Conservative surgery for renal cell carcinoma has been widely diffused and performed in the last 15 years. It showed excellent oncological results in imperative and then elective indications. A greater number of small renal lesions are now being discovered, and elective partial nephrectomy has been adopted more frequently for the treatment of such tumours. However results regarding morbidity are extremely variable in the literature and the overall complication rate after NSS ranges between 4% and 30%. Fortunately, better patient selection, operating techniques, perioperative care, and surgical experience have guaranteed a significant reduction of complication in the last decade. The purpose of this review was to assess the incidence of complications of conservative renal surgery for renal cell carcinoma and to discuss treatment modalities.
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Crit Care Resusc
December 2024
Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
Background: Severe intensive care unit-acquired hypernatraemia (ICU-AH) is a serious complication of critical illness. However, there is no detailed information on how this condition develops.
Objectives: The objective of this study was to study the prevalence, risk factors, trajectory, management, and outcome of severe ICU-AH (≥155 mmol·L).
JTCVS Open
December 2024
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
Objective: Evaluate sex differences in patients undergoing repair of acute type A aortic dissection (ATAAD).
Methods: Sex-stratified, single-center cohort study of patients undergoing ATAAD repair from 1997 to 2022. The primary outcome was aortic diameter at time of presentation with ATAAD.
JTCVS Open
December 2024
Thoracic and Cardiovascular Surgery Department, Sorbonne Université, APHP, Groupe Hospitalier Pitié-Salpétrière, Institute of Cardiology, Paris, France.
Objective: The study objective was to evaluate outcomes of patients directly bridged with venoarterial extracorporeal membrane oxygenation to heart transplantation.
Methods: A single-center retrospective study was performed on 1152 adult patients undergoing isolated cardiac transplantation between January 2007 and December 2021. Among these, patients bridged with an extracorporeal membrane oxygenation to transplantation (extracorporeal membrane oxygenation group, n = 317) were compared with standard cohorts of patients (no extracorporeal membrane oxygenation group, n = 835).
JTCVS Open
December 2024
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
Objective: Previous retrospective studies have established a relationship between postoperative hypoglycemia and adverse outcomes after cardiac surgery, but none have accounted for the cause of hypoglycemia.
Methods: A retrospective review was performed of patients who underwent cardiac surgery at a single institution between 2016 and 2021. Patients were categorized as hypoglycemic if they had 1 or more postoperative blood glucose measurement less than 70 mg/dL and normoglycemic otherwise.
JTCVS Open
December 2024
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
Objective: To develop a model for preoperatively predicting postcardiotomy cardiogenic shock (PCCS) in patients with poor left ventricular (LV) function undergoing cardiac surgery.
Methods: From the Society of Thoracic Surgeons Adult Cardiac Database, 11,493 patients with LV ejection fraction ≤35% underwent isolated on-pump surgery from 2018 through 2019, of whom 3428 experienced PCCS. In total, 68 preoperative clinical variables were considered in machine-learning algorithms trained and optimized using scikit-learn software.
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