Treatment of severe idiopathic pulmonary fibrosis-is sildenafil the next (in)stage?
Authors: Hayton C, Craig C, Chaudhuri N PMID: 30962967 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Improving pain after video-assisted thoracoscopic lobectomy-advantages of a wound retractor camera port.
Authors: Julliard W, Krupnick AS PMID: 30962968 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Right ventricular-pulmonary artery coupling-an emerging perspective in transcatheter aortic valve replacement.
Authors: Arora S, Patil N, Vavalle J PMID: 30962969 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Right ventricular-pulmonary artery coupling in patients undergoing transcatheter aortic valve replacement: is it relevant?
Authors: Hirji SA, Kaneko T PMID: 30962970 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Immune checkpoint inhibitors in esophagogastric cancer: still a long way to go.
Authors: Fountzilas C, Hochwald SN PMID: 30962971 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Editorial on "Complications after esophagectomy are associated with extremes of body mass index".
Editorial on "Complications after esophagectomy are associated with extremes of body mass index". J Thorac Dis. 2019 Feb;11(2):354-356 Authors: Corsini EM, Sepesi B PMID: 30962972 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Adjunctive therapies in idiopathic pulmonary fibrosis-where do we stand?
Authors: Nokes B, Afshar K PMID: 30962973 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Long-term outcomes and quality of life should be the future focus of research measuring effectiveness of lung cancer surgery approaches.
Authors: Reddy RM PMID: 30962974 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Aligning airway management strategy with resuscitation priorities for out-of-hospital cardiac arrest.
Authors: Burjek NE, Burns KM, Jagannathan N PMID: 30962975 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

The promise and challenges of deep learning models for automated histopathologic classification and mutation prediction in lung cancer.
Authors: Patil PD, Hobbs B, Pennell NA PMID: 30962976 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Protective ventilation for lung cancer surgery, the truth likely lies somewhere in the middle.
Authors: Milman S, Ng T PMID: 30962977 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Mechanical ventilation during lobectomy: is this lung behaving as a "baby"?
Mechanical ventilation during lobectomy: is this lung behaving as a "baby"? J Thorac Dis. 2019 Feb;11(2):376-378 Authors: Sagar AS, Casal RF PMID: 30962978 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Is nerve-sparing surgery enough to prevent chronic post-thoracotomy pain?
Authors: Pearson-Chauhan K, Buvanendran A PMID: 30962979 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Understanding the mechanisms of immune-evasion by lung cancer in the context of chronic inflammation in emphysema.
Authors: Salehi-Rad R, Dubinett SM PMID: 30962980 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Incidence of malignancy and survival in patients with idiopathic pleuritis.
Conclusions: Our study confirms a low incidence of malignancy in idiopathic pleuritis after VATS. Nearly all incident cases of malignancy were diagnosed within 12 months from VATS. No survival disadvantage was observed in patients with incident malignancy. Our data suggest that follow-up of idiopathic pleuritis could safely be limited to 1 year. The optimal follow-up strategy remains to be investigated. PMID: 30962981 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Computational fluid dynamic study of different incision length of coronary artery bypass grafting in a native coronary stenosis model.
Conclusions: In the end-side anastomosis, an anastomosis length of 8 mm was the ideal length with less flow complexity, low OSI, and less energy loss and high energy efficiency in the native 90% stenosis model. PMID: 30962982 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Clinical implications of discrepant results between genotypic MTBDRplus and phenotypic L öwenstein-Jensen method for isoniazid or rifampicin drug susceptibility tests in tuberculosis patients.
Conclusions: Despite the low frequency, discordant results were obtained between the genotypic and phenotypic DSTs for INH or RIF, especially for patients with MDR TB or INH resistance. Furthermore, it seemed that RIF discrepancy with a genotypic mutation might have a greater impact on the clinical outcome than INH discrepancy. PMID: 30962983 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Clinical efficacy of high-flow oxygen therapy through nasal cannula in patients with acute heart failure.
