Patient risk factors for conversion during video-assisted thoracic surgery-the Epithor conversion score.

Objectives: Intraoperative conversion from video-assisted thoracic surgery (VATS) to thoracotomy may occur during anatomical lung resection. The objectives of the present study were to identify risk factors for intraoperative conversion and to develop a predictive score.

Methods: We performed a multicentre retrospective analysis of French thoracic surgery departments that contributed data on anatomical lung resections to the Epithor database over a 10-year period (from January-2010 to December-2019).

Elective late open conversion after endovascular aneurysm repair is associated with comparable outcomes to primary open repair of abdominal aortic aneurysms.

Objective: Three of four patients with infrarenal abdominal aortic aneurysm are now treated with endovascular aneurysm repair (EVAR). The incidence of secondary procedures and surgical conversions is increasing for a population theoretically unfit for open surgery. The indications and outcomes of late open surgical conversions after EVAR in a high-volume tertiary vascular unit are reported.

Short- and Long-Term Outcomes Following Biological Pericardium Patches Versus Prosthetic Patches for Carotid Endarterectomy: A Retrospective Bicentric Study.

Background: Currently, there are various types of patches available on the market for carotid endarterectomy (CEA) with enlargement angioplasty, prosthetic, and biological patches including bovine pericardial patches. Despite the increasing use of these biological patches, there are little data in the literature comparing the results of these 2 types of patch. The purpose of this study is to compare the short- and long-term results of bovine pericardium patches (BPPs) with prosthetic patches (PPs) in carotid thromboendarterectomy.

Medicoeconomic analysis of lobectomy using thoracoscopy versus thoracotomy for lung cancer: a study protocol for a multicentre randomised controlled trial (Lungsco01).

Introduction: In the last decade, video-assisted thoracoscopic surgery (VATS) lobectomy for non-small cell lung cancer (NSCLC) has had a major effect on thoracic surgery. Retrospective series have reported benefits of VATS when compared with open thoracotomy in terms of postoperative pain, postoperative complications and length of hospital stay. However, no large randomised control trial has been conducted to assess the reality of the potential benefits of VATS lobectomy or its medicoeconomic impact.

Outcomes of Left Subclavian Artery Transposition for Hybrid Aortic Arch Debranching.

Background: The aim of this study was to evaluate outcomes of left subclavian artery (LSA) revascularization for hybrid aortic arch debranching.

Methods: Between 1998 and 2015, 68 patients (41 men; mean age, 67 ± 16 years) underwent thoracic endovascular aortic repair (TEVAR) with LSA coverage, 19.2% (n = 13) were never revascularized, and the remaining patients underwent LSA revascularization (n = 55; 80.

Homemade proximal scalloped stent graft for thoracic endovascular aortic repair of zone 2 acute aortic syndrome.

Objective: The aim of this study was to evaluate the outcomes of homemade proximal scalloped stent grafts for thoracic endovascular aortic repair of zone 2 acute aortic syndrome.

Methods: Between May 2015 and December 2015, 10 patients with unremitting symptoms or rupture secondary to an acute aortic syndrome involving zone 2 underwent urgent or emergency thoracic endovascular aortic repair. Among them, 8 were treated using homemade proximal scalloped stent grafts to preserve the patency of the left subclavian artery.

Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer: Literature Review.

Background: The aim of the study was to provide a literature review of thoracic endovascular aortic repair (TEVAR) outcomes for penetrating ulcer of the aorta.

Methods: Relevant articles in the Embase, Medline, and Cochrane databases reporting the results of endovascular repair for penetrating ulcers of the thoracic aorta were systematically searched and reviewed.

Results: Thirty-one articles were integrated after a literature review, and 310 patients treated by TEVAR for penetrating ulcers of the aorta were identified.

Titanium Implant Failure After Chest Wall Osteosynthesis.

Background: Our objective was to assess potential contributing factors to implant failure (displacement or rupture) after titanium chest wall osteosynthesis.

Methods: We retrospectively reviewed the clinical data and preoperative and postoperative computed tomographic scans of patients undergoing chest wall osteosynthesis with titanium implants: the Stratos or the Matrix Fixation System in two European departments of thoracic surgery. The indications for titanium chest wall osteosynthesis, the type and number of implants, the topography of the reconstruction, surgical site infection, and role of associated flap and mesh were assessed.

Anterior mediastinal tracheostomy as salvage operation.

Background: This study aimed to assess early and long-term results after anterior mediastinal tracheostomy (AMT) as a salvage operation for recurrent neck malignancies.

Methods: Between October 2006 and February 2013, 12 patients (mean age, 57 years) underwent AMT. All patients had experienced stomal recurrence, with or without esophageal involvement, after laryngectomy.

Pulmonary sleeve resection in locally advanced lung cancer using cryopreserved allograft for pulmonary artery replacement.

Background: During lobectomy, resection of pulmonary artery, followed by reconstruction or replacement with or without concomitant sleeve bronchial resection, is feasible in selected cases. We report morbidity, mortality, and technical issues in pulmonary artery replacement using a cryopreserved arterial allograft after sleeve resection for centrally located non-small cell lung carcinoma (NSCLC).

Methods: We reviewed clinical and pathologic data of patients who underwent arterial sleeve lobectomy with pulmonary artery replacement in our institution from 2007 to 2012.

Video-assisted thoracoscopic lobectomy: an unavoidable trend? A retrospective single-institution series of 410 cases.

Objectives: Evaluation of the feasibility, safety and oncological validity of video-assisted thoracic lobectomy (VATS). The VATS study exclusion criteria included T3 or T4 tumours, central hilar tumours, tumours visible on bronchoscopy requiring sleeve resection, hilar lymphadenopathy, N2 disease, history of neoadjuvant chemotherapy or radiation, previous thoracic surgery or pleurodesis.

