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Thoracic surgical clinic

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https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#1
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28728688/transcatheter-versus-surgical-aortic%C3%A2-valve%C3%A2-replacement-propensity-matched-comparison
#2
J Matthew Brennan, Laine Thomas, David J Cohen, David Shahian, Alice Wang, Michael J Mack, David R Holmes, Fred H Edwards, Naftali Z Frankel, Suzanne J Baron, John Carroll, Vinod Thourani, E Murat Tuzcu, Suzanne V Arnold, Roberta Cohn, Todd Maser, Brenda Schawe, Susan Strong, Allen Stickfort, Elizabeth Patrick-Lake, Felicia L Graham, Dadi Dai, Fan Li, Roland A Matsouaka, Sean O'Brien, Fan Li, Michael J Pencina, Eric D Peterson
BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. OBJECTIVES: The aim of this study was to determine the safety and effectiveness of TAVR versus surgical aortic valve replacement (SAVR), particularly in intermediate- and high-risk patients, in a nationally representative real-world cohort...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28728296/-intramural-gastric-metastasis-of-esophageal-squamous-cell-carcinoma-an-analysis-of-imaging-findings-and-clinicopathological-features
#3
Y J Zhu, L Y Xue, Y Li, J Jiang, T T Liu, L M Jiang
Objective: To discuss the imaging findings and clinicopathological features of the intramural gastric metastasis (IGM) of esophageal squamous cell carcinoma. Methods: The imaging findings of 11 patients with IGM confirmed by surgical pathology were reviewed retrospectively, and compared with clinicopathological features. Of the 11 cases, eight underwent upper gastrointestinal radiography, ten underwent contrast enhanced computed tomography (CT) scans and one underwent plain CT scanning. Results: In all 11 cases, the primary cancer was located in the middle or lower thoracic esophagus, and nine of 11 had lymph nodes metastasis...
July 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28717395/brain-imaging-before-primary-lung-cancer-resection-a-controversial-topic
#4
Zoe Hudson, Eveline Internullo, Anthony Edey, Isabel Laurence, Davide Bianchi, Alfredo Addeo
OBJECTIVE: International and national recommendations for brain imaging in patients planned to undergo potentially curative resection of non-small-cell lung cancer (NSCLC) are variably implemented throughout the United Kingdom [Hudson BJ, Crawford MB, and Curtin J et al (2015) Brain imaging in lung cancer patients without symptoms of brain metastases: a national survey of current practice in EnglandClin Radiol https://doi.org/10.1016/j.crad.2015.02.007]. However, the recommendations are not based on high-quality evidence and do not take into account cost implications and local resources...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28712885/detection-of-cftr-function-and-modulation-in-primary-human-nasal-cell-spheroids
#5
John J Brewington, Erin T Filbrandt, F J LaRosa, Alicia J Ostmann, Lauren M Strecker, Rhonda D Szczesniak, John P Clancy
BACKGROUND: Expansion of CFTR modulators to patients with rare/undescribed mutations will be facilitated by patient-derived models quantifying CFTR function and restoration. We aimed to generate a personalized model system of CFTR function and modulation using non-surgically obtained nasal epithelial cells (NECs). METHODS: NECs obtained by curettage from healthy volunteers and CF patients were expanded and grown in 3-dimensional culture as spheroids, characterized, and stimulated with cAMP-inducing agents to activate CFTR...
July 13, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#6
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28709837/what-are-the-possibilities-of-spontaneous-resorption-of-a-thoracic-disc-herniation-occupying-more-than-20-of-the-spinal-canal-in-the-asymptomatic-subject-comparative-study
#7
David Brauge, Rachid Madkouri, Robert Clément, Vincent Reina, Thomas Brauge, Stephan Gaillard
Thoracic disc herniation is a rare pathology for which surgical treatment is difficult. The discovery of asymptomatic or only slightly symptomatic lesions can be problematic, especially in cases of marked canal stenosis. The possibility of spontaneous resorption has been documented by a few case reports but there is no study on this subject. Our objective was to compare the clinical and radiological data for two groups of patients with significant thoracic herniation (occupying more than 20% of the spinal canal): one showing spontaneous resorption (group 1) and the other persistence of the lesion during follow up (group 2)...
