Esophageal perforation following anterior cervical discectomy and fusion.

Anterior cervical discectomy and fusion (ACDF) is one of the most common spinal surgeries performed in the US but is associated with various morbidities. Esophageal perforation is one of the rarest complications of ACDF, but it is potentially fatal, therefore requiring timely detection and treatment. We present three cases of esophageal perforation after ACDF.

Extracorporeal membrane oxygenation for respiratory failure in phases of COVID-19 variants.

Background: Adaptive mutations of the severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) virus have emerged throughout the coronavirus disease 2019 (COVID-19) pandemic. The characterization of outcomes in patients requiring extracorporeal membrane oxygenation (ECMO) for severe respiratory distress from COVID-19 during the peak prevalence of different variants is not well known.

Methods: There were 131 patients with laboratory-confirmed SARS-CoV-2 infection supported by ECMO at two referral centers within a large healthcare system.

Treatment of acute respiratory distress syndrome from COVID-19 with extracorporeal membrane oxygenation in obstetrical patients.

Background: Extracorporeal membrane oxygenation therapy has been used as a rescue therapy for patients with severe acute respiratory distress syndrome from COVID-19 who have failed conventional ventilatory strategies. Little is known about the outcome of pregnant and postpartum patients on extracorporeal membrane oxygenation therapy.

Objective: To describe the medical and surgical outcomes of pregnant and postpartum patients who were placed on extracorporeal membrane oxygenation therapy for severe acute respiratory distress syndrome from COVID-19.

Power washing pulmonary alveolar proteinosis.

Pulmonary alveolar proteinosis is an uncommon cause of insidious onset shortness of breath and hypoxemia. It is caused by an accumulation of surfactant within the alveoli. Left untreated, it can be fatal.

A 49-Year-Old Woman With Persistent Bilateral Pleural Effusions.

A 49-year-old woman presented to the ED with sudden onset abdominal pain, nausea, and vomiting. Her medical history included an uncomplicated gastric lap band surgery 9 years ago and subsequent removal of lap band after 6 years. She had a Roux-en-Y gastric bypass and cholecystectomy 5 months prior to the current presentation.

Usefulness of endobronchial stenting for nonmalignant right middle lobe syndrome.

We report herein a case of nonmalignant middle lobe atelectasis of the right lung resulting in significant stenosis of the airway. The new short self-expandable metallic stents (SEMS) were used to perform temporary stenting and expansion of the right middle lobe airway. SEMS have been used to treat airway obstructions in the trachea, as well as the right and left carina, but few studies have looked at placing SEMS at the level of the bronchi, especially right middle lobe bronchus.

Outcomes of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by COVID-19 Versus Influenza.

Background: Extracorporeal membrane oxygenation (ECMO) can be effective for refractory acute respiratory distress syndrome (ARDS) in patients with influenza, but its utility in patients with coronavirus disease 2019 (COVID-19) is uncertain. We compared outcomes of patients with refractory ARDS from COVID-19 and influenza placed on ECMO.

Methods: We conducted a retrospective analysis of 120 patients with refractory ARDS due to COVID-19 or influenza placed on ECMO at 2 referral centers from January 2013 to October 2020.

Venovenous extracorporeal membrane oxygenation for patients with refractory coronavirus disease 2019 (COVID-19): Multicenter experience of referral hospitals in a large health care system.

Background: The benefit of extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress from coronavirus disease 2019 refractory to medical management and lung-protective mechanical ventilation has not been adequately determined.

Methods: We reviewed the clinical course of 37 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection supported by venovenous ECMO at 4 ECMO referral centers within a large health care system. Patient characteristics, progression of hemodynamics and inflammatory markers, and clinical outcomes were evaluated.

Tracheal resection for tracheal stenosis.

Anatomically, patients with refractory tracheal stenosis benefit from tracheal resection, depending on the medical comorbidities or challenging tracheal anatomy, which is often the reason for denial of this option in these patients. We evaluated 15 patients undergoing tracheal resection at our institution from May 2016 through December 2017. Eleven patients had a history of previous tracheostomy, six in place at the time of resection.

Effect of extracorporeal membrane oxygenation transport on short- and long-term survival in patients with acute respiratory distress syndrome.

Venovenous extracorporeal membrane oxygenation (ECMO) has emerged as an important tool in the treatment of acute respiratory distress syndrome (ARDS). The creation of portable ECMO circuits and pumps has supported the development of interfacility ECMO programs. Prior studies have demonstrated that ECMO transport is safe; however, long-term outcomes for these patients remain unknown.

