The Annals of thoracic surgery
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Comparative Study
Surgical resection should be considered for stage I and II small cell carcinoma of the lung.
Small cell lung carcinoma (SCLC) is rarely treated with resection, either alone or combined with other modalities. This study evaluated the role of surgical resection in the treatment of stage I and II SCLC. ⋯ Surgical resection as a component of treatment for stage I or II SCLC is associated with significantly improved survival and should be considered in the management of early-stage SCLC.
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Multicenter Study
Evaluation of failure to rescue as a quality metric in pediatric heart surgery: an analysis of the STS Congenital Heart Surgery Database.
Failure to rescue (FTR; the probability of death after a complication) has been adopted as a quality metric in adult cardiac surgery, in which it has been shown that high-performing centers with low mortality rates do not have fewer complications, but rather lower mortality in those who experience a complication (lower FTR). It is unknown whether this holds true in pediatric heart surgery. We characterized the relationship between complications, FTR, and mortality in this population. ⋯ This analysis suggests that hospitals with low mortality rates do not have fewer complications after pediatric heart surgery, but instead have lower mortality in those who experience a complication (lower FTR). Further investigation into FTR as a quality metric in pediatric heart surgery is warranted.
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The purpose of this work was to assess career demographics, professional activities, and career satisfaction of board-certified female cardiothoracic surgeons in the United States, 50 years after certification of the first women diplomats by the American Board of Thoracic Surgery (ABTS). ⋯ Women represent a minority of cardiothoracic surgeons in the United States. The numbers in academic versus private practice are roughly equal, with high levels of job satisfaction in both. Importantly, 90% of surveyed women remain in practice and are academically productive; 50% entered the profession in the past 10 years. The exponential increase in the number of women in the field over the past 10 years provides optimism for continued recruitment.
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Extracorporeal membrane oxygenation (ECMO) has demonstrated utility in the management of adult respiratory failure refractory to mechanical ventilation. The recent introduction of a bicaval dual-lumen ECMO cannula has improved the efficiency of venovenous ECMO and has enabled the concept of full extracorporeal respiratory support in place of mechanical ventilation. Standard placement of this cannula through the right internal jugular vein is particularly troublesome in individuals of short stature, because of excess cannula length. We describe a method for cannula placement through the left subclavian vein that is well suited for smaller patients and convenient for patient mobility.