Disparities and Underutilization of Surgery for Early Stage Small Cell Lung Cancer.

Background: The National Comprehensive Cancer Network recommends surgical resection for stage I small cell lung cancer (SCLC). Despite these recommendations and the curative potential of such surgery, many continue to underutilize surgery. Our aim is to investigate factors that contribute to underutilization of surgery for stage I SCLC.

Becoming a Cardiothoracic Surgical Educator.

Cardiothoracic training continues to evolve and is a completely different teaching environment than prior. Cardiothoracic surgical educators are tasked to ensure that all levels of learners are appropriately trained. To be an effective surgical educator, one must expand their skills beyond being content experts but also acquire knowledge of educational theory and formal training in how to teach effectively.

Single Setting Robotic Lung Nodule Diagnosis and Resection.

Lung cancer remains the leading cause of cancer-related deaths. Early tissue diagnosis followed by timely therapeutic procedures can have a significant impact on overall survival. While robotic-assisted lung resection is an established therapeutic procedure, robotic-assisted bronchoscopy is a more recent diagnostic procedure that improves reach, stability, and precision in the field of bronchoscopic lung nodule biopsy.

Trends in segmentectomy for the treatment of stage 1A non-small cell lung cancers: Does the robot have an impact?

Objectives: Lobectomy may unnecessarily resect healthy lung parenchyma in Stage 1A non-small cell lung cancers (NSCLC). Segmentectomies may provide a lung-sparing option. VATS segmentectomies can be technically challenging; robotics may have features that provide advantages in performing segmentectomies.

The lasting footprint of COVID-19 on surgical education: A resident and attending perspective on the global pandemic.

Background: The COVID-19 pandemic has impacted surgical training nationwide. Our former curricula will likely not return, and training will need to adapt, so we are able to graduate residents of the same caliber as prior to the pandemic.

Methods: A survey evaluating perceptions of changes made in surgical training was conducted on surgery residents and attendings.

Management of Complications in Paraesophageal Hernia Repair.

Paraesophageal hernia repair is a technically challenging operation. Factors that influence morbidity of the operation include the timing of the operation, surgical approach, and patient factors. Medical complications are the most common and usually are respiratory or cardiac related.

Does the Approach Matter? Comparing Survival in Robotic, Minimally Invasive, and Open Esophagectomies.

Background: Our objective was to determine how surgical approach impacts overall survival and postoperative outcomes when comparing robotic-assisted minimally invasive esophagectomy (RAMIE), minimally invasive esophagectomy (MIE), and open esophagectomy (OE).

Methods: The National Cancer Database was queried for patients diagnosed with pathologic Stage 0 to III esophageal cancer from 2010 to 2015. Primary outcome measures evaluated were length of stay, 30-day unplanned readmissions, mortality rates at 30 and 90 days, and overall survival rates.

Versatility of a mini-trapdoor incision in upper mediastinal exposure.

Exposure of the upper mediastinum and thoracic outlet can pose major surgical challenges. We report our application of a previously described mini-trapdoor incision to a variety of surgical problems involving the upper mediastinum and thoracic outlet, including subclavian vein thrombosis, penetrating subclavian artery injury, debridement of subjacent chest wall infection, lymph node excision, and Pancoast tumor resection. This versatile approach provides excellent structural visualization while obviating clavicular resection or sternoclavicular joint disruption, or both.

The use of human acellular dermal matrix for chest wall reconstruction.

Background: Reconstruction of chest wall defects has evolved, but challenges remain. This is particularly true when defects are large or contamination is present. Although numerous materials are available for reconstruction, acellular dermal matrix has the advantage of becoming vascularized and incorporated autologously.