Conclusions: This study showed HFNC group had a similar result of improvement of oxygen saturation and in-hospital clinical outcomes compared with intubation group in AHF. Present study supported HFNC could be considered as initial choice of oxygen therapy in selected patients of AHF. PMID: 30962984 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Perioperative systemic magnesium sulphate to minimize acute and chronic post-thoracotomy pain: a prospective observational study.
Authors: Ghezel-Ahmadi V, Ghezel-Ahmadi D, Schirren J, Tsapopiorgas C, Beck G, Bölükbas S Abstract Background: Thoracotomy leads to acute and chronic post-thoracotomy pain (CPTP). The purpose of this study was to investigate the effect of magnesium sulphate (MgSO4) administered perioperatively on acute postoperative and CPTP syndrome. Methods: One hundred patients were enrolled in this prospective, observational study. Analgesic medication was provided according to the World Health Organization pain relief ladder (control group). The study group received additionally MgSO4 (40 mg/kg over 10 minutes) d...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

The association between living below the relative poverty line and the prevalence of chronic obstructive pulmonary disease.
Conclusions: People living below the relative poverty line have an increased prevalence of COPD, especially older people with COPD. From the perspective of COPD disease control, policy makers should consider providing national economic support for the early detection and management of COPD in people living below the relative poverty line. PMID: 30962986 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Thoracoscopic thymectomy with partial superior vena cava resection for locally advanced thymomas.
Conclusions: With careful patient selection and plenty surgical expertise, VATS thymectomy for locally invasive thymic tumors with limited the SVC invasion is challenging yet technically feasible. PMID: 30962987 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

An audit of mortality by using ECMO specific scores and APACHE II scoring system in patients receiving extracorporeal membrane oxygenation in a tertiary intensive care unit in Hong Kong.
Authors: Ng WT, Ling L, Joynt GM, Chan KM Abstract Background: Outcomes of patients receiving extracorporeal membrane oxygenation (ECMO) therapies risk-adjusted by ECMO specific scores have rarely been reported. Our primary aim was to determine the risk adjusted outcome of these patients by the use of Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP), Survival After Veno-Arterial-ECMO (SAVE) and APACHE II scores. The differences in predicted mortality between these scoring systems were analyzed. Methods: This is a single-center retrospective study reviewing 62 patients who received veno...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Pathological discrepancies in the diagnosis of thymic epithelial tumors: the Tallinn-Lyon experience.
Conclusions: Implementing structured pathology reports may help to decrease discrepancies in the diagnosis of thymic epithelial tumors. The development of expert networks is an opportunity to improve diagnosis and patient care, particularly in regard to rare cancers. PMID: 30962989 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Galactomannan detection in bronchoalveolar lavage fluid corrected by urea dilution for the diagnosis of invasive pulmonary aspergillosis among nonneutropenic patients.
Authors: Yu Y, Zhu C, Shen H, Liu C, Guo R, Gao Y, Wu W, Lu L Abstract Background: To investigate the diagnostic performance of galactomannan (GM) detection in bronchoalveolar lavage fluid (BALF) corrected by urea dilution and modification of the AspICU clinical algorithm. Methods: GM detection in serum and BALF samples was performed in nonneutropenic patients on the day of clinically suspected invasive pulmonary aspergillosis (IPA) between January 2016 and June 2018, and urea was measured in the plasma and BALF. The BALF GM concentration was corrected by urea dilution, and receiver operating characteristic (RO...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection.
Authors: Chen S, Huang S, Yu S, Han Z, Gao L, Shen Z, Kang M Abstract Background: To evaluate the safety, thoroughness and feasibility of "tunnel-type en bloc mediastinal lymph node dissection" in video-assisted thoracic surgery (VATS) for right non-small cell lung cancer (NSCLC) radical resection, which functionally dissected the lymph nodes of station 2R/4R/7. Methods: A retrospective study was performed in the clinical data of 196 patients with VATS right NSCLC radical resection. According to the different methods of lymph node dissection of station 2R, 4R and 7, they were divided into the tunnel-t...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Application of alveolar recruitment strategy and positive end-expiratory pressure combined with autoflow in the one-lung ventilation during thoracic surgery in obese patients.
