Lobectomy Is Not Associated With Improved Survival as Compared to Segmentectomy in Early-Stage Lung Cancer Patients With Visceral Pleural Invasion.

Objective: The purpose of this study is to utilize a representative national sample to compare survival outcomes of patients with visceral pleural invasion (VPI) who underwent either a lobectomy or a segmentectomy.

Methods: National Cancer Database from 2010 to 2019 was utilized. Patients with tumor size ≤ 2 cm, with VPI, non-small cell lung cancer (NSCLC), with a known vital status were included in the study.

Metrics for Perioperative Exercise in Patients Undergoing Lung Cancer Resection: A Systematic Review.

Perioperative exercise interventions have been shown to mitigate morbidity associated with lung resection. While these interventions have established a role in this patient population, there has been little discussion regarding which metrics are used to standardize perioperative exercise interventions. A better understanding of these metrics is needed to define best practices and ensure interventions are reproducible.

Association Between Utilization of Services and Perioperative Outcomes for Lung Cancer Resection.

Introduction: Lung cancer resection has largely focused on perioperative outcomes (eg, mortality) to benchmark performance. While variations in perioperative outcomes and in utilization of services (eg, ambulatory procedures, hospitalization) have been independently demonstrated, there has been limited evaluation of associations between these outcomes. We evaluated the association between perioperative outcomes and utilization of services to evaluate provider performance across a broader context of care.

Factors Associated With Margin Positivity After Lung Resection Surgery.

Introduction: The purpose of this study is to utilize a representative national sample to investigate the factors associated with margin positivity after attempted surgical resection. Given the changes in surgical approaches to lung cancer for the last 10 years, margin positivity and outcomes between robotic, video assisted thoracoscopic surgery (VATS) and open surgical resections may vary.

Methods: This retrospective cohort study utilized the National Cancer Database.

Association between surgical quality and long-term survival in lung cancer.

Objectives: There are significant variations in both perioperative and long-term outcomes after lung cancer resection. While perioperative outcomes are often used as comparative measures of quality, they are unreliable, and their association with long-term outcomes remain unclear. In this context, we evaluated whether historical perioperative mortality after lung cancer resection is associated with 5-year survival.

Wedge Resection Outcomes: A Comparison of Video-Assisted and Robot-Assisted Wedge Resections.

Background: Quality of oncologic resection for early-stage non-small cell lung cancer (NSCLC) may differ by surgical approach. Minimally invasive surgery has become the standard for surgical treatment of NSCLC. Our study compares quality of wedge resection by video-assisted thoracoscopic surgery (VATS) vs robotic video-assisted thoracoscopic surgery (RVATS).

Access to Guideline Concordant Care for Node-Positive Non-Small Cell Lung Cancer in the United States.

Background: This study sought to determine whether seeking care at multiple Commission on Cancer (CoC) hospitals is associated with different rates of receiving guideline-concordant care (GCC) among patients with non-small cell lung cancer (NSCLC).

Methods: The National Cancer Database was queried for the years 2004 to 2018 for patients with margin-negative pT1 to pT3 N1 to N2 M0 noncarcinoid NSCLC without neoadjuvant therapy. GCC was defined as chemotherapy for pN1 disease and as chemotherapy with or without radiation for pN2 disease.

Is wedge a dirty word? Demographic and facility-level variables associated with high-quality wedge resection.

Objectives: Although sublobar resections have gained traction, wedge resections vary widely in quality. We seek to characterize the demographic and facility-level variables associated with high-quality wedge resections.

Methods: The National Cancer Database was queried from 2010 to 2018.

Intraoperative Versus Preoperative Diagnosis of Lung Cancer: Differences in Treatments and Patient Outcomes.

Objectives: Non-small cell lung cancer (NSCLC) is frequently diagnosed during surgical resection. It remains unclear if lack of preoperative tissue diagnosis influences likelihood of receipt of guideline-concordant care or postoperative outcomes.

Methods: A retrospective cohort analysis was completed utilizing the National Cancer Database for patients undergoing lung resection with clinical stage 1 NSCLC from 2004 to 2018.

