The quality of published paediatric audits and their standards.

Objective: Audit is a recognised tool for evaluating the performance and improving the quality of health services. In Ireland and the UK, clear resources are available outlining audit elements. This study was undertaken to evaluate paediatric audits published from 2007 to 2020 to determine the adherence level to the definition of audit and to assess the quality of audit standards.

Planned Peri-Extubation Fasting in Critically Ill Children: An International Survey of Practice.

Introduction: Cumulative energy/protein deficit is associated with impaired outcomes in pediatric intensive care Units (PICU). Enteral nutrition is the preferred mode, but its delivery may be compromised by periods of feeding interruptions around procedures, with peri-extubation fasting the most common procedure. Currently, there is no evidence to guide the duration of the peri-extubation fasting in PICU.

Successful Management of a COVID-19 Positive Infant With Transposition of the Great Arteries.

A six-week-old infant presented in extremis and was diagnosed with dextro-transposition of the great arteries, intact ventricular septum, features of left ventricular deconditioning, and abnormal coronary arteries. Treatment with prostaglandin E1 and balloon atrial septostomy was insufficient, necessitating extracorporeal membrane oxygenation (ECMO). Severe acute respiratory syndrome coronavirus-2 was detected.

Non-intercostal access for video-assisted thoracic surgery-analysis of technical advantages and disadvantages.

Background: Video-assisted thoracoscopic surgery (VATS) lobectomy has become an accepted method for the treatment of early-stage non-small-cell lung cancer (NSCLC). The standard VATS approach is an intercostal one which is often followed by postoperative pain due to injury of the intercostal nerve. The non-intercostal techniques of VATS include the subxiphoid, transcervical, transdiaphragmatic and transoral procedures.

Transcervical uniportal pulmonary lobectomy.

Background: The aim of the study is a description of surgical technique of uniportal transcervical video-assisted thoracoscopic surgery (VATS) for pulmonary lobectomy.

Methods: We used a collar neck incision (transcervical) of an average length 5-8 centimeters. The manubrium of the sternum is elevated with a hook connected to the Zakopane II frame (Aesculap-Chifa, B.

Opportunity Costs in Paediatric Training: The Specialist Registrars Experience.

In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression, 2) perceived functional effectiveness at work, 3) psychological impact of hospital based training, and 4) the personal and social cost of training.

Subxiphoid uniportal VATS thymectomy.

Background: To present the technique of minimally invasive extended thymectomy performed through the uniportal subxiphoid approach, with double elevation of the sternum for nonthymomatous myasthenia gravis (MG).

Methods: Operative technique: the whole dissection was performed through the 4-7 cm transverse or longitudinal subxiphoid incision with use of videothoracoscope. The sternum was elevated with two hooks connected to the sternal frame (Rochard bar, Aesculap-Chifa, Nowy Tomysl, Poland).

The Zakopane Pulmonary Hospital experience on subxiphoid thymectomy.

Background: To present the technique of minimally invasive extended thymectomy performed through the subxiphoid-bilateral subcostal video-assisted thoracoscopic surgery (VATS) approach, with double elevation of the sternum for nonthymomatous myasthenia gravis (MG).

Methods: The whole dissection was performed through the 4-7 cm transverse subxiphoid incision with single 10 mm extra-long bariatric laparoscopy ports inserted subcostally to the right and left chest cavities for videothoracoscope and subsequently for chest tubes. The sternum was elevated with two hooks connected to the sternal frame (Rochard bar, Aesculap-Chifa, Nowy Tomysl, Poland).

Uniportal transcervical video-assisted thoracoscopic surgery (VATS) approach for pulmonary lobectomy combined with transcervical extended mediastinal lymphadenectomy (TEMLA).

Background: To present the technique of uniportal transcervical video-assisted thoracoscopic surgery (VATS) approach for pulmonary lobectomy combined with transcervical extended mediastinal lymphadenectomy (TEMLA).

Methods: Transcervical extended approach utilizes a typical a 5-8 centimeters collar incision in the neck. The critical technical point enabling a wide access to the chest is an elevation of the sternal manubrium with a special retractor (modified Rochard frame, Asculap-Chifa Company).

Resection of thymomas with use of the new minimally-invasive technique of extended thymectomy performed through the subxiphoid-right video-thoracoscopic approach with double elevation of the sternum.

Objectives: To present the new technique of minimally invasive extended thymectomy performed through the subxiphoid-right video-thoracoscopic (VATS) approach with double elevation of the sternum and the early results of resection of thymomas with the use of this technique.

Operative Technique: whole dissection was performed through a 4- to 7-cm transverse subxiphoid incision, and a single 5-mm port was inserted into the right chest cavity for the video thoracoscope and subsequently for the chest tube. The sternum was elevated with two hooks connected to the sternal frame (Rochard bar, Aesculap-Chifa, Nowy Tomysl, Poland).

[Transcervical Extended Mediastinal Lymphadenectomy (TEMLA) for staging of non-small-cell lung cancer (NSCLC)].

Introduction: The aim of the study is to analyze diagnostic yield of the new surgical technique--the Transcervical Extended Mediastinal Lymphadenectomy (TEMLA) in preoperative staging of Non-Small-Cell Lung Cancer (NSCLC).

Material And Methods: Operative technique included 5-8 cm collar incision in the neck, elevation of the sternal manubrium with a special retractor, bilateral visualization of the laryngeal recurrent and vagus nerves and dissection of all mediastinal nodal stations except of the pulmonary ligament nodes (station 9).

Results: 698 patients (577 men, 121 women), of mean age 62.

Comparison of complete remission rates after 5 year follow-up of three different techniques of thymectomy for myasthenia gravis.

Objective: This study aims to analyse the effectiveness of treatment of myasthenia gravis with three different techniques of thymectomy.

