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Thoracic Surgery Clinics

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https://www.readbyqxmd.com/read/29150044/thoracic-surgery-in-the-special-care-patient
#1
Sharon Ben-Or
No abstract text is available yet for this article.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150043/synchronous-esophageal-and-lung-cancer
#2
REVIEW
Amar N Mukerji, Andrea Wolf
Synchronous lung and esophageal cancers are rare but represent a unique challenge to thoracic surgeons. The literature is limited but series describe long-term survival with curative surgery for concomitant esophageal and lung cancer. Preoperative risk assessment is critical because surgical resection of both cancers requires adequate cardiopulmonary function and performance status. Chemotherapy and radiation are used as adjuvant therapy or as primary treatment of unresectable lesions. Although long-term survival for patients with concomitant lung and esophageal cancer is lower than that of patients with either one alone, survival with curative surgery is higher than that of patients with metastatic disease of either primary...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150042/empyema-from-obstructing-lung-cancer
#3
REVIEW
Julian Guitron
Pleural collections on the side of an obstructing bronchial cancer pose a particular challenge. All efforts should be placed into determining whether the collection is malignant or para-malignant with its significant implications on cancer staging. This article discusses various diagnostic modalities and therapeutic interventions needed for the optimal management of patients presenting with this situation. The order of interventions is dictated by the individual circumstances that patients present with, often requiring the pleural interventions to take place ahead of the bronchial obstruction management...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150041/thoracic-surgery-in-early-stage-small-cell-lung-cancer
#4
REVIEW
Matthew Low, Sharon Ben-Or
Small cell lung cancer (SCLC) has a complex history and remains difficult to treat. Most patients with SCLC present with metastases or extensive stage disease, rendering most not amenable to surgical resection. Until recently, chemoradiotherapy had become the standard of care for all patients with SCLC. However, recent studies have shown improved survival following surgical resection with chemotherapy in patients with early-stage SCLC, specifically those with stage I disease. This article presents the literature on treatment of early-stage SCLC and addresses the question of whether surgery should be considered a viable treatment modality...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150040/management-of-malignant-lung-entrapment-the-oncothorax
#5
REVIEW
Roman Petrov, Charles Bakhos, Abbas E Abbas
Pleural metastasis is a common occurrence in up to 30% of patients with metastatic cancer. When lung entrapment and loculation of fluid occur, treatment is more difficult and we have named this condition "oncothorax." The malignant adhesions that entrap the lung in an oncothorax are not typically amenable to surgical decortication. The standard approach for managing these patients is to place an indwelling catheter. Other options may include pleurectomy and decortication, intrapleural hyperthermic chemoperfusion, and intrapleural photodynamic therapy...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150039/management-of-lung-cancer-with-concomitant-cardiac-disease
#6
REVIEW
Benjamin Powell, William D Bolton
This article discusses the numerous issues surrounding lung cancer treatment in patients with concomitant cardiac disease. It also addresses the preoperative work-up of these patients and the specifics of surgical intervention.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150038/thoracic-surgery-considerations-in-the-mentally-ill-or-handicapped-patient
#7
REVIEW
Anthony B Mozer, James E Speicher, Carlos J Anciano
Increasing prevalence of mentally ill and handicapped populations requiring surgical thoracic interventions has brought to light their worse associated morbidity and mortality. Baseline functional status, caretaker environment, and mental limitations in day to day life have an impact in the short and long term from these interventions. Aggressive perioperative care, multispecialty approach, technical aspects, palliative procedures, and ethical considerations all play a part in improving outcomes. In this article real cases are presented illustrating points of care and situations for discussion...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150037/esophagectomy-after-weight-reduction-surgery
#8
REVIEW
Katy A Marino, Benny Weksler
Obesity is now epidemic worldwide, and an increasing number of patients have undergone a weight-loss procedure. Although obesity is a risk factor for esophageal cancer, there are few reports on esophagectomy after bariatric procedures. Careful understanding of the patient's gastroesophageal anatomy as a result of the bariatric procedure and attention to the creation of the esophageal replacement conduit are fundamental for the success of esophagectomy after bariatric surgery.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150036/thoracic-surgery-considerations-in-the-child-and-young-adult
#9
REVIEW
Marvin D Atkins, Stephanie Fuller
Vascular rings and slings may represent life-threatening compression of the esophagus and trachea. Such anatomic variants, although rare, are encountered by all thoracic surgeons in the scope of their practice at some time. The thoracic surgeon, whether treating such patients in the practice of congenital heart surgery, or in the practice of adult cardiac or thoracic surgery must have a requisite understanding of such anatomic variants, their diagnostic workup and radiologic interpretation, as well as their surgical management...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150035/thoracic-surgery-considerations-in-obese-patients
#10
REVIEW
Douglas Z Liou, Mark F Berry
The obesity epidemic in the United States has increased greatly over the past several decades, and thoracic surgeons are likely to see obese patients routinely in their practices. Obesity has direct deleterious health effects such as metabolic disorder and cardiovascular disease, and is associated with many cancers. Obese patients who need thoracic surgery pose practical challenges to many of the routine elements in perioperative management. Preoperative assessment of obesity-related comorbid conditions and risk stratification for surgery, thorough intraoperative planning for anesthesia and surgery, and postoperative strategies to optimize pulmonary hygiene and mobility minimize the risk of adverse outcomes...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150034/lung-resection-in-the-postpneumonectomy-patient
