The Annals of thoracic surgery
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Randomized Controlled Trial
Impact of an Early Oral Feeding Protocol on Inflammatory Cytokine Changes After Esophagectomy.
The aim of the current study was to investigate the impact of early oral feeding (EOF) on inflammatory cytokine levels after McKeown minimally invasive esophagectomy (MIE) for cancer. ⋯ Compared with conventional rehabilitation programs the EOF protocol may decrease stress response after McKeown MIE.
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Comparative Study Observational Study
Extracorporeal Life Support for Refractory Cardiac Arrest: A 10-Year Comparative Analysis.
Cardiopulmonary resuscitation of cardiac arrest has poor outcomes. Extracorporeal life support (ECLS) could represent a salvage option. This study aimed to analyze the outcomes of ECLS used for refractory cardiac arrest. ⋯ Patients in the IHCA and OHCA groups experienced the same survival with good neurologic outcome after ECLS support. A better selection of patients with IHCA is mandatory to avoid futile support.
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Multicenter Study
Two Ventricles Are Not Better Than One in the Fontan Circulation: Equivalent Late Outcomes.
A subset of patients who underwent Fontan operations has two adequate-sized ventricles, but an anatomic biventricular circulation cannot be achieved because of complex morphology or for technical reasons. This study sought to determine whether these patients with two-ventricle Fontan circulation had superior outcomes compared with those with a single ventricle. ⋯ The two-ventricle Fontan circulation does not have better outcomes compared with the single-ventricle Fontan circulation. Late outcomes may depend more on other characteristics of the Fontan circulation. This finding is relevant when the Fontan procedure is being considered as an alternative to anatomic repair in patients with complex two-ventricle morphologies.
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Multicenter Study
Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of The Society of Thoracic Surgeons National Database.
This study evaluated outcomes of reoperative mitral valve surgery (MVS) in the United States. ⋯ Despite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in patients with prior MVS and without endocarditis undergoing elective operations.
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Opioid dependence, misuse, and abuse in the United States continue to rise. Prior studies indicate an important risk factor for persistent opioid use includes elective surgical procedures, though the probability following thoracic procedures remains unknown. We analyzed the incidence and factors associated with new persistent opioid use after lung resection. ⋯ The greatest risk factors for persistent opioid use (14%) following lung resection were adjuvant therapy and thoracotomy. Future studies should focus on reducing excess prescribing, perioperative patient education, and safe opioid disposal.