ChatGPT vs Expert-Guided Care Pathways for Postesophagectomy Symptom Management.

Background: The objective of this study was to compare generative artificial intelligence-initiated care pathways, using ChatGPT, with expert-guided consensus-initiated care pathways from AskMayoExpert (AME) for symptom management of esophageal cancer patients after esophagectomy.

Methods: A formal protocol for development of 9 AME care pathways was followed for specific patient-identified domains after esophagectomy for esophageal cancer. Domain scores were measured and assessed through the Upper Digestive Disease tool.

Improving Patient Understanding and Outcomes in Lung Cancer Using an Animated Patient's Guide with Visual Formats of Learning.

Lung cancer patient education resources that address barriers to health literacy, improve understanding, and demonstrate improved patient outcomes are limited. Our study aim was to evaluate and report on learner knowledge improvement and intent to implement behavior change, and validate the benefits of the You and Lung Cancer website and YouTube resources. Our study occurred from November 2017 to December 2023.

Gender gap in cardiothoracic surgery randomized controlled trial and post-hoc analysis of randomized controlled trial authorship from 2014 to 2020.

Objectives: To estimate gender disparities among first and last authorships in cardiothoracic randomized controlled trials (RCTs) and association of gender with publications in high-impact journals.

Methods: PubMed/MEDLINE database was searched from 1 January 2014 to 31 December 2020 using R statistical software via the 'easyPubMed' package to retrieve pertinent data. The 'gender' package was utilized to determine gender using the United States Social Security Administration Baby Name Data.

PRO-Angoff method for remote standard setting: establishing clinical thresholds for the upper digestive disease tool.

Background: The Upper Digestive Disease (UDD) Tool™ is used to monitor symptom frequency, intensity, and interference across nine symptom domains and includes two Patient-Reported Outcome Measurement Information System (PROMIS) domains assessing physical and mental health. This study aimed to establish cut scores for updated symptom domains through standard setting exercises and evaluate the effectiveness and acceptability of virtual standard setting.

Methods: The extended Angoff method was employed to determine cut scores.

Esophagectomy Enhanced Recovery After Surgery Initiative Results in Improved Outcomes.

Background: Esophagectomy for esophageal cancer is a procedure with high morbidity and mortality. This study developed a Multidisciplinary Esophagectomy Enhanced Recovery Initiative (MERIT) pathway and analyzed implementation outcomes in a single institution.

Methods: The MERIT pathway was developed as a practice optimization and quality improvement initiative.

Patients Struggle With Severe Symptoms Even After Surviving Esophagectomy for Esophageal Cancer.

Background: This prospective study was conducted to determine postesophagectomy symptom severity of esophageal cancer survivors with use of the Upper Digestive Disease (UDD) questionnaire.

Methods: A prospective trial included adult esophagectomy patients diagnosed with primary esophageal carcinoma at a single institution from 2000 to 2011. Those who remained alive in 2015 to 2021 were enrolled.

Developing & integrating a mobile application tool into a survivorship clinic for esophageal cancer patients.

Esophageal cancer (EC) patients are living longer due to enhanced screening and novel therapeutics, however, the post-esophagectomy long-term management remains challenging for patients, caregivers, and providers. Patients experience significant morbidity and have difficulty managing symptoms. Providers struggle to manage symptoms, affecting patients' quality of life and complicating care coordination between surgical teams and primary care providers.

Esophagectomy for Cancer After One Anastomosis Gastric Bypass.

One anastomosis gastric bypass (OAGB) is growing in popularity, although it is potentially associated with biliary gastritis and gastroesophageal reflux esophagitis, with a potential rise in esophageal carcinoma. We describe the surgical management of a 53-year-old man with history of OAGB in whom biliary reflux and esophageal adenocarcinoma developed. We performed a minimally invasive Ivor Lewis esophagectomy, resected the sleeved stomach pouch, created a new conduit out of the remnant greater curve of the remnant stomach with blood supply from an intact gastroepiploic artery, and created an esophagogastric anastomosis.

Food Deserts Increase Readmission After Esophagectomy for Cancer: A Multi-institutional Study.

Background: Food deserts are low-income census tracts with poor access to supermarkets and are associated with worse outcomes in breast, colon, and a small number of esophageal cancer patients. This study investigated residency in food deserts on readmission rates in a multi-institutional cohort of esophageal cancer patients undergoing trimodality therapy.

Methods: A retrospective review of patients who underwent trimodality therapy at 6 high-volume institutions from January 2015 to July 2019 was performed.

