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Mediastinoscopy

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https://www.readbyqxmd.com/read/28283236/cost-effectiveness-of-mediastinal-lymph-node-staging-in-non-small-cell-lung-cancer
#1
Katarzyna Czarnecka-Kujawa, Ursula Rochau, Uwe Siebert, Eshetu Atenafu, Gail Darling, Thomas Kenneth Waddell, Andrew Pierre, Marc De Perrot, Marcelo Cypel, Shaf Keshavjee, Kazuhiro Yasufuku
OBJECTIVE: To assess the cost-effectiveness of various modes of mediastinal staging in non-small cell lung cancer (NSCLC) in a single-payer health care system. METHODS: We performed a decision analysis to compare the health outcomes and costs of 4 mediastinal staging strategies: no invasive staging, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinoscopy, and EBUS-TBNA followed by mediastinoscopy if EBUS-TBNA is negative. We determined incremental cost effectiveness ratios (ICER) for all strategies and performed comprehensive deterministic sensitivity analyses using a willingness to pay threshold of $80,000/quality adjusted life year (QALY)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28272203/sarcoidosis-associated-with-infliximab-therapy-in-ulcerative-colitis-a-case-report
#2
Georgiana-Emmanuela Gîlcă, Smaranda Diaconescu, Gheorghe Gh Bălan, Oana Timofte, Gabriela Ştefănescu
RATIONALE: Although immunomodulatory therapy has been clearly stated as an important landmark in treatment of ulcerative colitis, significantly improving the quality of life for patients with inflammatory bowel disease, there are several aspects to be considered regarding the possible side-effects of anti-TNF alpha agents. In spite of a good safety profile, biologic TNF antagonists may induce paradoxical inflammation, which can manifest as sarcoid-like granulomatosis, consisting of noncaseating granulomas in the affected organs...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28223072/surgical-treatment-of-lung-cancer-with-synchronous-adrenal-metastases-adrenalectomy-first
#3
Fernando Pardo Aranda, Itziar Larrañaga Blanc, Joaquín Rivero Déniz, Juan Carlos Trujillo, Arantxa Rada Palomino, Esteban García-Olivares, Ramón Rami Porta, Enrique Veloso Veloso
INTRODUCTION: The aim of this study is to present our patients with lung cancer and synchronous adrenal metastases treated with a reversal approach: starting with adrenalectomy and doing the lung resection second. METHODS: A total of 108 laparoscopic adrenalectomies were performed, and we analyze a consecutive serie of 10 patients with isolated adrenal synchronous metastases from the lung, surgically treated in a sequential way. All patients underwent staging mediastinoscopy, and patients with positive lymph nodes were primary treated with chemotherapy...
February 18, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28220765/the-endosonography-guided-needle-aspiration-in-the-diagnosis-of-sarcoidosis-randomized-study
#4
Piotr Kocoń, Artur Szlubowski, Jarosław Kużdżał, Lucyna Rudnicka-Sosin, Adam Ćmiel, Jerzy Soja, Janusz R Włodarczyk, Piotr Talar, Tomasz Smęder, Tomasz Gil, Janusz Warmus, Romana Tomaszewska
INTRODUCTION    There are no widely accepted standards of diagnosis of sarcoidosis.  OBJECTIVES    The aim of the study was to assess the relative diagnostic yield of endobronchial ultrasound needle aspiration (EBUS-NA) and endoscopic ultrasound needle aspiration (EUS-NA), and to compare them with the standard diagnostic techniques, i.e. endobronchial biopsy (EBB), transbronchial lung biopsy (TBLB), transbronchial needle aspiration (TBNA) and mediastinoscopy.  PATIENTS AND METHODS    A prospective randomized study including consecutive patients with clinical diagnosis of stage I or II sarcoidosis...
February 9, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28187791/primary-mediastinal-large-b-cell-lymphoma-in-a-woman-who-is-human-immunodeficiency-virus-positive-presenting-with-superior-vena-cava-syndrome-a-case-report
#5
Pedro Pallangyo, Paulina Nicholaus, Frederick Lyimo, Elikaanany Urio, Peter Kisenge, Mohamed Janabi
BACKGROUND: The risk of non-Hodgkin lymphoma is increased 200-fold in individuals seropositive for human immunodeficiency virus compared to those free from human immunodeficiency virus. Human immunodeficiency virus-associated non-Hodgkin lymphoma is known for its atypical presentation, aggressive ability, widespread involvement, poor response to chemotherapy, and high relapse potential which makes both the diagnosis and management a difficult undertaking especially in resource-poor settings...