July 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28709171/omental-actinomycosis-imitating-a-foreign-body-infection
#8
Yoo Shin Choi, Yong Gum Park
Actinomycosis is a rare chronic disease caused by a group of anaerobic Gram-positive bacteria that colonize the mouth, colon, and urogenital tract. Infection involving the cervicofacial area is the most common clinical presentation, followed by that of the pelvic and thoracic areas. The preoperative diagnosis of abdominal actinomycosis is difficult because the condition can be easily confused with malignancy, tuberculosis, or other inflammatory diseases. We report a case of omental actinomycosis mimicking a foreign body...
July 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28705774/asia-a-sensory-and-motor-complete-is-not-different-than-asia-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#9
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
Background Context We receive a large number of spinal cord injury (SCI) patients due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Though many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete due to sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from ASIA A completes. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28695972/the-incidence-of-postoperative-pneumonia-in-various-surgical-subspecialties-a-dual-database-analysis
#10
Morad Chughtai, Chukwuweike U Gwam, Anton Khlopas, Jared M Newman, Gannon L Curtis, Pedro A Torres, Rafay Khan, Michael A Mont
INTRODUCTION: Pneumonia is the third most common postoperative complication. However, its epidemiology varies widely and is often difficult to assess. For a better understanding, we utilized two national databases to determine the incidence of postoperative pneumonia after various surgical procedures. Specifically, we used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the Nationwide Inpatient Sample (NIS) to determine the incidence and yearly trends of postoperative pneumonia following orthopaedic, urologic, otorhinolaryngologic, cardiothoracic, neurosurgery, and general surgeries...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28688935/indirect-transfer-of-the-sternal-head-of-the-pectoralis-major-with-autogenous-semitendinosus-augmentation-to-treat-scapular-winging-secondary-to-long-thoracic-nerve-palsy
#11
Tao Li, Ze Z Yang, Yuan Deng, Ming Xiao, Chuan Jiang, Jin W Wang
BACKGROUND: Scapular winging resulting from long thoracic nerve palsy is uncommon but debilitating, and the choice of surgical treatment is inconsistent. The autogenous semitendinosus tendon plays a key role as an interposed tendon graft, although its use in the indirect transfer of the sternal head of the pectoralis major during the treatment of scapular winging has rarely been reported. MATERIALS AND METHODS: A retrospective review was performed during a 9-year period from the clinical data of 26 cases (28 shoulders) with indirect transfer of the sternal head of the pectoralis major with the interposition of an autogenous semitendinosus tendon graft for dynamic stabilization of the scapula...
July 5, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28688218/early-versus-late-inpatient-awake-transcervical-injection-laryngoplasty-after-thoracic-aortic-repair
#12
Diane W Chen, Matt D Price, Scott A LeMaire, Joseph S Coselli, N Eddie Liou, Julina Ongkasuwan
BACKGROUND: Vocal fold movement impairment (VFMI), a known complication following thoracic aortic surgery, has been associated with poorer surgical outcomes, including higher pulmonary complications and longer length of stay (LOS). Awake transcervical injection laryngoplasty in the inpatient setting serves to augment pulmonary toilet function for affected patients. This study investigates clinical outcomes of patients who underwent early versus late injection laryngoplasty following aortic surgery...
July 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28688062/giant-thoracic-discs-treatment-outcome-and-follow-up-of-33-patients-in-a-single-centre
#13
Saurabh Kapoor, Meriem Amarouche, Farah Al-Obeidi, Jean Marie U-King-Im, Nick Thomas, David Bell
PURPOSE: To help guide treatment strategies and create insight into functional outcomes in patients with Giant herniated thoracic discs (GHTD), which are defined as occupying more than 40% of spinal canal. METHODS: Authors did a retrospective analysis of prospective cohort of 33 cases of GHTD, using clinical letters, notes, and telephonic questionnaires to determine their pre and postoperative functional status, surgical details, and complication rates. 16 males and 17 females operated between 2006 and 2014 were included in the study...
