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Journal and News Scan
This study set out to analyze the shifting surgical approach and outcomes in esophagectomy using The Society of Thoracic Surgeons General Surgery Database. The authors found that over the past decade, the dominant approach has changed to be overwhelmingly minimally invasive. While there are still complications resulting from these methods, they have not raised operative mortality.
Thoracic oncology patients are a high-risk group for venous thromboembolism (VTE). The ESTS and AATS panel reviewed the evidence using the GRADE approach and made twenty-four recommendations for VTE prophylaxis, focusing on pharmacological and mechanical methods. The certainty surrounding the evidence for VTE prevention in thoracic surgery was generally low. Conditional recommendations were made concerning parenteral anticoagulation, extended prophylaxis and VTE screening. The need for further research on preoperative thromboprophylaxis and risk stratification in extended prophylaxis was identified.
This multicenter retrospective study aimed to compare the outcomes of uniportal robotic-assisted thoracic surgery (U-RATS) with multiportal robotic-assisted thoracic surgery (M-RATS). The authors found that, although both methods have a low thirty-day morbidity and mortality rate, U-RATS has a lower operative duration and length of postoperative hospital stay.
This population-based study used data to develop clinical models that predict the length of intensive care unit (ICU) stay after cardiac surgery. These updated models, based on certain risk factors that tend to lengthen time in the ICU, predicted length of stay within two days in the validation cohort.
A surgical team at Northwestern Medicine has successfully performed two double lung transplants in patients with stage 4 lung cancer. Their method evolved from treatment of COVID-19 patients who needed double lung transplants. This technique allows both lungs to be replaced at once to avoid the spread of cancer from the diseased lung to the donor lung.
Surgical mitral valve repair is the gold standard treatment for mitral regurgitation due to degenerative disease. Repair is performed on the arrested heart, meaning that assessments of success can only be made after removal of cardiopulmonary bypass. The saline test remains an integral part of repair, however, its hemodynamics have not been evaluated. The authors present a simple technique to quantify the saline test. The authors note that the saline test may be less informative in cases where the maximum left ventricle diastolic pressure is low.
A retrospective study found that women continue to have a higher mortality and morbidity rate after CABG compared with men. This has historically been the case, as women are often referred to surgery later than men and have more cardiovascular risk factors. Researchers emphasize that since this trend has not changed, there needs to be greater action to increase the quality of care for women who require CABG surgery. Read the original study, published in JAMA Surgery.