MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Thoracic Surgery Clinics' source. Tue, 07 Feb 2012 03:52:42 +0100 http://www.medworm.com/index.php?rid=5438573&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001435%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438573 Wed, 23 Nov 2011 21:01:21 +0100 5438573 http://www.medworm.com/index.php?rid=5438570&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001095%2Fabstract%3Frss%3Dyes This article outlines the data supporting current management strategies. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438570 Wed, 23 Nov 2011 21:01:21 +0100 5438570 http://www.medworm.com/index.php?rid=5438569&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001058%2Fabstract%3Frss%3Dyes This article focuses on the current surgical management of pulmonary metastases providing the reader with reasonable guidance from the vast literature that exists. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438569 Wed, 23 Nov 2011 21:01:21 +0100 5438569 http://www.medworm.com/index.php?rid=5438568&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001149%2Fabstract%3Frss%3Dyes Thymic malignancies are rare tumors of the chest that express a broad range of biological behaviors. Surgery remains the mainstay of therapy, and complete surgical resection is the primary predictor of long-term survival. Although there is a paucity of clinical trials assessing the role of induction/adjuvant chemotherapy and/or radiation therapy in the treatment of thymic malignancies, existing data suggest that induction therapy should be offered for the treatment of advanced-stage disease, and postoperative radiation for specific stages. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438568 Wed, 23 Nov 2011 21:01:21 +0100 5438568 http://www.medworm.com/index.php?rid=5438562&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001137%2Fabstract%3Frss%3Dyes Perioperative management of anticoagulants requires one to balance the patient's risk factors for operative bleeding, the type of operation to be performed, and the patient's risk of thromboembolism. At present, no set algorithm exists for the perioperative management of all the anticoagulants. In this article, we address the perioperative management of the most commonly used anticoagulants seen in practice today, such as warfarin, heparin, dabigatran, clopidogrel, and aspirin, for the most commonly performed general thoracic operations. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438562 Wed, 23 Nov 2011 21:01:21 +0100 5438562 http://www.medworm.com/index.php?rid=5438559&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001125%2Fabstract%3Frss%3Dyes Smoking is the leading cause of preventable death worldwide. Smoking cessation programs that include counseling and pharmacotherapy have been proved to be effective in achieving long-standing abstinence. Smoking cessation is associated with significant improvements in quality of life, mortality, life expectancy, and postsurgical complication rates. Contrary to general belief, smoking cessation close to the time of elective surgery does not increase the risk of pulmonary complications. Longer-term quit rates are generally higher in cohorts who quit in anticipation of surgery compared with those quitting for general health considerations. A team approach and adherence to the guidelines for smoking cessation improves long-term chances of success. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438559 Wed, 23 Nov 2011 21:01:21 +0100 5438559 http://www.medworm.com/index.php?rid=5438558&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001344%2Fabstract%3Frss%3Dyes Thoracic surgery, as a specialty, covers a great breadth of pathology and care. Thoracic surgeons deal with a variety of conditions affecting multiple organs and systems, from benign processes such as hyperhydrosis and achalasia to multiple malignancies, both primary and metastatic. The optimal management of such a diverse group of patients is very complex. For clinical questions, guidelines have been developed. Guidelines may represent an institutional approach from extensive experience or collaborative efforts within or between societies. They usually serve to provide clarity in an area where multiple strategies may exist or where treatment strategies are evolving. For these guidelines, an exhaustive search of the literature is performed with the level of evidence weighted and statements... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438558 Wed, 23 Nov 2011 21:01:21 +0100 5438558 http://www.medworm.com/index.php?rid=5438557&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001423%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438557 Wed, 23 Nov 2011 21:01:21 +0100 5438557 http://www.medworm.com/index.php?rid=5438556&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001411%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438556 Wed, 23 Nov 2011 21:01:21 +0100 5438556 http://www.medworm.com/index.php?rid=5438555&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100140X%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438555 Wed, 23 Nov 2011 21:01:21 +0100 5438555 http://www.medworm.com/index.php?rid=5438571&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001071%2Fabstract%3Frss%3Dyes The management of localized esophageal cancer has traditionally been surgical resection; yet, despite improvements in outcomes and techniques, survival for patients with esophageal cancer, especially those with evidence of nodal involvement, remains poor. In this article, we have used an evidence-based approach to define optimal therapy based on clinical stage for esophageal cancer. We review the currently available evidence supporting the use of neoadjuvant and adjuvant therapies for locally advanced esophageal cancer. Additionally, we review the evidence supporting the role of endoscopic therapies, rather than resection, for early-stage esophageal cancer. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438571 Thu, 03 Nov 2011 04:00:00 +0100 5438571 http://www.medworm.com/index.php?rid=5377897&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001228%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377897 Tue, 01 Nov 2011 04:00:00 +0100 5377897 http://www.medworm.com/index.php?rid=5377896&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001101%2Fabstract%3Frss%3Dyes Eosinophilic esophagitis is a chronic disease limited to the esophagus and has a persistent or spontaneously fluctuating course. So far it does not seem to limit life expectancy, but it often substantially impairs the quality of life. To date, there has been no association with malignant conditions, but there is concern that the chronic, uncontrolled inflammation will evoke irreversible structural alterations of the esophagus, leading to tissue fibrosis, stricture formation, and impaired function. This esophageal remodeling may result in several disease-inherent and procedure-related complications. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377896 Tue, 01 Nov 2011 04:00:00 +0100 5377896 http://www.medworm.com/index.php?rid=5377895&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001113%2Fabstract%3Frss%3Dyes This article highlights current and emerging pharmacological treatments for gastroesophageal reflux disease (GERD), opportunities for improving medical treatment, the extent to which improvements may be achieved with current therapy, and where new therapies may be required. These issues are discussed in the context of current thinking on the pathogenesis of GERD and its various manifestations and on the pharmacologic basis of current treatments. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377895 Tue, 01 Nov 2011 04:00:00 +0100 5377895 http://www.medworm.com/index.php?rid=5377894&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000909%2Fabstract%3Frss%3Dyes This article reviews current advances in the diagnosis and management of acute esophageal perforation. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377894 Tue, 01 Nov 2011 04:00:00 +0100 5377894 http://www.medworm.com/index.php?rid=5377893&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000971%2Fabstract%3Frss%3Dyes This article describes the patient selection and the status of currently available esophagus-preserving options, and discusses the strategy for treating HGD and intramusocal adenocarcinoma. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377893 Tue, 01 Nov 2011 04:00:00 +0100 5377893 http://www.medworm.com/index.php?rid=5377892&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000934%2Fabstract%3Frss%3Dyes Peroral endoscopic myotomy (POEM) has been developed as an incisionless, minimally invasive endoscopic treatment intending a permanent cure for esophageal achalasia. The concept of endoscopic myotomy was first reported about 3 decades ago, but the direct incision method through the mucosal layer was not considered to be a safe and reliable approach. A novel method of endoscopic myotomy was developed and established by the authors. In this article, the current techniques, applications, and clinical results of POEM are described. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377892 Tue, 01 Nov 2011 04:00:00 +0100 5377892 http://www.medworm.com/index.php?rid=5377891&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100096X%2Fabstract%3Frss%3Dyes Cricopharyngeal dysphagia and Zenker 's diverticulum result from cricopharyngeal dysfunction, a failure of the upper esophageal sphincter to relax at the initiation of swallowing. The focus of surgical management involves a cricopharyngeal myotomy that is performed by either an open or an endoscopic approach. The endoscopic approach offers faster operating times, a shorter hospital stay, earlier time to oral intake, and lower complication rates, but a role for open cricopharyngeal myotomy remains. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377891 Tue, 01 Nov 2011 04:00:00 +0100 5377891 http://www.medworm.com/index.php?rid=5377888&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000892%2Fabstract%3Frss%3Dyes Gastroesophageal reflux disease (GERD) is a well-defined disease characterized by symptoms or complications caused by an abnormal amount of GER, which is a retrograde movement of gastric contents into the esophagus. Laryngopharyngeal reflux (LPR) is a subset of GERD and given its own identity, because the main symptomatic regions are the larynx and pharynx. Accurate diagnosis and effective treatment of LPR has been challenging. Much research has been dedicated to the elucidation of its complex pathophysiology and the development of accurate diagnostic modalities and effective treatment. Considerable advancements have been made in the evaluation and treatment of LPR. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377888 Tue, 01 Nov 2011 04:00:00 +0100 5377888 http://www.medworm.com/index.php?rid=5377887&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000958%2Fabstract%3Frss%3Dyes This article provides an HRM-related atlas of esophageal motility disorders focused on dysphagia and gastroesophageal reflux disease (GERD). Although there is some overlap between esophageal motor disorders associated with dysphagia and the defects and esophageal motor function that would predispose the patient to more severe GERD, this review is organized to differentiate the distinct pathophysiologic components of the two disease groups. A section on impaired bolus transit is also included to highlight the important aspect of impaired clearance in the pathogenesis of GERD. