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https://www.readbyqxmd.com/read/28614864/-the-patient-with-chest-trauma-surgical-management
#1
Patrick Zardo, Henning Busk, Stefan Piatek, Norman Zinne, Irina Kropivnitskaya, Ingo Kutschka
Even though isolated cases of penetrating chest wounds are exceptionally rare in Germany, chest trauma accounts for major morbidity and mortality in over 18 0000 multitrauma patients encountered every year. Injuries range from immediately fatal cardiac wounds and major vessel lacerations to intercostal bleeding, parenchymal damage, chronic haematothorax and secondary empyema. Placement of large-bore chest tubes constitutes a sufficient treatment for most of these pathologies. In select cases further treatment either by minimally invasive techniques (VATS) or conventional thoracotomy is warranted...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28614249/thymectomy-via-open-surgery-or-robotic-video-assisted-thoracic-surgery-can-a-recommendation-already-be-made
#2
Judith Buentzel, Carmen Straube, Judith Heinz, Christian Roever, Alexander Beham, Andreas Emmert, Marc Hinterthaner, Bernhard C Danner, Alexander Emmert
BACKGROUND: Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy). METHODS: A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28583423/postoperative-bleeding-after-change-in-heparin-supplier-a-cardiothoracic-center-experience
#3
Mirela Bojan, Andreas Fischer, Ashok Narayanasamy, Paul Yea, Eleanor Dunnett, Andrea Kelleher
OBJECTIVE: Unfractionated heparin is a mixture of glycosaminoglycans with different pharmacologic and pharmacokinetic properties. The literature suggests that blood loss after cardiac surgery is related to both elevated postoperative heparin concentrations and the potency of different heparin brands. DESIGN: An audit of the observed increase in the incidence of cardiac surgery-related bleeding after change in heparin supplier. Patient characteristics were compared between groups before and after a change in heparin brands...
February 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28550170/right-atrial-pressure-and-venous-return-during-cardiopulmonary-bypass
#4
Per Werner Moller, Berhard Winkler, Samuel Hurni, Paul Philipp Heinisch, Andreas Martin Bloch, Soren Sondergaard, Stephan M Matthias Jakob, Jukka Takala, David Christian Berger
The relevance of right atrial pressure (RAP) as the back-pressure for venous return (QVR) and mean systemic filling pressure (MSFP) as up-stream pressure is controversial during dynamic changes of circulation. To examine the immediate response of QVR (sum of caval vein flows) to changes in RAP and pump function we used a closed chest, central cannulation, heart bypass porcine preparation (n=10) with veno-arterial extracorporeal membrane oxygenation (ECMO). MSFP was determined by clamping ECMO tubing with open or closed arterio-venous shunt at Euvolemia, Volume Expansion (9...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28538780/anatomic-pulmonary-resection-via-video-assisted-thoracic-surgery-analysis-of-117-cases-at-a-referral-center-in-brazil
#5
Stephan Adamour Soder, Frederico Barth, Fabiola Adelia Perin, José Carlos Felicetti, José de Jesus Peixoto Camargo, Spencer Marcantônio Camargo
Objective: To describe our experience with video-assisted thoracic surgery (VATS) for anatomic pulmonary resection at a referral center for thoracic surgery in Brazil. Methods: All patients who underwent anatomic pulmonary resection by VATS between 2010 and 2015 were included. Clinical and pathological data, as well as postoperative complications, were analyzed. Results: A total of 117 pulmonary resections by VATS were performed, of which 98 were lobectomies and 19 were anatomic segmentectomies...
March 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28532537/-video-assisted-thoracoscope-versus-video-assisted-mini-thoracotomy-for-non-small-cell-lung-cancer-a-meta-analysis
#6
Bing Wang, Fang Lv, Liang Zhao, Minjun Du, Shugeng Gao
BACKGROUND: The aim of this study is to assess the effect of video-assisted thoracoscopic surgery (VATS) and video-assisted mini-thoracotomy (VAMT) in the treatment of non-small cell lung cancer (NSCLC). METHODS: We searched PubMed, EMbase, CNKI, VIP and ISI Web of Science to collect randomized controlled trials (RCTs) of VATS versus VAMT for NSCLC. Each database was searched from May 2006 to May 2016. Two reviewers independently assessed the quality of the included studies and extracted relevant data, using RevMan 5...