Methods: A retrospective study of 410 patients (143 women, mean age 61.

Chest-wall reconstruction in case of infection of the operative site: is there any interest in titanium rib osteosynthesis?

Objectives: To describe the management of thoracic reconstructions in the presence of primary chest-wall infection (PCWI) or secondary deep chest-wall infection (SCWI), focussing on local tolerance of a titanium rib osteosynthesis system.

Methods: PCWI included infected chest wall tumours (CWT), infected T3 non-small-cell lung carcinoma (NSCLC) and open flail chest. SCWI was defined by deep infection of previous thoracic-wall reconstructions.

The combination of polytetrafluoroethylene mesh and titanium rib implants: an innovative process for reconstructing large full thickness chest wall defects.

Objectives: The reconstruction of large full thickness chest wall defect after resection of T3/T4 non-small cell lung cancer (NSCLC) or primary chest wall tumours presents a technical challenge for thoracic surgeons and is a critical factor in determining post-operative outcome. When the defect is large, complications are common with a 27% mean rate of respiratory morbidity.

Methods: Since 2006, 31 patients underwent reconstruction for wide chest wall defects using titanium implants and strong mesh.

Use of the titanium vertical ribs osteosynthesis system for reconstruction of large posterolateral chest wall defect in lung cancer.

We report a case of reconstruction of a large full-thickness posterolateral defect of the chest wall after resection of a stage III non-small cell lung carcinoma (NSCLC) using the combination of a vertical expandable prosthetic titanium device and a polytetrafluoroethylene (PTFE) mesh. A 40-year-old female presented with a NSCLC classified as type IIIA and required both neoadjuvant radiotherapy and chemotherapy. An en bloc resection including the left upper lobe, posterolateral segments of five ribs (K3-K7) and vertebral bodies (T3-T6) was performed through a posterior J-shaped approach.

Titanium plates and Dualmesh: a modern combination for reconstructing very large chest wall defects.

Background: The reconstruction of large full-thickness chest wall defects after resection of T3/T4 non-small cell lung carcinomas or primary chest wall tumors presents a technical challenge for thoracic surgeons and plays a central role in determining postoperative morbidity. The objective is to evaluate our results in chest wall reconstruction using a combination of expanded polytetrafluoroethylene (ePTFE) mesh and titanium plates.

Methods: Since 2006, 19 patients underwent reconstruction for wide chest wall defects using a combination of ePTFE mesh and titanium plates.

Proximal fixation of thoracic stent-grafts as a function of oversizing and increasing aortic arch angulation in human cadaveric aortas.

Purpose: To assess the fixation of 4 commercially available thoracic stent-grafts as a function of oversizing and increasing aortic arch angulation.

Methods: A benchtop pulsatile flow model was devised to test stent-graft anchorage in a 2-cm-long proximal landing zone at varying landing zone angles (70 degrees to 140 degrees ) and stent-graft oversizing (5% to 37%). The experiments were performed using 15 human thoracic cadaveric aortas and 4 stent-grafts with different proximal anchoring mechanisms: TAG, Zenith TX, Valiant, and Relay.

Acute carotid artery thrombosis: description of 12 surgically treated cases.

The morbidity and mortality of stroke secondary to acute internal carotid artery thrombosis range from 40 to 69% and from 15 to 55%, respectively, after purely medical treatment. This report describes a series of 12 patients who underwent urgent surgical treatment for primary acute carotid artery thrombosis between January 1999 and December 2002. Upon admission, all patients had severe neurologic deficits contralateral to carotid artery thrombosis.

Improvement in proximal aortic endograft fixation: an experimental study using different stent-grafts in human cadaveric aortas.

Purpose: To compare the proximal fixation characteristics of different types of stent-grafts (SG) and the adjunctive effect of a proximally placed Palmaz stent.

Methods: Human cadaveric aortas were obtained at autopsy and cut into 30 aortic segments. Appropriately oversized (10% to 20%) commercial stent-grafts (Zenith, Ancure, Excluder, Talent) and 4 configurations of homemade Palmaz-based stent-grafts (polytetrafluoroethylene or polyester coverings each with no uncovered proximal edge or a 20-mm bare section of stent) were implanted 20 mm into an aortic segment and balloon dilated.

Dissection of the abdominal aorta in blunt trauma: Endovascular or conventional surgical management?

Background: Dissection of the abdominal aorta caused by blunt trauma is a rare injury, often complicated by thrombosis within the true and false lumens and sometimes aortic rupture. The mortality rate with conservative medical management is approximately 75%, whereas it ranges from 18% to 37% with surgical treatment.

Methods: At our institution, 7 of the 87 patients admitted because of blunt aortic trauma, between January 1995 and January 2002, had abdominal aortic dissection.

Endovascular repair for acute traumatic rupture of the thoracic aorta.

Background: We report endovascular treatment of acute traumatic rupture of the thoracic aorta as a potential alternative to open surgery for high-risk patients.

Methods: Between January 2001 and July 2002, 9 patients with acute traumatic rupture of the thoracic aorta were treated with a stent-graft. In all cases the endovascular management was selected because of age, associated polytrauma, or comorbidities.

Endovascular repair for acute rupture of the descending thoracic aorta.

Purpose: To report the endovascular treatment of acute descending thoracic aortic rupture as an alternative to open surgery in high-risk patients.

Methods: Between November 1999 and April 2001, 10 patients (7 men; median age 75 years) underwent endovascular stent-grafting of the descending thoracic aorta for acute rupture from an aneurysm (n=7) or blunt trauma (n=3). All patients were evaluated as high operative risk.