Impact of FDG PET Standardized Uptake Value in Resected Clinical Stage IA Non-Small Cell Lung Cancer.

Background: A significant proportion of patients with clinical stage IA non-small cell lung cancer (NSCLC) experience will recurrence and decreased survival after surgery. This study examined the impact of preoperative primary tumor positron emission tomography (PET) scan maximum standardized uptake value (SUVmax) on oncologic outcomes after surgery.

Methods: This was a retrospective review of 251 patients who underwent surgical treatment of clinical stage IA NSCLC at an academic medical center (2005-2014).

Pafolacianine for intraoperative molecular imaging of cancer in the lung: The ELUCIDATE trial.

Objective: The study objective was to determine the clinical utility of pafolacianine, a folate receptor-targeted fluorescent agent, in revealing by intraoperative molecular imaging folate receptor α positive cancers in the lung and narrow surgical margins that may otherwise be undetected with conventional visualization.

Methods: In this Phase 3, 12-center trial, 112 patients with suspected or biopsy-confirmed cancer in the lung scheduled for sublobar pulmonary resection were administered intravenous pafolacianine within 24 hours before surgery. Participants were randomly assigned to surgery with or without intraoperative molecular imaging (10:1 ratio).

Impact of Federal Lung Cancer Screening Policy on the Incidence of Early-stage Lung Cancer.

Background: In December 2013 the US Preventative Services Task Force (USPSTF) recommended annual lung cancer screening for high-risk patients. The Centers for Medicare & Medicaid Services (CMS) later announced coverage in 2015. The impact of these federal decisions at the population level is unknown.

Supercharged Jejunal Interposition.

Complex esophageal reconstruction represents a high risk and challenging procedure. A dedicated pathway with multispecialty teams can facilitate a systematic checklist approach to perioperative management and evaluation of long-term outcomes. Refinements in the operative technique for supercharged pedicled jejunum (SPJ) for long segment interposition in esophageal reconstruction are reviewed in this article.

Agreement Between Upper Digestive Disease App and Provider Evaluation of Esophagectomy Symptoms in a Mobile App Tool.

Background: The objective of this study was to assess the criterion validity of score thresholds for the Upper Digestive Disease (UDD) App.

Methods: From December 15, 2017, to December 15, 2020, patients presenting after esophagectomy were offered the UDD App concurrent with a provider visit. This tool consists of 67 questions including 5 novel domains.

Preoperative Type and Screen Before General Thoracic Surgery: A Nomogram to Reduce Unnecessary Tests.

Background: A preoperative type and screen (T&S) is traditionally routinely obtained before noncardiac thoracic surgery; however an intraoperative blood transfusion is rare. This practice is overly cautious and expensive.

Methods: We included adult patients undergoing major thoracic surgery at the Mayo Clinic from 2007 to 2016.

Outcomes of Standardized Protocols in Supercharged Pedicled Jejunal Esophageal Reconstruction.

Background: This study evaluated clinical and patient-reported outcomes (PROs) of long-segment supercharged pedicled jejunal (SPJ) interposition after implementation of a dedicated multidisciplinary pathway and technical refinements.

Methods: This study was a 6-year review of consecutive patients who underwent complex esophageal reconstruction with SPJ interposition. Clinical data were abstracted, and PRO data were collected prospectively by using the Upper Digestive Disease mobile application (UDD App).

A prospective trial of CT-guided percutaneous microwave ablation for lung tumors.

Background: Percutaneous ablation is an alternative treatment for lung cancer in non-operable patients. This is a prospective clinical trial for percutaneous microwave ablation (pMWA) of biopsy-proven lung cancer to demonstrate safety and efficacy.

Methods: A prospective trial from 6-1-2016 to 1-1-2019 enrolled patients with biopsy-proven primary or metastatic lung cancer <3 cm in size and 1 cm away from the pleura for pMWA with the Emprint Ablation System with Thermosphere Technology for Phase I analysis, (Clinicaltrials.

Overview of Cardiothoracic Surgeon Compensation: Practice Setting, Productivity, and Payment Structures.

The Centers for Medicare and Medicaid Services recently proposed a substantial cut to reimbursement for surgical services, punctuating a steady decline in reimbursement for clinical services provided by cardiothoracic surgeons during the last several decades. Meanwhile, the costs of practicing cardiothoracic surgery continue to increase. In an effort to defect against diminishing control over patient care and further negative changes affecting reimbursement, cardiothoracic surgeons must be able to convincingly demonstrate their value to patients and the health care system.