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Otherwise, inoperable. The role of ECMO in thoracic surgery - focus on the mediastinum.

Port J Card Thorac Vasc Surg

January 2025

Thoracic surgeon, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

The use of extracorporeal membrane oxygenation (ECMO) in surgery is expanding as the medical community started adopting it, with good results, for procedures with high risk of respiratory and hemodynamic instability. This technique provided the possibility to reduce the number of patients previously considered inoperable because of these limitations. Thymic epithelial tumors (TETs) are rare neoplastic mediastinal lesions, with a reported incidence of 0.

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Immune checkpoint inhibitor (ICI) therapy is a cornerstone treatment for many cancers, but it can induce severe immunotoxicity, including acute interstitial nephritis (AIN). Currently, kidney biopsy is required to differentiate ICI-AIN from other causes of acute kidney injury (AKI). However, this invasive approach can lead to morbidity, delayed glucocorticoid treatment for patients with AIN, and unnecessarily prolonged suspension of ICI therapy in non-AIN patients.

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While internal hernias are rare in the paediatric population, it should be considered as a cause for an acute abdomen following blunt trauma. Internal hernias represent a surgical emergency that requires prompt recognition due to the high risk of strangulation and ischaemia of affected bowel loops. The case of a transomental hernia (TOH) is described in a young girl.

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Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.

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An 80-year-old lady had a history of progressive swallowing difficulty over several years with significant weight loss, but prior investigations in several medical departments proved negative. Neurological assessment noted her complaint of impaired feeling for food in her mouth and examination showed impaired corneal reflexes and facial sensory function. Blink reflex electrodiagnostic testing was consistent with a diagnosis of facial onset sensory and motor neuronopathy (FOSMN).

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