The Annals of thoracic surgery
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Case Reports
Thoracoscopic lobectomy for synchronous intralobar pulmonary sequestration and lung cancer.
Bronchopulmonary sequestration is a rare congenital pulmonary malformation for which surgical resection is recommended, and several reports have described successful resection by video-assisted thoracoscopic surgery. Coexistence of sequestration with lung malignancy is extremely rare. We report the first case of thoracoscopic resection of synchronous intralobar pulmonary sequestration and non-small cell lung cancer.
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This study evaluated the feasibility of performing thoracoscopy without lung isolation employing single lumen endotracheal tube (SLET) intubation and carbon dioxide insufflation. ⋯ Single lumen endotracheal tube intubation is a feasible and safe airway management alternative for thoracoscopic procedures. This method resulted in shorter operative times, no aberrant hemodynamic shifts, low complication rates, and similar hospital stays as compared with traditional DLET intubation.
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Midventricular obstruction in hypertrophic cardiomyopathy (HCM) is less common than subaortic obstruction, and there are few data on outcomes after surgical treatment. ⋯ A transapical approach allows excellent exposure for midventricular myectomy and relief of intraventricular gradients and related symptoms. There were no complications unique to the apical incision, and 5-year survival was similar to expected survival (95% versus 97%).
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Multicenter Study Comparative Study
Hospital variation in postoperative infection and outcome after congenital heart surgery.
Several initiatives aim to reduce postoperative infection across a variety of surgical patients as a means to improve overall quality of care and reduce variation across centers. However, the association of infection rates with hospital-level outcomes and resource utilization has not been well described. We evaluated this association across a multicenter cohort undergoing congenital heart surgery. ⋯ Infection after congenital heart surgery contributes to prolonged LOS and increased costs on a hospital level. However, given that infection rates alone explained relatively little of the variation in these outcomes across hospitals, further study is needed to identify additional factors that may be targeted in initiatives to reduce variation and improve outcomes across centers.