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https://www.readbyqxmd.com/read/28977365/hybrid-bilobectomy-for-treatment-of-an-early-stage-lung-cancer-in-a-patient-with-severe-emphysema-using-the-benefits-of-lung-volume-reduction
#1
Periklis Perikleous, Rocco Bilancia, Inger Oey, David A Waller
Patients with resectable lung cancer and concomitant emphysema can fall outside the accepted guidelines for surgery. Lung volume reduction can improve their lung function but involves resecting an emphysematous lobe containing the tumour. Volume reduction can also be achieved by endobronchial one-way valve insertion, causing lobar collapse, but intact fissures are required. A 'hybrid bilobectomy' was performed on a 77-year-old ex-smoker with suspected T2aN0M0 bronchogenic carcinoma and severe pulmonary emphysema...
July 21, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28965258/low-voltage-coagulation-polyglycolic-acid-sheets-and-fibrin-glue-to-control-air-leaks-in-lung-surgery
#2
Norikazu Kawai, Takeshi Kawaguchi, Shuko Suzuki, Motoaki Yasukawa, Takashi Tojo, Shigeki Taniguchi
OBJECTIVE: We evaluated the efficacy of low-voltage coagulation (LVC) with polyglycolic acid (PGA) sheets (Neoveil, GUNZE Ltd., Japan) and fibrin glue to control intraoperative alveolar air leaks after lung surgery. METHODS: We included 176 patients with non-small cell lung cancer who underwent thoracoscopic lobectomies. When alveolar air leak was confirmed after lung resection, we applied LVC system to the pleural defect followed by layers of PGA sheets and fibrin glue (n = 40)...
September 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28964422/thoracoscopic-decortication-of-stage-iii-tuberculous-empyema-is-effective-and-safe-in-selected-cases
#3
Arvind Kumar, Belal B Asaf, Vijay C Lingaraju, Sai Yendamuri, Mohan V Pulle, Jayashree Sood
BACKGROUND: Open decortication of advanced tuberculous empyema remains standard of care. As with other aspects of thoracic surgery, minimally invasive approaches are making inroads into procedures traditionally performed open. In this retrospective analysis, we sought to examine feasibility, efficacy, and outcomes of thoracoscopic decortication of stage III tuberculous empyema in our experience. METHODS: The records of all patients in whom thoracoscopic decortication of stage III tuberculous empyema was performed between March 2012 and December 2015 were examined...
September 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28962506/do-pleural-adhesions-influence-the-outcome-of-patients-undergoing-major-lung-resection
#4
Vasileios K Kouritas, Emmanuel Kefaloyannis, Peter Tcherveniakov, Richard Milton, Nilanjan Chaudhuri, Alessandro Brunelli, Kostas Papagiannopoulos
OBJECTIVES: Our goal was to investigate whether pleural adhesions identified during an operation can induce adverse events. We investigated the outcome of major lung resection in patients with pleural adhesions encountered on entry into the pleural cavity. METHODS: We conducted a retrospective analysis of 144 patients undergoing major lung resection over a period of 9 months. Recorded data included demographics, comorbidities, surgical data, fluid volume drainage (on postoperative days [POD] 1 and 2 and in total), the overall and pleural space-associated morbidity (empyema, prolonged air leak or drainage, space issues), 30-day and late mortality rates...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28959372/a-decision-theoretic-comparison-of-treatments-to-resolve-air-leaks-after-lung-surgery-based-on-nonparametric-modeling
#5
Yanxun Xu, Peter F Thall, Peter Müller, Reza J Mehran
We propose a Bayesian nonparametric utility-based group sequential design for a randomized clinical trial to compare a gel sealant to standard care for resolving air leaks after pulmonary resection. Clinically, resolving air leaks in the days soon after surgery is highly important, since longer resolution time produces undesirable complications that require extended hospitalization. The problem of comparing treatments is complicated by the fact that the resolution time distributions are skewed and multi-modal, so using means is misleading...
2017: Bayesian Analysis
https://www.readbyqxmd.com/read/28934741/successful-management-of-a-positive-air-leak-test-during-laparoscopic-colorectal-surgery
#6
Kazuhito Sasaki, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Tomomichi Kiyomatsu, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Koji Yasuda, Koji Murono, Toshiaki Watanabe
BACKGROUND/AIMS: Anastomotic leakage remains the most serious complications of colorectal surgery. To prevent colorectal anastomotic leakage (CAL), an air leak test (ALT) with intraoperative colonoscopy (IOCS) is performed to detect mechanically insufficient colorectal anastomoses. The approaches to an intraoperative anastomotic air leak (IOAL) have not been fully investigated. This study aimed to clarify the safe management of an IOAL in laparoscopic colorectal surgery. METHODS: One hundred forty-eight consecutive patients who underwent laparoscopic resection with double-stapling technique (DST) anastomosis for left-sided colorectal cancer between April 2015 and June 2016 were included and retrospectively reviewed...