May 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#7
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28505359/thoracoscopic-anatomical-lung-segmentectomy-using-3d-computed-tomography-simulation-without-tumour-markings-for-non-palpable-and-non-visualized-small-lung-nodules%C3%A2
#8
Hirohisa Kato, Hiroyuki Oizumi, Jun Suzuki, Akira Hamada, Hikaru Watarai, Mitsuaki Sadahiro
OBJECTIVES: Although wedge resection can be curative for small lung tumours, tumour marking is sometimes required for resection of non-palpable or visually undetectable lung nodules as a method for identification of tumours. Tumour marking sometimes fails and occasionally causes serious complications. We have performed many thoracoscopic segmentectomies using 3D computed tomography simulation for undetectable small lung tumours without any tumour markings. The aim of this study was to investigate whether thoracoscopic segmentectomy planned with 3D computed tomography simulation could precisely remove non-palpable and visually undetectable tumours...
May 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28499641/outcomes-of-research-biopsies-in-clinical-trials-of-egfr-mutation-positive-non-small-cell-lung-cancer-patients-pretreated-with-egfr-tyrosine-kinase-inhibitors
#9
Bin-Chi Liao, Ya-Ying Bai, Jih-Hsiang Lee, Chia-Chi Lin, Shu-Yung Lin, Yee-Fan Lee, Chao-Chi Ho, Jin-Yuan Shih, Yeun-Chung Chang, Chong-Jen Yu, James Chih-Hsin Yang, Pan-Chyr Yang
BACKGROUND/PURPOSE: Research biopsies (RBs) are crucial for developing novel molecular targeted agents. However, the safety and diagnostic yields of RBs have not been investigated in EGFR mutation-positive non-small cell lung cancer (NSCLC) patients pretreated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). METHODS: We searched the medical records of NSCLC patients who participated in lung cancer clinical trials and underwent mandatory RBs between 2012 and 2014 at our institution...
May 9, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28457690/nurse-and-patient-factors-that-influence-nursing-time-in-chest-tube-management-early-after-open-heart-surgery-a-descriptive-correlational-study
#10
Myra Cook, Laura Idzior, James F Bena, Nancy M Albert
PURPOSE: Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. DESIGN: Prospective, descriptive. METHODS: Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors...
April 27, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28455779/microvascular-reactivity-measured-by-vascular-occlusion-test-is-an-independent-predictor-for-postoperative-bleeding-in-patients-undergoing-cardiac-surgery
#11
Karam Nam, Hyung-Min Oh, Chang-Hoon Koo, Tae Kyong Kim, Youn Joung Cho, Deok Man Hong, Yunseok Jeon
The purpose of the study is to investigate the relationship between microvascular reactivity and postoperative bleeding in cardiac surgery. The authors retrospectively analyzed a prospectively collected registry of cardiac surgery patients. Data from 154 patients enrolled in the registry were analyzed. A linear mixed model was performed to evaluate the association between the amount of postoperative chest tube output (CTO, milliliter, repeatedly measured at 0-8, 8-24, and 24-48 h) and tissue oxygen saturation (StO2) recovery slope (%/s) measured by vascular occlusion test (VOT) at skin closure...
April 28, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28453792/triple-valve-surgery-through-a-less-invasive-approach-early-and-mid-term-results
#12
Petar Risteski, Nadejda Monsefi, Aleksandra Miskovic, Tanja Josic, Sherife Bala, Razan Salem, Andreas Zierer, Anton Moritz
OBJECTIVES: A partial upper sternotomy has become established as a less invasive approach mainly for single and double valve surgery. This report evaluates the clinical outcomes of triple valve surgery performed through a partial upper sternotomy. METHODS: We reviewed the medical records of 37 consecutive patients (28 men, 76%) who underwent triple valve surgery through a partial upper sternotomy between 2005 and 2015. The patients' mean age was 67 ± 17 years; 27 (73%) were in New York Heart Association Class III or IV...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28430304/pre-ecmo-coagulopathy-does-not-increase-the-occurrence-of-hemorrhage-during-extracorporeal-support
#13
Pilar Anton-Martin, Lakshmi Raman, Nikhil Thatte, Jefferson Tweed, Vinai Modem, Janna Journeycake
INTRODUCTION AND METHODS: Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children's hospital. RESULTS: Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28365134/utility-of-sonoclot-in-prediction-of-postoperative-bleeding-in-pediatric-patients-undergoing-cardiac-surgery-for-congenital-cyanotic-heart-disease-a-prospective-observational-study
#14
Vishwakarma Rajkumar, Bhupesh Kumar, Vikas Dutta, Anand K Mishra, Goverdhan Dutt Puri