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377887 Tue, 01 Nov 2011 04:00:00 +0100 5377887 http://www.medworm.com/index.php?rid=5377885&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001083%2Fabstract%3Frss%3Dyes In this issue of Thoracic Surgery Clinics, an amalgam of the most challenging clinical scenarios in benign esophageal diseases is addressed by experts in the field of esophagology. The recent introduction of novel technologies that have redefined the ways in which we diagnose and treat diseases of the esophagus occupies a prominent place in this issue. For example, an in-depth coverage of high-resolution manometry, a “game changer,” along with colored examples of normal and abnormal tracings are provided in a detailed atlas format to serve as a primer and enduring reference. The use of impedance testing in the context of laryngopharyngeal reflux and end-stage lung disease is reviewed and sets the stage for a paradigm shift in our understanding of proximal reflux. Endoscopic imaging in ... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377885 Tue, 01 Nov 2011 04:00:00 +0100 5377885 http://www.medworm.com/index.php?rid=5377884&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001216%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377884 Tue, 01 Nov 2011 04:00:00 +0100 5377884 http://www.medworm.com/index.php?rid=5377883&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001204%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377883 Tue, 01 Nov 2011 04:00:00 +0100 5377883 http://www.medworm.com/index.php?rid=5377882&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001198%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377882 Tue, 01 Nov 2011 04:00:00 +0100 5377882 http://www.medworm.com/index.php?rid=5438565&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100106X%2Fabstract%3Frss%3Dyes The preferred treatment of stage I non–small cell lung cancer (NSCLC) is anatomic resection with systematic mediastinal lymph node evaluation. However, 20% of patients with operable lung cancer are not candidates for this type of resection. Recent advancements in radiology-guided technologies have expanded the treatment options for high-risk patients with early-stage NSCLC. There has simultaneously been resurgence in interest and refinement of indications and techniques for sublobar resection in this population. While these treatments appear to have decreased peri-procedural morbidity and mortality, their oncologic efficacy compared to that of lobectomy remains to be determined. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438565 Wed, 26 Oct 2011 04:00:00 +0100 5438565 http://www.medworm.com/index.php?rid=5438563&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001009%2Fabstract%3Frss%3Dyes This article discusses the evidence-based indications for antibiotic prophylaxis after lung resection, esophageal surgery, and lung transplantation. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438563 Mon, 24 Oct 2011 04:00:00 +0100 5438563 http://www.medworm.com/index.php?rid=5438572&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000995%2Fabstract%3Frss%3Dyes The authors have systematically performed a literature search using 8 databases identifying established guidelines for follow-up after resected thoracic malignancies. Seven different societies' (found to have published recommendations for non-small cell lung cancer, esophageal cancer, thymoma, or mesothelioma) guidelines are reviewed in this article. High-quality evidence leading to consistent, strong recommendations among societies has not been found. With the subsequent advancements in surgical treatment and other curative modalities, the ability to detect and intervene with curative therapy at earlier stages of disease in a growing portion of the current patient population will benefit from higher-quality evidence. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438572 Thu, 20 Oct 2011 04:00:00 +0100 5438572 http://www.medworm.com/index.php?rid=5438567&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001034%2Fabstract%3Frss%3Dyes Chest wall sarcomas are uncommon tumors. The best patient outcomes likely result from a formalized multidisciplinary treatment plan in a specialized center. No clear guidelines exist to determine whether patients with chest wall sarcomas benefit from preoperative adjuvant therapy. Most decisions are made on a case-by-case basis with little available evidence. It is unclear whether established guidelines for the more commonly occurring extremity sarcomas can be appropriately extrapolated to the care of patients with chest wall disease. The single most important factor in local control and long-term survival is a wide, complete, R0 resection. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438567 Fri, 14 Oct 2011 04:00:00 +0100 5438567 http://www.medworm.com/index.php?rid=5438560&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001046%2Fabstract%3Frss%3Dyes Atrial fibrillation (AF) commonly affects patients after general thoracic surgery. Postoperative AF increases hospital stay and charges. Effective prophylaxis and treatment is the goal. Calcium channel blockers prevent postoperative AF. Beta blockers are a less viable choice. Amiodarone prophylaxis should be avoided in patients with pulmonary dysfunction or who require pneumonectomy. In management of AF, a brief trial of rate-control agents is appropriate; however, chemical cardioversion with rhythm-control agents should be instituted after 24 hours. High-risk patients with history of stroke or transient ischemic attack, or with two or more risk factors for thromboembolism should receive anticoagulation therapy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438560 Fri, 14 Oct 2011 04:00:00 +0100 5438560 http://www.medworm.com/index.php?rid=5438566&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000983%2Fabstract%3Frss%3Dyes In spite of numerous clinical trials, the jury is still out on the value of induction therapy for locally advanced lung cancer. We elected to address this topic from the multifaceted views of the clinicians often involved in lung cancer management and according the most recent views on locally advanced NSCLC. The concept of a prognostic stratification of N2 disease subsets, especially single vs multiple zone, has been introduced and this may lead to a new interpretation of locally advanced NSCLC. Ten crucial issues were identified that may have an impact on the approach to patients with locally advanced lung cancer in everyday practice. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438566 Thu, 13 Oct 2011 04:00:00 +0100 5438566 http://www.medworm.com/index.php?rid=5438564&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001010%2Fabstract%3Frss%3Dyes This article reviews an evidence-based approach to the physiologic evaluation of patients under consideration for surgical resection of lung cancer. Adequate physiologic evaluation often includes a multidisciplinary evaluation, with complete identification of risk factors for perioperative complications and long-term disability including cardiovascular risk, assessment of pulmonary function, and smoking cessation counseling. Consideration of tumor-related anatomic obstruction, atelectasis, or vascular occlusion may alter measurements. Careful preoperative physiologic assessment helps to identify patients at increased risk of morbidity and mortality after lung resection. These evaluations are helpful in identifying patients who may not benefit from surgical management of their lung cancer. ... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438564 Thu, 13 Oct 2011 04:00:00 +0100 5438564 http://www.medworm.com/index.php?rid=5438561&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711001022%2Fabstract%3Frss%3Dyes Thoracic surgery patients should be regarded at high risk for postoperative venous thromboembolism (VTE). VTE mechanical and pharmacologic prophylaxis with low molecular weight heparin, or low-dose unfractionated heparin or fondaparinux (Arixtra) is therefore strongly recommended. Pharmacologic prophylaxis should be extended to 4 weeks after major cancer surgery. Pulmonary embolism should be always managed with anticoagulation, in addition to thrombolytic therapy, in patients presenting with cardiogenic shock or persistent arterial hypotension. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5438561 Mon, 10 Oct 2011 04:00:00 +0100 5438561 http://www.medworm.com/index.php?rid=5377886&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000910%2Fabstract%3Frss%3Dyes Advancements in foregut diagnostic technologies have led to improvements in the esophagologist's ability to accurately diagnose and classify esophageal pathophysiology and increased patient satisfaction and compliance in undergoing testing. The esophageal surgeon's ability to bring about a successful outcome is dependent on the proper application and interpretation of these diagnostic modalities. The ability to reliably and consistently differentiate foregut disorders from other potential contributors is an essential ingredient in assuring appropriate therapy and predicting success. The physician or surgeon treating esophageal disorders is well advised to keep abreast of ongoing advancements and to implement them into their diagnostic armamentarium. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377886 Fri, 23 Sep 2011 04:00:00 +0100 5377886 http://www.medworm.com/index.php?rid=5377889&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000922%2Fabstract%3Frss%3Dyes Obesity and gastroesophageal reflux disease (GERD) are common chronic illnesses. They often coexist and need to be treated concomitantly. Fundoplication may be effective for the short-term control of GERD in the obese patient; however, this procedure does not induce weight loss or treat the comorbid conditions related to obesity. Roux-en-Y gastric bypass is a highly effective treatment of GERD, obesity, and the associated comorbidities. Surgeons who are not comfortable with a bariatric surgical procedure in these patients should either complete appropriate advanced training in bariatric surgery or refer those patients to a qualified surgeon who can offer these options. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377889 Mon, 19 Sep 2011 04:00:00 +0100 5377889 http://www.medworm.com/index.php?rid=5377890&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000946%2Fabstract%3Frss%3Dyes This article reviews the existing literature and discusses the strategy to manage GERD in patients with end-stage pulmonary diseases before and after lung transplantation. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5377890 Mon, 12 Sep 2011 04:00:00 +0100 5377890 http://www.medworm.com/index.php?rid=5035922&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000843%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035922 Sun, 17 Jul 2011 22:01:45 +0100 5035922 http://www.medworm.com/index.php?rid=5035921&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000636%2Fabstract%3Frss%3Dyes Swimming with the sharks is neither enjoyable nor exhilarating, and it is not an acknowledged sport. Some individuals, however, must swim by virtue of their occupation. If such an individual finds himself or herself in shark-infested waters, this article provides useful guidelines for survival. