European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2013
Bilateral internal mammary artery grafting reverses the negative influence of gender on outcomes of coronary artery bypass grafting surgery.
Coronary artery bypass grafting (CABG) has historically demonstrated higher hospital mortality in women compared with men. The influence of gender on long-term outcomes has not been clearly defined. ⋯ When liberally applied, BIMA grafting ameliorates both the increased perioperative mortality in female patients and the reduced long-term survival of male patients, effectively reversing the negative influence of gender on both short- and long-term outcomes of CABG surgery.
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Eur J Cardiothorac Surg · Jul 2013
The maximum standardized uptake value of fluorodeoxyglucose positron emission tomography of the primary tumour is a good predictor of pathological nodal involvement in clinical N0 non-small-cell lung cancer.
Fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in the evaluation of resectable non-small-cell lung cancer (NSCLC). However, this modality cannot be used to detect histological nodal involvement, which can result in stage-migration for resectable lung cancer. In this study, we tried to evaluate the possibility of predicting histological nodal involvement in patients with NSCLC using the maximum standardized uptake value (SUVmax) of FDG-PET of the primary tumour instead of that of the lymph nodes. ⋯ Postoperative nodal status was significantly predicted by the SUVmax of FDG-PET of the primary tumour instead of the lymph nodes themselves. The patients with NSCLC in particular who show strong uptake values of SUVmax in the primary tumour could have occult nodal metastases, and may be indicated for a further preoperative modality for an accurate staging.
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Eur J Cardiothorac Surg · Jul 2013
Phenylephrine infusion improves blood flow to the stomach during oesophagectomy in the presence of a thoracic epidural analgesia.
Gastric tube necrosis is a major cause of mortality after oesophagectomy. The construction of the gastric tube used for oesophageal reconstruction involves a division of several arteries leading to a reduction in the blood supply at the fundus, which is used for the oesophageal anastomosis. This study was undertaken to determine the effect of thoracic epidural anaesthesia and intravenous phenylephrine on haemodynamics and blood flow in the tubularized stomach. ⋯ An intravenous phenylephrine infusion can reverse the epidural bolus-induced reduction in blood flow at the anastomotic end of the newly formed gastric tube.
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Eur J Cardiothorac Surg · Jul 2013
Post-thoracotomy pain and long-term survival associated with video-assisted thoracic surgery lobectomy methods for clinical T1N0 lung cancer: a patient-oriented, prospective cohort study.
To provide a less-invasive procedure for video-assisted thoracic surgery (VATS), we prospectively evaluated the feasibility of two existing VATS approaches. ⋯ Both procedures are feasible with regard to perioperative factors and long-term survival rates. Patients undergoing complete VATS required less medication than those undergoing assisted VATS.