Pneumonectomy Space Infection After Thoracic Duct Embolization.

Thoracic duct embolization has gained widespread acceptance as an effective treatment of postoperative chylothorax. We describe a patient with chylothorax after pneumonectomy requiring thoracic duct embolization who presented again with a pneumonectomy space infection. Bacterial culture was positive for gastrointestinal flora, which suggests that the pleural space was inoculated at the time of thoracic duct embolization.

Primary pulmonary leiomyosarcoma with invasion of the pulmonary vein-A case report.

Introduction: Primary pulmonary leiomyosacromas are a subset of the rare sarcomatous lung neoplasms, found to be less than 0.5% of the organ's primary malignant tumors (Attanoos et al., 1996).

When the Gastrointestinal Conduit for Total Esophageal Reconstruction Is Not an Option: Review of the Role of Skin Flaps and Report of Salvage With a Single-Stage Tubed Anterolateral Thigh Flap.

This review adds to the limited body of literature describing the use of skin flaps for reconstruction of the esophagus and includes a report of a successful 1-stage, intrathoracic reconstruction of the cervical and thoracic esophagus after failed gastrointestinal conduit. Already widely used for reconstruction of the pharynx and cervical esophagus, the versatile anterolateral thigh flap can be considered an option for more extensive defects of the cervical and thoracic esophagus in this challenging patient population when gastric, jejunal, or colon conduits are not available. The authors believe the anterolateral thigh flap should be considered in 1-stage anatomic reconstruction of the cervical and thoracic esophagus in the absence of feasible gastrointestinal conduits.

First nationwide survey of US integrated 6-year cardiothoracic surgical residency program directors.

Objective: The recently implemented integrated 6-year (I-6) format represents a significant change in cardiothoracic surgical residency training. We report the results of the first nationwide survey assessing I-6 program directors' impressions of this new format.

Methods: A 28-question web-based survey was distributed to program directors of all 24 Accreditation Council for Graduate Medical Education-accredited I-6 training programs in November 2013.

Impact of a six-year integrated thoracic surgery training program at the Medical College of Wisconsin.

Background: Thoracic residency program enrollment continues to decline. While job market and decreasing reimbursements are often cited as the main reasons, length of and format of training may also be significant.

Methods: The Medical College of Wisconsin established an Accreditation Council for Graduate Medical Education-approved 6-year integrated thoracic training program.

Roux-en-Y diversion for debilitating reflux after esophagectomy.

Two patients with debilitating reflux after esophagectomy are reported. Complete relief of symptoms after creation of a Roux-en-Y limb to the gastric conduit is described.

Serratus anterior in vivo contractile force study.

Background: A major limitation of functional muscle transfer for facial and intrinsic hand reanimation is the inability to predict the force that will be generated by the transplanted muscle.

Methods: The authors studied the contractile force of the slips of the serratus anterior in situ in 10 patients and tested the gracilis muscle in four subjects as a control.

Results: Mean contractile force generated by each serratus slip was 0.

A novel approach to the management of tracheoinnominate artery fistula.

A 75-year-old gentleman with tracheoinnominate fistula is reported. The issues regarding the surgical approach to this problem are reviewed and a creation of an aorto-axillary bypass graft described.