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035921 Sun, 17 Jul 2011 22:01:45 +0100 5035921 http://www.medworm.com/index.php?rid=5035920&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000648%2Fabstract%3Frss%3Dyes The traditional action-oriented surgical personality, although essential in the service of solving emergent operative dilemmas, may serve as a barrier to introspection. Certainly, challenges of the twenty-first century practice environment, including time constraints, also distract from self-reflection. Without engaging in moments of introspection, surgeons risk not only abandoning dying patients in their time of need, but leave the surgeons themselves at risk for burnout and its consequences. The increase in the number of women surgeons, as well as the less heroic image of surgeons performing laparoscopic operations, may reorient traditional extroverted behavior toward a persona of professional grace. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035920 Sun, 17 Jul 2011 22:01:44 +0100 5035920 http://www.medworm.com/index.php?rid=5035919&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100065X%2Fabstract%3Frss%3Dyes This article explores causes of surgeon burnout and reviews results from the American College of Surgeons Burnout Survey. Strategies for personal and professional growth, wellness and renewal are also discussed. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035919 Sun, 17 Jul 2011 22:01:44 +0100 5035919 http://www.medworm.com/index.php?rid=5035917&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000569%2Fabstract%3Frss%3Dyes A philosophic discussion is pertinent to all residents and practicing thoracic surgeons as they see retirement as just a continuum of their lives in the context of full engagement in life. In this article, the author extends the concept of engagement into a third dimension, one that includes autonomy, mastery, purpose, physical fitness, quality of life, life expectancy, personal finances, philanthropy, and a desire to be part of a national reckoning in the development of medicine in general and thoracic surgery in particular. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035917 Sun, 17 Jul 2011 22:01:44 +0100 5035917 http://www.medworm.com/index.php?rid=5035916&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000612%2Fabstract%3Frss%3Dyes This article briefly reviews 7 important North American thoracic surgery organizations (the American Association for Thoracic Surgery, the Canadian Association of Thoracic Surgeons, the General Thoracic Surgical Club, the Society of Thoracic Surgeons, the Southern Thoracic Surgical Association, the Western Thoracic Surgical Association, and Women in Thoracic Surgery). The authors also review the criteria that may assist in deciding which organizations best meet a surgeon's career goals and personal expectations. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035916 Sun, 17 Jul 2011 22:01:44 +0100 5035916 http://www.medworm.com/index.php?rid=5035915&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000582%2Fabstract%3Frss%3Dyes It is self-evident to most thoracic surgeons what it takes to be successful as a surgeon. It is equally important to recognize the importance of taking on leadership and administrative responsibilities to shape your career, your department, and your institution to achieve the ultimate in clinical and academic productivity and patient care. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035915 Sun, 17 Jul 2011 22:01:43 +0100 5035915 http://www.medworm.com/index.php?rid=5035913&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000600%2Fabstract%3Frss%3Dyes This article highlights current concepts in surgical education and methods of incorporating teaching opportunities into practice. General strategies on how to be a better teacher and increase student feedback evaluation scores are addressed. Finally, the evolving roles and responsibilities of a mentor in assisting residents and colleagues in developing successful thoracic surgical careers are explored. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035913 Sun, 17 Jul 2011 22:01:43 +0100 5035913 http://www.medworm.com/index.php?rid=5035912&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000545%2Fabstract%3Frss%3Dyes This article explores theses nuances in both the American and the Canadian medical systems in building a successful practice. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035912 Sun, 17 Jul 2011 22:01:43 +0100 5035912 http://www.medworm.com/index.php?rid=5035911&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000533%2Fabstract%3Frss%3Dyes This article provides an overview of several practical strategies that can foster the successful establishment and growth of a thoracic surgery practice. Processes related to organizing outpatient clinics and referral systems, and running a well-managed operating room team and hospital ward are discussed. Valuable insights related to mentor selection, leadership opportunities, and maintaining a positive work-life balance are also shared. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035911 Sun, 17 Jul 2011 22:01:43 +0100 5035911 http://www.medworm.com/index.php?rid=5035910&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000570%2Fabstract%3Frss%3Dyes The authors discuss the factors to be considered in selecting locations in which to train and to practice, and in conducting successful interviews and site visits. The advantages and disadvantages of different types of surgical practice (ie, solo vs group) are also reviewed, as are issues surrounding negotiations related to contracts, benefits, and covenants. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035910 Sun, 17 Jul 2011 22:01:42 +0100 5035910 http://www.medworm.com/index.php?rid=5035909&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000521%2Fabstract%3Frss%3Dyes As surgeons progress through their careers, they are often entrusted with leadership roles in administration, education, research, and patient management. Insights into one's own personality type and leadership style as well as an understanding of the value of emotional intelligence are critical for success. Knowledge of group dynamics and team leading; networking; techniques in leading, changing, and innovation; as well as proficiency in negotiation and conflict resolution are also essential to the development of leadership skills. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035909 Sun, 17 Jul 2011 22:01:42 +0100 5035909 http://www.medworm.com/index.php?rid=5035908&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000624%2Fabstract%3Frss%3Dyes Success is a difficult concept to define because “success” for one individual may not be the same as for another. For some, success includes receiving a major research grant, joining a major thoracic surgery association, or receiving a promotion. For others, success may involve teaching a trainee to correctly perform a procedure, participating in the successful outcome of a surgical intervention, or achieving a good work-life balance. For many, varying degrees of all of these outcomes will define our success. In building my thoracic surgery career, I have learned from the experience and lessons of other surgeons as they realized their vision of success. I hope that these articles will assist students, residents, fellows, and attending staff as they each work toward “success” in the... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035908 Sun, 17 Jul 2011 22:01:42 +0100 5035908 http://www.medworm.com/index.php?rid=5035907&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100079X%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035907 Sun, 17 Jul 2011 22:01:42 +0100 5035907 http://www.medworm.com/index.php?rid=5035906&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000788%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035906 Sun, 17 Jul 2011 22:01:42 +0100 5035906 http://www.medworm.com/index.php?rid=5035905&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000776%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035905 Sun, 17 Jul 2011 22:01:42 +0100 5035905 http://www.medworm.com/index.php?rid=5035918&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000594%2Fabstract%3Frss%3Dyes The contributors to this article have been recognized as outstanding leaders in thoracic surgery. Each has addressed particular elements that he or she considers to be important in developing a successful thoracic surgical career. These unique perspectives provide valuable insights. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035918 Wed, 15 Jun 2011 23:00:00 +0100 5035918 http://www.medworm.com/index.php?rid=5035914&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000557%2Fabstract%3Frss%3Dyes The incorporation of research into a career in thoracic surgery is a complex process. Ideally, the preparation for a career in academic thoracic surgery begins with a research fellowship during training. In the academic setting, a research portfolio might include clinical research, translational research, or basic research. Using strategies for developing collaboration, thoracic surgeons in community-based programs may also be successful clinical investigators. In addition to the rigors of conducting research, strategies for reserving protected time and obtaining grant support must be considered to be successful in academic surgery. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=5035914 Tue, 24 May 2011 23:00:00 +0100 5035914 http://www.medworm.com/index.php?rid=4683780&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100017X%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683780 Thu, 07 Apr 2011 17:24:19 +0100 4683780 http://www.medworm.com/index.php?rid=4683779&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001908%2Fabstract%3Frss%3Dyes This article describes the current radiographic techniques for examining the gastrointestinal tract with contrast materials, emphasizing the role of barium suspensions, computed tomography scan, and magnetic resonance imaging, and illustrating normal anatomy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683779 Thu, 07 Apr 2011 17:24:19 +0100 4683779 http://www.medworm.com/index.php?rid=4683778&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000065%2Fabstract%3Frss%3Dyes The esophagus spans three body cavities and has no mesentery, continually borrowing or sharing vessels, lymphatics, and nerves with associated organs. However, constant along this path is an intricate mural structure. An understanding of the esophageal wall, its blood supply, lymphatic drainage, and innervation is essential for successful esophageal surgery. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683778 Thu, 07 Apr 2011 17:24:19 +0100 4683778 http://www.medworm.com/index.php?rid=4683777&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000041%2Fabstract%3Frss%3Dyes This article reviews the embryology and general anatomy of the esophagus, including the topography and relationships of the esophagus to surrounding structures. The esophagus is the only internal organ that traverses 3 body cavities, and a complete understanding of the anatomy and anatomic relationships of the esophagus in each area is essential for surgeons who address esophageal disorders. Details regarding the normal histology and basic function of the esophagus are also provided. