ALERT!
This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Journal and News Scan
Data from the Barrett's and Esophageal Adenocarcinoma Genetic Susceptibility Study were used to determine the relationship of a genetic risk score associated with obesity to cancer risk. The risk score was not associated with GERD or smoking. Cancer and Barrett's were strongly associated with increasing BMI. The authors conlude that those with a genetic makeup associated with obesity have increased risk of cancer and Barrett's.
Data from the National Lung Screening Trial (NLST) were examined by exploring different size thresholds for classifying CT screening scans as positive. In the NLST, nearly two-thirds of nodules were 7mm in diameter or less. Using a threshold of 5mm, the percentage of missed/delayed diagnosis and the likelihood of avoiding false positive findings were 1% and 16%. Using a threshold of 8mm increased those rates to 11% and 66%. Increasing size thresholds reduced follow-up CTs and invasive procedures. Interestingly, differences in thresholds did not affect survival or mortality.
You have to check out this amazing VATS lobectomy surgery simulator. It is unbelievably realistic and comes in a LAP surgery simulator: staplers, slings, the works!!
Henrik Hansen was key in designing this, so it uses his anterior approach to do the lobectomy.
301 pts with CAD required revascularization and moderate MR were randomly assigned to CABG or CABG with MV repair. The outcome was LV end-systolic index at 1 year. MV repair contributed to longer pump times, longer hospitalization, and more neurologic events. MV repair did not result in an improved primary outcome at 1 year, but was associated with reduced rates of moderate to severe MR. The potential benefit of this latter finding is unclear.
Data from 20 observational studies including nearly 3000 pts were reviewed to assess the prevalence of pre-frailty/frailty and clinical outcomes in older cancer patients. Frailty was identified in 42% and pre-frailty in 43% of patients. Combined frailty was associated with increased all cause mortality (5-yr HR 1.57), postoperative mortality, and postoperative complications.
This trial randomized 900 pts with type 1 or 2 diabetes to screening with coronary computed tomography angiography (CCTA) or standard care and evaluated death and non-fatal coronary outcomes. The major outcome was a composite of death, MI, and admission for management of unstable angina. The secondary outcome was a composite of CAD-associated death, MI, or unstable angina. CCTA screening did not influence the rate of major or secondary outcomes.
This is a matched case controlled study of 27 consecutive patients with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 (SV3)device in 2 centers. These patients were matched with patients who had undergone TAVI with the 26-mm SAPIEN XT (SXTV) who were drawn from a prospective database of 270 consecutive patients.
The rate of balloon postdilation after valve implantation was higher in the SXTV group compared with the S3V group (p = 0.047). In the S3V group, only 2 patients (7%) had a paravalvular leak graded as mild or greater, compared with 42% of the patients in the SXTV group (p = 0.002). In the univariate analysis, the implantation of the S3V was the only factor associated with no/trace paravalvular leaks after TAVI.
The authors aimed to study whether systemic lupus erythematosus (SLE) resulted in an increased risk of congenital heart defects (CHD). Mothers with SLE were selected from a large Quebec healthcare database and matched to mothers without SLE. Children born to mothers with SLE were more likely to experience CHD (5.2% versus 1.9%). The odds ratio in a multivariable model was 2.62 (95% CI, 1.77-3.88). Moreover, children born to mothers with SLE also had an increased risk of a CHD repair procedure.
This retrospective study evaluated results of transthoracic (TTE) vs transhiatal (THE) esophagectomy in patients with squamous cell cancer and adenocarcinoma from two high volume centers. Prospensity score matching was used. TTE yielded a higher R0 resection rate and higher numbers of nodes dissection. TTE was associated with improved survival for T3 tumors and for patients with node-positive disease.
This article systematically reviewed the impact of surgical adverse events (SAEs) on quality of life after major GI surgery. The mean difference in QOL between pts with and without SAEs was highest for esophagectomy (0.14; scale 0 to 1), while results for antireflux surgery were mixed.