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Journal and News Scan
February 10, 2016
Submitted by: Joel Dunning
NHS England is evaluating a series of operations in the UK. One of the procedures it is looking at is Pectus Excavatum surgery.
At the moment the proposal is to ban all pectus surgery in the UK funded by the NHS. This document is currently available for 25 more days for public consultation and to obtain the views of the public and profession widely.
There are only around 200 of these operations conducted per year in the UK and therefore we believe that the money saved will be minimal.
However the benefit to patients of Pectus surgery, many patients of which are teenagers or adolescents we believe is very large in terms of their confidence and ability to face the world.
These patients are also often not able to afford the money to fund this operation as they are not yet earning.
If you also believe in Pectus Excavatum as a good operation, and you would like us to help preserve this in the UK then please sign this signature and send this on to others.
you are also able to send a personal view to NHS england as well as see all their documents here :
https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wa...
Many thanks for your Help
The UK thoracic Surgery community
February 9, 2016
Submitted by: CTSNet Staff
This article analyzes the amount of lung function loss in 31 patients who underwent bilateral metastasectomy for pulmonary metastases.
February 6, 2016
Submitted by: Joel Dunning
NHS england carries out a series of consultations to guide national policy. Their recommendations are usually completely binding and result in policy change across the whole of the UK. Hospitals are unable to carry out operations for which they withdraw NHS funding.
The current NHS England evaluation for robotic thoracic surgery concludes :
Robotic surgery requires expensive equipment, which represents a capital cost as well as the cost of consumables. Currently providers are reimbursed for robotic assisted surgery through the national prices, with a separate additional payment for the cost of the robotic consumables.
NHS England has concluded that there is not sufficient evidence to support a proposal for the routine commissioning of robotic assisted lung resection for primary lung cancer.
It is open for 30 days of evaluation before they make the final decision. Anyone can respond to their document, so please do respond if you want to influence this decision
Further information can be found here.
https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wave2
February 5, 2016
Submitted by: Aristotle Protopapas
A useful reference tool for all colleagues interested in research and biomedical publishing
February 2, 2016
Submitted by: Aristotle Protopapas
This randomized trial (NEAT-HFpEF) of 110 subjects (59 placebos) disproves, by clinical and biological markers, the utility of nitrates for exercise tolerance. This is a subset of cardiac failure patients we are likely to encounter in general cardiothoracic surgical practice.
February 1, 2016
Submitted by: Mark Ferguson
A retrospective analysis of patients suffering blunt cardiac injury was performed to identify factors associated with mortality. Death was not associated with abnormal ECG or the site or number of bone fractures. Mortality was related to hypotension, elevated lactate, and elevated troponins.
January 31, 2016
Submitted by: Mark Ferguson
Whether open and VATS lobectomy for lung cancer result in similar nodal assessment is unclear. The authors compared rates of nodal upstaging for nearly 17,000 patients in the National Cancer Database who underwent resection for T2N0M0 or lower stage NSCLC. Upstaging was more common in patients undergoing open resection (12.8% vs 10.3%). This finding persisted when evaluating propensity score matched pairs. The difference in nodal upstaging was not significant among patients operated on in academic centers.
January 30, 2016
Submitted by: Mark Ferguson
The authors determined the need for transannular patch enlargement (TAPE) in management of ToF by measuring the ratio between pulmonary annulus size to aortic valve annulus size (GA ratio). A retrospective analysis of 122 pts who had undergone ToF repair with or without TAPE was performed. GA ratios were smaller in patients undergoing TAPE. The GA ratio was a better predictor of TAPE (accuracy 90%) than a traditional method (z-score).
January 30, 2016
Submitted by: Mark Ferguson
3D echo was used to preoperatively assess the likelihood of recurrent MR after ring annuloplasty for ischemic MR. Recurrence was asssociated with P3 tethering angle greater than 29.9 degrees (accuracy 92%). The authors suggest that valve replacement rather than ring annuloplasty should be considered in such patients.
January 30, 2016
Submitted by: Mark Ferguson
Outcomes of CABG for patients in cardiogenic shock after acute MI were evaluated using data from the STS Database. The study group of nearly 5,500 patients comprised 1.5% of all CABG patients during the study period. Operative mortality was 18.7%. Mechanical circulatory support use was most common in patients with more risk factors or high clinical acuity, and was associated with an operative mortality of 37.2% (preop and intraop use) and 58.4% (postoperative use only). CABG as salvage had an operative mortality of 53.3%.