The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2003
Mediastinal metastases from testicular nonseminomatous germ cell tumors: patterns of dissemination and predictors of long-term survival with surgery.
The purpose of this study was to determine the pattern of mediastinal dissemination of nonseminomatous germ cell tumors of testicular origin and evaluate variables that may influence survival with mediastinal dissection in patients with metastatic nonseminomatous germ cell tumors. ⋯ Testicular nonseminomatous germ cell tumors follow a predictable pattern of mediastinal dissemination, primarily following the course of the thoracic duct and its major tributaries. Patients who require surgery to remove residual mediastinal disease after cisplatin-based chemotherapy for metastatic nonseminomatous germ cell tumors have good to excellent long-term survivals. These results justify an aggressive surgical approach, including multiple surgical procedures if clinically indicated.
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J. Thorac. Cardiovasc. Surg. · Apr 2003
Comparative StudyDeep hypothermic circulatory arrest and antegrade selective cerebral perfusion during ascending aorta-hemiarch replacement: a retrospective comparative study.
We sought to compare the results of ascending aorta-hemiarch replacement by using 2 different methods of cerebral protection in terms of hospital mortality, neurologic outcome, and systemic morbidity and to determine predictive risk factors associated with hospital mortality and neurologic outcome after ascending aorta-hemiarch replacement. ⋯ The use of antegrade selective cerebral perfusion and deep hypothermic circulatory arrest during ascending aorta-hemiarch replacement resulted in acceptable hospital mortality and neurologic outcome. Reduced postoperative intubation time and better renal function preservation were observed in the antegrade selective cerebral perfusion group.
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J. Thorac. Cardiovasc. Surg. · Apr 2003
Comparative StudyPositron emission tomography scanning with 2-fluoro-2-deoxy-d-glucose as a predictor of response of neoadjuvant treatment for non-small cell carcinoma.
Surgical resection after preoperative chemotherapy in patients with non-small cell lung cancer might only be best for patients who are responders. We compared positron emission tomographic scanning with 2-fluoro-2-deoxy-d-glucose (FDP-PET scanning) with computed tomographic scanning to evaluate their ability to predict this response for the primary tumor, N1 and N2 lymph nodes. ⋯ Repeat FDP-PET scanning is more specific and has a higher positive predictive value and negative predictive value than computed tomographic scanning for detecting residual tumor in the lung in patients with non-small cell lung cancer who have received preoperative chemotherapy. It is more sensitive and accurate for paratracheal N2 nodes as well. However, there is no significant difference in its detection of N1 lymph nodes.
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J. Thorac. Cardiovasc. Surg. · Mar 2003
Comparative StudyThe short-term and long-term effects of warm or tepid cardioplegia.
Clinical studies of myocardial protection rarely identify differences in hard clinical outcomes after surgery, either early or late, because most trials lack sufficient statistical power to deal with low-frequency events. ⋯ In 6064 patients undergoing isolated coronary artery bypass grafting, warm or tepid blood cardioplegia may be associated with better early and late event-free survivals than is cold cardioplegia.