Authors: Shi ZG, Geng WM, Gao GK, Wang C, Liu W Abstract Background: The present study aims to evaluate the influence of alveolar recruitment strategy (ARS) and positive end-expiratory pressure (PEEP) combined with autoflow on respiratory mechanics, the oxygen index (OI), pulmonary shut [Qs/Qt(%)], and the concentrations of IL-6 and TNF-α in venous blood after surgery in obese patients who experienced thoracic surgery with one-lung ventilation (OLV). Methods: A total of 36 obese patients with ASAII-III degree, who experienced selective pulmonary lobectomy, were within 36-74 years old, and had a BMI of 30-...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Initial clinical impact of inhaled nitric oxide therapy for refractory hypoxemia following type A acute aortic dissection surgery.
Conclusions: iNO therapy might play an ameliorative role in patients with refractory hypoxemia after surgical reconstruction for TAAD. This therapy may lead to sustained improvement in oxygenation and reduce the duration of invasive mechanical ventilation. PMID: 30962993 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Comparison of lymph node dissection and lymph node sampling for non-small cell lung cancers by video-assisted thoracoscopic surgery.
Authors: Zhao W, Chen T, Feng J, Gu Z, Wang Z, Ji C, Fang W Abstract Background: Video-assisted thoracoscopic surgery (VATS) has been increasingly used in the treatment of lung cancers. But it is still unclear whether mediastinal lymph node dissection (LND) under VATS is safe and feasible. The aim of this study is to figure out whether LND by VATS is safe and feasible. Methods: Consecutive patients with primary resectable lung cancers referred for lobectomy and LND or sampling by VATS between January 2012 and December 2016 were retrospectively reviewed. Clinicopathological characteristics and perioperative resu...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Re-challenge chemotherapy in patients with sensitive relapse small-cell lung cancer and interstitial lung disease.
Conclusions: Re-challenge chemotherapy can be effective and considered in SCLC patients with pre-existing ILD. PMID: 30962995 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Pneumonitis as a complication of immune system targeting drugs?-a meta-analysis of anti-PD/PD-L1 immunotherapy randomized clinical trials.
Authors: Rahouma M, Baudo M, Yahia M, Kamel M, Gray KD, Elmously A, Ghaly G, Eldessouki I, Abouarab A, Cheriat AN, Karim NA, Mohamed A, Morris J, Gaudino M Abstract Background: Anti-PD/PD-L1-targeted immunotherapy is associated with remarkably high rates of durable clinical responses in patients across a range of tumor types, although their high incidence of skin, gastrointestinal, and endocrine side effects with their use. The risk of pneumonitis associated with checkpoint inhibition therapy is not well described. Methods: A systematic review of the literature was conducted on randomized clinical trials (RCTs)...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

One-stage video-assisted thoracic surgery for bilateral multiple pulmonary nodules.
Conclusions: Through rigorous preoperative assessment, it was demonstrated that one-stage VATS is safe and feasible for patients with BMPNs. Patients can avoid progression of the contralateral tumor, the trauma of the second operation, and the various burdens of medical treatment. PMID: 30962997 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Mechanical circulatory support for refractory cardiogenic shock post-acute myocardial infarction-a decade of lessons.
Conclusions: MCS usage in these patients carries a high mortality in the early post-implantation period. However, there is a significant benefit to patients who survive the initial bridging period to recovery or destination therapy. PMID: 30962998 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

A comparison of fractional flow reserve determination and coronary angiography results in patients with unstable angina and analysis of related factors.