Left upper lobectomy for a large incidental simple arteriovenous malformation.

We present an incidental finding of a large left upper lobe diffuse pulmonary arteriovenous malformation (PAVM) presenting with cyanosis, exertional shortness of breath, polycythemia, and low peripheral oxygen saturation. PAVMs are mostly diagnosed in symptomatic patients with therapeutic embolization as the first choice of therapy. This young woman had no symptoms but showed signs of hypoxemia, and further investigation revealed a huge central left upper lobe PAVM.

Timing of ECMO Initiation Impacts Survival in Influenza-Associated ARDS.

In the past decade, extracorporeal membrane oxygenation (ECMO) has emerged as an innovative therapy for influenza-associated acute respiratory distress syndrome (ARDS). Despite its promising results, the ideal timing of ECMO initiation for these patients remains unclear. Retrospective analysis of a single institution experience with venovenous ECMO for influenza-induced ARDS was performed.

Antitumor activity of paclitaxel is significantly enhanced by a novel proapoptotic agent in non-small cell lung cancer.

Background: Newer targeted agents are increasingly used in combination chemotherapy regimens with enhanced survival and improved toxicity profile. Taxols, such as paclitaxel, independently potentiate tumor destruction via apoptosis and are used as first line therapy in patients with advanced non-small cell lung cancer (NSCLC). Procaspase-3-activating compound-1 (PAC-1) is a novel proapoptotic agent that directly activates procaspase-3 (PC-3) to caspase-3, leading to apoptosis in human lung adenocarcinoma cells.

Robotic thymectomy for thymic neoplasms.

Robotic thymectomy has been well described for the management of myasthenia gravis and thymic masses. Both short- and long-term safety and efficacy have been demonstrated. Surgical approaches vary, but the technique for thymic dissection and excision is universal.

The effect of metallic tracheal stents on radiation dose in the airway and surrounding tissues.

Background: Metallic airway stents are often used in the management of central airway malignancies. The presence of a metallic foreign body may affect radiation dose in tissue. We studied the effect of a metallic airway stent on radiation dose delivery in a phantom and an in vivo porcine model.

Internal mammary silicone lymphadenopathy diagnosed by robotic thoracoscopic lymphadenectomy.

Internal mammary lymphadenopathy can be caused by a variety of disease processes and is a difficult diagnostic dilemma. We report a case of internal mammary lymphadenopathy, in a patient with a significant history of malignancy, requiring a tissue diagnosis. Robotic thoracoscopic lymphadenectomy was used to facilitate excisional biopsy.

Role of mitral valve plication in the surgical management of hypertrophic cardiomyopathy.

Background: We have previously reported our 3-step repair for obstructive hypertrophic cardiomyopathy (HCM) consisting of resection of the septum, horizontal plication of the anterior mitral leaflet (AML), and release of abnormal papillary muscle attachments. This article reviews our complete experience with surgical management of HCM to better understand the role and relevance of mitral plication.

Methods: From 1997 to 2011, 132 patients with HCM underwent surgical treatment at our institution.

Robotic-assisted resection of an intrapericardial bronchogenic cyst.

The advantages of robotic-assisted surgery have been well described and include improved three-dimensional visualization, increased precision of dissection, and the absence of tremor. These characteristics are particularly useful in the mediastinal dissection of major vascular structures. We present a case of an intrapericardial bronchogenic cyst resected with robotic assistance.

Morbidity and mortality after hepatic and pancreatic resections: results from one surgeon at a low-volume urban hospital over thirty years.

Background: Recent reviews of state and national databases suggest that hospital volume is inversely proportional to morbidity after hepatic and pancreatic resection. Volume may be a surrogate marker for factors such as coordination of care and surgeon training. The authors hypothesized that low-volume centers can obtain acceptable outcomes if these requirements are satisfied.

The role of gender in coronary surgery.

Gender-based outcome data in coronary artery bypass graft (CABG) surgery has been the focus of extensive research over the last two decades. Increased awareness in gender-specific health and advancements in scientific research have produced evidence that risk profiles vary between genders and alter operative mortality after CABG. Some of these data remain controversial, emphasizing the complexity of gender as an independent variable and questioning processes of care that are intimately associated with outcome.

Endoscopic tracheoplasty: segmental tracheal ring resection in a porcine model.

Endoscopic tracheoplasty is used for the relief of airway obstruction because of several benign conditions such as postintubation stenosis, inflammatory disorders such as Wegener granulomatosis, and benign neoplastic processes. Several endoscopic treatment modalities exist for these conditions, all with good initial results. However, recurrence is common and often requires frequent reintervention.