Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy.
Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy. Chest. 2019 Oct 09;: Authors: Verdial FC, Berfield K, Wood DE, Mulligan M, Roth J, Francis DO, Farjah F Abstract BACKGROUND: There remains debate over the best invasive diagnostic modality for mediastinal nodal evaluation. Prior studies have limited generalizability and insufficient power to detect differences in rare adverse events. We compared the risks and costs of endobronchial ultrasound-guided nodal aspiration (EBUS) and mediastinoscopy performed for any indication in a large national cohort. METHODS: We conducted a retrospective study (2007-2015) using MarketScan-a claims database of individuals with employer-provided insurance in the United States. Patients who underwent multi-modality mediastinal evaluation (n=1,396) or same-day pulmonary resection (n=2,130) were excluded. Regression models were used to evaluate associations between diagnostic modalities and risks and costs while adjusting for patient characteristics, year, concomitant bronchoscopic procedures, and lung cancer diagnosis. RESULTS: Among 30,570 patients, 49% underwent EBUS. Severe adverse events-pneumothorax, hemothorax, airway/vascular injuries, or death-were rare and invariant between EBUS and mediastinoscopy (0.3% versus 0.4%, p=0.189). The rate of vocal cord paralysis was lower for EBUS (1.4% versus 2.2%, p
ConclusionsCT ‐guided percutaneous MWA is a safe and effective modality for treating patients aged 80 years and older with early‐stage peripheral NSCLC.
CONCLUSION: Adaptive re-planning of radiation was performed in a fifth of locally advanced lung cancer patients. In most cases tumor volume decreased, or atelectasis resolved, causing mediastinal shifts, which, if unidentified and left uncorrected, may have led to local failure and increased toxicity. The heart V40Gy was reduced significantly in all cases, but significant reduction in lung doses was evident only if simulation technique was altered. ADVANCES IN KNOWLEDGE: In locally advanced lung cancer image-guidance with CBCT can detect significant mediastinal shifts and gross tumor volume changes that raise the need...
CONCLUSIONWe report a case of laparoscopic hepatectomy for liver metastasis of lung LCNEC. It is suggested that surgical resection for solitary distant metastasis of LCNEC may improve prognosis.
Smoke-measuring smart shirts, breath sound analyzing algorithms, and smart inhalers pave the way of pulmonology and respiratory care into the future. As the number of patients suffering from asthma, COPD, or lung cancer due to rising air pollution and steady smoker-levels will unfortunately not decrease any time soon, we looked around what technology can do to help both patients and caregivers. The results are breathtaking. Attacks of breathlessness are too common The diseases which pulmonologists and respiratory care specialists attempt to fight are among the most common conditions in the modern world – and t...
In this study, we reported the safety and efficacy of hypofractionated 192Ir source stereotactic ablative brachytherapy (SABT) with coplanar template assistance for peripheral lung cancer, and compared the dosimetric parameters between SABT and stereotactic body radiotherapy (SBRT). Material and methods: Thirty-three peripheral lung cancer patients, with the gross lung tumor volume (GTVL) 0.05); the remaining dosimetric parameters were significantly lower in SABT than in SBRT (all p
ConclusionsEndovascular coil fiducial placement for lung SBRT is associated with high procedural success rates and lower rates of clinically relevant complications than transthoracic marker placement.
CONCLUSIONS: Patients with a history of lung disease including chronic bronchitis, emphysema, tuberculosis, lung cancer and pneumonia, and a history of thoracic surgery, might have an increased post-acupuncture risk of pneumothorax. This information may possibly help physicians avoid post-acupuncture pneumothorax. PMID: 31433202 [PubMed - as supplied by publisher]
CONCLUSION: Our manuscript depicts the results of a Delphi process in 2017 - 1018 involving experts of the German Thoracic Society from high volume departments certified for thoracic surgery. A very high rate of consensus was documented for topics such as chest tube insertion, peri-interventional management and removal algorithm. The most important topic for which there was no consensus was the case of persistent air leakage. The resulting expert recommendations of the Delphi process could be used as a starting point for internal clinical procedures. PMID: 31394582 [PubMed - as supplied by publisher]
Authors: Sabath BF, Casal RF Abstract Lung cancer is the leading cause of cancer-related death worldwide and lobectomy remains the standard of care for patients with early-stage non-small cell lung cancer (NSCLC). The combination of an aging population and the implementation of low-dose CT for lung cancer screening is leading to an increase in diagnosis of early stage NSCLC in medically "inoperable" patients. The recommended treatment for this latter group of patients is stereotactic body radiation therapy (SBRT). However, many patients cannot undergo SBRT because they have received prior radiation or bec...
Conclusion For small pulmonary nodules requiring thoracoscopic surgery, the optimized computed tomography-guided pulmonary nodule microcoil localization technique is convenient, safe and effective, and worthy of promotion to use. DOI: 10.3779/j.issn.1009-3419.2019.06.04