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October 19, 2015
The authors present a novel technique in which argon plasma energy (APE) is utilized to perform meticulous decortication, while preserving the lung parenchyma.
October 1, 2015
This single institution study evaluated patients with traumatic rib fracture treated with rib fixation vs medical management; patients were propensity score matched.  RF pts experienced a lower incidence of re-intervention for retained hemothorax, a lower incidence of empyema, and a lower incidence of readmision.
September 4, 2015
This study used a multicenter cohort in Italy to identify prognostic indicators for 3-year survival in patients who had undergone extrapleural pneumonectomy (EPP) for mesothelioma.  23% lived 3 years or longer.  This survival was related to age, epitheliod histology, lack of asbestos exposure, and involved LN ratio.  A risk score for survival was dev
July 30, 2015
The ESMO Guidelines Committee provides an update to its guidelines for evaluation and management of malignant pleural mesothelioma.  They recommend against screening.  A biopsy demonstrating tissue invasion is required for a definitive diagnosis.  Definitions for different extents of surgical radicality are provided.  No specific recommendations for
June 11, 2015
The authors evaluated VATS vs pleural drainage for initial primary spontaneous pneumothorax in 122 pts, evaluating costs and QOL.  Costs for VATS were half of those for pleural drainage.  Quality adjusted life years were better for VATS.  The incremental cost-effectiveness ratio for VATS was 7,600 euros at 1 year and 10,000 euros at 5 years, well wit
May 19, 2015
The question in this review was whether patients who experience tension pneumothorax differ in presentation depending on whether they are breathing spontaneously or are on positive pressure ventilation.  Assisted ventilation was more often associated with hypoxia, hypotension, and cardiac arrest.  These adverse clinical signs frequently arose within
April 30, 2015
This prospective study evaluated QOL and lung function after extended pleurectomy/decortication (EPD) for mesothelioma in 36 patients.  Patients with performance status (PS) 0 experienced little or no improvement in QOL but did have a significant decrease in lung function (FVC, FEV1, TLC, DLCO).  Patients with PS 1-2 experienced improved QOL and no i
April 9, 2015
This article offers an overview of the evolution of thoracic drainage and development of the modern chest tube from ancient Greece to the present time.
January 14, 2015
A tool for assessing competency in chest tube insertion was developed and validated using mannequins and patients.  Scores varied according to participant experience, and interrater consistency in evaluations was high.  It is suggested that this assessment tool can be used to judge the development of competence in chest to insertion and to evaluate t
November 6, 2014
The authors performed a single center review to assess outcomes of thoracentesis for inpatients.  For 9,320 thoracenteses in 4,618 patients the incidence of adverse outcomes was quite low: pneumothorax 0.6%, reexpansion pulmonary edema 0.01%, and bleeding 0.2%.  Current guidelines may not be aligned with outcomes of expert clinical practice.