Robotic Minimally Invasive Esophagectomy.

Robotic minimally invasive esophagectomy can be safely performed by adhering to key technical principles. Careful development of the gastric conduit with attention to blood supply and conduit orientation is critical. During thoracic dissection, capnothorax can distort the proximity of key mediastinal structures.

Race is a Risk Factor for the Deferral of Resection and Radiation for Early-Stage Lung Cancer.

Purpose: There remain profound race-related disparities in the treatment of non-small cell lung cancer (NSCLC). Deferral of operative management for early-stage disease is recognized as driver of this disparity. Black race has been associated with higher rates of surgical deferral.

Surgical Outcomes in the National Lung Screening Trial Compared With Contemporary Practice.

Background: The National Lung Screening Trial (NLST) established a role for lung cancer screening. Mortality benefits with screening are predicated on successful treatment with low surgical mortality. Given variations observed in perioperative outcomes after lung cancer resection, it remains unknown whether benefits observed in the NLST are generalizable to a broader population.

Facility-level national trends in racial disparities of surgical therapy for early-stage lung cancer.

Objective: The racial gap in surgical treatment for early-stage non-small cell lung cancer (NSCLC) has been narrowing at the population level, but it is unknown if this trend persists at the facility level.

Patients And Methods: We queried the National Cancer Database Participant User File from 2006 to 2016 for patients with stage I NSCLC. Facilities were grouped by type, location, and resection volume.

Extracorporeal life support and cardiopulmonary bypass for central airway surgery: A systematic review.

Background: Major airway surgery can pose a complex problem to perioperative central airway management. Adjuncts to advanced ventilation strategies have included cardiopulmonary bypass, veno-arterial, or veno-venous extracorporeal life support. We performed a systematic review to assess the existing evidence utilizing these strategies.

Outcomes in Lung Cancer Surgery: Capturing Reliable Metrics.

Background: Measuring variation in perioperative outcomes to accurately discriminate performance between surgical providers may be limited by reliability. We aimed to evaluate reliability estimates of metrics associated with lung cancer resection.

Methods: We performed a retrospective cohort study utilizing the 2015 National Cancer Database to identify patients undergoing lung cancer resection.

Incidence, Burden on the Health Care System, and Factors Associated With Incisional Hernia After Trauma Laparotomy.

Importance: The evidence provided supports routine and systematic capture of long-term outcomes after trauma, lengthening the follow-up for patients at risk for incisional hernia (IH) after trauma laparotomy (TL), counseling on the risk of IH during the postdischarge period, and consideration of preventive strategies before future abdominal operations to lessen IH prevalence as well as the patient and health care burden.

Objective: To determine burden of and factors associated with IH formation following TL at a population-based level across health care settings.

Design, Setting, And Participants: This population-based cohort study included adult patients who were admitted with traumatic injuries and underwent laparotomy with follow-up of 2 or more years.

Similar Quality of Life After Conventional and Robotic Transhiatal Esophagectomy.

Background: Patient-reported outcomes (PROs) for minimally invasive esophagectomy (MIE) have demonstrated benefits compared with open transthoracic or 3-hole esophagectomy. PROs, including quality of life (QoL) and fear of recurrence (FoR), comparing open transhiatal esophagectomy (THE) and transhiatal robotic-assisted MIE (Th-RAMIE) have been limited.

Methods: At a single, high-volume academic center, patients undergoing THE and Th-RAMIE with gastric conduit for clinical stage I to III esophageal cancer from 2013 to 2018 were evaluated.

Nina Braunwald: The First Female Cardiothoracic Surgeon.

Dr Nina Braunwald is celebrated for her work as the first female cardiothoracic surgeon and her key role in the design and implementation of the first prosthetic mitral valve. She began her residency at Bellevue Hospital in 1952, a time in the United States where the scope of women's work was limited. Once her training took her to the National Institutes of Health (NIH), her historic flexible leaflet valve was developed and Dr Braunwald paved an innovative step toward the advanced prostheses of today.