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683777 Thu, 07 Apr 2011 17:24:19 +0100 4683777 http://www.medworm.com/index.php?rid=4683776&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001921%2Fabstract%3Frss%3Dyes The diaphragm acts as a partition between the thoracic and abdominal cavities. On computed tomography, it is seen as a curved soft-tissue density with fat below and aerated lung above. The direct multiplanar capability of magnetic resonance technology can improve depiction of normal or abnormal diaphragmatic anatomy. Despite the usefulness of these imaging modalities, adequate visualization of the diaphragm can be difficult. Thoracic surgeons must be familiar with the correlative anatomy of the diaphragm because this knowledge is a prerequisite to making an accurate diagnosis of diaphragmatic abnormalities. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683776 Thu, 07 Apr 2011 17:24:19 +0100 4683776 http://www.medworm.com/index.php?rid=4683775&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000028%2Fabstract%3Frss%3Dyes This article provides an overview of the normal anatomy of the diaphragm. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683775 Thu, 07 Apr 2011 17:24:19 +0100 4683775 http://www.medworm.com/index.php?rid=4683774&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000191X%2Fabstract%3Frss%3Dyes This article describes the mediastinal anatomy, correlating the findings of plain radiography, CT, and MRI. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683774 Thu, 07 Apr 2011 17:24:19 +0100 4683774 http://www.medworm.com/index.php?rid=4683773&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000077%2Fabstract%3Frss%3Dyes Knowledge of the anatomy of the mediastinal nerves is essential for the evaluation and surgical treatment of most thoracic neoplasms. Thorough knowledge of the normal anatomy of the mediastinal nerves and of their variants cannot be overestimated because nerve trauma during nerve anatomy is also important because mediastinal or lung tumors can locally infiltrate those nerves either directly or through nodal metastases, making them generally unresectable. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683773 Thu, 07 Apr 2011 17:24:19 +0100 4683773 http://www.medworm.com/index.php?rid=4683772&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271100003X%2Fabstract%3Frss%3Dyes This article reviews the embryology, anatomy, and multiple variations of the thoracic duct. Proper knowledge of this anatomy should ease understanding the pathophysiology of diseases involving the lymph channels and also prevent injury to the duct during major procedures in which the duct or its tributaries can be involved. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683772 Thu, 07 Apr 2011 17:24:19 +0100 4683772 http://www.medworm.com/index.php?rid=4683771&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001878%2Fabstract%3Frss%3Dyes This article discusses the anatomy and the most common congenital abnormalities of the thoracic aorta and its branches. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683771 Thu, 07 Apr 2011 17:24:19 +0100 4683771 http://www.medworm.com/index.php?rid=4683770&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000089%2Fabstract%3Frss%3Dyes This article describes the normal anatomy of the heart and pericardium. Included is a detailed description of the pericardium, mediastinal nerves, cardiac chambers, valves, coronary arteries and veins, and the conduction tissues. As cardiac and thoracic surgery continue to get more specialized and the procedures become less invasive, it is essential for the cardiothoracic surgeon to have a thorough working knowledge of cardiothoracic anatomy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683770 Thu, 07 Apr 2011 17:24:19 +0100 4683770 http://www.medworm.com/index.php?rid=4683769&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001933%2Fabstract%3Frss%3Dyes The venous side of the systemic vascular circulation returns the left ventricular cardiac output in a converging fashion to the superior and inferior vena cava and hence to the right atrium. Oxygenated blood is returned to the left atrium. The volumes of these 2 systems are in balance in a normal physiologic state. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683769 Thu, 07 Apr 2011 17:24:19 +0100 4683769 http://www.medworm.com/index.php?rid=4683768&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001945%2Fabstract%3Frss%3Dyes In the case of the thymus gland, the most common indications for resection are myasthenia gravis or thymoma. The consistency and appearance of the thymus gland make it difficult at times to discern from mediastinal fatty tissues. Having a clear understanding of the anatomy and the relationship of the gland to adjacent structures is important. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683768 Thu, 07 Apr 2011 17:24:19 +0100 4683768 http://www.medworm.com/index.php?rid=4683767&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000188X%2Fabstract%3Frss%3Dyes This article describes the various classifications of the mediastinum. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683767 Thu, 07 Apr 2011 17:24:19 +0100 4683767 http://www.medworm.com/index.php?rid=4683766&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001891%2Fabstract%3Frss%3Dyes Although pleural disorders are commonly encountered in the daily practices of thoracic surgeons, their assessment can be difficult. Being able to correlate normal and abnormal anatomy with imaging characteristics provides additional information that can be useful not only to accurately locate pleuropulmonary lesions but also to characterize abnormalities, such as pleural thickening or malignant processes. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683766 Thu, 07 Apr 2011 17:24:19 +0100 4683766 http://www.medworm.com/index.php?rid=4683765&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001866%2Fabstract%3Frss%3Dyes This article describes the anatomy of the pleura, which is made up of five layers. Blood supply and lymphatics are described, as are pleural fluid, mesothelial cells, and Kampmeier foci. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683765 Thu, 07 Apr 2011 17:24:19 +0100 4683765 http://www.medworm.com/index.php?rid=4683764&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001854%2Fabstract%3Frss%3Dyes Knowledge of the anatomy of the lines of pleural reflection, triangular ligaments, and pleural recesses is important to thoracic surgeons because their anatomic areas are used daily for radiographic interpretation as well as for the performance of procedures such as chest tube insertion, thoracentesis, and pericardiocentesis. Their knowledge is also important for thoracic surgeons doing surgical procedures such as parietal pleurectomies, extrapleural mobilization and resection of the lungs, and pleuroneumonectomies for destroyed lungs or malignant pleural neoplasms. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683764 Thu, 07 Apr 2011 17:24:18 +0100 4683764 http://www.medworm.com/index.php?rid=4683763&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001842%2Fabstract%3Frss%3Dyes The pleura is a monolayer of mesothelial cells covering the lung and inner surface of the chest cavity, creating the pleural space. The mesothelial cells rest on a matrix of collagen, elastic fibers, blood vessels, and lymphatics, which allow the lung and chest to expand and contract, protected from friction by the pleural fluid and properties of the mesothelial cells. With a rich blood supply and lymphatic system just deep to the mesothelial layer, the pleura is a dynamic layer protecting the lung and pleural cavity from infection while transmitting the forces of respiration without damage to the underlying lung parenchyma. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683763 Thu, 07 Apr 2011 17:24:18 +0100 4683763 http://www.medworm.com/index.php?rid=4683762&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000053%2Fabstract%3Frss%3Dyes Surface anatomy is an integral part of a thoracic surgeon's armamentarium to assist with the diagnosis, staging, and treatment of thoracic pathology. As reviewed in this article, the surface landmarks of the lungs, heart, great vessels, and mediastinum are critical for appropriate patient care and should be learned in conjunction with classic anatomy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683762 Thu, 07 Apr 2011 17:24:18 +0100 4683762 http://www.medworm.com/index.php?rid=4683761&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000090%2Fabstract%3Frss%3Dyes In the preface of his masterpiece “De Humani Corporis Fabrica” (1543), Andreas Vesalius (1514–1564) wrote that anatomy should be regarded as the firm foundation of the art of medicine and its essential preliminary. This observation, which marked a new era in the history of medicine, is even more applicable to surgery, where safe techniques are dependent on adequate knowledge and understanding of normal anatomy. Although thoracic anatomy remains the same as it was in the past, our understanding of it is vastly different that what it was only 10 or 20 years ago. This relates to new imaging techniques (CT, MR, echo), which have given us new visions of the morphology of thoracic organs, and to new surgical techniques, which use the smallest of incisions to achieve the same objectives pr... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683761 Thu, 07 Apr 2011 17:24:18 +0100 4683761 http://www.medworm.com/index.php?rid=4683760&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000168%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683760 Thu, 07 Apr 2011 17:24:18 +0100 4683760 http://www.medworm.com/index.php?rid=4683759&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000156%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683759 Thu, 07 Apr 2011 17:24:18 +0100 4683759 http://www.medworm.com/index.php?rid=4683758&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412711000144%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4683758 Thu, 07 Apr 2011 17:24:18 +0100 4683758 http://www.medworm.com/index.php?rid=4151203&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001763%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151203 Wed, 10 Nov 2010 18:46:33 +0100 4151203 http://www.medworm.com/index.php?rid=4151202&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001398%2Fabstract%3Frss%3Dyes Thymic epithelial tumors (TETs) are rare thoracic malignancies, with an overall incidence of 1.5 per million people. The TET Registry Project aims at federating an international network to provide a resource to support studies on the epidemiology and clinical management and monitoring some standards of clinical care of these tumors. Recorded data span all the specifications of the management of TET: paraneoplastic syndromes, histologic subtypes, diagnostic and staging issues, multimodal treatment strategies, and exceptional surgeries and therapies. Data collection for the registry is done both prospectively and retrospectively through different paths to allow the involvement of as many centers as possible, including data-sharing arrangements with some already established databases. This am... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151202 Wed, 10 Nov 2010 18:46:33 +0100 4151202 http://www.medworm.com/index.php?rid=4151201&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001295%2Fabstract%3Frss%3Dyes This article reviews these many guidelines and summarizes them for the reader. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151201 Wed, 10 Nov 2010 18:46:33 +0100 4151201 http://www.medworm.com/index.php?rid=4151200&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001313%2Fabstract%3Frss%3Dyes This article reviews current knowledge about the molecular data that define molecular subsets and support the use of targeted therapies in thymic tumors. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151200 Wed, 10 Nov 2010 18:46:33 +0100 4151200 http://www.medworm.com/index.php?rid=4151199&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001301%2Fabstract%3Frss%3Dyes Although thymoma and thymic carcinoma are rare malignancies, they constitute a large proportion of tumors of the anterior mediastinum. Surgery forms the mainstay of therapy; however, thymic malignancies are sensitive to chemotherapy and radiation therapy also. Systemic chemotherapy is primarily used for treatment of metastatic or recurrent disease. Chemotherapy is also used as a component of multimodality treatment in the neoadjuvant setting with the aim of increasing the chances of achieving a complete surgical resection. In this article we outline various clinical trials that have been performed to evaluate the role of chemotherapy in the treatment of thymic malignancies. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151199 Wed, 10 Nov 2010 18:46:33 +0100 4151199 http://www.medworm.com/index.php?rid=4151198&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001386%2Fabstract%3Frss%3Dyes Radiotherapy is a major therapeutic modality for thymic malignancies. The exact role of adjuvant radiotherapy after complete resection is still debated for stage II through III tumors. Histology or size, capsular invasion, and even molecular data may be included in the decision making. Radiotherapy may be recommended for stage III thymomas, thymic carcinoma, or after incomplete surgical resection. Combination with chemotherapy may be useful, and must be further evaluated using validated end points, including 5- and 10-year time-to-progression and overall survival. Several initiatives have been taken worldwide to launch collaborative studies in the field, including prospective trials specifically readdressing the role of radiotherapy for thymic malignancies. (Source: Thoracic Surgery Clinic... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151198 Wed, 10 Nov 2010 18:46:32 +0100 4151198 http://www.medworm.com/index.php?rid=4151197&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001349%2Fabstract%3Frss%3Dyes Stage IVA disease can be de novo disease or more commonly represent recurrent disease. The pleura is the most common site of relapse after thymoma resection. Local pleural disease is usually simply resected. This is usually combined with either induction or adjuvant chemotherapy. The ultimate extended surgery for advanced thymic tumors is an extrapleural pneumonectomy done for extensive pleural disease. This rarely performed operation is done for both stage IVA disease found at initial presentation and for recurrent disease as a salvage procedure. Again, these advanced patients with pleural spread are probably best managed by induction chemotherapy followed by resection. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151197 Wed, 10 Nov 2010 18:46:32 +0100 4151197 http://www.medworm.com/index.php?rid=4151195&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001325%2Fabstract%3Frss%3Dyes Thymectomy for thymoma has traditionally been performed through a transsternal approach because of the excellent exposure that that the median sternotomy provides. Minimally invasive alternatives, such as transcervical thymectomy, video-assisted thymectomy, and robotic thymectomy, have not been extensively evaluated for this disease process. It is uncertain which patients may benefit from minimally invasive approaches and data regarding the oncologic effectiveness of these techniques remains to be established. However, given the excellent capability of these techniques to perform a complete and extensive thymectomy, there does appear to be a role for minimally invasive thymectomy in the treatment of thymoma. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151195 Wed, 10 Nov 2010 18:46:32 +0100 4151195 http://www.medworm.com/index.php?rid=4151194&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001283%2Fabstract%3Frss%3Dyes With a knowledgeable assessment of the clinical presentation and demographic and radiologic characteristics, most thymomas can be reliably identified preoperatively without the need for a biopsy. Surgery is the mainstay of treatment for stage I and II thymoma. The rate of complete resection is essentially 100% by open techniques, and recurrences are rare. A complete thymectomy via a sternotomy is the standard approach. Adjuvant radiotherapy after a complete resection does not appear to be of benefit. In the rare event of a recurrence, an aggressive approach should be taken with re-resection whenever possible. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151194 Wed, 10 Nov 2010 18:46:32 +0100 4151194 http://www.medworm.com/index.php?rid=4151193&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001362%2Fabstract%3Frss%3Dyes Myasthenia gravis (MG) associated with thymomas differs from nonthymomatous MG, and thymomas associated with MG are also different from non-MG thymomas. According to the World Health Organization classification, the incidence of MG in thymomas was the highest in the subtypes B2, B1, and AB. Transsternal approach is still regarded as the gold standard for surgical treatment of thymomas. Less-invasive techniques of thymectomy are promising, but it is too early to estimate their real oncological value. In the series including more than 100 patients, the prognosis for survival is better in patients with thymomas associated with MG than in those with non-MG thymomas, and the prognosis for patients with MG associated with thymoma is worse than that for patients with nonthymomatous MG. (Source: T... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151193 Wed, 10 Nov 2010 18:46:31 +0100 4151193 http://www.medworm.com/index.php?rid=4151192&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001416%2Fabstract%3Frss%3Dyes This article reports on and discusses the role of IHC in diagnostic and translational research of TET. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151192 Wed, 10 Nov 2010 18:46:31 +0100 4151192 http://www.medworm.com/index.php?rid=4151191&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001374%2Fabstract%3Frss%3Dyes The second edition of the World Health Organization (WHO) classification of thymic tumors (2004) has resumed the previous separation of thymic carcinomas (TCs) from thymomas. This “reseparation” was mainly based on new genetic data. Consequently, it is no longer recommended to label TCs as type C thymomas. TCs are very heterogeneous and comprise squamous, basaloid cell, mucoepidermoid, neuroendocrine, and many other subtypes. They resemble morphologic mimics in other organs and are labeled accordingly. However, only thymic squamous cell carcinomas (TSCCs) and lymphoepithelioma-like carcinomas are relatively common. For TSCCs, quite specific immunohistochemical markers (eg, CD5, CD70, CD117, CD205, FOXN1) and chromosomal gains and losses have been defined that help to distinguish TSCCs... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151191 Wed, 10 Nov 2010 18:46:31 +0100 4151191 http://www.medworm.com/index.php?rid=4151188&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001581%2Fabstract%3Frss%3Dyes Epithelial thymic tumors are still a controversial subject sparking continuous debate in the international literature. Lack of agreement persists about the clinical impact of the WHO classification, the staging system, and multidisciplinary management. This clearly contributes to a rise in interest regarding thymoma and thymic carcinoma, including the efforts of thoracic surgeons, pathologists, immunologists, and medical and radiation oncologists. However, answers will not be available until we understand the biology, pathology, and clinical behavior of these tumors. For this reason a closer cooperation with basic scientists should be pursued. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151188 Wed, 10 Nov 2010 18:46:31 +0100 4151188 http://www.medworm.com/index.php?rid=4151187&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001751%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151187 Wed, 10 Nov 2010 18:46:31 +0100 4151187 http://www.medworm.com/index.php?rid=4151186&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000174X%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151186 Wed, 10 Nov 2010 18:46:31 +0100 4151186 http://www.medworm.com/index.php?rid=4151185&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001738%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151185 Wed, 10 Nov 2010 18:46:31 +0100 4151185 http://www.medworm.com/index.php?rid=4105369&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001519%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105369 Tue, 26 Oct 2010 12:13:12 +0100 4105369 http://www.medworm.com/index.php?rid=4105368&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001210%2Fabstract%3Frss%3Dyes This article discusses the clinical features of pectus excavatum and reviews the preoperative considerations and the steps involved in the repair of the deformity. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105368 Tue, 26 Oct 2010 12:13:12 +0100 4105368 http://www.medworm.com/index.php?rid=4105367&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000112X%2Fabstract%3Frss%3Dyes Defects of the thoracic cage with bone and/or muscle deficit are relatively rare and can present a real risk depending on the severity of manifestations. Cleft sternum results from failed midline fusion of the sternal halves that leaves the heart and great vessels unprotected, and is commonly associated with craniofacial hemangiomas. Correction is recommended during the neonatal period when compliant thorax allows direct suturing of the divided sternum. Sternal foramen requires precaution during biopsy and acupuncture as well as forensic awareness. In addition to the thoracic defect, Poland syndrome can be associated with hand anomalies, dextrocardia, renal agenesia, and various tumors. Age and gender, together with the degree of the defect, define the method of surgical correction. (Sourc... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105367 Tue, 26 Oct 2010 12:13:12 +0100 4105367 http://www.medworm.com/index.php?rid=4105366&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000126X%2Fabstract%3Frss%3Dyes Pectus carinatum or keel chest is a spectrum of progressive inborn anomalies of the anterior chest wall, named after the keel (carina) of ancient Roman ships. It defines a wide spectrum of inborn protrusion anomalies of the sternum and/or the adjacent costal cartilages. Pectus carinatum is often associated with various conditions, notably Marfan disease, homocystinuria, prune belly, Morquio syndrome, osteogenesis imperfecta, Noonan syndrome, and mitral valve prolapse. Treatment of pectus carinatum by nonsurgical methods such as exercise and casting has not been worthwhile, whereas surgical management is simple and successful. