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Journal and News Scan
August 14, 2025
Submitted by: Jade Qu
This large single-center retrospective study of 682 patients compared outcomes after sleeve lobectomy for non-small cel lung cancer (NSCLC) with and without buttressing the bronchial anastomosis using autogenous flaps. After propensity weighting, perioperative outcomes, including postoperative complications, bronchopleural fistula, and anastomotic stenosis, were similar between groups, with the exception of a longer operative time in the wrapping group. Five-year recurrence-free and overall survival rates did not differ significantly. Multivariable analyses confirmed that buttressing was not associated with reduced complications or improved long-term survival. These results suggest that routine bronchial anastomosis wrapping does not confer additional benefits and may be unnecessary.
August 14, 2025
Submitted by: Mujtaba Mubashir
This cadaver-based study evaluated the variations in vascular perfusion territories of the descending thoracic aorta, including variations in the anatomy of the artery of Adamkiewicz. The authors found important variations in origin and location of the artery of Adamkiewicz and demonstrated its importance, along with the anterior spinal arteries in spinal cord perfusion. This was based on the differential dye staining of the anterior and posterior aspects of the spinal cord along its entire length. A pictorial representation of these differences is shown, as well as variations in the anatomy of the arterial supply itself.
August 7, 2025
Submitted by: Joel Dunning
This article outlines best practice for achieving safe on-table extubation following cardiac surgery. It focuses on optimizing patient fitness postoperatively and emphasizes the importance of multidisciplinary coordination. The guidelines aim to reduce complications, enhance recovery times, and promote faster rehabilitation by implementing structured approaches to patient selection and anesthetic management.
August 7, 2025
Submitted by: Jade Qu
This single-institution study evaluated 78 patients undergoing single-anesthetic robotic bronchoscopy with intraoperative biopsy, followed by possible lung resection. Intraoperative frozen section diagnoses showed almost perfect agreement with final pathology (Cohen’s kappa 0.94), supporting their reliability for surgical decision-making. The diagnostic yield improved over time, reaching 80.8 percent in the late phase. The rate of unnecessary benign resections decreased significantly as experience grew, dropping to zero percent in the late phase. No malignancies were missed when surgery was aborted based on benign biopsy.
August 7, 2025
Submitted by: Erica Curcio
This study examines the impact of the 2018 United Network for Organ Sharing (UNOS) heart transplant allocation criteria change on posttransplant stroke rates. The study included 19,512 patients from the UNOS database who received a heart transplant between October 18, 2014, and October 17, 2022, divided into precriteria change (n = 9768) and postcriteria change (n = 9744) cohorts. The primary outcome was stroke, and secondary outcomes included mortality and adverse events. The study found that the 2018 donor heart allocation criteria change is associated with a higher risk of posttransplant stroke. Posttransplant stroke increased the risk of mortality by six-fold during the early posttransplant period.
August 7, 2025
Submitted by: Mujtaba Mubashir
Frozen elephant trunk (FET) is an established surgical option for the single-stage treatment of acute type A aortic dissection. The authors studied 222 patients who underwent FET and compared outcomes and reintervention rates. The authors found significantly improved 30-day mortality with a zone 2 repair technique (7 percent) compared to a zone 3 repair technique (18 percent). Early mortality was driven by the presence of complicated dissection, including the presence of malperfusion syndrome, rupture, the need for presurgical intubation, or the need for cardiopulmonary resuscitation. Secondary distal aortic interventions were frequently performed after FET (37.4 percent); however, this did not adversely affect five-year survival. The authors also discuss the importance of patient selection for FET vs more expeditious procedures in type A dissections, since this could affect both short- and long-term outcomes, although further investigation in this area is necessary.
August 7, 2025
Submitted by: Jade Qu
This large, retrospective study (1997–2023) found that surgical resection offers a significant survival benefit for both stage III and stage IV pulmonary carcinoid tumors, including those with metastatic disease. Surgery reduced mortality risk in both stages, regardless of histologic subtype, and survival rates were similar after lobectomy or sublobar resection. Atypical histology and the presence of multiple metastases were associated with worse outcomes. Chemotherapy and radiotherapy did not provide additional survival benefits. These findings, supported by SEER database analyses, suggest that surgery should be considered even for advanced-stage or metastatic pulmonary carcinoid tumors, challenging current conservative guidelines.
July 30, 2025
Submitted by: Joel Dunning
This article discusses the Ross procedure in young adults with aortic valve disease, highlighting its excellent long-term outcomes, including a 94 percent survival rate at 10 years and a 70 percent survival rate at 25 years. Improvements in patient selection and surgical techniques since 2000 have enhanced both clinical results and quality of life, with mental health scores notably surpassing those of the general population. Overall, the Ross procedure offers significant benefits for young patients, ensuring stable valve function and improved quality of life.
July 30, 2025
Submitted by: Mujtaba Mubashir
Cardiac valve replacement during pregnancy is a high-risk operation that is performed occasionally when indicated. This study queried the Registry of Pregnancy and Cardiac disease (ROPAC) III database, as well as available cases in the literature, and found an overall maternal mortality of 9 percent, while fetal mortality was 34 percent. Maternal mortality occurred in eight cases, all of whom underwent a mitral valve replacement. Predictors of maternal mortality included surgeries performed during the first trimester and acute malfunction of the prosthetic valve. The mean gestational age during delivery was 36.4 weeks in women who underwent cardiac surgery, with a preterm birth at 31.7 percent, and most women delivered via Cesarean section (71 percent). Interestingly, when comparing cases before and after 2010, there was no significant improvement in survival over time. This underscores the importance of preventing valve dysfunction before pregnancy, highlighting the role of preconception assessment and counselling.
July 30, 2025
Submitted by: Jade Qu
This multi-institutional study of 81 patients with postoperative bronchopleural fistula (BPF) found a noncure rate of 46.9 percent and a mortality rate of 58 percent, with nearly half of the deaths directly related to BPF. Surgical intervention was performed in 85 percent of cases, with open-window thoracostomy being the most common procedure. Endoscopic treatments alone cured 21 percent of those attempted. Multivariate analysis identified low albumin (<3.0 g/L) and low hemoglobin (<11.0 g/L) at the onset of BPF as significant noncure risk factors. Notably, omental flaps achieved 100 percent fistula closure in several series and may be more favorable than muscle flaps for complex cases.