Chest
-
Robotic-assisted lobectomy is being offered increasingly to patients. However, little is known about its safety, complication profile, or effectiveness. ⋯ In this early experience with robotic surgery, robotic-assisted lobectomy was associated with a higher rate of intraoperative injury and bleeding than was thoracoscopic lobectomy, at a significantly higher cost.
-
Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. ⋯ Twenty-two procedures (92%) were performed in the outpatient setting. This report confirms the safety and efficacy of administering talc slurry through IPCs in an outpatient setting. Studies in a larger cohort are necessary to define the role of this novel approach in the treatment algorithm of patients with this condition.
-
Comparative Study
Pulmonary Changes of Pleural Tuberculosis: Up-to-Date CT Imaging.
The objective of this study was to evaluate pulmonary abnormalities of pleural TB by CT scanning and to determine CT scan findings for the development of the paradoxical response (PR). ⋯ Pulmonary abnormalities are very common in pleural TB. Th e most common CT scan findings were micronodules in the subpleural and peribronchovascular interstitium and interlobular septal thickening, suggesting the lymphatic spread of TB. In addition, PR is not rare in patients with pleural TB, especially in young, previously healthy, male patients who show subpleural nodules on initial CT scans.
-
Resting mean pulmonary artery pressure (mPAP) values between 20 and 25 mm Hg are above normal but do not fulfill the criteria for pulmonary hypertension (PH). The clinical relevance of such borderline hemodynamics is a matter of discussion. ⋯ In patients undergoing right-sided heart catheterization with exclusion of manifest PH, borderline elevation of pulmonary arterial pressure is associated with cardiac and pulmonary comorbidities, decreased exercise capacity, and a poor prognosis.