The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Aug 2022
Meta AnalysisEffect of routine jejunostomy tube insertion in esophagectomy: A systematic review and meta-analysis.
Routine feeding jejunostomy tube post esophagectomy is being revaluated because of its associated postoperative complications. We performed a systematic review and meta-analysis to evaluate the effect of routine feeding jejunostomy tube insertion on mortality and postesophagectomy outcomes. ⋯ Feeding jejunostomy tube after esophagectomy might lead to lower 30-day all-cause mortality with no difference in common postesophagectomy complications. A routine insertion of a jejunostomy tube should be considered at the time of surgery for esophageal cancer resection.
-
J. Thorac. Cardiovasc. Surg. · Aug 2022
Subnormothermic ex vivo lung perfusion attenuates graft inflammation in a rat transplant model.
Ex vivo lung perfusion has emerged as a novel technique to safely preserve lungs before transplantation. Recent studies have demonstrated an accumulation of inflammatory molecules in the perfusate during ex vivo lung perfusion. These proinflammatory molecules, including damage-associated molecular patterns and inflammatory cytokines, may contribute to acute and chronic allograft dysfunction. At present, ex vivo lung perfusion is performed clinically at normothermic temperature (37°C). The effect of lowering temperature to the subnormothermic range during ex vivo lung perfusion has not been reported. In this study, we hypothesized that lower ex vivo lung perfusion temperature will lead to a reduction in allograft inflammation and result in improved post-transplant graft function. ⋯ Subnormothermic ex vivo lung perfusion at 25°C reduces the production of inflammatory mediators during ex vivo lung perfusion and is associated with reduced histologic graft injury after transplantation.
-
J. Thorac. Cardiovasc. Surg. · Aug 2022
Branch pulmonary artery stenosis after arterial switch operation: The effect of preoperative anatomic factors on reintervention.
We hypothesized that preoperative patient characteristics and branch pulmonary artery (PA) size might influence the rate of postoperative branch PA reintervention in patients with transposition of the great arteries who undergo the arterial switch operation (ASO). ⋯ Branch PA reintervention was common and often required surgical or catheter-based reinterventions after ASO. PA branch diameters became significantly smaller after ASO. Smaller preoperative branch PA predicted late branch PA reintervention, indicating a smaller margin of geometrical tolerance to this effect.