The Annals of thoracic surgery
-
In this article, we assessed the pooled sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in studies during the last 10 years that have solely used EBUS-TBNA as a minimally invasive technique, with or without computed tomography or positron-emission tomography screening. The meta-analysis included 1,066 patients from 9 studies who underwent EBUS-TBNA. ⋯ It has excellent sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. EBUS-TBNA is well tolerated and does not lead to complications in patients.
-
Intubated general anesthesia with one-lung ventilation is considered mandatory for anatomical pulmonary resections. Nonintubated thoracoscopic segmentectomy for management of lung tumors, which is technically challenging, has not been reported previously. The goal of this study was to evaluate the feasibility and safety of thoracoscopic anatomical segmentectomy without endotracheal intubation. ⋯ Nonintubated thoracoscopic segmentectomy is technically feasible and safe. It can be an alternative to intubated single-lung ventilation for management of lung tumors in selected patients.
-
Comparative Study
Gender differences in long-term survival of Medicare beneficiaries undergoing mitral valve operations.
Gender disparities in outcomes have been documented in cardiac surgery. Gender differences in long-term survival after mitral valve operations, especially in the elderly, are less well studied. ⋯ In this large comparative study of gender differences in mitral valve operations, elderly women had higher operative mortality and lower long-term survival. These differences appeared to be driven largely because women present for mitral valve operations later in the disease process. Mitral repair appeared to restore normal life expectancy for men but not for women. Future studies should examine the factors that influence physician referral to mitral valve operations for men and women.