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105366 Tue, 26 Oct 2010 12:13:12 +0100 4105366 http://www.medworm.com/index.php?rid=4105365&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001167%2Fabstract%3Frss%3Dyes This article focuses on new materials available to thoracic surgeons for the reconstruction of chest wall defects. Each surgeon is called to select the best reconstructive strategy based on the disease for which the resection is needed, the possible extension to adjacent structures, the availability of professional colleagues for multidisciplinary involvement, and the preferred (or available) material for full or partial thickness reconstruction. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105365 Tue, 26 Oct 2010 12:13:12 +0100 4105365 http://www.medworm.com/index.php?rid=4105364&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001179%2Fabstract%3Frss%3Dyes Chest wall reconstructions can be complex and challenging procedures, especially when huge thoracic defects have been generated by radical excisions. Nonrigid reconstructions with meshes or patches have the goal of avoiding a lung hernia caused by the chest wall defect, or preventing the impaction of the scapula in case of posterior chest wall resections, especially when the resection is extended down to the 5th and 6th ribs. Large anterior and lateral resections result in thoracic instability and alteration of pulmonary physiology, and render intrathoracic structures vulnerable to external impact. They necessitate rigid reconstructions according to several techniques using alloplastic materials (eg, methyl methacrylate-based customized plates or neo-ribs, osteosynthesis systems, or dedica... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105364 Tue, 26 Oct 2010 12:13:12 +0100 4105364 http://www.medworm.com/index.php?rid=4105361&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001131%2Fabstract%3Frss%3Dyes This article describes improvements in reconstruction techniques with musculocutaneous flaps that have made coverage of wide sternal defects reliable. A rigid reinforcement of the sternum can now be achieved with titanium bars and clips after a total sternectomy. Large sternal defects are safely reconstructed with a musculocutaneous flap. The completeness of the resection and the histologic grade of the tumors are the strongest survival predictors. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105361 Tue, 26 Oct 2010 12:13:11 +0100 4105361 http://www.medworm.com/index.php?rid=4105360&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001155%2Fabstract%3Frss%3Dyes Non–Small cell lung cancer invading the chest wall represents an advanced stage of the disease. Chest wall resection may be achieved in up to 100% of the patients, and the ensuing defect requires to be reconstructed in 40% to 64% of cases. Once a surgical challenge, chest wall resection is no longer a technical problem and en bloc chest wall and lung resections regularly provide good results. However, survival rates are jeopardized by incompleteness of the resection and mediastinal lymph node involvement. Nowadays, the challenge is represented by the use of the other nonsurgical modalities (chemotherapy and radiation therapy) to increase the chance of performing a complete resection, the need to achieve a better control of probable lymphatic or hematogenous spread, and the reduction of t... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105360 Tue, 26 Oct 2010 12:13:11 +0100 4105360 http://www.medworm.com/index.php?rid=4105359&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001428%2Fabstract%3Frss%3Dyes Chest wall involvement by breast cancer remains a difficult clinical challenge that may occur at the time of the primary diagnosis or later as a result of locoregional breast cancer recurrence. A case-by-case multidisciplinary approach is strongly recommended, and a multimodality therapy should be always considered. Full-thickness resection of the chest wall can be done with acceptable morbidity and mortality, providing a good palliation and a better quality of life even to patients with poor prognosis. Moreover, in well-selected cases, chest wall resection results in locoregional control of disease and prolongation of life. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105359 Tue, 26 Oct 2010 12:13:11 +0100 4105359 http://www.medworm.com/index.php?rid=4105358&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001222%2Fabstract%3Frss%3Dyes The differential diagnosis of chest wall tumors is diverse, including both benign and malignant lesions (primary and malignant), local extension of adjacent disease, and local manifestations of infectious and inflammatory processes. Primary chest wall tumors are best classified by their primary component: soft tissue or bone. Work-up consists of a thorough history, physical examination and imaging to best assess location, size, composition, association with surrounding structures, and evidence of any soft tissue component. Biopsies are often required, especially for soft tissue masses. Treatment depends on histological subtype and location, but may include chemotherapy and radiotherapy in addition to surgical resection. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105358 Tue, 26 Oct 2010 12:13:11 +0100 4105358 http://www.medworm.com/index.php?rid=4105357&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001143%2Fabstract%3Frss%3Dyes This article addresses the risk factors, pathophysiology, clinical presentation, and management of chest wall and sternoclavicular joint infections, necrotizing processes, and radiation injury. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105357 Tue, 26 Oct 2010 12:13:11 +0100 4105357 http://www.medworm.com/index.php?rid=4105355&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001271%2Fabstract%3Frss%3Dyes Despite significant improvements in surgical technique and perioperative care, the management of patients requiring chest wall resection and reconstruction is an ongoing challenge for thoracic surgeons. A successful approach includes a thorough assessment of the patient and the lesion, an adequate biopsy to confirm tissue diagnosis, and a well-established treatment plan. In the case of a primary tumor of the chest wall, the extent of the resection should not be limited by the size of the resulting defect. Following resection, chest wall reconstruction mandates an appreciation for restoration of functional and structural components. An algorithmic approach to chest wall reconstruction begins with the assessment of the nature of the defect, taking into consideration factors such as infection... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105355 Tue, 26 Oct 2010 12:13:11 +0100 4105355 http://www.medworm.com/index.php?rid=4105354&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001258%2Fabstract%3Frss%3Dyes The chest wall, like other regional anatomy, is a remarkable fusion of form and function. Principal functions are the protection of internal viscera and an expandable cylinder facilitating variable gas flow into the lungs. Knowledge of the anatomy of the whole cylinder (ribs, sternum, vertebra, diaphragm, intercostal spaces, and extrathoracic muscles) is therefore not only important in the local environment of a specific chest wall resection but also in its relation to overall function. An understanding of chest wall kinematics might help define the loss of function after resection and the effects of various chest wall substitutes. Therefore, this article is not an exhaustive anatomic description but a focused summary and discussion. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105354 Tue, 26 Oct 2010 12:13:11 +0100 4105354 http://www.medworm.com/index.php?rid=4105353&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001180%2Fabstract%3Frss%3Dyes This issue of Thoracic Surgery Clinics is dedicated to a technical aspect of the clinical practice with which surgeons have become increasingly familiar through the years. Indeed, by the term “chest wall surgery,” a wide variety of procedures are referred to, varying from a straightforward removal of one rib or the correction of a congenital malformation to an extremely complex resection and subsequent reconstruction of the chest wall primarily aimed at preserving geometric and functional integrity. As such, chest wall surgery can offer scenarios where the creativity and the technical skills are emphasized to an unprecedented level in the thoracic surgical practice. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105353 Tue, 26 Oct 2010 12:13:11 +0100 4105353 http://www.medworm.com/index.php?rid=4105352&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001507%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105352 Tue, 26 Oct 2010 12:13:11 +0100 4105352 http://www.medworm.com/index.php?rid=4105351&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001490%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105351 Tue, 26 Oct 2010 12:13:11 +0100 4105351 http://www.medworm.com/index.php?rid=4105350&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001489%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105350 Tue, 26 Oct 2010 12:13:11 +0100 4105350 http://www.medworm.com/index.php?rid=4151196&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001337%2Fabstract%3Frss%3Dyes Thymic tumors are classified as stage III when they clearly invade the surrounding structures: pericardium, great vessels (superior vena cava, innominate veins, ascending aorta, and main pulmonary artery), lung parenchyma, phrenic nerves, and chest wall. Surgical treatment with or without induction therapy should always aim to complete resection removing en bloc all the involved structures. Also, extended procedures are justified because only R0 resection allows long-term survival. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151196 Mon, 11 Oct 2010 00:00:00 +0100 4151196 http://www.medworm.com/index.php?rid=4151190&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001404%2Fabstract%3Frss%3Dyes Neuroendocrine tumors of the thymus (NETTs) are unusual thymic neoplasms that were misdiagnosed as thymomas until the 1970s, when they eventually acquired a distinct identity. No collective large series have been published so far, and information about clinical presentation, diagnosis, histology, and treatment is derived from analysis of the case series and case reports published over a long period. NETTs are more aggressive than their pulmonary and abdominal counterparts, presenting at a more advanced stage, often with distant metastases, and are associated with poor long-term survival. Most patients are symptomatic at presentation as a result of the local invasion. Twenty percent to 30% of the cases are associated with endocrine disorders, mostly Cushing syndrome and multiple endocrine n... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151190 Mon, 11 Oct 2010 00:00:00 +0100 4151190 http://www.medworm.com/index.php?rid=4151189&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001350%2Fabstract%3Frss%3Dyes This article describes the prediction of thymoma histology and stage on the basis of radiographic criteria by reviewing the following: the WHO histologic classification of thymic epithelial tumors, the clinical staging of thymomas based on prognosis, and the radiographic appearance of thymomas according to the WHO histologic classification. