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March 2, 2014
LVI is thought to be an adverse prognostic indicator of survival in patients with NSCLC. This review quantified the relationship of LVI and survival. The unadjusted effect of LVI for recurrence-free survival was HR=3.63 and for overall survival was HR=2.38. After adjustment for covarates, these HRs were 2.52 and 1.81, both highly significant.
February 24, 2014
Using SEER data the authors compared open to VATS segmental resection in a population of pts >65 years old. Propensity score matching was used to adjust for baseline differences between the groups. VATS pts had lower complication rates, fewer ICU admissions, and shorter length of hospital stay. Outcomes did not appear to be surgeon-specific.
February 24, 2014
This study evaluated safety and efficacy of EBUS-TBNA in a population of pts 70 or older and compared their results to those of younger patients. Tolerance was better in the older group, and complication rates were similar. Overall accuracy was higher in the older group, possibly related to differences in the underlying diagnoses.
February 24, 2014
The authors hypothesized that major lung surgery may predispose patients to post-traumatic stress disorder (PTSD). 47 pts were evaluated prospectively. 50% were identified as having an elevated PTSD risk score 3 months posteroperatively. Predictors included excess preoperative anxiety and increased acute postoperative pain.
February 15, 2014
Over 700 lung cancer patients were surveyed at diagnosis and a mean of 54 months later regarding smoking status. 56% of those smoking at the time of diagnosis and stopped smoking 1 year later. Smoking cessation was adversely affected by second hand smoke exposure from housemates, spouses, and peers; these effects were cumulative.
February 15, 2014
Pts surviving esophagectomy longer than 10 years were queried as to QOL. Alimentary comfort rating was 9 out of 10. 33% experienced diarrhea, dumping, or regurgitation. 15% had aspiration requiring hospital care. Mean weight loss was 26 lbs. Median GI QOL score was 2.9 out of 4.
February 10, 2014
The CROSS trials randomized pts with esophageal cancer or GEJ cancer to surgery vs induction chemoradiotherapy (CRT) followed by surgery. Prior studies reported a significant improvement in survival and freedom from recurrence associated with induction therapy.
February 6, 2014
The authors hypothesized that examination of more lymph nodes resulting from lung resection for NSCLC would result in fewer missed nodal metastases and be associated with better survival related to more accurate staging. Based on nearly 25,000 pts from SEER, they found the median number of nodes examined was only 6.
January 27, 2014
This video examines the example of two similar operations performed in a hospital in Spain and a hospital in Brazil, using the same uniportal VATS technique. The purpose of this video is to demonstrate how the approach by uniportal VATS offers a direct view of the hilum, giving a clear and safe view of the fissure from its anterior and most inferior aspect.
January 23, 2014
The authors removed chest tubes after video-assisted thoracic surgery (VATS) lobectomy with serous fluid production up to 500 ml/day in 622 patients. Of them, 17 (2,8%) needed reinterventions due to recurrent pleural effusion. There was no association to the postoperative day of tube removal.