The Annals of thoracic surgery
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The Nuss procedure is a minimally invasive technique using a retrosternal bar to repair pectus excavatum. Although its technical simplicity and cosmetic advantages are remarkable, early applications have been limited to children with symmetrical pectus excavatum. We report a large single-institution experience including technical modifications to correct asymmetric configurations and extend the procedure to adult patients. ⋯ Precise morphologic classification has led to modifications of the Nuss technique that facilitate correction of virtually all varieties of pectus excavatum including patients with asymmetric varieties and adults.
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Recent reports indicate that age is not a contraindication to pulmonary resection for octogenarians with nonsmall cell lung cancer (NSCLC), but other data are lacking. The purpose of this study was to determine outcomes in these patients, particularly short- and long-term survival with stage I disease. ⋯ The 5-year survival, particularly in patients with stage Ia tumors with favorable ASA and FEV(1), supports the notion that health status and tumor stage outweigh chronologic age in determining surgical candidates.
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Randomized Controlled Trial Clinical Trial
Intermittent infusion of 0.25% bupivacaine through an intrapleural catheter for post-thoracotomy pain relief.
The present study was designed to evaluate the effectiveness of intrapleural 0.25% bupivacaine delivered by intermittent infusions for post-thoracotomy pain relief. ⋯ The easy placement of an intrapleural catheter and better pain relief observed in the present study suggest that intermittent pleural infusion of 0.25% bupivacaine has proven to be a safe and effective method for relief of post-thoracotomy pain.
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Clinical Trial
Positron emission tomography scanning poorly predicts response to preoperative chemotherapy in non-small cell lung cancer.
The ability to accurately predict pathologic response to preoperative chemotherapy may have a significant impact on the treatment strategy for non-small cell lung cancer (NSCLC). The purpose of this study was to examine the accuracy of positron emission tomography (PET) scanning in predicting the pathologic response to preoperative chemotherapy in the primary tumor and draining lymph nodes. ⋯ Positron emission tomography scanning does not reliably predict pathologic response to preoperative chemotherapy in NSCLC in either the primary tumor or the draining lymph nodes.
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The objective of this study was to assess the role of a symptom-limited stair climbing test in predicting postoperative cardiopulmonary complications in elderly candidates for lung resection. ⋯ A symptom-limited stair climbing test was a safe and simple instrument capable of predicting cardiopulmonary complications in the elderly after lung resection.