduces intercostal nerve compression and skin injuries, improves the camera maneuverability, does not displace during operation, and protects the camera by any small parietal bleeding.