The Annals of thoracic surgery
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Randomized Controlled Trial Comparative Study
Effect of hemostatic material on sternal healing after cardiac surgery.
Postoperative sternal infection and dehiscence cause increased morbidity, mortality, and socioeconomic costs as well as patient discomfort and pain. Some predisposing factors have been uncovered but others remain uninvestigated. Among these are the influence of topical hemostatic agents such as bone wax (BW) and Ostene (Ceremed Inc, Los Angeles, CA) a new, water-soluble polymer wax (WSW). The object of this study was to investigate the impact of topical hemostatic agents on sternal healing in patients. ⋯ The results from this study suggest that WSW provides a useful alternative to BW when topic hemostasis on the sternum is required.
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Randomized Controlled Trial Comparative Study
Sivelestat attenuates lung injury in surgery for congenital heart disease with pulmonary hypertension.
Pulmonary hypertension associated with congenital heart disease increases the risk of surgery using cardiopulmonary bypass. Sivelestat is a neutrophil elastase inhibitor thought to have a prophylactic effect against lung injury after surgery using bypass. We elucidated that Sivelestat had the protective effect on lung in patients with congenital heart disease and pulmonary hypertension who underwent surgery using bypass. ⋯ Administration of sivelestat during bypass prevented pulmonary damage and activities of proinflammatory cytokines at the cardiac operation in neonates or infants. Our results show that sivelestat may be considered to protect pulmonary function against the injury by bypass.
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Randomized Controlled Trial Comparative Study
Effect of phrenic nerve palsy on early postoperative lung function after pneumonectomy: a prospective study.
The issue of phrenic nerve preservation during pneumonectomy is still an unanswered question. So far, its direct effect on immediate postoperative pulmonary lung function has never been evaluated in a prospective trial. ⋯ Our results show that phrenic nerve palsy causes a significant impairment of dynamic lung volumes during the early postoperative period after pneumonectomy. Therefore, in these already compromised patients, intraoperative phrenic nerve injury should be avoided whenever possible.
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Randomized Controlled Trial Comparative Study
The short-term outcome of three-field minimally invasive esophagectomy for Siewert type I esophagogastric junctional adenocarcinoma.
The incidence of esophagogastric junctional adenocarcinoma is increasing, and the surgery is associated with high mortality and morbidity rates. This study aims to evaluate whether three-field minimally invasive surgery promotes outcome as compared with three-incision open surgery. ⋯ Minimally invasive esophagectomy could lead to a significant improvement of the short-term benefits for patients with Siewert type I esophagogastric junctional adenocarcinoma.
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Randomized Controlled Trial Comparative Study
Segmentectomy versus wedge resection for non-small cell lung cancer in high-risk operable patients.
Patients with early-stage lung cancer and limited pulmonary reserve may not be appropriate candidates for lobectomy. In these situations, sublobar resection (wedge or segmentectomy) is generally performed. Many physicians believe that segmentectomy is superior because it allows for an improved parenchymal margin and nodal sampling. ⋯ In ACOSG Z4032, wedge resection, regardless of the approach, was associated with a smaller parenchymal margin and a lower yield of lymph nodes and rate of nodal upstaging when compared with segmentectomy.