September 22, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28932566/non-intubated-single-incision-video-assisted-thoracic-surgery-a-two-center-cohort-of-188-patients
#7
Man-Ling Wang, Carlos Galvez, Jin-Shing Chen, Jose Navarro-Martinez, Sergio Bolufer, Ming-Hui Hung, Hsao-Hsung Hsu, Ya-Jung Cheng
BACKGROUND: Non-intubated single-incision procedures are slowly expanding because of high experience and skill required, and stricter selection criteria. The aim of this study is to present the first retrospective two-center series in Taiwan and Spain. METHODS: We performed a retrospective analysis of 188 patients undergoing non-intubated single-incision video-assisted thoracic surgery (NI-SI-VATS) procedures between July 2013 to November 2015 in two centers in Taiwan (170 patients) and Spain (18 patients) with two different anesthetic methods...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28927375/effects-of-lubrication-on-air-sealing-performance-of-a-pediatric-cuffed-tracheal-tube
#8
Hiroko Nishioka, Yutaka Usuda, Go Hirabayashi, Koichi Maruyama, Tomio Andoh
BACKGROUND: Lubrication of cuffed tracheal tubes (CTTs) reduces liquid leakage. However, it is not clear how cuff lubrication influences air leakage. We aimed to test the hypothesis that pretreatment with K-Y jelly, a water-soluble lubricant, would improve the air-sealing performance of pediatric CTTs in a model study. METHODS: We placed Parker Flex-Tip™ CTT with 4.0- and 5.0-mm internal diameter (ID) into a tracheal model with 9- and 12-mm ID. The tracheal model was connected to a test lung ventilated in pressure control mode...
September 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28920559/functional-mechanics-of-a-pectin-based-pleural-sealant-after-lung-injury
#9
Andrew B Servais, Cristian D Valenzuela, Arne Kienzle, Alexandra B Ysasi, Willi L Wagner, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
Pleural injury and associated air leaks are a major influence on patient morbidity and health care costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal weight % mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products...
September 16, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28919105/airflow-error-measurement-due-to-pneumotachograph-mask-rim-leaks
#10
Nicholas A May, Ronald C Scherer
Airflow during speech production is recorded using a pneumotachograph system wherein typically a mask is placed upon the face. Accurate measures of airflow require mask calibration and a complete seal of the mask rim to the face. Literature frequently cites mask rim leaks as causing flow measurement inaccuracies, but quantitative studies of the inaccuracies are needed. The purpose of this study was to determine the degree of inaccuracy of flow measurement using a Glottal Enterprises aerodynamic system for a variety of mask rim leak conditions...
September 14, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28885469/bigger-is-better-comparison-of-alternative-devices-for-tension-hemopneumothorax-and-pulseless-electrical-activity-in-a-yorkshire-swine-model
#11
Matthew L Leatherman, Laura M Fluke, Christian S McEvoy, Douglas M Pokorny, Robert L Ricca, Matthew J Martin, Christopher S Gamble, Travis M Polk
BACKGROUND: Tension pneumothorax is a cause of potentially preventable death in pre-hospital and battlefield settings and 14g angiocatheter (14G AC) decompression remains the current treatment standard, despite its high incidence of failure. Traumatic pneumothorax is often associated with hemothorax, but 14G AC has no proven efficacy for associated hemothorax. We sought to compare the 14G AC to three alternative devices for treatment of tension hemopneumothorax (t-H/PTX) in a positive pressure ventilation swine model...
September 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28880048/histopathological-changes-associated-to-an-absorbable-fibrin-patch-tachosil%C3%A2-covering-in-an-experimental-model-of-high-risk-colonic-anastomoses
#12
C García-Vásquez, S Gómez García de Las Heras, C Pastor Idoate, D De Pablo, M J Fernández-Aceñero
BACKGROUND: TachoSil® is a fibrin sponge that contains fibrinogen and thrombin and is a useful adjuvant to enhance control of air leaks in thoracic surgery and to control bleeding in vascular and general surgery. Its use in intestinal surgery to prevent suture dehiscence is currently under investigation. MATERIAL AND METHODS: We report the results of a prospective randomized experimental study on 33 large white pigs in which a high-risk suture was created by induction of ischemia...
September 7, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28869278/cerebral-near-infrared-spectroscopy-monitoring-for-prevention-of-brain-injury-in-very-preterm-infants
#13
REVIEW
Simon Hyttel-Sorensen, Gorm Greisen, Bodil Als-Nielsen, Christian Gluud
BACKGROUND: Cerebral injury and long-term neurodevelopmental impairment is common in extremely preterm infants. Cerebral near-infrared spectroscopy (NIRS) enables continuous estimation of cerebral oxygenation. This diagnostic method coupled with appropriate interventions if NIRS is out of normal range (that is cerebral oxygenation within the 55% to 85% range) may offer benefits without causing more harms. Therefore, NIRS coupled with appropriate responses to abnormal findings on NIRS needs assessment in a systematic review of randomised clinical trials and quasi-randomised studies...
