European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 2013
Impact of interstitial lung disease on short-term and long-term survival of patients undergoing surgery for non-small-cell lung cancer: analysis of risk factors.
The study aimed to determine the impact of interstitial lung disease (ILD) on postoperative morbidity, mortality and long-term survival of patients with non-small-cell lung cancer (NSCLC) undergoing pulmonary resection. ⋯ In conclusion, major lung resection in patients with NSCLC and ILD is associated with an increased postoperative morbidity and mortality. Patients with a low preoperative FVC% should be carefully assessed prior to undergoing surgery, particularly in the presence of a lower DLCO%. Long-term survival is significantly lower when compared with patients without ILD, but still achievable in a substantial subgroup. Thus, surgery can be offered to properly selected patients with lung cancer and ILD, keeping in mind the risk of respiratory failure during the evaluation of such patients.
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Eur J Cardiothorac Surg · Jan 2013
Massive pulmonary embolism: surgical embolectomy versus thrombolytic therapy--should surgical indications be revisited?
The treatment of massive pulmonary embolism (PE) is a matter of debate. We present our institutional experience of patients suffering from massive PE with the aim of comparing the early results, the outcome and quality of life (QoL) between patients primarily assigned to either pulmonary surgical embolectomy (SE) or thrombolytic therapy (TL). A subgroup of patients (TS) with failed responses to TL requiring SE was separately analysed. ⋯ SE is an excellent treatment option in massive PE with comparable early mortality rates and significantly less bleeding complications than TL. Patients having surgery after inefficient thrombolysis have the worst early outcome. The RV/LV CT-scan ratio might serve as a predictor to differentiate patients, who could profit from direct surgical intervention than thrombolytic treatment attempts. Further studies are required to confirm these results.
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Eur J Cardiothorac Surg · Jan 2013
Case ReportsEmergency laparotomy helped the resection of an intralobar pulmonary sequestration with haemorrhagic shock.
Massive intrapulmonary haemorrhage and haemothorax are uncommon presentations associated with pulmonary sequestration. Here, we describe the case of a 40-year-old man who suffered from high fever and haemoptysis for 1 week before he was admitted to our hospital with a complaint of chest discomfort with shock. ⋯ A pulmonary sequestration has a severe complication resulting in shock due to intrapulmonary haemorrhage and haemothorax. Accordingly, early resection of a sequestered lung should be the choice of the treatment in these cases.
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Eur J Cardiothorac Surg · Jan 2013
The North American view: the perspective of the American Association for Thoracic Surgeons.
The American Association for Thoracic Surgeons (AATS) is a small, selective organization focused on scholarship in thoracic surgery, complementing the Society of Thoracic Surgeon's focus on practice issues impacting all practicing surgeons. AATS works to improve the academic quality of North American and International meetings and symposia and focuses specific lobbying efforts on improving National Institutes of Health funding for thoracic surgeons. We need to embrace new technologies and incorporate them into our training programmes, and to cultivate the creativity necessary for innovation. It is necessary to make residents and medical students more aware of the virtues of a career in our specialty and focus less on making the training process more attractive for its own sake.
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Eur J Cardiothorac Surg · Jan 2013
Right vertical infra-axillary mini-incision for repair of simple congenital heart defects: a matched-pair analysis.
To evaluate the efficacy and safety of the right vertical infra-axillary mini-incision (RVAI) used for the repair of simple congenital heart defects. ⋯ The RVAI surgical approach to simple congenital heart defects was a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard MSI for simple congenital heart defects.