Intersurgeon variations in postoperative length of stay after video-assisted thoracoscopic surgery lobectomy.

Objectives: To identify factors associated with prolonged postoperative length of stay (LOS) after VATS lobectomy (VATS-L), explore potential intersurgeon variation in LOS and ascertain whether or not early discharge influences hospital readmission rates.

Methods: We conducted a retrospective analysis of patients who underwent VATS-L at a single academic center between 2018 and 2021. Each VATS lobectomy procedure was performed by 1 of 7 experienced thoracic surgeons.

Post-Operative Outcomes Associated With Open Versus Robotic Thymectomy: A Propensity Matched Analysis.

To compare post-operative outcomes associated with thymectomy performed using either open or robotic approaches. Retrospective cohort study from a single-center prospective registry consisting of patients undergoing thymectomy between 2000 and 2020. Patients were grouped according to surgical approach (open vs robotic).

Impact of Volume on Mortality and Hospital Stay After Lung Cancer Surgery in a Single-Payer System.

Background: There is a literature gap for hospitals in single-payer health care systems quantifying the influence of hospital volume on outcomes after major lung cancer resection. We aimed to determine the effect of hospital volume on mortality and length of stay.

Methods: A retrospective cohort study using administrative, population-based data from a single-payer universal health care system was performed in adults with non-small cell lung cancer who underwent lobectomy or pneumonectomy between 2008 and 2017.

Balloon Dilation for Endosonographic Staging in Esophageal Cancer: A Phase 1 Clinical Trial.

Background: Dilation in patients with malignant esophageal strictures precluding the passage of the endoscopic ultrasonography (EUS) scope allows complete evaluation; however, it may be associated with complications. This study evaluates the safety and clinical value of balloon dilation to complete EUS in patients with stenotic esophageal cancers.

Methods: This study consists of a phase I clinical trial.

Transvascular endosonographic-guided needle biopsy of intrathoracic lesions.

Background: Endoscopic ultrasound-guided biopsy techniques, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), are currently the standard of care for the assessment of mediastinal lymphadenopathy. Traditionally, passing the needle through and through vascular structures has been avoided owing to the risk of bleeding. In this study, we evaluated the safety and diagnostic accuracy of transvascular endosonographic-guided biopsies of mediastinal, hilar and lung lesions.

Phase 1 Trial Evaluating Safety of Pulmonary Artery Sealing With Ultrasonic Energy in VATS Lobectomy.

Background: Energy-sealing devices may be useful to divide small pulmonary arteries (PAs) during video-assisted thoracoscopic surgery (VATS) lobectomy. We evaluated the safety of PA branch sealing with an ultrasonic energy vessel-sealing device during VATS lobectomy.

Methods: The study consisted of a phase 1 trial.

Pulmonary artery sealing with ultrasonic energy in open lobectomy: A phase I clinical trial.

Objective: Pulmonary artery branch sealing in video-assisted thoracoscopic surgical lobectomy is usually achieved with vascular endostaplers. Iatrogenic pulmonary artery injury may be caused by endostaplers. We evaluated the safety of pulmonary artery sealing with an ultrasonic energy vessel-sealing device in a phase I clinical trial evaluating in vivo safety of the device during open lobectomy.

Impact of pregabalin on the occurrence of postthoracotomy pain syndrome: a randomized trial.

Background: Postthoracotomy pain syndrome (PTPS) is a frequent cause of chronic postoperative pain. Pregabalin might reduce the incidence of chronic postoperative pain. The goal of this study was to evaluate the impact of perioperative pregabalin on the occurrence of PTPS, defined as any surgical site pain 3 months after surgery.

Pilot study of pulmonary arterial branch sealing using energy devices in an ex vivo model.

Objective: Vascular endostaplers are bulky and can be dangerous when dividing small pulmonary arterial (PA) branch vessels during video-assisted thoracoscopic lobectomy. We aimed to evaluate and compare the immediate efficacy of modern energy sealing devices in an ex vivo PA sealing model.

Methods: Patients undergoing anatomical lung resection or lung transplantation were recruited for a prospective cohort pilot study.

Gabapentin does not reduce post-thoracotomy shoulder pain: a randomized, double-blind placebo-controlled study.

Purpose: Despite adequate epidural analgesia, up to 97% of patients undergoing thoracotomy experience ipsilateral shoulder pain. In this setting, this study evaluated the safety and the efficacy of pre-emptive gabapentin.

Methods: A double-blind, placebo-controlled study was undertaken in 51 patients randomized into two groups.

Acetaminophen decreases early post-thoracotomy ipsilateral shoulder pain in patients with thoracic epidural analgesia: a double-blind placebo-controlled study.

Objective: Despite effective epidural analgesia, up to 85% of post-thoracotomy patients complain of moderate-to-severe ipsilateral shoulder pain. This study assessed the efficacy of acetaminophen in decreasing postoperative shoulder pain after a thoracotomy.

Design: Double-blind randomized and placebo-controlled study.

Balloon dilation and stent placement for esophageal lesions: indications, methods, and results.

Esophageal balloon dilation and expandable stent placement are safe, minimally invasive, effective treatments for esophageal strictures and fistulas. These procedures have brought the management of dysphagia due to esophageal strictures into the field of interventional radiology. Esophageal dilation is usually indicated for benign stenoses and is technically successful in more than 90% of cases.

Effects of emphysema and lung volume reduction surgery on transdiaphragmatic pressure and diaphragm length.

Study Objectives: To determine the effect of emphysema and lung volume reduction surgery (LVRS) on diaphragm length (Ldi) and its capacity to generate transdiaphragmatic pressure (Pdi).

Design: Prospective clinical trial with a parallel group design.

Setting: Laboratory investigations in normal volunteers recruited by advertisement and in emphysema outpatients being evaluated for elective LVRS.

Oculopharyngeal muscular dystrophy: What's new?

The authors place autosomal dominant oculopharyngeal muscular dystrophy in a historical perspective, look at the genealogy involved, and review the genetic studies. In addition to summarizing what happens at the histopathological level, they examine the clinical characteristics of this late-onset dystrophy. Based on this knowledge, they try to present their rationale for the surgical treatment of the eyelid ptosis, taking into account that this disease is progressive and that treatment should be planned for the lifetime of the patient.