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Thoracic Surgery Clinics

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https://www.readbyqxmd.com/read/30268305/innovations-in-and-around-the-foregut
#1
EDITORIAL
Brian E Louie
No abstract text is available yet for this article.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268304/erratum
#2
(no author information available yet)
No abstract text is available yet for this article.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268303/best-practices-for-training-educating-and-introducing-new-techniques-and-technology-into-practice
#3
REVIEW
Monisha Sudarshan, Shanda H Blackmon
Adoption of new practices is challenging to the surgeon innovator given lack of standardized processes for implementation. Credentialed surgeons who want to apply new practices need to ensure adequate training depending on the procedure and underlying skills. A competent and motivated team needs to be identified and appropriate privileging sought for the procedure from the local institution. Planning for meticulous monitoring of outcomes ensures continuous safety and quality surveillance. Patients need complete transparency when being informed about a novel practice with information on comparison to standard of care treatments...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268302/the-role-of-intraoperative-fluorescence-imaging-during-esophagectomy
#4
REVIEW
Simon R Turner, Daniela R Molena
Intraoperative fluorescence imaging (FI) with indocyanine green has several potential uses during esophagectomy. Intravascular injection for enhancing the visualization of conduit vascularity and assessing macro and microperfusion has the most literature support and may help reduce anastomotic leaks. Peritumoral injection has been reported for use in identifying sentinel nodes during lymphadenectomy and intralymphatic injection may be used to help preserve or ligate the thoracic duct. The authors' own technique of FI for conduit assessment is described...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268301/the-role-of-novel-functional-probes-in-the-evaluation-and-treatment-of-esophageal-disease
#5
REVIEW
Ezra N Teitelbaum, Christy M Dunst
The understanding of esophageal function and dysfunction in a variety of disease states has been driven largely by the introduction of a variety of measurement technologies. Included in these are contrast esophagram, computed tomography, high-resolution manometry, and 24-hour pH monitoring. Two novel measurement technologies, the functional lumen imaging probe (FLIP) and mucosal impedance (MI) catheter have recently introduced and studied. This review will discuss the technological basis of these tools and the evidence behind their application in the measurement of esophageal anatomy, physiology, and histology pertaining to a number of diseases, including gastroesophageal reflux disease, achalasia, and esosinophilic esophagitis...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268300/endoluminal-therapies-for-esophageal-perforations-and-leaks
#6
REVIEW
Jeffrey R Watkins, Alexander S Farivar
Esophageal perforation has historically been a devastating condition resulting in high morbidity and mortality. The use of endoluminal therapies to treat esophageal leaks and perforations has grown exponentially over the last decade and offers many advantages over traditional surgical intervention in the appropriate circumstances. New interventional endoscopic techniques, including endoscopic clips, covered metal stents, and endoluminal vacuum therapy, have been developed over the last several years to manage esophageal perforation in an attempt to decrease the related morbidity and mortality...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268299/management-of-the-difficult-hiatal-hernia
#7
REVIEW
Matthew Rochefort, Jon O Wee
The ideal operative solution to giant paraesophageal hernias involves a complex evaluation of the functional anatomy and the intraoperative assessment of both esophageal length and crural closure tension. The addition of surgical adjuncts such as extended transmediastinal dissection, Collis gastroplasty, and mesh reinforcement are all necessary, on an individualized basis, to address these 2 primary causes of hernia recurrence. We discuss the options available.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268298/endoluminal-approaches-to-gastroesophageal-reflux-disease
#8
REVIEW
Marissa Anne Mayor, Hiran Chrishantha Fernando
Endoluminal antireflux procedures were pioneered in the 1980s as an alternative to the more invasive Nissen fundoplication. Recent advances in device design and technique have generated renewed interest. Herein we review available data for currently available devices used for endoluminal therapy for GERD.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268297/extraluminal-approaches-to-gastroesophageal-reflux-disease
#9
REVIEW
James M Tatum, John C Lipham
Gastroesophageal reflux disease (GERD) is a common affliction in Western society. In patients in whom GERD is resistant to medical therapy or who desire nonpharmacological definitive therapy, several surgical interventions are available. The most common and traditional surgical therapy is partial or complete gastric fundoplication; however, new alternatives, including the magnetic augmentation system LINX and EndoStim device, are increasingly common and efficacious.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268296/endoscopic-approaches-to-cricopharyngeal-myotomy-and-pyloromyotomy
#10
REVIEW
Anee Sophia Jackson, Ralph W Aye
Endoscopic cricopharyngeal myotomy has been demonstrated to be a safe and efficacious procedure with favorable outcomes for the treatment of cricopharyngeal dysfunction with or without Zenker diverticulum. It is a less invasive approach with decreased morbidity compared with the open approach and minimal reported complications. Peroral endoscopic pyloromyotomy is a novel technique for the treatment of gastroparesis. It has shown promising results in terms of its safety, complication profile, and symptom improvement in a minimally invasive approach that is appealing to many patients...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268295/peroral-endoscopic-myotomy-for-achalasia
#11
REVIEW
