European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Feb 2003
Evaluations of bronchoplasty and pulmonary artery reconstruction for bronchogenic carcinoma.
To evaluate the surgical results of bronchovascular reconstruction and the prognostic factors for lung cancer. ⋯ Any type of lobectomy with bronchial reconstruction is an adequate cancer operation for both compromised and uncompromised patients especially in patients with stages I and II lung cancer with reasonably good results. Sleeve lobectomy with PA reconstruction may finally be indicated in patients considered compromised because of cardiac or respiratory impairment contraindicating pneumonectomy.
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Eur J Cardiothorac Surg · Feb 2003
Rupture of the aorta following road traffic accidents in the United Kingdom 1992-1999. The results of the co-operative crash injury study.
The true incidence and survivability of blunt traumatic aortic rupture following road traffic accidents in the UK is unclear. The objective of this study was to determine the extent of blunt traumatic aortic rupture in the UK after road traffic accidents and the conditions under which it occurs. ⋯ Blunt traumatic aortic rupture carries a high mortality and occurred in 21% of car occupant deaths in this sample of road traffic accidents. Impact scenarios varied but were most common from the side. The use of an airbag or seat belt does not eliminate risk. The injury can occur at low severity impacts particularly in side impact.
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Eur J Cardiothorac Surg · Feb 2003
Predicting pulmonary complications after pneumonectomy for lung cancer.
Patients undergoing pneumonectomy for lung cancer are thought to be at high risk for the development of postoperative pulmonary complications (PC) and these complications are associated with high mortality rates. The purpose of this study was to identify independent factors associated with increased risk for the development of postoperative PC after pneumonectomy for lung cancer, and to assess the usefulness of predicted pulmonary function to identify high risk patients and other adverse outcomes. ⋯ PC after pneumonectomy are associated with high mortality rates. Careful attention must be paid to patients with COPD and heart disease. Our results confirm the relevance of previous chest physiotherapy and the importance of the length of the surgical procedure to minimize the incidence of PC. The predicted pulmonary function (ppo-FEV1) may be useful to identify high risk patients for PC development and adverse outcomes.
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Eur J Cardiothorac Surg · Feb 2003
Off-pump coronary artery bypass surgery does not reduce gastrointestinal complications.
Gastrointestinal (GI) complications following on-pump coronary artery bypass grafting (CABG) are rare, but carry a high mortality rate. Prolonged cardiopulmonary bypass (CPB) has been associated with a higher incidence of such complications. Little is known about the effect of avoiding CPB on GI complications. Our hypothesis was that off-pump CABG might reduce such complications. ⋯ Our study suggests that off-pump and on-pump techniques are similar in the rates of GI complications. We suggest that a properly designed randomized control trial is needed to verify our findings.