Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Oct 1992
ReviewResults of standard left thoracoabdominal esophagogastrectomy.
The left thoracoabdominal incision is approaching its first century of use. Although less popular than the Ivor Lewis and transhiatal techniques, it continues to be a useful approach for esophageal or gastric tumors near the gastroesophageal junction. For these tumors, the incision provides excellent exposure, and maximizes reconstructive options during esophagogastrectomy. The incision has a proven track record of safety and is well-tolerated.
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Semin. Thorac. Cardiovasc. Surg. · Jul 1992
ReviewBlunt cardiac trauma: clinical manifestations and management.
In conclusion, blunt cardiac trauma is the leading cause of fatalities following motor vehicle accidents. Although many of the patients with anatomic cardiac injuries die at the scene, with improved prehospital care these patients have more likelihood of surviving the first hour and presenting to an emergency room alive for definitive treatment. Prompt recognition of the injury based on the mechanism and a high index of suspicion must lead to immediate surgical intervention in order for these patients to survive. ⋯ This will allow better allocation of scarce hospital resources rather than blindly pursuing "routine" (expensive) work-ups. The sequelae of these injuries are generally nonfatal. If serious sequelae do arise in the ICU or in the OR, prompt treatment with inotropic support is usually successful.
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Semin. Thorac. Cardiovasc. Surg. · Jul 1992
ReviewThe diagnostic and therapeutic approach to chest trauma.
The diagnosis of thoracic injuries is now accomplished by a combination of time-honored techniques and new modalities such as echocardiography, CT, and thoracoscopy. Operative approaches are reserved for exsanguination, significant false aneurysms, tamponade, and perforation of the main aerodigestive tracts.