New-onset atrial fibrillation after anatomic lung resection: predictive factors, treatment and follow-up in a UK thoracic centre.

Objectives: Postoperative atrial fibrillation (POAF) increases morbidity, hospital stay and healthcare expenditure. This study aims to determine the perioperative factors correlating with POAF as well as to evaluate both treatment strategies and AF persistence beyond discharge.

Methods: The records of all patients undergoing anatomical lung resection over a 1-year period were retrospectively reviewed.

Prognostic factors for survival after surgical palliation of malignant pleural effusion.

Introduction: To investigate prognostic factors for patient survival after surgical palliation of malignant pleural effusion (MPE).

Method: We reviewed 278 consecutive nonoverseas patients (108 men, median age: 60 years [range 26-89]) undergoing 310 surgical procedures for palliation of MPE over a 72-month period. There were 195 thoracoscopic talc pleurodesis, 39 pleuroperitoneal shunts, 38 pleurodesis by an intercostal drain, 29 pleural biopsies alone, and nine long-term drains.

Prolonged survival due to spontaneous regression and surgical excision of malignant mesothelioma.

We report a case of malignant pleural mesothelioma with histologically proven spontaneous regression of pleural disease. During a 12-year follow-up there was a single recurrence, which was a lesion in the chest wall at 6 years that was surgically excised. A prominent host response to tumor was seen in both the primary tumor and the recurrence.

Abdominal compartment syndrome: a rare complication of plication of the diaphragm.

Abdominal compartment syndrome is an increasingly recognized phenomenon. We report the case of an otherwise fit and healthy 42-year-old man who underwent plication of the right hemidiaphragm for idiopathic phrenic paresis. His postoperative recovery was complicated by abdominal compartment syndrome, which was managed conservatively.

A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients.

Objective: Sublobar resections may offer a method of increasing resection rates in patients with lung cancer and poor lung function, but are thought to increase recurrence and therefore compromise survival for stage I non-small cell lung cancer (NSCLC). To test this hypothesis we have compared the long-term outcome from lobectomy and anatomical segmentectomy in high-risk cases as defined by predicted postoperative FEV1 (ppoFEV1) less than 40%.

Methods: Over a 7-year period 55 patients (27% of all resections for stage I NSCLC) with ppoFEV1<40% underwent resection of stage I NSCLC.

The effect of extent of local resection on patterns of disease progression in malignant pleural mesothelioma.

Background: We sought to determine whether or not there are differences in disease progression after radical or nonradical (debulking) surgical procedures for malignant pleural mesothelioma.

Methods: Over a 49-month period, 132 patients with malignant pleural mesothelioma underwent surgery. Fifty-three underwent extrapleural pneumonectomy and 79 underwent nonradical procedures.

Salvage intensive care following initial recovery from pulmonary resection: is it justified?

Background: There is little objective evidence concerning the outcome of thoracic surgical patients who suffer postoperative complications. We assessed the outcome and cost of care for patients admitted to the intensive care unit after initial recovery from pulmonary resection in a high dependency unit.

Methods: In a single surgeon's practice, over a 3-year period, 28 patients [22 male, median age 66 years old (range 48-80 years old)] required intensive care admission.