Multidisciplinary approach in resection of stage IIIA lung cancer with severe aortic stenosis: A case report.

Thoracic surgery in the context of complex multimorbidity and clinical deterioration presents a unique set of challenges when balancing risk and benefit. Advances in anaesthesia, surgical technique, and imaging, have allowed for operative options for patients that were once deemed too high-risk. An effective proactive multi-disciplinary approach is essential for successful outcomes.

Impact of the TNM staging system for thymoma.

Background: Masaoka-Koga staging system remains the most frequently applied clinical staging system for thymic malignancy. However, the International Association for the Study of Lung Cancer (IASLC)/International Thymic Malignancy Interest Group (ITMIG) proposed a tumor-node-metastasis (TNM) staging system in 2014. This study aims to evaluate its impact on stage distribution, clinical implementation, and prognosis for thymomas.

Risks and rewards of the surgical treatment of lung cancer in octogenarians.

Objectives: Surgeons will face an increasing number of octogenarians with lung cancer potentially curable by surgery. The goal of this study was to evaluate short- and long-term outcomes after lung resection.

Methods: We performed a single-centre study of consecutive patients ≥80 years old, surgically treated for suspected lung cancer between 2009 and 2016.

Maintaining safe lung cancer surgery during the COVID-19 pandemic in a global city.

Background: SARS-CoV-2 has challenged health service provision worldwide. This work evaluates safe surgical pathways and standard operating procedures implemented in the high volume, global city of London during the first wave of SARS-CoV-2 infection. We also assess the safety of minimally invasive surgery(MIS) for anatomical lung resection.

New N1/N2 classification and lobe specific lymphatic drainage: Impact on survival in patients with non-small cell lung cancer treated with surgery.

Objective: to validate the proposed N descriptor revision on a large cohort of patients and assess the impact of tumour location on the distribution pattern of lymph node metastases for patients with NSCLC.

Methods: This is a retrospective review of a consecutive series of patients who had anatomical lung resections. Systematic lymph node dissection was done for all patients.

Retrospective Observational Study into the Early Causes of Death Following Surgery for NSCLC.

Introduction: Respiratory failure has historically been the major cause of mortality after elective lung resections. With improved intubation using fiber-optic scopes, better preoperative respiratory risk assessment, more advanced anesthetic single lung ventilation, and minimally invasive surgical technique, this may have changed. Our objective was to assess the main causes of mortality over the past 10 years in patients undergoing elective lung surgery in a major UK center.

Prognostic factors including lymphovascular invasion on survival for resected non-small cell lung cancer.

Objectives: The aim of this study was to report on the influence of tumor lymphovascular invasion on overall survival and in patients with resected non-small cell lung cancer and identify prognostic factors for survival.

Methods: This is a retrospective observational study of a consecutive series of patients who had surgical resection of non-small cell lung cancer in a single institution. The study covers a 3-year period.

The Requirement of Sutures to Close Intercostal Drains Site Wounds in Thoracic Surgery.

Background: Chest drains are used routinely in thoracic surgery. Often a pursestring or mattress suture is used to facilitate closure of the defect on removal of the drain. This stitch can cause an unsightly scar, increase drain removal pain, and necessitate that the patient attend a community health care center to have this removed.

Clinical and quality of life outcomes following anatomical lung resection for lung cancer in high-risk patients.

Background: Surgery remains the gold standard for patients with resectable nonsmall cell lung cancer. Current guidance identifies patients with poor pulmonary reserve to fall within a high-risk cohort. The aim of this study was to determine the clinical and quality of life outcomes of anatomical lung resection in patients deemed high risk based on pulmonary function measurements.

An Isolated Traumatic Medial Third Clavicular Fracture Requiring Surgical Fixation.

Fractures of the medial clavicle are rare injuries but are associated with significant morbidity and mortality. The current trend is shifting from conservative treatment to surgical intervention to reduce long-term sequelae. We present an isolated medial clavicular fracture associated with significant displacement and demonstrate excellent results after open reduction and internal fixation.

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.

An Unusual Case of Needle Embolus Presenting With Delayed Spontaneous Pneumothorax.

We report the case of a 39-year-old man presenting with an acute right-sided traumatic pneumothorax secondary to migration of a hypodermic needle fractured during intravenous drug use. We discuss the unusual passage of this foreign body from the left groin to the right ventricular wall and into the mediastinum, ultimately presenting with a right pneumothorax 1 year later.

Perioperative Extracorporeal Membrane Oxygenation to Facilitate Lung Resection After Contralateral Pneumonectomy.

A 75-year-old man previously underwent pneumonectomy for lung cancer. He subsequently had colorectal adenocarcinoma, and resection of metastases from his remaining lung was performed. Venovenous extracorporeal membrane oxygenation was used for perioperative respiratory support to facilitate intraoperative deflation of the remaining lung and optimization of the surgical field.

Does Previous Surgical Training Impact the Learning Curve in Video-Assisted Thoracic Surgery Lobectomy for Trainees?

Background To analyze if the number of open lung resections performed by trainees before starting video-assisted thoracic surgery (VATS) lobectomy training program has any impact on intraoperative and postoperative outcomes. Materials and Methods Retrospective analysis of 46 consecutive patients who underwent VATS lobectomies between December 2011 and September 2012 by two trainees (A.B.

Thoracoscopic lobectomy: comparison of intraoperative and postoperative outcomes between 3 and 4 incision accesses.

Aims And Background: Several techniques have been proposed to perform a video-assisted thoracic lobectomy. We compared the results of a 3 versus 4-port procedure, analyzing intraoperative data, morbidity, and mortality.

Methods: Prospective analysis of 30 consecutive patients who underwent a 4-port approach video-assisted thoracic lobectomy (group A) and comparison with a historical series with 30 patients who had a 3-port video-assisted thoracic lobectomy (group B).

Pulmonary arteriovenous malformation unmasked in pregnancy: A case report.

Pulmonary arteriovenous malformations are anomalous communications between arteries and veins of the pulmonary vasculature. Its incidence is rare. Pulmonary arteriovenous malformations can be asymptomatic or cause profound cardiovascular compromise and adverse neurological sequelae, as a result of right to left shunting of deoxygenated blood.

Which stages of thymoma benefit from adjuvant chemotherapy post-thymectomy?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Which stages of thymoma benefit from adjuvant chemotherapy post thymectomy?' Altogether more than 150 papers were found using the reported search, of which only eight represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated; these studies have mainly reported the survival and recurrence rates of post-thymectomy patients who received adjuvant radiotherapy or chemoradiotherapy, and adjuvant radiotherapy alone was only used in a small group of patients in these studies.