February 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28149581/recent-advances-in-diagnostic-bronchoscopy
#6
REVIEW
Philip G Ong, Labib G Debiane, Roberto F Casal
The field of diagnostic bronchoscopy has been revolutionized in the last decade primarily with the advent of endobronchial ultrasound (EBUS) but also with the addition of multiple different techniques for "guided-bronchoscopy". These advances have had a substantial impact in the management of lung cancer with bronchoscopy now providing both diagnosis and mediastinal staging in a single procedure. EBUS has, in fact, become the first choice for staging of the mediastinum over cervical mediastinoscopy (CM). Although EBUS is now a well-established technique, there are continuous efforts from the scientific community to improve its diagnostic performance, and these will be reviewed in this manuscript...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149542/does-videomediastinoscopy-with-frozen-sections-improve-mediastinal-staging-during-video-assisted-thoracic-surgery-pulmonary-resections
#7
Alessandro Gonfiotti, Stefano Bongiolatti, Domenico Viggiano, Sara Borgianni, Roberto Borrelli, Giorgia Tancredi, Massimo O Jaus, Leonardo Politi, Camilla E Comin, Luca Voltolini
BACKGROUND: To assess if video-mediastinoscopy (VM) with frozen sections (FS) combined with a video-assisted thoracic surgery major pulmonary resection (VMPRS) is able to improve VATS mediastinal intraoperative staging. METHODS: From June 2012 to March 2015 a total of 146 patients underwent VMPRS lymphadenectomy. NCCN guidelines were followed for pre-operative staging, including VM with FS in 27 patients (19%). Procedural time, dissected nodal stations, complications related to VM and VATS lymphadenectomy and definitive histology, were evaluated...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28074327/when-should-negative-endobronchial-ultrasonography-findings-be-confirmed-by-a-more-invasive-procedure
#8
Basil S Nasir, Kazuhiro Yasufuku, Moishe Liberman
The treatment of non-small cell lung cancer is largely dependent on accurate staging in order to determine appropriate therapy. Despite advances in imaging, such as computed tomography and positron emission tomography, invasive mediastinal staging is frequently needed to rule out mediastinal involvement prior to curative-intent stereotactic ablative radiotherapy or surgical resection. Surgical mediastinal staging with mediastinoscopy, or anterior mediastinotomy, were traditionally considered the gold standard for invasive mediastinal staging...
January 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28018536/computer-modeling-to-evaluate-the-impact-of-technology-changes-on-resident-procedural-volume
#9
Tyler R Grenda, Tiffany N S Ballard, Andrea T Obi, William Pozehl, F Jacob Seagull, Ryan Chen, Amy M Cohn, Mark S Daskin, Rishindra M Reddy
BACKGROUND : As resident "index" procedures change in volume due to advances in technology or reliance on simulation, it may be difficult to ensure trainees meet case requirements. Training programs are in need of metrics to determine how many residents their institutional volume can support. OBJECTIVE : As a case study of how such metrics can be applied, we evaluated a case distribution simulation model to examine program-level mediastinoscopy and endobronchial ultrasound (EBUS) volumes needed to train thoracic surgery residents...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27999784/a-patient-with-situs-inversus-totalis-and-lung-cancer-a-rare-combination
#10
Konstantinos Grapatsas, Anastasios Piyis, Konstantinos Neofotistos, Zoi Tsilogianni, Paul Zarogoulidis, Dimitrios Paliouras, Apostolos Gogakos, Nikolaos Barbetakis, John Organtzis, Ioannis Kioumis, Konstantinos Porpodis, Wolfgang Hohenforst-Schmidt, Ilias Karapantzos, Chrysa Karapantzou, Kosmas Tsakiridis, Aggeliki Rapti, Charalampos Charalampidis, Konstantinos Kaselouris
Situs inversus totalis (SIT) is a rare clinical entity which is characterized by a complete reverse anatomy of the thoracic cage and abdomen. There are a few reports of patients with SIT and lung cancer. The number of the cases that have been treated surgically is also very small. We report a case of an 80 years old patient who underwent left lower lobectomy after staging with uniportal video-assisted thoracoscopic surgery (VATS) and mediastinoscopy.