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4151189 Mon, 11 Oct 2010 00:00:00 +0100 4151189 http://www.medworm.com/index.php?rid=4105356&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001234%2Fabstract%3Frss%3Dyes Recent paradigm shift in major trauma profile elevates chest wall injuries among the most important topics of the specialty. Due to mass casualties of terror attacks and asymmetric warfare, civilian and military trauma care challenges thoracic surgery, traumatology, intensive anesthesiology, and related specialties. Contemporary advances of the main issues are systemically presented and discussed, such as soft tissue and bony structure injuries, complex traumas like flail chest, and extensively destroyed chest wall. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105356 Mon, 06 Sep 2010 23:00:00 +0100 4105356 http://www.medworm.com/index.php?rid=4105363&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001209%2Fabstract%3Frss%3Dyes Reconstruction of the chest wall represents an important part of a patient's treatment following resection of various thoracic tumors. Many different types of flaps, including both pedicled and free flaps, have been described for use in chest wall reconstruction. These reconstructions are most effectively managed with a multidisciplinary approach involving plastic and cardiothoracic surgery. The pectoralis major, latissimus dorsi, rectus abdominis, trapezius, and external oblique muscles and the omentum are all local options that can play an important role in the reconstruction of the chest wall. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105363 Tue, 31 Aug 2010 23:00:00 +0100 4105363 http://www.medworm.com/index.php?rid=4105362&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001246%2Fabstract%3Frss%3Dyes Chest wall resection requires wide local excision, negative margins, and adequate reconstruction. Outcomes are generally good to excellent with wide local excision and negative margins. Mortality is nearly 0% to 1% with mild morbidity. Multispecialty surgical teams may be required for more complex situations. Early diagnosis of chest wall sarcomas, confirmation by an experienced sarcoma pathologist, and multidisciplinary discussion before treatment initiation, are all required for optimal and successful therapy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=4105362 Sun, 29 Aug 2010 23:00:00 +0100 4105362 http://www.medworm.com/index.php?rid=3771991&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001015%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771991 Wed, 21 Jul 2010 07:58:07 +0100 3771991 http://www.medworm.com/index.php?rid=3771990&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000472%2Fabstract%3Frss%3Dyes This article provides a review of the available evidence-based literature that addresses the efficacy of the options currently available to prevent and manage AALs. Management suggestions based on this literature are presented. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771990 Wed, 21 Jul 2010 07:58:07 +0100 3771990 http://www.medworm.com/index.php?rid=3771989&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000538%2Fabstract%3Frss%3Dyes This article describes the incidence of prolonged air leak in these populations, the causes ascribed to their development, and strategies that may be applied to their prevention and treatment. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771989 Wed, 21 Jul 2010 07:58:07 +0100 3771989 http://www.medworm.com/index.php?rid=3771987&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000496%2Fabstract%3Frss%3Dyes Recently, several companies have manufactured and commercialized new pleural drainage units that incorporate electronic components for the digital quantification of air through chest tubes and, in some instances, pleural pressure assessment. The goal of these systems is to objectify this previously subjective bedside clinical parameter and allow for more objective, consistent measurement of air leaks. The belief is this will lead to quicker and more accurate chest tube management. In addition, some systems feature portable suction devices. These may afford earlier mobilization of patients because the pleural drainage chamber is attached to a battery-powered smart suction device. In this article we review the clinical experiences using these new devices. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771987 Wed, 21 Jul 2010 07:58:07 +0100 3771987 http://www.medworm.com/index.php?rid=3771986&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000054X%2Fabstract%3Frss%3Dyes Air leaks after pulmonary resection remain a common occurrence. The impact, or cost, of a complication such as prolonged air leak differs for patients and the involved health care providers. In both cases, the cost is in part determined by the treatment strategy chosen to deal with the complication. Complication costs extend beyond financial aspects and involve quality and delivery of care, postoperative quality of life, and patient satisfaction. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771986 Wed, 21 Jul 2010 07:58:07 +0100 3771986 http://www.medworm.com/index.php?rid=3771985&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000514%2Fabstract%3Frss%3Dyes Most patients who undergo pulmonary resection can have one chest tube and have it removed by postoperative day 3. Air leaks are probably best treated with water seal (passive suction) for most patients with small leaks. If they develop a new or enlarging pneumothorax or subcutaneous emphysema, some suction (active suction) is needed and alternating suction at night with waters seal during the day may be best. Most patients with persistent air leaks can be discharged home safely on an outpatient device and have their tubes removed in 2 to 3 weeks even if they still have an air leak. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771985 Wed, 21 Jul 2010 07:58:07 +0100 3771985 http://www.medworm.com/index.php?rid=3771984&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000460%2Fabstract%3Frss%3Dyes Air leakage after pulmonary resections is considered the most prevalent postoperative problem, and it is often the only morbidity identified. Ideally, treatment begins with prevention; the onset of this complication should be anticipated and recognized during surgery, and intraoperative strategies should be attempted to avoid it and reduce the impact on the clinical course. Once an air leak develops, in most of the cases it seals spontaneously within 2 or 3 days of operation. When it persists, it might elicit the onset of other complications and increase costs and length of hospitalization. The postoperative approaches to a prolonged air leak include management of the pleural drainage and residual space, pleurodesis, pneumoperitoneum, endobronchial one-way valve placement, and potential re... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771984 Wed, 21 Jul 2010 07:58:07 +0100 3771984 http://www.medworm.com/index.php?rid=3771983&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000502%2Fabstract%3Frss%3Dyes This article reviews the contemporary literature and provides recommendations for intraoperative use of agents to control air leak. An evidence-based analysis of the current literature does not support routine use, prophylactically or for air leaks present at operation, of sealants or buttressing material in pulmonary surgery. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771983 Wed, 21 Jul 2010 07:58:07 +0100 3771983 http://www.medworm.com/index.php?rid=3771981&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000526%2Fabstract%3Frss%3Dyes Thoracoscopic lobectomy has become an accepted, safe, and oncologically sound procedure compared with open lobectomy. Several studies have reported that it reduces the length of stay, postoperative pain, and postoperative complications, including air leaks. Although there are specific technical considerations that must be taken into account, it is increasingly becoming the preferred method of anatomic lobectomy. Surgeons should be encouraged to embrace the minimally invasive strategy, which may be learned in courses using novel simulation techniques. Future directions suggest that this technique will be expanded to address even the most challenging thoracic procedures. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771981 Wed, 21 Jul 2010 07:58:06 +0100 3771981 http://www.medworm.com/index.php?rid=3771980&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000447%2Fabstract%3Frss%3Dyes Practical risk models stratifying the risk of prolonged air leak after pulmonary lobectomy have been developed and discussed. These scores may assist during preoperative patients' counseling, to identify patients at higher risk for prolonged air leak, who may benefit from the use of prophylactic measures such as the use of sealants, buttressed staple lines, or pleural tents. Furthermore, they may be used as standardized inclusion criteria for future randomized clinical trials testing the efficacy of these new technologies, and in doing so make the interpretation of results across different centers and studies more comparable. The clinical use of digital chest drainage units that permit quantitative measurement and recording of air leak flow and intrapleural pressure appears to add to the p... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771980 Wed, 21 Jul 2010 07:58:06 +0100 3771980 http://www.medworm.com/index.php?rid=3771979&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000435%2Fabstract%3Frss%3Dyes Thoracic surgery that requires resection of a portion of lung or of a whole lung profoundly alters the mechanical and fluid dynamic setting of the lung-chest wall coupling, as well as the water balance in the pleural space and in the remaining lung. The most frequent postoperative complications are of a respiratory nature, and their incidence increases the more the preoperative respiratory condition seems compromised. There is an obvious need to identify risk factors concerning mainly the respiratory function, without neglecting the importance of other comorbidities, such as coronary disease. At present, however, a satisfactory predictor of postoperative cardiopulmonary complications is lacking; postoperative morbidity and mortality have remained unchanged in the last 10 years. The aim of ... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771979 Wed, 21 Jul 2010 07:58:06 +0100 3771979 http://www.medworm.com/index.php?rid=3771977&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710001003%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771977 Wed, 21 Jul 2010 07:58:06 +0100 3771977 http://www.medworm.com/index.php?rid=3771976&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000099X%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771976 Wed, 21 Jul 2010 07:58:06 +0100 3771976 http://www.medworm.com/index.php?rid=3771975&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000988%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771975 Wed, 21 Jul 2010 07:58:06 +0100 3771975 http://www.medworm.com/index.php?rid=3771982&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000459%2Fabstract%3Frss%3Dyes In thoracic surgery, the intraoperative solution of difficult air space problems relies heavily on the operating surgeon's creativity, versatility, and meticulous surgical technique, as well us profound knowledge of the anatomy and past surgical heritage. The same degree of expertise and experience is needed to simply observe innocent residual spaces without resorting to unnecessary aggressiveness. Management of residual air spaces is an art that conclusively defines the maturity of a thoracic surgeon. