The Annals of thoracic surgery
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Comparative Study
Comparison of Two National Databases for General Thoracic Surgery.
Improving the quality of surgical care through accurate measurement of outcomes is an important endeavor. The purpose of this study was to compare data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and The Society of Thoracic Surgeons (STS) general thoracic surgery database to determine if a sampling technique (ACS NSQIP) is as effective and accurate as the comprehensive technique (STS database). ⋯ Databases built on partial sampling that do not capture all patients, such as the ACS NSQIP, may be useful for global analyses, but fall short of providing a foundation for meaningful quality improvement initiatives when analyzing data for specific thoracic surgical operations. These results highlight the utility and importance of complete databases such as the STSDB. National comparisons of clinical outcomes for thoracic surgical procedures should be interpreted with caution when using partial databases.
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This systematic review examined the clinical and hemodynamic performance of the stentless Freedom SOLO (Sorin Group, Milan, Italy) aortic bioprosthesis. The occurrence of postoperative thrombocytopenia was also analyzed. ⋯ Thrombocytopenia is more severe than in other aortic prostheses; however, this is without clinical consequences. Within a few years, the 15-year follow-up of this bioprosthesis will be known, which will be key to evaluating its long-term durability.
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Single-incision thoracoscopic surgery is an alternative procedure used to treat primary spontaneous pneumothorax, although conventional three- or four-port video-assisted thoracoscopic surgery is the recognized standard procedure. Single-incision thoracoscopic surgery is not yet popular when a wedge resection is required during general thoracic surgery, including pneumothorax surgery and lung biopsy, because of the danger of collision between instruments during surgery. In addition, introducing all of the instruments through a single incision means that a relatively large incision is required, leading to less than satisfactory cosmetic outcomes. The purpose of this study was to show that our in-house surgical method is a safe, alternative procedure for treating a primary spontaneous pneumothorax. ⋯ Small (<2 cm) single-incision thoracoscopic surgery using a wound protector and a bidirectional anchoring suture was safe and feasible and yielded acceptable outcomes for treating primary spontaneous pneumothorax.
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Screening programs have increased the identification of small or indistinct pulmonary lesions that are difficult to localize. We report our experience in their preoperative localization by radiotracer and resection. ⋯ Radiotracer localization of pulmonary lesions is a simple and feasible procedure with a high rate of success. Optimal candidates are patients with suspicious-looking nodules detected by screening or incidental CT resulting frm the high rate of nonsolid morphology and small size.