The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Predictors of conversion to thoracotomy for video-assisted thoracoscopic lobectomy: a retrospective analysis and the influence of computed tomography-based calcification assessment.
Conversion to an open thoracotomy during video-assisted thoracoscopic surgery lobectomy is reported to occur in up to 23% of cases and can be associated with increased morbidity. We developed a preoperative computed tomography calcification score based on anatomic location and extent of calcifications to evaluate the ability to predict video-assisted thoracoscopic surgery conversion. ⋯ Calcification score based on the location and degree of calcifications can predict the increased likelihood of video-assisted thoracoscopic surgery conversion. This scoring system could be one element used to choose the approach for a lobectomy, especially during a surgeon's learning curve.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Controlled Clinical TrialApplication of bronchoscopic argon plasma coagulation in the treatment of tumorous endobronchial tuberculosis: historical controlled trial.
The purpose of this study was to evaluate the efficacy and safety of bronchoscopic argon plasma coagulation for tumorous endobronchial tuberculosis. ⋯ Bronchoscopic argon plasma coagulation can accelerate the healing of tumorous endobronchial tuberculosis and can help prevent progressive bronchial stenosis resulting from tumorous endobronchial tuberculosis, and it is a very safe method.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Comparative StudyEarly and long-term outcomes of coronary artery bypass grafting in patients with acute coronary syndrome versus stable angina pectoris.
The aim of the present study was to determine the early and long-term outcomes of coronary artery bypass grafting in patients with acute coronary syndrome and stable angina pectoris. ⋯ Although acute coronary syndrome is an independent predictor of early mortality in patients undergoing coronary artery bypass grafting, the long-term outcomes after surgery were similar between patients with acute coronary syndrome and stable angina pectoris who survived the early postoperative period.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Does preoperative hyponatremia potentiate the effects of left ventricular dysfunction on mortality after cardiac surgery?
Left ventricular dysfunction and preoperative hyponatremia are associated with adverse outcomes after cardiac surgery. However, the interactions between them are unknown. Thus, we evaluated the interaction of low left ventricular ejection fraction (<40%) and preoperative hyponatremia (Na <135 mEq/L) with morbidity and mortality after cardiac surgery. ⋯ Hyponatremia is more common in patients with low ejection fraction. Although preoperative hyponatremia is independently associated with adverse outcomes in patients with normal ejection fraction, an association with adverse outcomes in patients with low ejection fraction was not demonstrated.
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Intramucosal esophageal cancer treatment is evolving. Less-invasive therapies have emerged, necessitating review of safety, effectiveness, and determinants of long-term outcome after esophagectomy to clarify the role of this traditional, maximally invasive, and potentially harmful therapy. ⋯ Survival after esophagectomy for intramucosal adenocarcinoma is excellent, determined more by patient than cancer characteristics. Patient selection and respiratory function are crucial to minimize harm. Considering the outcome of emerging therapies, esophagectomy should be reserved for patients with a long intramucosal adenocarcinoma or those in whom endoscopic therapies fail or are inappropriate.