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771982 Sun, 23 May 2010 23:00:00 +0100 3771982 http://www.medworm.com/index.php?rid=3771988&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000484%2Fabstract%3Frss%3Dyes Ambulatory treatment of pleural problems such as pneumothorax and malignant pleural effusions has been extensively described and is commonly used. On the contrary, outpatient management of chest tubes after lung resection is less frequently performed. Because prolonged air leak after lobectomy is a common problem, early discharge of these patients under pleural drainage can avoid many hospital days without compromising the quality of care. In this article, general rules for outpatient chest tube management are described and available portable devices are reviewed. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771988 Wed, 19 May 2010 23:00:00 +0100 3771988 http://www.medworm.com/index.php?rid=3771978&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000551%2Fabstract%3Frss%3Dyes Despite recent progress in surgical technique and improved perioperative care, prolonged air leak remains a frequent complication after pulmonary resection. Several studies have shown that air leak and in general chest tube management are the major factors influencing duration of hospital stay and postoperative costs. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3771978 Mon, 17 May 2010 23:00:00 +0100 3771978 http://www.medworm.com/index.php?rid=3537927&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000630%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537927 Fri, 30 Apr 2010 23:00:00 +0100 3537927 http://www.medworm.com/index.php?rid=3537926&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000174%2Fabstract%3Frss%3Dyes This article reviews the published data on robotic mediastinal surgery, focusing on technical aspects and perioperative outcomes. These are evaluated for differences and potential benefits over open and conventional minimally invasive techniques. Is there a need for the robot in the mediastinum? Is its application justified? (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537926 Fri, 30 Apr 2010 23:00:00 +0100 3537926 http://www.medworm.com/index.php?rid=3537925&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000411%2Fabstract%3Frss%3Dyes With the advent of videotechnology, sympathectomy has assumed a more important role in the armamentarium of managing diseases of the autonomic system. Currently it is used primarily for hyperhydroisis, although sympathectomy for reflex sympathetic dystrophy (RSD), Raynaud disease and other diseases still are performed, but less frequently. Most of this article will refer primarily to hyperhydrosis patients. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537925 Fri, 30 Apr 2010 23:00:00 +0100 3537925 http://www.medworm.com/index.php?rid=3537924&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000162%2Fabstract%3Frss%3Dyes This article reports on the current state of the art of the videothoracoscopic approaches most commonly employed for the surgical treatment of thoracic idiopathic scoliosis. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537924 Fri, 30 Apr 2010 23:00:00 +0100 3537924 http://www.medworm.com/index.php?rid=3537923&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000356%2Fabstract%3Frss%3Dyes This article describes the operative procedure and summarizes the advantages of this approach. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537923 Fri, 30 Apr 2010 23:00:00 +0100 3537923 http://www.medworm.com/index.php?rid=3537922&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000381%2Fabstract%3Frss%3Dyes This article discusses the indications for the open approach in adults and outlines the surgical procedure. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537922 Fri, 30 Apr 2010 23:00:00 +0100 3537922 http://www.medworm.com/index.php?rid=3537921&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000344%2Fabstract%3Frss%3Dyes Malignant tumors of the anterior mediastinum frequently appear locally advanced at the time of diagnosis, with invasion of the surrounding organs including major blood vessels, lungs, and pericardium. Surgery can be indicated either with diagnostic intent or for radical resection, usually as a part of a multimodality treatment. Extended operations with complex vascular reconstructions may be required for the complete removal of the mediastinal mass. In this article, surgical approaches and techniques of diagnostic and therapeutic procedures are reported and discussed. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537921 Fri, 30 Apr 2010 23:00:00 +0100 3537921 http://www.medworm.com/index.php?rid=3537920&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000149%2Fabstract%3Frss%3Dyes This article presents the evolution of technical and surgical advances achieved within the authors' program of extended endoscopically assisted thymectomy since 1995. The use of video-assisted thoracic surgery and its variants for performing thymectomy in MG patients is now well established and will continue to evolve for further improvement in the results. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537920 Fri, 30 Apr 2010 23:00:00 +0100 3537920 http://www.medworm.com/index.php?rid=3537919&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000037X%2Fabstract%3Frss%3Dyes The two primary indications for thymectomy are the treatments of patients with thymoma and patients with myasthenia gravis. Several different methods have been described to remove the thymus gland, including transcervical-transsternal “maximal” thymectomy, extended transsternal thymectomy, classic transsternal thymectomy, (extended) transcervical thymectomy, and video-assisted thoracoscopic thymectomy. The purpose of this article is to focus on the technical aspects of performing an extended transsternal thymectomy and the published results of extended transsternal thymectomy as compared with other techniques available. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537919 Fri, 30 Apr 2010 23:00:00 +0100 3537919 http://www.medworm.com/index.php?rid=3537918&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000368%2Fabstract%3Frss%3Dyes This article describes surgery using a transcervical approach with thoracoscopic visualization. The video-assisted extended approach is well suited for patients undergoing thymectomy for myasthenia gravis, thymic cysts, small thymoma, or mediastinal parathyroid adenoma. It incorporates the minimally invasive nature of the transcervical method with the extensive anterior mediastinal dissection, while allowing for complete removal of the thymus and anterior mediastinal fat and avoiding the morbidity of a sternotomy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537918 Fri, 30 Apr 2010 23:00:00 +0100 3537918 http://www.medworm.com/index.php?rid=3537917&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000150%2Fabstract%3Frss%3Dyes Anterior mediastinal masses can develop from a wide spectrum of pathologic conditions, most of which are malignant in nature and require prompt diagnosis for immediate initiation of the appropriate treatment. Clinical pictures can be variable and complicated by associated intrathoracic conditions requiring surgical management such as pleural and pericardial effusions or nodules (complex anterior mediastinal masses). We have used a single-trocar video-assisted thoracoscopic surgery (VATS) approach using thoracic epidural or sole local anesthesia in awake patients. Advantages of awake VATS biopsy include avoidance of all potential adverse effects related to the use of general anesthesia, wide visual control of mediastinal sampling, and accurate assessment of the disease extent with the possi... Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537917 Fri, 30 Apr 2010 23:00:00 +0100 3537917 http://www.medworm.com/index.php?rid=3537916&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS154741271000040X%2Fabstract%3Frss%3Dyes Operative technique of a new surgical method, transcervical extended mediastinal lymphadenectomy (TEMLA), is described in detail. TEMLA enables almost complete en bloc removal of the mediastinal nodes in semiopen fashion. Sensitivity and negative predictive value of TEMLA for staging were 95.6% and 98.4%, respectively, and for restaging, 95.7% and 98.4%, respectively. Other uses of TEMLA include resection of the mediastinal tumors and resection of the metastatic nodes to the mediastinum, esophagectomy with 3-field dissection (combined with laparoscopy or laparotomy), closure of postpneumonectomy fistula, and right upper pulmonary lobectomy. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537916 Fri, 30 Apr 2010 23:00:00 +0100 3537916 http://www.medworm.com/index.php?rid=3537915&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000332%2Fabstract%3Frss%3Dyes Mediastinal lymph node dissection improves the staging of patients who have non–small cell lung cancer at the time of resection. Thoracoscopic lobectomy is seen as an effective strategy for patients who have early-stage lung cancer. Videothoracoscopic lymphadenectomy performed during thoracoscopic lobectomy achieves complete mediastinal lymph node dissection. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537915 Fri, 30 Apr 2010 23:00:00 +0100 3537915 http://www.medworm.com/index.php?rid=3537914&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000186%2Fabstract%3Frss%3Dyes This article discusses the current deployment of videomediastinoscopy in the diagnosis and management of NSCLC. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537914 Fri, 30 Apr 2010 23:00:00 +0100 3537914 http://www.medworm.com/index.php?rid=3537913&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000423%2Fabstract%3Frss%3Dyes When nature accomplished its task, the mediastinum resulted as one of the most anatomically complex regions of the human body. A real Pandora's box, it is a relatively inaccessible area containing different structures whose surgical dominium represented a long-lasting challenge. The multiplicity of conditions and diseases that afflict the mediastinal organs adds to the challenge when considering surgical therapeutic solutions. (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537913 Fri, 30 Apr 2010 23:00:00 +0100 3537913 http://www.medworm.com/index.php?rid=3537912&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000629%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537912 Fri, 30 Apr 2010 23:00:00 +0100 3537912 http://www.medworm.com/index.php?rid=3537911&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000617%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537911 Fri, 30 Apr 2010 23:00:00 +0100 3537911 http://www.medworm.com/index.php?rid=3537910&cid=s_38685_157_f&fid=38685&url=http%3A%2F%2Fwww.thoracic.theclinics.com%2Farticle%2FPIIS1547412710000605%2Fabstract%3Frss%3Dyes (Source: Thoracic Surgery Clinics) Thoracic Surgery Clinics journals http://www.medworm.com/rss/comments.php?id=3537910 Fri, 30 Apr 2010 23:00:00 +0100 3537910