September 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28868600/a-pleural-vacuum-relief-device-for-pleural-drain-unit-use-in-the-hyperbaric-environment
#14
Marco Gelsomino, Theo Tsouras, Ian Millar, Andrew Fock
INTRODUCTION: When a standard water-seal pleural drain unit (PDU) is used under hyperbaric conditions there are scenarios where excessive negative intrapleural pressure (IPP) and/or fluid reflux can be induced, risking significant morbidity. We developed and tested a pleural vacuum relief (PVR) device which automatically manages these risks, whilst allowing more rapid hyperbaric pressure change rates. METHODS: The custom-made PVR device consists of a one-way pressure relief valve connected in line with a sterile micro filter selected for its specific flow capacity...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28865448/pediatric-supraglottic-airway-devices-in-clinical-practice-a-prospective-observational-study
#15
Maren Kleine-Brueggeney, Anne Gottfried, Sabine Nabecker, Robert Greif, Malte Book, Lorenz Theiler
BACKGROUND: Supraglottic airway devices (SGA) are commonly used in pediatric anesthesia and serve as primary or back-up devices for difficult airway management. Most SGA are marketed without proper clinical evaluation. The purpose of this study was to evaluate the performance of the pediatric LMA Supreme™, Air-Q® and Ambu® Aura-i™. METHODS: This prospective observational study was performed at Bern University Hospital, Switzerland. With ethics committee approval and a waiver for written informed consent 240 children undergoing elective surgery with an ASA class I-III and a weight of 5-30 kg were included...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28863023/evaluation-of-the-augmented-infant-resuscitator-a-monitoring-device-for-neonatal-bag-valve-mask-resuscitation
#16
Desmond J Bennett, Taiga Itagaki, Christopher T Chenelle, Edward A Bittner, Robert M Kacmarek
BACKGROUND: Annually, 6 million newborns require bag-valve-mask resuscitation, and providing live feedback has the potential to improve the quality of resuscitation. The Augmented Infant Resuscitator (AIR), a real-time feedback device, has been designed to identify leaks, obstructions, and inappropriate breath rates during bag-valve-mask resuscitation. However, its function has not been evaluated. METHODS: The resistance of the AIR was measured by attaching it between a ventilator and a ventilator tester...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28859924/the-use-of-platelet-rich-fibrin-for-immediate-closure-of-acute-oroantral-communications-an-alternative-approach
#17
Kani Bilginaylar
Currently, the buccal advancement flap, palatal rotational flap, and buccal fat pad techniques are frequently used to close an oroantral communication (OAC). In this study, platelet-rich fibrin (PRF) clots were used for immediate closure of acute OACs after extraction of posterior maxillary molars. Acute oroantral perforations larger than 3 mm in diameter in 21 patients were treated uneventfully using PRF clots. None of the patients had systemic diseases or symptoms of sinus disease. After tooth extraction, the diagnosis of acute OAC was examined by the Valsalva maneuver (compressing the nostrils with the fingers and then blowing out air)...
August 3, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28859039/clinical-profile-and-outcome-of-influenza-a-h1n1-in-pediatric-oncology-patients-during-the-2015-outbreak-a-single-center-experience-from-northern-india
#18
Nishant Verma, Vishal Pooniya, Archana Kumar
BACKGROUND: Owing to their immunocompromised status, childhood cancer patients on chemotherapy are at a greater risk for Influenza infection and its associated complications. There is limited data available on the clinical profile and outcome of Influenza A/H1N1 in this subset of patients. METHODS: A retrospective study was performed of Influenza A/H1N1 cases diagnosed between January 2015 to December 2015 in the in-patients of Pediatric Oncology unit of a tertiary care hospital from Northern India...
August 30, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28845456/outcome-analysis-of-congenital-diaphragmatic-hernia-cohort-before-and-after-implementation-of-standardized-protocol-in-a-tertiary-neonatal-unit
#19
Amitava Sur, Adjemoke Awoseliya, Alok Sharma
Despite evolving evidence and increased understanding, there is a strong argument that best outcomes in managing congenital diaphragmatic hernia (CDH) patients are achieved in centers which have a high admission rate of such patients and follow standardized operating protocols of management. Pneumothorax and air leak syndromes are one of the main causes of pre- and postoperative morbidity in these patients and experts believe that delivery room sedation and gentle ventilation strategies can minimize this. We observed a significant drop in incidence of pneumothorax and reduction of mortality following implementation of standardized guidelines at the neonatal unit at Southampton which is a tertiary-level neonatal care in the southern United Kingdom and a regional referral center for CDH patients...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28840000/a-meta-analysis-of-video-assisted-thoracoscopic-decortication-versus-open-thoracotomy-decortication-for-patients-with-empyema
#20
Hui Pan, Jiaxi He, Jianfei Shen, Long Jiang, Wenhua Liang, Jianxing He
BACKGROUND: Thoracic pleural empyema is a collection of pus within a thoracic cavity. In stage 2 (fibrinopurulent) and stage 3 (organizational), decortication is the only choice. But there is no consensus on whether to choose video-assisted thoracoscopic decortication (VATD) or open thoracotomy decortication (OTD). We sought to answer this question by performing a meta-analysis. METHOD: Six electronic databases were searched. Primary outcomes were operative time, postoperative hospital stay, prolonged air leak, chest tube duration, relapse rate, morbidity and mortality...
July 2017: Journal of Thoracic Disease
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