Publications by authors named "Peter Kneuertz"

Purpose: Neoadjuvant therapy (NT) is increasingly used for gastrointestinal (GI) and hepatopancreatobiliary (HPB) cancers. Risk factors for surgical attrition during NT are poorly understood. A planned secondary analysis of patient-reported outcomes (PROs) from a prospective cohort study of patients undergoing NT was performed to identify factors associated with surgical attrition.

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Objective: Chat-based artificial intelligence programs like ChatGPT are reimagining how patients seek information. This study aims to evaluate the quality and accuracy of ChatGPT-generated answers to common patient questions about lung cancer surgery.

Methods: A 30-question survey of patient questions about lung cancer surgery was posed to ChatGPT in July 2023.

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Thoracic endovascular aortic repair (TEVAR) enables rapid and effective treatment of life-threatening aortic injuries. The occurrence of long-term complications from TEVAR and their management is ill-defined in young patients. This report describes a complex case of a 38-year-old male patient who underwent staged interventions for different acute pathologies instigated by blunt thoracic spinal trauma.

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Background: In the early 2000s, a significant shortage of cardiothoracic surgeons was predicted. We sought to evaluate our specialty's progress and to update the predicted needs of cardiothoracic surgeons in the coming decades.

Methods: To assess the supply of cardiothoracic surgeons, the evolution of cardiothoracic surgery training was reviewed.

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Early-stage lung cancer patients are increasingly considered for preoperative systemic therapy. Older adults in particular are among the most vulnerable patients, with little known on how preoperative therapies affect the risk-benefit of surgery. We sought to summarize the current literature and elucidate existing evidence gaps on the effects of prehabilitation interventions relative to age-related functional impairments and the unique needs of older patients undergoing lung cancer surgery.

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Article Synopsis
  • - Lung cancer, diagnosed at a median age of 70, poses serious health challenges for older Americans, particularly after surgery, where patients face issues like pain and diminished physical function.
  • - A study involving 382 older adults with lung cancer will compare two approaches: telephone-based physical activity coaching versus self-monitoring of physical activity, focusing on their impact on functional capacity and quality of life.
  • - The primary goal is to see if coaching can improve patients' performance on a 6-minute walk test and overall well-being 30 days post-surgery, while also addressing the needs of their family caregivers.
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Article Synopsis
  • Giant calcified thoracic discs pose surgical challenges due to their central location and calcification, leading to complications like CSF leaks and pleural fistulas after removal; traditional treatments often involve CSF diversion and direct repair.* -
  • A case study of a 45-year-old man with severe thoracic myelopathy revealed that the removal of a calcified disc caused a significant dural defect, necessitating a novel salvage technique after standard treatments failed.* -
  • The innovative use of a rotational pedicled latissimus dorsi flap, along with additional surgical methods for sealing the dural defect, ultimately restored the patient's functional independence post-surgery.*
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Esophagectomy remains a procedure with one of the highest complication rates. Given the advances in medical and surgical management of patients and increased patient survival, the number of complications reported has increased. There are different grading systems for complications which vary based on severity or organ system, with the Esophageal Complications Consensus Group unifying them.

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Neoadjuvant immunotherapy has gone from an idea to an indication in locally advanced lung cancer. Several phase III trials have demonstrated the superiority of neoadjuvant chemoimmunotherapy compared with chemotherapy in this setting. Although such progress has revolutionized the treatment of locally advanced disease, the unmet needs of stage I and stage II patients without lymph node disease have largely been underrepresented in existing trials.

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A 39-year-old woman originally from Northeast Africa sought medical attention for positional dyspnea. Computed tomography of the chest revealed an 8.5 cm hypodense anterior mediastinal mass with peripheral calcifications that raised a wide differential diagnosis including infectious and neoplastic lesions.

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Sublobar resection for early-stage non-small cell lung cancer has been an emerging topic of great interest to thoracic surgeons. However, data regarding the efficacy and safety of sublobar resection vs lobectomy was lacking until now. Recently, 3 published randomized controlled trials (Cancer and Leukemia Group B [CALGB]140503/Alliance, Japan Clinical Oncology Group [JCOG]0802 and Das Deutsche Register Klinischer Studien [DRKS]00004897) confirmed the noninferiority of sublobar resection for early-stage non-small cell lung cancer in carefully selected populations.

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Background: While surgery is generally necessary for most solid-organ cancers, curative-intent resection is occasionally aborted due to unanticipated unresectability or occult metastases. Following aborted cancer surgery (ACS), patients have unique and complex care needs and yet little is known about the optimal approach to their management.

Objective: The aim of this study was to define the practice patterns and perspectives of an international cohort of cancer surgeons on the management of ACS.

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Purpose Of Review: Patient-reported outcomes (PROs) are increasingly recognized as a clinical tool for measuring and improving patient-centric care. This review provides a summary on recent advances in the use of PROs in the field of thoracic surgery.

Recent Findings: PROs have been used as primary endpoints in clinical trials and observational studies evaluating clinical care pathways and quantifying the benefits of minimally invasive surgical techniques for patients undergoing lung surgery.

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In the era of free flap reconstruction, mandibular defects are routinely reconstructed with osseous free flaps, and non-free flap bony reconstruction options are limited. A patient with T4N0 mandibular squamous cell carcinoma underwent resection with fibula free flap reconstruction of a parasymphyseal to angle defect. After free flap failure due to venous congestion, the flap was explanted.

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This case series describes 2 patients who underwent a single anesthesia strategy for definitive management of bilateral ground-glass opacities harboring adenocarcinoma-spectrum lesions using robotic navigational localization paired with robotic thoracoscopic resection.

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Objective: To use a customized smartphone application to prospectively measure QOL and the real-time patient experience during neoadjuvant therapy (NT).

Background: NT is increasingly used for patients with localized gastrointestinal (GI) cancers. There is little data assessing patient experience and quality of life (QOL) during NT for GI cancers.

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