The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Mar 2013
Comparative StudyDoes dose matter? Effect of two different neoadjuvant protocols in advanced NSCLC.
For stage III, NSCLC neoadjuvant protocols have been intensified up to full dose protocols but up till now the effect of more intensive protocols in a trimodal setting could not be compared directly because of different selection criteria or experience of involved facilities in different studies or multicenter studies. We analyzed our experience with two different neoadjuvant protocols, consistent selection criteria, and surgical teams over 17-year time period. ⋯ The median survival benefit of 9 months is evident but (probably still) not significant. The more aggressive protocol 2 shows a significant better downstaging effect concerning N- and UICC-stage if R0-resection can be achieved. Insofar dose does matter!
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Thorac Cardiovasc Surg · Mar 2013
Case ReportsPresurgical planning using a three-dimensional pulmonary model of the actual anatomy of patient with primary lung cancer.
Video-assisted thoracoscopic surgery (VATS) for both lobectomy and segmentectomy has been used widely for early stage nonsmall cell lung cancer (NSCLC). The objective of this study was to investigate the clinical feasibility of surgical planning using patient's actual three-dimensional (3D) pulmonary model for the thoracoscopic surgical treatment of early stage NSCLC. ⋯ Presurgical planning based on patient's actual 3D pulmonary model is useful for patients with stage IA NSCLC ≤ 2 cm in diameter and for selecting an appropriate VATS lung resection for an individual.
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Thorac Cardiovasc Surg · Jan 2013
Case ReportsPostpartum acute coronary syndrome due to intramural hematoma and coronary artery dissection.
A 38-year-old woman presented with acute coronary syndrome 9 days postpartum. Coronary catheterization showed an intramural hematoma of the left main artery (LM) and the left anterior descending artery (LAD). During angiography, dissection of the LM, with involvement of the LAD and circumflex artery occurred. ⋯ After resuscitation, intra-aortic balloon pump was inserted. The patient underwent two-vessel off-pump surgical revascularization. She was discharged 10 days later.
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Thorac Cardiovasc Surg · Jan 2013
Case ReportsSuccessful treatment of catamenial hemoptysis by video-assisted thoracoscopic surgery.
We report a case of a 23-year-old woman with a 5-year history of recurrent hemoptysis during menstrual period. Catamenial hemoptysis was diagnosed using chest computed tomography and bronchoscopic examination during menstruation. The patient was managed successfully with wedge resection and has been free of recurrence for 5 years. We suggest that surgery is an effective treatment, and complete resection with accurate localization is important for the prevention of recurrence.
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Thorac Cardiovasc Surg · Jan 2013
Comparative StudyInfluence of gender on postoperative outcome after intra-aortic balloon counter-pulsation and cardiac surgery.
Female gender is an established risk factor for worse outcomes after cardiac surgery, and women are more likely to experience postoperative complications. Our aim was to analyze the influence of gender on outcome and postoperative complications after the use of intra-aortic balloon counter-pulsation (IABP) in cardiac surgery patients. ⋯ Women have a worse outcome after the use of IABP, including LOS at the ICU, postoperative renal failure, and inhospital mortality, despite higher EF, when compared with men.