Lara W Schaheen, Manuel Villa Sanchez, James D Luketich
Peroral endoscopic myotomy surgery is an incisionless, minimally invasive, natural orifice technique used to treat the symptoms of achalasia and other spastic disorders of the esophagus. Recent experience demonstrates that it can be performed safely by experienced esophageal surgeons and there are very good short-term outcomes comparable to laparoscopic myotomy. The rapid worldwide adoption of this technique demonstrates its potential to replace the current therapies available for achalasia. A cautionary note is important in that long-term outcomes are not yet available in terms of dysphagia and GERD symptoms...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268294/endoscopic-resection-in-the-esophagus
#12
REVIEW
Andrew F Feczko, Brian E Louie
The article is a review of the principles behind endoscopic resection of esophageal dysplasia and early cancers. The techniques of endoscopic mucosal resection and endoscopic submucosal dissection are reviewed, and the supporting literature compared. Endoscopic resection is compared with esophagectomy for the management of these lesions and current areas of controversy with regard to T1b lesions and gastroesophageal reflux following resection are addressed.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268293/mucosal-ablation-techniques-for-barrett-s-esophagus-and-early-esophageal-cancer
#13
REVIEW
Ravi Rajaram, Wayne L Hofstetter
Patients with esophageal intestinal metaplasia, or Barrett's esophagus, may undergo dysplastic changes that eventually lead to invasive adenocarcinoma. Endoscopic therapy in the form of radiofrequency ablation and cryoablation has been described as a minimally invasive intervention to halt this sequence of dysplasia to carcinoma. Studies demonstrate that the use of radiofrequency ablation and cryoablation is highly successful at eradicating intestinal metaplasia and dysplasia and reducing the risk of disease progression...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268292/advanced-endoluminal-technologies-for-barrett-s-esophagus-focus-on-optical-coherence-tomography-and-confocal-laser-endomicroscopy
#14
REVIEW
Ahmed M Zihni, Steven R DeMeester
Barrett's esophagus (BE) may progress to dysplasia and adenocarcinoma. The value of Barrett's surveillance with random biopsies is being questioned, but new technologies may enhance detection of progression within BE and guide endoscopic resection and ablation techniques. This review will focus on optical coherence tomography and endomicroscopy for patients with BE.
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30268291/enhancing-the-detection-of-barrett-esophagus
#15
REVIEW
Yoshihiro Komatsu, Kirsten M Newhams, Blair A Jobe
In Western countries, the incidence of esophageal adenocarcinoma has increased rapidly in parallel with its premalignant condition, Barrett esophagus (BE). Unlike colonoscopy, endoscopic screening for BE is not currently recommended for all patients; however, surveillance endoscopy is advocated for patients with established BE. Novel imaging and sampling techniques have been developed and investigated for the purpose of improving the detection of Barrett esophagus, dysplasia, and neoplasia. This article discusses several screening and surveillance techniques, including Seattle protocol, chromoendoscopy, electronic chromoendoscopy, wide area transepithelial sampling with 3-dimensional analysis, nonendoscopic sampling devices, and transnasal endoscopy...
November 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30054085/frederick-griffith-pearson-the-father-of-modern-thoracic-surgery
#16
EDITORIAL
Jean Deslauriers, Noriaki Tsubota
No abstract text is available yet for this article.
August 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30054084/fundamentals-of-airway-surgery-part-ii
#17
EDITORIAL
Jean Deslauriers, Farid M Shamji
No abstract text is available yet for this article.
August 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30054083/importance-of-a-team-effort-in-success-of-airway-surgery
#18
REVIEW
Farid M Shamji, Jean Deslauriers, Bill Nelems
The thoracic surgeon occupies a unique position in the team of those who are involved in looking after surgical patients in need of airway operations. It may be for urgent and life-threatening situations as in tracheo-vascular fistula or critical airway obstruction. Or it may be semiurgent in the intensive care unit in patients on assisted ventilation requiring tracheostomy (open or percutaneous). It may be elective for patients with tracheal stricture (benign or malignant), cervical exenteration, anterior mediastinal tracheostomy, and tracheo-bronchomalacia...
August 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30054082/use-of-silicone-tubes-in-the-management-of-complex-airway-problems
#19
REVIEW
Joel D Cooper
Silicone airway stents are extremely useful for both temporary or long-term management of upper airway obstruction, especially in the proximal half of the trachea and in the subglottic region. They cannot migrate are well tolerated, relatively easy to manage, durable, and generally cause little or no injury to the underlying airway mucosa. They are particularly important as part of the management of subglottic strictures. For patients with postintubation tracheal or laryngotracheal stenosis they can be used to temporize for periods up to a year or two, until the patients' condition is optimal for proceeding with a resection or reconstruction...
August 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30054081/cricothyroid-approach-for-emergency-access-to-the-airway
#20
REVIEW
Alejandro Bribriesco, G Alexander Patterson
Airway emergencies are life-threatening events that face providers of many different backgrounds. In cannot-intubate-cannot-ventilate situations, emergent access to the airway can be obtained through the cricothyroid membrane by cricothyroidotomy. The 3 main techniques are open, percutaneous, and needle cricothyroidotomy. To date, there is no compelling evidence demonstrating superiority of a particular approach. Ultimately, the method used for cricothyroidotomy should be based on the comfort and experience of the provider performing the procedure...
August 2018: Thoracic Surgery Clinics
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