November 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27895343/cervical-mediastinoscopy-in-the-diagnosis-of-lymphadenopathy-in-south-asia
#11
Sulaiman Bashir Hasan, Fazal Wahab Khan, Shiraz Hashmi, Ahsan Ehtesham, Rizwana Ahmed Magsi, Syed Shahabuddin
We planned to determine the clinical utility and safety of mediastinoscopy in the pathologic diagnosis of mediastinal lymphadenopathy and to determine disease patterns in a tertiary care setting in Karachi. The retrospective review comprised record of patients who underwent mediastinoscopy over 25 years between July, 1990 and August, 2015. Of the 122 patients, records were complete for 88(72%). Mean age was 42.5±12.9 years and 55(62.5%) were male. Overall, 60(68.2%) patients had benign inflammatory diseases; 25 (28...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27870565/concurrent-chemotherapy-and-radiation-therapy-for-inoperable-locally-advanced-non-small-cell-lung-cancer
#12
Kenneth E Rosenzweig, Jorge E Gomez
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
January 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27867546/transoral-endoscopic-mediastinal-surgery-toems-results-of-a-first-clinical-study-for-scarless-mediastinal-lymph-node-biopsies
#13
Wolfram Klemm, Steffen Frese, Gunda Leschber, André Nemat, Thomas Wilhelm
BACKGROUND: Video-assisted mediastinoscopy (VAM) represents the standard procedure for mediastinal lymph node biopsies. This operation results in a scar at prominent position at the anterior neck. Since there is a trend to less invasive procedures, natural orifice transluminal endoscopic surgery (NOTES) was introduced to different fields of surgery. Based on NOTES we developed a new approach for mediastinoscopy: transoral endoscopic mediastinal surgery (TOEMS). In previous studies using human cadavers and living pigs the feasibility of TOEMS was shown...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27846176/mediastinoscopy-assisted-transhiatal-esophagectomy-for-esophageal-cancer-a-single-institutional-cohort-study
#14
Tsutomu Nomura, Takeshi Matsutani, Nobutoshi Hagiwara, Itsuro Fujita, Yoshiharu Nakamura, Hiroshi Makino, Masao Miyashita, Eiji Uchida
We compared the therapeutic outcomes of mediastinoscopy-assisted transhiatal esophagectomy (MATHE) with transthoracic esophagectomy (TTE), and with video-assisted thoracoscopic esophagectomy (VATS-E) for the treatment of esophageal cancer. Twenty patients underwent MATHE in our institute from 2001 to 2005 were enrolled. We evaluated the therapeutic outcomes, including perioperative complications and long-term prognosis after surgery, and compared these with 15 patients who underwent TTE during the same time period and 15 who underwent VATS-E at a later date...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27789164/-a-case-of-mediastinum-actinomycosis-by-aggregatibacter-actinomycetemcomitans
#15
N N M Razafimanjato, A M Portela, D M Radu, P Guiraudet, M D Destable, A Seguin, E Martinod
The actinomycosis is a suppurative infection due to an anaerobic and microaerophillic bacteria called actinomyces. Only few case reports are described for the mediastinal locations of this rare entity. We report a new case of inflammatory pseudotumor in the mediastinum due to Aggregatibacte actinomycetemcomitans revealed by hemoptysis. The mediastinoscopy procedure with biopsy was needed to confirm the definitive bacteriological diagnosis by a positive culture. During the postoperative course, a cutaneous fistula was found which had a favourable evolution after appropriate antibiotherapy...
December 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27772612/ultrasound-guided-video-assisted-mediastinoscopic-biopsy-a-novel-approach
#16
Jinbai Miao, Mei Li, Yili Fu, Xiaoxing Hu, Bin Hu, Hui Li
Video-assisted mediastinoscopy (VAM) is the most commonly used invasive method for the preoperative mediastinal staging of lung cancer and for the diagnosis of other mediastinal diseases. However, VAM has the risk of causing life-threatening bleeding consequent to the specific mediastinal anatomy. We adopted the ultrasonic technique for VAM biopsies that can easily distinguish the lymph nodes from the surrounding great vessels and thus makes the procedure easier and safer.
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27747078/prof-qingdong-cao-single-port-inflatable-mediastinoscopy-combined-with-laparoscopy-for-the-radical-treatment-of-esophageal-cancer
#17
Grace S Li
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27747020/excision-of-middle-mediastinal-parathyroid-adenoma-by-videoscopic-assisted-mediastinoscopy-vam
#18
Rene Razzak, Todd McMullen, Eric L R Bédard
We report a case involving a female patient with primary hyperparathyroidism arising from a middle mediastinal parathyroid adenoma. Initial diagnosis was made based on a history of polyuria and recurrent renal colic. At the age of 77 she underwent videoscopic assisted mediastinoscopy (VAM) for resection of the adenoma which was localized using single-photon emission computed tomography (SPECT/CT). This case illustrates the importance for accurate pre-operative localization and intra-operative monitoring to ensure complete surgical removal in order to improve postoperative normocalcemia success rates...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27642473/the-role-of-cervical-mediastinoscopy-in-nigerian-thoracic-surgical-practice
#19
Bode Falase, Mgbajah Ogadinma, Adetinuwe Majekodunmi, Barakat Nimasahun, Olufunke Adeyeye
INTRODUCTION: Cervical mediastinoscopy is the gold standard for obtaining histological diagnosis of mediastinal pathology. It has been used for the staging of lung cancer as well as to determine the cause of Isolated Mediastinal Lymphadenopathy. There is very limited evidence in the literature of its use in Nigeria to assess mediastinal pathology. The aim of this study was to describe our institutional experience with cervical mediastinoscopy. METHODS: This study was a retrospective analysis of 40 patients that underwent cervical mediastinoscopy in our institution between March 2007 and February 2013...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27637288/endosonography-versus-mediastinoscopy-in-mediastinal-staging-of-lung-cancer-systematic-review-and-meta-analysis
#20
REVIEW
Inderpaul Singh Sehgal, Sahajal Dhooria, Ashutosh Nath Aggarwal, Digambar Behera, Ritesh Agarwal
Whether endosonography can replace mediastinoscopy as the initial procedure for mediastinal staging of non-small cell lung cancer remains controversial. Herein, we perform a systematic review of randomized controlled trials and observational studies (both procedures performed in same subjects) comparing the two procedures. Nine studies (960 subjects) were identified. The pooled risk-difference of the sensitivity of endosonography versus mediastinoscopy in observational studies and randomized controlled trials was 0...
November 2016: Annals of Thoracic Surgery
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