Purpose Of Review: Emphasizing a systems-based approach, we discuss the timing for referral for perioperative surgical consultation. This review then highlights several types of comorbidities that may complicate thoracic procedures, and references recent best practices for their management.
Recent Findings: Patients requiring thoracic surgeries present some of the most challenging cases for both intraoperative and postoperative management. The recent SARS-CoV-2 pandemic has only exacerbated these concerns. Effective preoperative optimization, however, provides for identification of patient comorbidities, allowing for mitigation of surgical risks. This kind of planning is multidisciplinary by nature. We believe patients benefit from early engagement of a dedicated preoperative clinic experienced for caring for complex surgical patients.
Summary: Optimizing patients for thoracic surgery can be challenging for small and large health systems alike. Implementation of evidence-based guidelines can improve care and mitigate risk. As surgical techniques evolve, future research is needed to ensure that perioperative care continues to progress.
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http://dx.doi.org/10.1097/ACO.0000000000001215 | DOI Listing |
Trials
January 2025
Department of Vascular Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
Background: Thoracic aortic pathologies involving the aortic arch are a great challenge for vascular surgeons. Maintaining the patency of supra-aortic branches while excluding the aortic lesion remains difficult. Thoracic EndoVascular Aortic Repair (TEVAR) with fenestrations provides a feasible and effective approach for this type of disease.
View Article and Find Full Text PDFBMC Cancer
January 2025
Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China.
Background: Multiple studies have demonstrated that the abundance and functionality of γδ T cells are favorable prognostic indicators for prolonged survival in cancer patients. However, the association between the immunophenotype of circulating γδ T cells and the therapeutic response in NSCLC patients undergoing chemotherapy or targeted therapy remains unclear.
Methods: Patients with EGFR wild-type (EGFR-WT) or mutant (EGFR-Mut) non-small cell lung cancer (NSCLC), diagnosed between January 2020 and January 2024, were included in this study.
BMC Med Genomics
January 2025
Department of Hepatobiliary Pancreatic Surgery, Shenzhen People's Hospital, No.1017 Dongmen North Road, Shenzhen, 518020, Guangdong Province, China.
Background: Gallstones, a common surgical condition globally, affect around 20% of patients. The development of gallstones is linked to abnormal cholesterol and bilirubin metabolism, reduced gallbladder function, insulin resistance, biliary infections, and genetic factors. In addition to these factors, research has shown that mucins play a role in gallstone formation.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.
Background: Halo-pelvic traction is a relatively safe treatment for preoperative spinal deformity correction in patients with severe scoliosis. Common device-related complications include local infection, back discomfort, and nerve compression symptoms. However, there are potential risks of mechanical compression of bronchial structures, especially in patients with severe thoracic lordosis and scoliosis, which can lead to life-threatening airway obstruction.
View Article and Find Full Text PDFBMC Gastroenterol
January 2025
Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
Background: Neuregulin (NRG) family is involved in energy metabolism, among which NRG1 is a neuregulin proved to play a protective role in MAFLD cells. But the presice echanism has not been fully illustrated. This study aimed to investigate the role of NRG1 via the ERK/SIRT1 signaling in the pathogenesis of MAFLD.
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