Outcomes after Conversion from Video-Assisted Thoracoscopic Lobectomy to Thoracotomy.

Background:  Lung cancer resections are increasingly being performed via video-assisted thoracoscopic surgery (VATS). Conversion to thoracotomy can occur for many reasons and may affect outcomes. The objective of this study was to investigate the impact of VATS conversion on short- and mid-term outcomes and identify reasons for conversion.

Case Report: Spontaneous lung intercostal hernia series and literature review.

Spontaneous lung intercostal hernia (SLIH) is a rare condition potentially carrying severe morbidity. About 120 cases have been described so far, with an apparently increasing number of reports in recent years. The main presenting findings are chest pain and bulging, with ecchymosis in the affected area, hemoptysis, respiratory distress, and signs of infection or incarceration being described as well.

Adequacy of Mediastinal Lymph Node Sampling in Patients With Lung Cancer Undergoing Lung Resection.

Background: Intraoperative mediastinal lymph node sampling (MLNS) is a crucial component of lung cancer surgery. Whilst several sampling strategies have been clearly defined in guidelines from international organizations, reports of adherence to these guidelines are lacking. We aimed to assess our center's adherence to guidelines and determine whether adequacy of sampling is associated with survival.

Comparison of traditional microbiological culture and 16S polymerase chain reaction analyses for identification of preoperative airway colonization for patients undergoing lung resection.

Purpose: Preoperative airway colonization is associated with increased risk of postoperative respiratory complications following lung resection. This study compares the rates of preoperative lower respiratory tract colonization identified by traditional culture and novel 16S polymerase chain reaction (PCR) tests.

Materials And Methods: Preoperative sputum and bronchoalveolar lavage (BAL) samples for 49 lung resection patients underwent culture and 16S PCR analyses.

Prevalence of nodal metastases in lymph node stations 8 & 9 in a large UK lung cancer surgical centre without routine pre-operative EUS nodal staging.

Introduction: Endoscopic ultrasound (EUS) allows access to the inferior mediastinal lymph node stations (8 and 9) which are beyond the reach of endobronchial ultrasound (EBUS). The addition of EUS to EBUS procedures requires cost and resource investment. This study sought to describe the prevalence of station 8/9 nodal metastases from intra-operative lymph node sampling in a UK region where routine pre-operative EUS is not available.

Adequacy of Intraoperative Nodal Staging during Surgical Resection of NSCLC: Influencing Factors and Its Relationship to Survival.

Introduction: Adequate intraoperative lymph node sampling is a fundamental part of lung cancer surgery, but adherence to standards is not well known. This study sought to measure the adequacy of intraoperative lymph node sampling at a regional Thoracic Surgery Centre and a tertiary lung cancer center in the United Kingdom.

Methods: This retrospective study analyzed the pathological reports from NSCLC resections over the 4-year period 2011-2014.

Is there a role for the high-risk multidisciplinary team meeting in thoracic surgery?

Objectives: There is little information on the impact of a high-risk multidisciplinary team (HRMDT) for thoracic surgery. In our unit, patients considered high risk for thoracic surgery have been discussed at this meeting since its inception in June 2013. The aim of this study was to audit our selection of patients discussed at the HRMDT and its effect on patient outcomes.

Does positron emission tomography scanning improve survival in patients undergoing potentially curative lung resections for non-small-cell lung cancer?

Objective: To determine if positron emission tomography (PET) scanning has resulted in an improvement in the short- and long-term survival of patients undergoing potentially curative resections for non-small-cell lung cancer. No publications exist to demonstrate an increased survival of patients with lung cancer due to the use of PET scanning. If PET scanning reduces unnecessary resections, the results from surgery should be improved with its introduction.

Should we operate on microscopic N2 non-small cell lung cancer?

Traditionally non-small cell lung cancer (NSCLC) stage N2 is considered as a contraindication for curative resection. We investigated the outcome of patients with microscopic N2 disease, who underwent potentially curative resections. The independent effects of lobectomy vs.

Aspirin and non-small cell lung cancer resections: effect on long-term survival.

Objective: Survival after resections for non-small cell lung cancer remains poor. Recurrent lung cancer remains common. Due to the common risk factor of smoking, cardiovascular deaths occur in the absence of recurrent lung cancer in up to 15% of patients.

Carotid artery diameter, plaque morphology, and hematocrit, in addition to percentage stenosis, predict reduced cerebral perfusion pressure during cardiopulmonary bypass: a mathematical model.

Cerebral complications after cardiac surgery are a significant cause of morbidity, mortality, and financial cost. Numerous risk factors have been proposed to explain the risk of cerebral damage. Carotid artery disease has an important role.

Effect of foreign surface pacification with albumin, aprotinin, propofol, and high-density lipoprotein.

Foreign surface pacification may significantly reduce the detrimental effects of the cardiopulmonary bypass (CPB) circuit. To date, albumin is the only intervention consistently shown to be beneficial. The cationic physical properties of aprotinin and the known negative charge on the plastic CPB circuit mean that aprotinin binds to the CPB circuit and membrane oxygenator.

Hypertonic cardiopulmonary bypass primes and endothelial damage.

The objective of this study was to investigate whether hypertonic hyperosmolar primes solution (HHPS), with an osmolarity of 2300 mOsmol/L, causes endothelial damage/loss. The bodies' normal osmolarity is -280 mOsmol/L. Aortic endothelial cells were cultured and plated to confluence, confirmed by light microscopy, on a 96-well plate.

Aggressive zero balance ultrafiltration on CPB in patients with renal failure may cause cerebral edema: a theoretical analysis.

The objective of this study was to determine the brain volume changes that occur secondary to hemofiltration during cardiopulmonary bypass in patients with renal failure. We hypothesized that in patients with elevated urea levels, quick aggressive hemofiltration could be associated with cerebral edema. We constructed a simple two-compartment model similar to the urea kinetic model developed by Depner.

Colo-pleural fistula following pneumonectomy.

Following pneumonectomy and diaphragmatic reconstruction for carcinoid tumour, a fistula developed between the pneumonectomy space and the splenic flexure of the colon. The problem was successfully treated by colon resection and thoracoplasty.