Journal and News Scan

Patient Care and General Interest

In this brief video, an oncologist shares some thoughts on the value of tumor board discussions and the importance of having them early in a patient’s care.

Drugs and Devices

The US Food and Drug Administration has given Investigational Device Exemption approval to the RejuvenAir System from CSA Medical, a bronchoscopic system that uses liquid nitrogen for targeted treatment in chronic obstructive pulmonary disease with chronic bronchitis.

Research, Trials, and Funding

Research presented at the recent Annual Meeting of the International Society for Heart and Lung Transplantation reports on the success of an approach to organ recovery and evaluation for transplant that is based on military-style Special Ops teams.

An association between coffee intake and lung cancer risk, as reported by researchers at the recent Annual Meeting of the American Association for Cancer Research, is noted as interesting but not a finding that should distract from the contribution of smoking to lung cancer.

Biomedical engineering researchers from the University of Arkansas in the USA applied vector flow imaging to improve ultrasound assessment of the heart in two children, demonstrating the feasibility of the technology.

Colorado becomes the second state (after Rhode Island) to require hospitals and ambulatory surgical centers to implement a surgical smoke evacuation system that prevents human exposure to surgical smoke. Effective May 1, 2021, all planned procedures in Colorado which are likely to generate surgical smoke must be conducted in facilities with policies and equipment in place to prevent human exposure to the smoke. According to the estimates of AORN, each year 500,000 healthcare workers, including surgeons, nurses, anesthesiologists, and other staff in the operating room, are exposed to laser or electrosurgical smoke, which can lead to serious and life-threatening respiratory diseases.

Gu and colleagues developed a surgeon-specific quality monitoring system using a structured database of information derived from electronic health records. Additionally, they used a mobile-based system to provide feedback to surgeons on risk-adjusted mortality, risk-adjusted complications, and other quality measures. The authors report on both the development of the system and the quality measures of top, middle, and bottom performing surgeons, with differences observed only for the rate of internal mammary artery use, the risk-adjusted postoperative length of stay, and risk-adjusted hospitalization cost. They conclude that the system allowed surgeons to compare their own surgical quality with that of their colleagues and identify priorities for improvement.

Intraoperative conversion may be necessary during video-assisted thoracoscopic surgery (VATS) for lung cancer. In this study on 610 patients, Fourdrain and colleagues observed that conversion during a VATS procedure was not associated with worse outcomes than undergoing an up-front thoracotomy. The authors conclude that thoracoscopic access should be preferred to thoracotomy, since conversion is not disadvantageous.