The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Comparative StudyPulmonary resections performed at hospitals with thoracic surgery residency programs have superior outcomes.
Pulmonary resections are performed at thoracic residency (TR), general surgery residency (GSR), no surgery residency, and no residency hospitals. We hypothesize that morbidity and mortality for these procedures are different between hospitals and that operations performed at TR teaching hospitals have superior results. ⋯ In comparison with other hospitals, including GSR hospitals, TR hospitals have lower morbidity and mortality. These results support using hospitals with a TR as an independent prognostic indicator of outcomes in pulmonary resections.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Effects of institutional volumes on operative outcomes for aortic root replacement in North America.
Hospital procedure volume has been strongly associated with postoperative mortality for a number of complex cardiovascular procedures. Although not yet described, a similar relationship might be expected for surgical procedures involving the aortic root and/or ascending aorta. The present study sought to evaluate the relationship between the volume of aortic root replacement procedures and the operative results for centers in North America. ⋯ Patients undergoing elective aortic root or combined aortic valve-ascending aortic surgery at North American hospitals that performed fewer than 30 to 40 of such procedures annually have greater risk-adjusted mortality than those undergoing surgery in higher volume hospitals. Causative factors for this inverse association between hospital volume and mortality deserve additional analysis.
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J. Thorac. Cardiovasc. Surg. · Jan 2013
Technical aspects and early results of robotic esophagectomy with chest anastomosis.
Minimally invasive esophagectomy with a chest anastomosis has advantages. We present technical lessons learned and early results. ⋯ Robotic thoracic esophagectomy using ports only is feasible, safe, and affords R0 resection with thorough thoracic lymph node dissection. It also allows the sewing of a 2-layered chest anastomosis with good early results.