European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled TrialNeuropsychological function in children with cyanotic heart disease undergoing corrective cardiac surgery: effect of two different rewarming strategies.
Hypothermia conventionally used in cardiopulmonary bypass necessitates rewarming to normothermic temperatures, which has been shown to be associated with neuropsychological injury. We studied the effects of two different rewarming strategies on postoperative neuropsychological function in cyanotic paediatric patients undergoing elective primary intracardiac repair of tetralogy of Fallot with the aid of cardiopulmonary bypass. ⋯ Weaning off bypass at 33 degrees C is associated with lesser postoperative neuropsychological dysfunction compared to rewarming to 37 degrees C before weaning off bypass. This may be used as a tool to decrease neurologic morbidity following cardiac surgery in children with congenital cyanotic heart disease.
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Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled Trial Multicenter StudySurgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy.
Endoscopic thoracic sympathetic surgery was effective for palmar hyperhidrosis (PH), but side effects such as compensatory sweating and over dry hands were common. A multiple centers prospective randomized study was designed to compare the efficiency and side effects of T3 and T4 sympathicotomy in the treatment of PH. ⋯ T3 and T4 sympathicotomies are both effective for the treatment of PH. T4 sympathicotomy, decreases the side effects but do not compromise the therapeutic effects, and should be the method of choice.
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Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled Trial Comparative StudyShort-term perioperative treatment with ambroxol reduces pulmonary complications and hospital costs after pulmonary lobectomy: a randomized trial.
To assess in a randomized clinical trial the influence of perioperative short-term ambroxol administration on postoperative complications, hospital stay and costs after pulmonary lobectomy for lung cancer. ⋯ Short-term perioperative treatment with ambroxol improved early outcome after lobectomy and may be used to implement fast-tracking policies and cut postoperative costs. Nevertheless, other independent trials are needed to verify the effect of this treatment in different settings.
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Eur J Cardiothorac Surg · Mar 2009
Multicenter StudyPlasmapheresis before thymectomy in myasthenia gravis: routine versus selective protocols.
The value of thymectomy in management of myasthenia gravis (MG) is well recognized. Plasmapheresis (PMP) before thymectomy appears to improve the postoperative outcome. As PMP has its own complications, selective use of PMP preoperatively for patients at risk of post-thymectomy complications would improve the postoperative outcome, and decreases the PMP-related complications. The aim of this study is to evaluate the effectiveness and safety of routine versus selective use of PMP before thymectomy. ⋯ This study demonstrated that selective use of PMP before thymectomy may reduce the incidence of PMP-related complications without affecting the overall outcome.
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Eur J Cardiothorac Surg · Mar 2009
Comparative StudyVideo-assisted thoracic surgery lobectomy: can we afford it?
Although video-assisted thoracoscopic (VATS) lobectomy offers advantages with regard to pain, respiratory function and mobility, concern is often expressed concerning the cost of stapling devices and increased operative time. We have therefore compared the costs of VATS and open lobectomy in order to assess the overall economic sustainability of a VATS programme. ⋯ VATS lobectomy is less expensive than conventional lobectomy. Increased theatre costs (disposables and time) are counteracted by shorter hospital stay. Importantly, the reduced HDU and ward bed stays free resources for other patients.