European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2009
Multicenter StudyThe management of trauma victims in England and Wales: a study by the National Confidential Enquiry into Patient Outcome and Death.
Trauma is the leading cause of death in the first four decades of life in western countries. A national prospective study was conducted in the UK to examine the process and quality of care of severely injured patients. We present a previously unpublished analysis of the severity of injury, place of treatment, quality of care and survival amongst patients with thoracic injuries. ⋯ Given that polytrauma patients rarely come under the care of thoracic surgeons and yet frequently have severe thoracic injuries there is a clear need for T and O surgeons and generalists to have a good grounding in thoracic procedures.
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In lung resection, thoracoscopy has been mainly used for wedge resection and lobectomy. There have been very few reports on pulmonary segmentectomy, mainly because of its complex nature. The present report evaluates the safety and efficacy of thoracoscopic pulmonary segmentectomy for the treatment of benign lung diseases or small lung carcinomas. ⋯ Thoracoscopic pulmonary segmentectomy is a feasible and safe technique. Reduced postoperative pain and an improved cosmetic outcome are considered advantages of this minimally invasive procedure.
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Eur J Cardiothorac Surg · Aug 2009
Randomized Controlled TrialA newly designed thorax support vest prevents sternum instability after median sternotomy.
Sternum infection remains one of the primary causes of postoperative morbidity and mortality after median sternotomy. We report the clinical efficacy for primary reinforcement of the sternum with a new design of thorax support vest. ⋯ The use of the Posthorax sternum vest shows a favourable outcome to prevent sternum instability after cardiac surgery. There was one reoperation in patients treated with this sternum vest compared to 16 in the control groups.
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Eur J Cardiothorac Surg · Aug 2009
Anomalous origin of the left coronary artery from the pulmonary artery: late results with special attention to the mitral valve.
Evaluate the late results of a uniform approach to the surgical management of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). ⋯ (1) Early mortality is related to the severity of preoperative left ventricular dysfunction; it may be reduced by a careful use of postoperative cardiac support techniques. (2) Late results are satisfactory and left ventricular function always recovers. (3) Mitral regurgitation improves along with left ventricular function, but recovery may be incomplete and need reoperation. The data suggest that mitral valve surgery is probably not indicated at initial surgery, except in selected cases with a low potential of recovery (severe regurgitation with relatively well-preserved left ventricular function).
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Eur J Cardiothorac Surg · Aug 2009
Fast-track rehabilitation for lung cancer lobectomy: a five-year experience.
Fast-track rehabilitation is a group of simple measures that reduces morbidity, postoperative complication and accelerates postoperative rehabilitation reducing hospital stay. It can be applied to lung cancer lobectomy. Fast-track rehabilitation cornerstones are: minimally invasive surgical techniques using video-assisted and muscle sparring incisions, normovolemia, normothermia, good oxygenation, euglicemia, no unnecessary antibiotics, epidural patient-controlled analgesia, systemic opiods-free analgesia, early ambulation and oral feeding. Our objective is to describe a five-year experience with fast-track rehabilitation for lung cancer lobectomy. ⋯ Fast-track rehabilitation for lung cancer lobectomies can be safely performed in a selected group of patients if a motivated multidisciplinary group of professionals is available and seems to reduce postoperative complication and hospital stay.