OBJECTIVES: To assess the utility of Sonoclot in prediction of postoperative bleeding in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass for congenital cyanotic heart disease. DESIGN: Prospective, observational study. SETTING: Single university hospital. PARTICIPANTS: Eighty-seven pediatric patients undergoing cardiac surgery for congenital cyanotic heart disease. INTERVENTIONS: Laboratory coagulation parameters (prothrombin time, international normalization ratio, activated partial thromboplastin time, fibrinogen, D-dimer) as well as point-of-care Sonoclot glass bead activation time, clot rate, and platelet function (gbPF) were done before induction of anesthesia and following heparin reversal after termination of cardiopulmonary bypass (CPB) in all patients...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28359027/predictors-of-postoperative-bleeding-in-children-undergoing-cardiopulmonary-bypass-a-preliminary-italian-study
#15
Luca Spiezia, Guido Di Gregorio, Elena Campello, Sara Maggiolo, Giacomo Bortolussi, Giovanni Stellin, Paolo Simioni, Vladimiro Vida
BACKGROUND: Several characteristics such as demographics, pre-existing conditions, surgical procedure, perioperative coagulopathy may predispose children undergoing cardiopulmonary bypass (CPB) to bleeding complications. As yet, studies on risk factors for postoperative bleeding have brought mixed results. The purpose of our study was therefore to retrospectively evaluate the parameters able to predict postoperative bleeding in a group of consecutive children undergoing cardiac surgery involving CPB...
March 22, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28326680/effect-of-desmopressin-on-the-amount-of-bleeding-and-transfusion-requirements-in-patients-undergoing-heart-transplant-surgery
#16
Alireza Jahangirifard, Mohammad Reza Razavi, Zargham Hosein Ahmadi, Mohammad Forozeshfard
One of the most common risks after a heart transplant is bleeding. In this study, the effect of desmopressin administration on the amount of bleeding and transfusion requirements after heart transplant surgery was investigated. In a double-blind clinical trial, 48 patients who were candidates for heart transplant surgery were randomly assigned to two groups. In the intervention group, patients received desmopressin of 0.3 μg/kg, 30 min. before surgery. Patients in the control group received normal saline at the same amount and time...
March 22, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#17
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28249381/echocardiography-guided-pericardiocentesis-as-the-method-of-choice-for-treatment-of-significant-pericardial-effusion-following-cardiac-surgery-a-12-year-single-centre-experience
#18
Martin Kolek, Radim Brat
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis following cardiac surgery in Europe. The aim of the study was to review tertiary cardiac surgery centre experience with postoperative pericardial effusion (PE) diagnosis and treatment. METHODS: A total of 6830 patients underwent open-heart surgery at our centre between December 2004 and November 2016. Of these patients, 208 (3%) required pericardiocentesis for significant PE...
March 1, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28174401/-thoracoscopic-temporary-segmental-bronchus-incision-technique-for-fissureless-lobectomy
#19
Yoshio Tsunezuka, Hideki Fujimori, Nobuyoshi Tanaka, Nobuhiro Tanaka
Several thoracoscopic fissureless lobectomy techniques have been reported;however, the indications for the same remain controversial. One of the reasons for conversion to open lobectomy is the swelling or inflammation of lymph nodes between the lobar bronchus and the adjacent pulmonary artery. In this report, we advocate temporary segmental bronchus incision technique(T-BIT)and describe its application for lung cancer patients with fused fissures. T-BIT involves initial segmental bronchus incision before lobar bronchus stapling to safely dissect the lymph nodes between the lobar bronchus and the pulmonary artery...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28149565/the-efficacy-of-thoracoscopic-fissureless-lobectomy-in-patients-with-dense-fissures
#20
Hitoshi Igai, Mitsuhiro Kamiyoshihara, Ryohei Yoshikawa, Fumi Osawa, Natsuko Kawatani, Takashi Ibe, Kimihiro Shimizu
BACKGROUND: Prolonged air leakage after a lobectomy remains a frequent complication in patients with dense fissures. To avoid postoperative air leakage, we used the "thoracoscopic fissureless technique" for patients with dense fissures. A thoracoscopic approach is useful for the fissureless technique because it gives a good operative view from various angles without dividing the fissure. In this study, we compared the peri- or intraoperative results of thoracoscopic fissureless lobectomies to traditional lobectomies with fissure dissection for pulmonary artery (PA) exposure in order to identify the efficacy of thoracoscopic fissureless lobectomy...
December 2016: Journal of Thoracic Disease
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