The Annals of thoracic surgery
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Although the role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) in pulmonary sarcoidosis has previously been investigated, the determining factors in diagnosing sarcoidosis by EBUS-TBNA without rapid on-site evaluation (ROSE) are unclear. ⋯ Endobronchial ultrasound-guided transbronchial needle aspiration is a safe procedure with high sensitivity for diagnosing sarcoidosis, having a higher diagnostic yield in stage I than stage II. To obtain a higher diagnostic yield of EBUS-TBNA in pulmonary sarcoidosis without ROSE, operators should select the largest mediastinal or hilar lymph node accessible and puncture with 3 to 5 passes.
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Flail chest is a life-threatening condition that occurs when 3 or more consecutive ribs are segmentally fractured due to severe trauma and become detached from the rest of the thoracic cage. Flail chest is usually associated with other intrathoracic injuries, including pulmonary contusion, which can result in respiratory failure. ⋯ The Nuss procedure was performed for both stabilization of severe flail chest and elevation of the depressed chest wall. The patient was weaned from mechanical ventilation on the first postoperative day and was ultimately discharged without any complications.
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Ischemia with subsequent necrosis of anastomoses, after central airway resection and reconstruction, remains a feared complication for thoracic surgeons and their patients. To date, there is no evidence to support the use of hyperbaric oxygen in the prevention of necrosis of airway reconstructions in humans. ⋯ Repeat visit to a hyperbaric oxygen chamber seemed to prevent the anastomosis from subsequent necrosis and dehiscence with complete healing as a result. In conclusion, hyperbaric oxygen treatment can be considered when ischemia or necrosis is observed in central airway anastomoses during postoperative bronchoscopic surveillance.