July 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28683987/node-negative-esophageal-cancer-with-short-interval-isolated-metastasis-to-the-gallbladder-a-case-report
#14
Christopher M Hart, Kelly R Haisley, Christian Lanciault, James P Dolan
A 55 year old male smoker presented with clinical T3N0 esophageal adenocarcinoma of the GE junction. He completed neoadjuvant chemoradiotherapy with carboplatin/paclitaxel and 5040cGy of radiation. He had limited clinical response on restaging but no evidence of metastatic disease and completed a minimally invasive three field esophagectomy. This was complicated by a chyle leak requiring thoracic duct embolization from which he recovered well. Surgical pathology showed no apparent nodal disease or metastases but a poorly differentiated primary tumor with signet-cell features...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683909/type-b-aortic-dissections-current-guidelines-for-treatment
#15
REVIEW
Daniel B Alfson, Sung W Ham
Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Acute TBAD with complications should be repaired with emergent thoracic endovascular aortic repair (TEVAR). Uncomplicated TBAD with high-risk features should undergo TEVAR in the subacute phase...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28683903/genetic-disorders-of-the-thoracic-aorta-and-indications-for-surgery
#16
REVIEW
Jack C J Sun
Genetic disorders of the aorta are rare but can lead to life-threatening thoracic aortic aneurysms. Although the genetic causes of many of these connective tissue diseases are well defined, others such as familial thoracic aortic aneurysm and bicuspid aortic valve aortopathy are not. The natural history of genetic thoracic aortic aneurysms is not well understood or predictable, and surgical guidelines for treatment remain imprecise. Future research should strive to provide in-depth and detailed genetic profiling to drive clinical management, including medical and surgical therapies...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28673764/how-to-assess-sensory-recovery-after-breast-reconstruction-surgery
#17
Helena K Puonti, Taina A Broth, Seppo O Soinila, Helena K Hallikainen, Satu K Jääskeläinen
BACKGROUND: We evaluated clinical against psychophysical (tactile and thermal quantitative sensory test [QST]), neurophysiologic (somatosensory evoked potential [SEP]), and epithelial nerve fiber density (ENFD) examinations in detection and follow-up of sensory alterations after breast reconstruction done with or without nerve anastomoses. PATIENTS AND METHODS: In a prospective 2-year follow-up design, 56 breast cancer patients underwent innervated and 20 patients noninnervated free rectus abdominis muscle-sparing flap (ms-TRAM) breast reconstruction...
April 29, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28671161/video-assisted-thoracoscopic-surgery-for-pulmonary-aspergilloma
#18
Arvind Kumar, Belal Bin Asaf, Harsh Vardhan Puri, Vijay C Lingaraju, Shireen Siddiqui, Pulle Mohan Venkatesh, Jayashree Sood
INTRODUCTION: Surgical management of pulmonary aspergilloma in symptomatic patients offers a significant chance of cure. Video-assisted thoracic surgery is a valid alternative for properly selected cases. We herein report our experience with thoracoscopic management of pulmonary aspergilloma. PATIENT AND METHODS: This retrospective analysis was performed on 41 patients operated between 2012 to 2015. The patient records were thoroughly analyzed for demography, clinical presentation, computed tomography , the procedure performed , post-operative complications and course during 6 month's follow up...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28667547/transversus-abdominis-plane-tap-block-versus-thoracic-epidural-analgesia-tea-in-laparoscopic-colon-surgery-in-the-eras-program
#19
Basilio Pirrera, Vincenzo Alagna, Andrea Lucchi, Pierluigi Berti, Carlo Gabbianelli, Giacomo Martorelli, Lorella Mozzoni, Federico Ruggeri, Alessandro Ingardia, Giuseppe Nardi, Gianluca Garulli
AIM: The enhanced recovery after surgery (ERAS) pathway and laparoscopic approach had been proven beneficial for patients and should now be considered as a standard of care in colorectal surgery. Multimodal analgesia is the gold standard in the ERAS program with the use of thoracic epidural analgesia (TEA). Few data are available on Transversus abdominis plane (TAP) blocks in laparoscopic colorectal surgery and ERAS pathway. The aim of this study is to evaluate the efficacy of TAP block compared to TEA in the management of postoperative pain and the impact on the recurrence of postoperative nausea, vomiting and ileus in laparoscopic colorectal surgery in the ERAS program...
July 1, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28664469/the-role-of-telemedicine-in-providing-thoracic-oncology-care-to-remote-areas-of-british-columbia
#20
REVIEW
Michael F Humer, Barbara G Campling
PURPOSE OF REVIEW: The purpose of this study is to review the role of telemedicine in providing oncology care; we describe our long-standing, high-volume telemedicine experience. RECENT FINDINGS: The Interior Health Thoracic Surgical Group (IHTSG) uses telemedicine, through Virtual Thoracic Surgical Clinics (VTSC), to provide service to remote patients. The IHTSG serves a population of 1.01 million people over an area of 807,538 km(2) (1.3 persons/km(2)) in the Interior and North of British Columbia, Canada...
August 2017: Current Oncology Reports
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