Notes

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lf-reported outcomes from the early to late phases. These findings, along with mediators of poorer outcomes, may aid surgeons in adopting a new approach and counseling patients on expected outcomes.
This study evaluated the impact of severe chronic lung disease on outcomes of index adult cardiac operations.

A single-center, retrospective study of adult patients with severe chronic lung disease (as defined by the Society of Thoracic Surgeons) undergoing index cardiac operations between 2010-2018 was performed. Multivariable Cox regression and Kaplan-Meier analyses were used to evaluate survival.

A total of 354 patients (median 69 years, 32.77% female) were identified. Current smokers comprised 42.66% of the population and 34.65% of patients required home oxygen. Median pre-operative forced expiratory volume in 1 second (FEV1) was 48% of predicted (IQR 41-56%) and median diffusing capacity for CO (DLCO) was 78% of predicted (55-101%). The majority of patients underwent isolated coronary artery bypass (57.06%) or isolated aortic valve replacement (19.49%). Overall, 33 patients (9.07%) required a tracheostomy (median of 10 days from surgery) for a median of 49 days (25-114 days) until decannulation. Prrgery in otherwise reasonable surgical candidates.
With a multimodal treatment strategy, cytoreductive surgery extends survival in malignant pleural mesothelioma. Improving the accuracy of staging can refine patient selection. Our objective was to determine whether diagnostic laparoscopy (DL) improves staging for patients with malignant pleural mesothelioma with routine use of positron emission tomography.

We performed a retrospective review of our prospectively maintained database from February 2014 until May 2019. Inclusion criteria were patients who had disease in the chest that was deemed potentially resectable by radiographic criteria and who underwent DL as part of staging evaluation prior to surgery.

187 patients (71% male, 80% epithelial) underwent DL during staging. 76% proceeded to surgery. 22% were unresectable at exploratory thoracotomy and 78% underwent resection (Pleurectomy and decortication, 68%; extrapleural pneumonectomy, 32%). 89% had a position-emission tomography-computed tomographic scan (PET-CT) and 11% had a pre-operative CT without PET. DL revealed peritoneal disease in 17%. Among patients with pathologically proven disease at DL, 77% had negative PET-CT imaging. Based upon the pathologic findings at DL, the sensitivity, specificity, positive predictive value, and negative predictive value of PET-CT were 23%, 78%, 17%, and 83%, respectively. The accuracy of PET-CT was 68%.

PET-CT has low sensitivity and diagnostic accuracy to identify peritoneal disease in malignant pleural mesothelioma. DL as part of pre-operative staging defines an important subset of patients with bicavitary disease. We recommend DL as a component of staging prior to surgery.
PET-CT has low sensitivity and diagnostic accuracy to identify peritoneal disease in malignant pleural mesothelioma. DL as part of pre-operative staging defines an important subset of patients with bicavitary disease. We recommend DL as a component of staging prior to surgery.
Appropriate collection of quality of life (QOL) measurements for left ventricular assist device (LVAD) patients is challenging. Patient-Reported Outcomes Measurement Information System (PROMIS) is a popular tool that has been validated across multiple disciplines, but its applicability to the LVAD population remains unknown.

This single-center, retrospective review included LVAD patients that completed a PROMIS assessment and Kansas City Cardiomyopathy Questionnaire (KCCQ-12) survey at clinical encounters postoperatively. Patients completed computer adaptive PROMIS assessments for physical function, pain interference and depression. https://www.selleckchem.com/products/bgj398-nvp-bgj398.html All PROMIS domains are designed to follow a normal distribution (mean T-score 50, standard deviation 10) in the general population. Assessments were aggregated over time and correlation between the KCCQ-12 summary score and each PROMIS domain was assessed individually.

A total of 178 LVAD patients were included in the study. The median time between LVAD implantation and PRO re symptoms.
Virtual 3-dimentional models of the lungs have been used for guiding thoracoscopic procedures including segmentectomy and subsegmentectomy. However, the virtual models displayed on the screen were not tangible. A printed model with assistance of Augmented Reality(AR) might add value to guide surgical performance. We investigated whether the combined technology with patient-specific printed models and the augmented reality displaying could offer better surgical outcomes than the onscreen models in complex thoracoscopic surgery.

142 patients with early lung cancers undertaking thoracoscopic segmentectomy or subsegmentectomy. The 3-dimentional lung models were either displayed on-screen (n=87) or printed out and displayed using augmented reality (n=55) in the operating room. A propensity score match analysis was used to compare the surgical outcomes between the two groups.

The surgical outcomes before/after propensity score match data showed 3D printing with AR had a shorter operating time (P = 0.001/0.001), less intraoperative blood loss (P = 0.024/0.006), shorter length of hospital stay (P = 0.001/0.001) than the onscreen group. The complications and operating success rate (P = 0.846/1.000) and (P = 0.567/1.000)were not significantly different. Surgeons gave a higher score in the tangible than the onscreen group (P = 0.001/0.001).

The printed 3-dimentional models enabled surgeons to see and touch interior structures of the lung. The augmented reality provided instant guidance to the surgery in the operating room. The combination of these technologies produced positive values in guiding laparoscopic lung surgery.
The printed 3-dimentional models enabled surgeons to see and touch interior structures of the lung. The augmented reality provided instant guidance to the surgery in the operating room. The combination of these technologies produced positive values in guiding laparoscopic lung surgery.
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