Zhang and colleagues examined serum biomarker levels in patients undergoing a lobectomy using video-assisted thoracic surgery. Among 626 patients, they found that preoperative serum LDH was an independent predictor of 90-day cardiopulmonary complications. The authors recommend including LDH measurements in the risk assessment process prior to major lung resection.
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Ljungqvist O, Batchelor T, Coates J. ERAS in Cardiothoracic Surgery and Digital Chest Drains. August 2019. doi:10.25373/ctsnet.9172451.
Enhanced Recovery After Surgery (ERAS) is a perioperative protocol that places the patient at the center of all medical decisions. It is designed to reduce stress for the patient, alleviate the amount of pain they experience, and crucially, speed up the recovery and mobilization process, where removing invasive lines and drains as soon as possible is essential.
During the Seventh ERAS World Congress, held in Liverpool, UK, in early May 2019, the myriad benefits of the protocol for both patients and the perioperative care team were discussed by three experts: Olle Ljungqvist, Professor of Surgery at Örebro University, Sweden, and co-founder and current president of the ERAS® Society; Tim Batchelor, a thoracic surgeon from Bristol in the UK and lead author of the recently published ERAS® Society/ESTS guidelines for lung surgery; and Jim Coates, clinical research fellow in cardiothoracic anesthesia and principal investigator of ERAS for heart patients at the James Cook University Hospital in Middlesbrough, UK. The group discusses the implementation of ERAS protocols, how patients benefit from ERAS approaches, and how digital chest drains fit into the ERAS philosophy.
Jim Coates directed a feasibility study for using digital chest drains during an ERAS program in Middelsbrough, UK, work that was supported by a grant from Medela. Additionally, the filming of this roundtable was organized and paid for by Medela; the panelists were not reimbursed for their participation.
Corsini et al examined the results of a single-institution's 5-year experience of cardiothoracic surgery mock oral examinations. They demonstrate that this time- and labor-intensive exercise where trainees verbalize and practice their certification examination in a safe, controlled environment with their faculty can lead to improvement in preparation for the high-stakes real examination, with an impressive 5-year 100% pass rate for trainees involved in this experience.
The 2019 Annual Meeting of the European Society of Thoracic Surgeons (ESTS) was held in Dublin, Ireland, June 9-12, 2019. On June 9-11, presentations from the meeting streamed live on CTSNet. Did you miss the livestream? Watch these sessions below, in the CTSNet YouTube channel, or on ESTS TV.
Sunday, June 9
- Postgraduate Symposium Master Cup
- Database and Quality Certification
- Key Papers Through the Year
- Black Swan Operations
- Video Abstracts
Monday, June 10
- Tracheal and Airway Surgery, presented with the Brazilian Society of Thoracic Surgery
- Robotic Surgery
- Lung Surgery of the Future, presented with ISMICS
Tuesday, June 11
- Innovative/Experimental Abstracts
- Esophagus/Mediastinum Abstracts
- Pulmonary Neoplastic Abstracts
Wood D, Farjah F, D'Amico TA, Detterbeck FC. Debate: Lung Cancer Screening Should Be Limited to Those Recommended by the ACCP Lung Cancer Screening Guidelines. January 2019. doi:10.25373/ctsnet.7450940.
Filmed at the 2018 STS Annual Meeting in Fort Lauderdale, Florida, Douglas Wood of the University of Washington in Seattle moderates a debate on the criteria that should be used to select which patients should undergo lung cancer screening. Dr Wood is joined by Farhood Farjah of the University of Washington, Thomas D'Amico of Duke University in Durham, North Carolina, and Frank Detterbeck of Yale University in New Haven, Connecticut. They discuss the screening guidelines from the American College of Chest Physicians (ACCP) and the National Comprehensive Cancer Network (NCCN), the differences between these guidelines, and the availability of risk calculators. To finish, Dr Wood asks each panel member how they would cover lung cancer screening in the US if they were Senior Medicare Administrator for a day.
Click on the link below and register for free to gain access to two operations that were performed live in Bologna, Italy, on October 1st, 2018.
The first video is a right upper lobe microthymectomy with energy division of the posterior ascending artery and tumour retrieval from a subxiphoid port with lymphadenectomy, followed by a presentation about microlobectomy.
Using the National Cancer Database, the effect of the timing of computed tomography (CT) surveillance after resection of non-small cell lung cancer on survival was investigated. Survival was similar for patients undergoing CTs every three months or every six months compared to those undergoing annual surveillance CTs. More frequent imaging also had no impact on survival after recurrence.
The highly respected Cochrane Collaboration is in crisis today at its 25th annual meeting in Edinburgh as one board member is expelled and six more resign. There are more links below but it seems to have been over a dispute regarding the independence of authors and members with regards to links to industry and pharmaceutical companies. Here is a statement from the rump governing board, released yesterday:
Sihoe A, Elkhayat H. Trends in Thoracic Surgery Literature. August 2018. doi:10.25373/ctsnet.6879425.
This lecture by Alan Sihoe of the University of Hong Kong was given during the Fourth Assiut VATS Workshop in Assiut, Egypt, in February 2018. In this lecture, Professor Sihoe gives an overview of trends in thoracic surgery literature and what editors and reviewers are looking for in submitted manuscripts. This lecture focuses primarily on thoracic surgery researchers from developing countries, but it gives tips and tricks for all researchers that range from choosing a journal for your current research to choosing a new topic for your next research plan.
Enhanced recovery programs are very popular now, but their benefits have been mostly theoretical. This article describes challenges and outcomes after initiation of such a program, citing decreased costs, lower opioid usage, and shortened length of stay.