#11
REVIEW
Megumi Asai, Walter J Scott
Pulmonary resection after pneumonectomy is a reasonable option in selected patients. Wedge resection for single peripheral metachronous disease has the best outcome with 5-year survival as high as 63%. Current and predicted postoperative cardiopulmonary reserve should be evaluated carefully. Stereotactic body radiotherapy is a promising alternative for inoperable patients.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150033/lung-cancer-and-lung-transplantation
#12
REVIEW
Timothy Brand, Benjamin Haithcock
Lung transplantation remains a viable option for patients with endstage pulmonary disease. Despite removing the affected organ and replacing both lungs, the risk of lung malignancies still exists. Regardless of the mode of entry, lung cancer affects the prognosis in these patients and diligence is required.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150032/thoracic-surgery-in-patients-with-aids
#13
REVIEW
Doraid Jarrar, Grace Y Song
The picture of human immunodeficiency virus (HIV)-infected patients has changed dramatically since the original description in 1981. The introduction of antiretroviral drugs in 1987 and combination antiretroviral therapy has decreased mortality by as much as 80%. We now see patients in their 60s and 70s, having lived decades with HIV and living a normal live. As outlined in the article, despite good viral control, patients with HIV may present with solid organ cancers earlier than noninfected patients and are also prone to other complications of their disease that may require the attention of a thoracic surgeon...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150031/thoracic-surgery-in-the-pregnant-patient
#14
REVIEW
Brian Whang
Thoracic surgeons are sometimes asked to consult on the management of a patient who is pregnant. Conditions commonly encountered are empyema, spontaneous pneumothorax, and diaphragmatic hernia. Lung cancer is rarely seen in pregnancy, but its incidence is rising. Diagnostic imaging and perioperative management involve the navigation of fetal risks and nuances in maternal physiology. Shared decision making within a multidisciplinary framework will optimally guide the course of management.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962716/e-pluribus-unum-from-the-many-only-one
#15
EDITORIAL
Gaetano Rocco
No abstract text is available yet for this article.
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962715/fast-tracking-patients-through-the-diagnostic-and-therapeutic-pathways-of%C3%A2-intrathoracic-conditions-the-role-of-uniportal-video-assisted-thoracic-surgery
#16
REVIEW
Mahmoud Ismail, Marc Swierzy, Dania Nachira, Jens C R├╝ckert
Fast-tracking patients in surgery has become standard in many hospitals. This allows for a shorter hospital stay and a complete organized pathway for treating patients. The operative trauma has an important role in the patient's recovery, as has the increasing use of minimally invasive procedures. In thoracic surgery, video-assisted thoracic surgery (VATS) procedures are aimed at reducing the operative trauma. One of the latest developments of VATS is represented by the uniportal approach, whose purpose is to reduce postoperative pain and morbidity...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962714/training-in-uniportal-video-assisted-thoracic-surgery
#17
REVIEW
Alberto Sandri, Alan D L Sihoe, Michele Salati, Diego Gonzalez-Rivas, Alessandro Brunelli
Interest in uniportal video-assisted thoracic surgery (VATS) is rapidly growing worldwide because it represents the surgical approach to the lung with the least possible trauma. Specific training in this surgical approach is crucial due to its technical implications, to perform it safely while upholding the required therapeutic radicality. Novel strategies, such as interactive learning technologies, simulators, high-volume preceptorships, and targeted proctorships, play important roles in the training for uniportal VATS which, ideally, should be standardized, governed, and credentialed by national and international surgical societies to ensure patient safety and academic responsibility...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962713/uniportal-video-assisted-thoracic-surgery-esophagectomy
#18
REVIEW
Sekhniaidze Dmitrii, Kononets Pavel
Several minimally invasive approaches for esophagectomy have been described, including robot-assisted esophagectomy and hybrid techniques, total transhiatal laparoscopic approach, esophagectomy using right thoracoscopy, combined laparoscopic and right thoracoscopic esophagectomy, and esophageal resection through mediastinoscopy. However, very few publications have focused on the uniportal video-assisted thoracic surgery (VATS) approach. The authors describe their technique of the minimally invasive esophagectomy using uniportal VATS as the thoracic step...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962712/nonintubated-awake-anesthesia-for-uniportal-video-assisted-thoracic-surgery-procedures
#19
REVIEW
Hui Zheng, Xue-Fei Hu, Ge-Ning Jiang, Jia-An Ding, Yu-Ming Zhu
Nonintubated video-assisted thoracic surgery (VATS) strategies are gaining popularity. This review focuses on noninutbated VATS, and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. Advances in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. The nonintubated thoracoscopic approach has been adapted for use with major lung resections. The need for general anesthesia and endotracheal intubation has been reexamined, such that regional or epidural analgesia may be sufficient for cases where lung collapse can be accomplished with spontaneous ventilation and an open hemithorax...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28962711/uniportal-video-assisted-thoracoscopic-surgery-segmentectomy
#20
REVIEW
Hyun Koo Kim, Kook Nam Han
This article addresses technical details of uniportal VATS segmentectomy by lung segments, suggesting available techniques for lesion localization and identification of the intersegmental plane. Long-term results and superiority have not yet been characterized in standard VATS for lung malignancy. Indications include almost all thoracic procedures currently performed by conventional multiport VATS. We review our experience and published literature on the feasibility of uniportal VATS segmentectomy.
November 2017: Thoracic Surgery Clinics
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