Higher Versus Standard Preoperative Radiation in the Trimodality Treatment of Stage IIIa Lung Cancer.

Background: The management of potentially resectable stage III non-small cell lung carcinoma (NSCLC) is controversial. Options include induction chemotherapy or induction chemoradiation followed by resection, or chemoradiation without surgery. No trial has compared the outcomes of induction chemoradiation using different radiation doses.

Research productivity of residents and surgeons with formal research training.

Objective: The spectrum of the surgeon-scientist ranges from a clinician who participates in the occasional research collaboration to the predominantly academic scientist with no involvement in clinical work. Training surgeon-scientists can involve resource-intense and lengthy training programs, including Masters and PhD degrees. Despite high enrollment rates in such programs, limited data exist regarding their outcome.

Incidental finding and management of intralobar sequestration of the lung in a 24-year-old man.

Pulmonary sequestration is described as a dysplastic mass of lung tissue that lacks communication with the tracheobronchial tree and receives systemic rather than pulmonary arterial blood supply. Two distinct classifications, intralobar and extralobar, have been described. The present article discusses the etiology, clinical and radiographic features of pulmonary sequestration as well as the management of this condition when it is discovered incidentally.

Thoracoscopic Nuss procedure for young adults with pectus excavatum: excellent midterm results and patient satisfaction.

Background: Chest wall remodeling by substernal placement of a Nuss bar is the treatment of choice for children with pectus excavatum; however, it has not yet gained widespread acceptance in adults. We demonstrate that thoracoscopic Nuss bar insertion in young adults is safe and leads to excellent results.

Methods: Adult patients who underwent thoracoscopic Nuss bar insertion at one institution between 2006 and 2012 were identified.

Length and pressure of the reconstructed lower esophageal sphincter is determined by both crural closure and Nissen fundoplication.

Background: Laparoscopic Nissen fundoplication is comprised of: a wrap thought responsible for the lower esophageal sphincter function and crural closure performed to prevent herniation. We hypothesized gastroesophageal junction competence effected by Nissen fundoplication results from closure of the crural diaphragm and creation of the fundoplication.

Methods: Patients with uncomplicated reflux undergoing Nissen fundoplication were prospectively enrolled.

The Hill antireflux repair at 5 institutions over 25 years.

Background: Long-term (> 5 years) studies of antireflux operations are needed. This study evaluates long-term results of the open Hill repair at multiple institutions.

Methods: This is a retrospective cohort study of open Hill repairs from 1972 to 1997 at 5 North American medical centers with a mean follow-up of 10 years.

Repair of symptomatic giant paraesophageal hernias in elderly (>70 years) patients results in improved quality of life.

Introduction: Giant paraesophageal hernias (PEH) involve herniation ofstomach and/or other viscera into the mediastinum. These are usually symptomatic and commonly occur in the elderly. The benefits and risks of operating on elderly patients with giant PEH have not been clearly elucidated.

Comparison of open and minimally invasive thymectomies at a single institution.

Background: Most thymectomies are performed via sternotomy. Minimally invasive thymectomy (MIT) has been described but its potential benefits and drawbacks remain unclear.

Methods: A retrospective chart review comparing thymectomies performed via sternotomy to MIT at a single institution between 2005 and 2009.

Chronic traumatic diaphragmatic hernia.

Chronic traumatic diaphragmatic hernia is an uncommon but persistent diagnosis associated with significant morbidity and mortality. Chronic TDH describes a spectrum of disease in antecedent mechanism of injury, timing of presentation, size of diaphragmatic defect, and amount and type of tissue displaced into the chest. Multiplanar CT with coronal, sagittal, and axial reconstruction is most effective in making this diagnosis.

Early removal of postmastectomy drains is not beneficial: results from a halted randomized controlled trial.

Background: Closed-suction drainage to reduce seromas is standard after mastectomy. This study evaluates the safety of early drain removal.

Methods: Women undergoing mastectomy were randomized to early removal on postoperative day 2 or standard removal (< 30 mL drainage in 24 hours or postoperative day 14).

Combined hepatic and inferior vena cava resection for colorectal metastases.

Surgical resection continues to offer the only hope for cure of colorectal cancer metastatic to the liver. Tumor involvement of the vena cava is often viewed as a contraindication to surgical resection. Whereas proven technically feasible, the survival advantages of en bloc liver and vena cava resection remain unclear.

Aerosolized magnesium sulfate for acute asthma: a systematic review.

Background: The use of MgSO(4) is one of numerous treatment options available during exacerbations of asthma. While the efficacy of therapy with IV MgSO(4) has been demonstrated, little is known about inhaled MgSO(4).

Objectives: A systematic review of the literature was performed to examine the effect of inhaled MgSO(4) in the treatment of patients with asthma exacerbations in the emergency department.

Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: a systematic review of randomized, controlled trials.

Vertebral collapse is one of the most common fractures associated with osteoporosis. The subsequent back pain is severe and often requires medications, bed rest and hospitalization to control pain and improve mobilization. The purpose of this systematic review was to assess the effects of calcitonin versus placebo for the treatment of acute pain in patients sustaining stable, recent, osteoporotic vertebral compression fractures.

Sirolimus-based immunosuppression for liver transplantation in the presence of extended criteria for hepatocellular carcinoma.

An increasing number of patients with hepatocellular carcinoma (HCC) are undergoing evaluation for listing for liver transplantation. Criteria for selection require ongoing review for suitability. A consecutive series of 40 patients with HCC within the standard Milan criteria (single tumors n = 19 < 5 cm, or up to 3 tumors < 3 cm) and beyond (Extended Criteria; single tumors n = 21 < 7.