European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled Trial Comparative StudyShort-term perioperative treatment with ambroxol reduces pulmonary complications and hospital costs after pulmonary lobectomy: a randomized trial.
To assess in a randomized clinical trial the influence of perioperative short-term ambroxol administration on postoperative complications, hospital stay and costs after pulmonary lobectomy for lung cancer. ⋯ Short-term perioperative treatment with ambroxol improved early outcome after lobectomy and may be used to implement fast-tracking policies and cut postoperative costs. Nevertheless, other independent trials are needed to verify the effect of this treatment in different settings.
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Eur J Cardiothorac Surg · Mar 2009
Computed tomography with volume rendering for the evaluation of parenchymal hyperinflation after bronchoscopic lung volume reduction.
To assess computed tomography with volume rendering (CT-VR) as a tool to evaluate parenchymal hyperinflation before and after bronchoscopic lung volume reduction (BLVR) in patients with advanced stage emphysema. ⋯ CT-VR is an excellent tool to confirm the efficacy of BLVR in reducing parenchymal hyperinflation. Functional advantages are proportional to the volume reduction as measured by CT-VR.
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Eur J Cardiothorac Surg · Mar 2009
Comparative StudyVideo-assisted thoracic surgery lobectomy: can we afford it?
Although video-assisted thoracoscopic (VATS) lobectomy offers advantages with regard to pain, respiratory function and mobility, concern is often expressed concerning the cost of stapling devices and increased operative time. We have therefore compared the costs of VATS and open lobectomy in order to assess the overall economic sustainability of a VATS programme. ⋯ VATS lobectomy is less expensive than conventional lobectomy. Increased theatre costs (disposables and time) are counteracted by shorter hospital stay. Importantly, the reduced HDU and ward bed stays free resources for other patients.
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Esophageal lipomas are benign tumors representing less than 0.5% of all gastrointestinal lipomas. They are typically detected incidentally but occasionally present with local symptoms and rarely with life-threatening complications. ⋯ Preoperative investigations included a barium meal, esophagoscopy and computerized tomography. The pedunculated lipoma was excised via a cervical approach and found, at final pathology, to be a spindle cell lipoma, a rare variant not previously described in relation to the esophagus.
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Eur J Cardiothorac Surg · Mar 2009
Exercise capacity assessment in patients undergoing lung resection.
The value is examined of preoperative functional assessment, including exercise capacity measurement by a cycloergometric maximal exercise test, in the prediction of postoperative cardio-pulmonary complication after lobar resection. ⋯ Preoperative exercise capacity assessment helps in stratifying patients at risk for postoperative pulmonary complication. However, it does not appear to be an independent prognostic factor for postoperative outcome.