Impact of Medicaid expansion under the Patient Protection and Affordable Care Act on lung cancer care in the US.

Background: Healthcare disparities significantly affect access to care and outcomes in lung cancer patients. The Patient Protection and Affordable Care Act (ACA) Medicaid expansion (ME) was enacted with the aim of improving access to quality and affordable healthcare. This study aims to determine the impact of ME on access to care and outcomes for patients with lung cancer.

A rare case of combined black esophagus and stomach: a case report.

Background: Black esophagus is a relatively rare phenomenon that seems to occur in a morbid patient population, however, this entity may be more common than we currently know. Additionally, black esophagus may even be reversible in some cases. There are far fewer cases of black stomach described.

Transsternal Approach for Broncho-Pleural Fistula Closure After Right Pneumonectomy.

Broncho-pleural fistula (BPF) is an abnormal communication between the bronchial lumen and the pleural space that typically occurs postoperatively. Surgical intervention is typically needed to patch the fistula; however, current literature lacks a gold standard for which treatment to use. With a high mortality rate, there is a clear urgency for quick and successful intervention.

Endoscopic interventions in the management of the gastroesophageal reflux: a narrative review.

Objective: The goal of this review is to describe and compare current and historic endoscopic interventions for gastroesophageal reflux disease (GERD).

Background: The prevalence of GERD affects a large portion of the population. Nearly half of those treated with conservative medical therapy have refractory symptoms of reflux.

Endoscopic tissue approximation in clinical practice and the OverStitch device: a narrative review.

Objective: The current article describes modern endoscopic technologies that allow for advanced endoscopic tissue approximation and suturing. These technologies include such devices as through the scope and over the scope clips, endoscopic suturing OverStitch device and through the scope suturing X-Tack device.

Background: Since the original introduction of the diagnostic endoscopy, progress in the field has been astonishing.

Robotic Belsey Mark IV Repair of the Paraesophageal Hernia.

Objective: Surgical repair of paraesophageal hernias in patients with hostile abdomen is challenging. Despite its utility as an open procedure, the adoption of the minimally invasive Belsey Mark IV procedure has been limited because of the complexity of using traditional video-assisted thoracoscopic instrumentation. The robotic platform offers additional degrees of freedom, which enables minimally invasive transthoracic approach despite challenging anatomy.

The Scan, the Needle, or the Knife? National Trends in Diagnosing Stage I Lung Cancer.

Objective: Indeterminate lung nodules have been increasingly discovered since the expansion of lung cancer screening programs. The diagnostic approach for suspicious nodules varies based on institutional resources and preferences. The aim of this study is to analyze factors associated with diagnostic modalities used for early-stage non-small cell lung cancer (NSCLC).

Pulmonary Open, Robotic, and Thoracoscopic Lobectomy study: Outcomes and risk factors of conversion during minimally invasive lobectomy.

Objective: Conversion to thoracotomy continues to be a concern during minimally invasive lobectomy. The aim of this propensity-matched cohort study is to analyze the outcomes and risk factors of intraoperative conversion during video-assisted thoracoscopic surgery (VATS) and robotic lobectomy (RL).

Methods: Data from consecutive lobectomy cases performed for clinical stage IA to IIIA lung cancer was retrospectively collected from the Pulmonary Open, Robotic, and Thoracoscopic Lobectomy study consortium of 21 institutions from 2011 to 2019.

Management of Native Lung Malignancy in a Lung Transplant Recipient.

A 75-year-old male patient with a history of previous right lung transplant presented with left upper lobe squamous cell carcinoma. Endobronchial ultrasound and positron emission tomography displayed no mediastinal lymphadenopathy. A ventilation-perfusion scan displayed minimal perfusion to the native lung.

A Rare Complication of Esophageal Exclusion: Esophageal Mucocele.

Bipolar esophageal exclusion is a "Hail Mary" procedure for control of leak and persistent mediastinal soilage from esophageal injury. Usually, the esophageal remnant scars down without negative consequences. Esophageal mucocele is a rare complication of bipolar esophageal exclusion.

Robotic Transgastric Reconstruction of the Double Lumen Esophagus.

Double lumen esophagus is an extremely rare condition, developing in most cases as a complication of antireflux procedures or gastroesophageal reflux itself secondary to the severe inflammatory process in and around the lower esophagus. We describe a case of iatrogenic double lumen esophagus after multiple previous Nissen fundoplications for chronic gastroesophageal reflux disease. There is no standard surgical intervention for the management of this complication.

Tracheobronchoplasty for tracheobronchomalacia.

Tracheobronchoplasty (TBP) consists of splinting of the posterior membranous wall of the central airways with the goal of restoring a normal configuration and preventing excessive collapse in patients with tracheobronchomalacia (TBM). Despite some variation in technique, it consists of sewing a mesh on the posterior membranous wall of the trachea and both main stem bronchi. Traditionally performed through a right posterolateral thoracotomy, it should be reserved for cases of severe TBM.

Minimally Invasive Diaphragm Plication for Acquired Unilateral Diaphragm Paralysis: A Systematic Review.

Diaphragm paralysis is a relatively uncommon entity that can be both congenital and acquired in nature. While commonly asymptomatic, it can also cause a significant decrease in pulmonary function and reserve, particularly in patients with underlying pulmonary diseases. Our aim was to summarize the current literature regarding the minimally invasive techniques used in the surgical correction of acquired diaphragm paralysis via traditional and robotic minimally invasive approaches.

Surveillance Following Treatment of Esophageal Cancer.

We describe the surveillance strategies after esophageal cancer treatment, whether local therapy, induction chemoradiation, or other definitive treatment such as trimodality therapy. We discuss the shortcomings of the different invasive and imaging studies, and the recommended stage-specific surveillance after local and organ-sparing approaches to esophageal cancer treatment.

Salvage Esophagectomy.

Salvage esophagectomy is an option for patients with recurrent or persistent esophageal cancer after definitive chemoradiation therapy or those who undergo active surveillance after induction chemoradiation therapy. Salvage resection is associated with higher rates of morbidity compared with planned esophagectomy but offers patients with locally advanced disease a chance at improved long-term survival. Salvage resection should be preferentially performed in a multidisciplinary setting by high-volume and experienced surgeons.

Surgical Management of Early Esophageal Cancer.

Esophageal cancer is the eighth most common cancer worldwide, and its incidence has been increasing over the past several decades. Esophagectomy currently is the standard of care for more advanced early esophageal cancer and should be performed at centers of excellence with high volumes, appropriate supportive staff, and multidisciplinary expertise.

Peroral endoscopic myotomy: techniques and outcomes.

Achalasia is progressive neurodegenerative disorder of the esophagus, resulting in uncoordinated esophageal motility and failure of lower esophageal sphincter relaxation, leading to impaired swallowing. Surgical myotomy of the lower esophageal sphincter, either open or minimally invasive, has been a standard of care for the past several decades. Recently, new procedure-peroral endoscopic myotomy (POEM) has been introduced into clinical practice.