Methods: Results of complete remission rates after 5-year follow-up of 60 patients who underwent basic transsternal thymectomies (group A) from 1 January 1996 to 31 December 1997, 75 patients who underwent extended transsternal thymectomies (group B) from 1 January 1998 to 30 June 2000 and 291 patients who underwent transcervical-subxiphoid-videothoracoscopic 'maximal' thymectomy (group C) from 1 September 2000 to 31 January 2009 were compared.

Results: There were no differences between groups according to patient's characteristics and postoperative complications' rate.

Non-small-cell lung cancer restaging with transcervical extended mediastinal lymphadenectomy.

Background: To analyse a diagnostic yield of the transcervical extended mediastinal lymphadenectomy (TEMLA) in restaging of the mediastinal nodes after neoadjuvant chemo- or chemo-radiotherapy for non-small-cell lung cancer (NSCLC).

Methods: From 1 January 2004 to 30 April 2009, 63 patients who underwent induction chemotherapy or chemo-radiotherapy for N2 and N2/3 metastatic nodes discovered preoperatively were restaged. There were 12 women and 51 men in the age group of 43-71 (mean 57.

Staging algorithm for diffuse malignant pleural mesothelioma.

An algorithm of preoperative mediastinal nodal staging with endobronchial/endoesophageal ultrasonography (EBUS/EUS) and transcervical extended mediastinal lymphadenectomy (TEMLA) combined with laparoscopy/peritoneal lavage and cytology was analyzed to establish the realistic criteria for radical multimodality treatment of malignant pleural mesothelioma (MPM). The algorithm included computed tomography (CT), thoracoscopy with multiple pleural biopsies and talc pleurodesis, EBUS/EUS and one-stage TEMLA and laparoscopy/peritoneal lavage and cytology of the fluid. Forty-two patients were diagnosed from 1 January 2004 to 31 December 2008.

Technique of the transcervical-subxiphoid-videothoracoscopic maximal thymectomy.

Background: The aim of this study is to present the new technique of transcervical-subxiphoid-videothoracoscopic "maximal"thymectomy introduced by the authors of this study for myasthenia gravis.

Materials And Methods: Two hundred and sixteen patients with Osserman scores ranging from I-III were operated on from 1/9/2000 to 31/12/2006 for this study. The operation was performed through four incisions: a transverse 5-8 cm incision in the neck, a 4-6 cm subxiphoid incision and two 1 cm incisions for videothoracoscopic (VTS) ports.

The right upper lobe pulmonary resection performed through the transcervical approach.

Objective: Preliminary report: presentation of the new technique of transcervical right upper lobectomy with transcervical extended mediastinal lymphadenectomy (TEMLA) for NSCLC.

Methods: Two patients underwent the operation that was performed through the collar incision, with elevation of the sternal manubrium with the mechanical sternal retractor. TEMLA and bilateral mediastinal lymph node excision (stations 1, 2R, 4R, 2L, 4L, 3A, 3P, 7 and 8) and bilateral supraclavicular lymph node excision were performed (frozen section analysis: all nodes negative).

Extended rethymectomy in the treatment of refractory myasthenia gravis: original video-assisted technique of resternotomy and results of the treatment in 21 patients.

Unlabelled: The aim of the study was to analyze the impact of extended rethymectomy in patients with myasthenia gravis. Additionally, an original technique of resternotomy is described. Extended rethymectomy was performed on 21 patients with refractory myastenic symptoms after a previous transsternal thymectomy.

Transcervical extended mediastinal lymphadenectomy.

Transcervical extended mediastinal lymphadenectomy (TEMLA) is a new procedure for bilateral excision of all nodal stations of the mediastinum, except for the pulmonary ligament nodes (station 9) and the most distal left lower paratracheal nodes (station 4L). The procedure is performed through a transverse 5-8 cm incision in the neck with elevation of the sternum with a traction device facilitating the access to the mediastinum. Most of the procedure is performed with an open technique, while the removal of the subcarinal (station 7) and periesophageal nodes (station 8) is performed with the mediastinoscopy assisted technique and excision of the paraaortic nodes (station 6), the aorta-pulmonary window nodes (station 5) and, sometimes, the prevascular nodes (station 3A) is performed with the aid of a videothoracoscope introduced to the mediastinum through the neck incision, without violating the pleura.

Transcervical extended mediastinal lymphadenectomy--the new operative technique and early results in lung cancer staging.

Objective: Mediastinal staging is one of the most important problems in thoracic surgery. Although the pathological examination is a generally accepted standard, none of the currently used techniques enables complete removal of all lymph node stations of the mediastinum. The aim of the study is to present a new technique of transcervical extended mediastinal lymphadenctomy (TEMLA) and to analyze its value in lung cancer staging.

Transcervical-subxiphoid-VATS "maximal" thymectomy for myasthenia gravis.

A maximally extended thymectomy is performed through four incisions: a transverse 5-8 cm incision in the neck, a 4-6 cm subxiphoid incision and two 1 cm incisions for videothoracoscopic ports. The cervical part of the procedure is performed with an open technique, the intrathoracic part of the procedure is performed with the videothoracoscopy assisted (VATS) technique. The whole thymus with the surrounding fatty tissue containing possible ectopic foci of the thymic tissue is removed.

Safety for preoperative use of steroids for transsternal thymectomy in myasthenia gravis.

Objective: Effects of preoperative steroids on morbidity and mortality after transsternal thymectomy are analyzed.

Methods: There were 620 transsternal thymectomies for myasthenia gravis performed in the period 1973-2002. There were 547 patients with nonthymomatous myasthenia, including 17 patients submitted to repeated thymectomy (rethymectomy) and 46 patients with thymoma.