This study aims to compare the two methods and investigate factors affecting FFR value. Methods: A total of 284 UA patients (296 coronary artery lesions) were enrolled from the Emergency Department of Anzhen Hospital Affiliated to Capital Medical University from January 2017 to December 2017. CAG and FFR determination were performed in all patients, and the roles of these two methods in guiding the treatment of UA were compared and analyzed. The subjects were divided into FFR ≤0.8 group and FFR>0.8 group. The general data and laboratory findings were compared between these two groups, and the possible influential...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Clinical characteristics and prognosis of ground-glass opacity nodules in young patients.
Conclusions: The GGO in young patients that received VATS has a high proportion of malignant, its prognosis is satisfied. PMID: 30963000 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Risk of recurrence in stage I adenocarcinoma of the lung: a multi-institutional study on synergism between type of surgery and type of nodal staging.
Conclusions: Patients affected by stage I pulmonary adenocarcinoma and submitted to lobectomy presented a significant lower recurrence rate than those submitted to sub-lobar resection. Moreover, SND presented an independent positive effect on recurrence development than other lymph node assessment strategy. Finally, lobectomy in combination with systematic lymph nodal resection showed the best results in term of CIR. PMID: 30963001 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Effect of second primary cancer on the prognosis of patients with non-small cell lung cancer.
Conclusions: The occurrence of SPC after the diagnosis of NSCLC was not a rare event, and it indicated a poorer prognosis compared with patients without it. During the follow-up, attention should be paid to the screening of SPC especially the second primary lung cancer, and a rational surveillance policy should be formed and implemented. PMID: 30963002 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Association of the TLR1 variant rs5743557 with susceptibility to tuberculosis.
Authors: Zhang M, Wang J, Wang Y, Wu S, Sandford AJ, Luo J, He JQ Abstract Background: Toll-like receptor 1 (TLR1) and TLR6 play important roles in the innate immune response against Mycobacterium tuberculosis (M.TB) via interactions with TIR domain-containing adaptor protein (TIRAP) and myeloid differentiation primary response 88 (MYD88). The aim of this study was to investigate the relationship of TLR1, TLR6, MYD88 and TIRAP polymorphisms with susceptibility to latent tuberculosis infection (LTBI) and tuberculosis (TB). Methods: In total, 204 uninfected healthy controls (HC), 201 individuals with LTBI and 209...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Radical aggressive treatment among non-small cell lung cancer patients with malignant pleural effusion without extra-thoracic disease.
Authors: Arrieta O, Escamilla-López I, Lyra-González I, Barrón F, Ramírez-Tirado LA, Vergara E, Corona-Cruz JF, Maldonado F, Jiménez-Fuentes E Abstract Malignant pleural effusion (MPE) is an indicator of advanced disease (stage M1a) in patients with non-small cell lung cancer (NSCLC). Typically, these patients are candidates for palliative treatment. There is a lack of evidence about the radical surgical treatment in carcinomatous pleuritis with massive effusion. Here, we present data from a specific subset of patients with MPE treated with systemic therapy and aggressive surgical...
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Endobronchial ultrasound-guided transbronchial needle aspiration mediastinal lymph node staging in malignant pleural mesothelioma.
Conclusions: EBUS-TBNA mediastinal LN staging may impact significantly management of patients with MPM by detecting mediastinal metastatic disease, therefore, preventing morbidity and mortality of surgical management. PMID: 30963005 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

A novel multimodal approach to treating proximal tracheal obstructions with spray cryotherapy.
Authors: Benn BS, Krishna G PMID: 30963006 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Survival implications of transbronchial cryobiopsy and other diagnostic modalities in idiopathic pulmonary fibrosis.
Authors: Pannu JK, Hewlett JC, Smith AB, Mason WR, Chen H, Rickman OB, Lentz RJ, Kropski JA, Maldonado F PMID: 30963007 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Erratum to epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world.
Authors: Rafiemanesh H, Mehtarpour M, Khani F, Hesami SM, Shamlou R, Towhidi F, Salehiniya H, Makhsosi BR, Moini A Abstract [This corrects the article DOI: 10.21037/jtd.2016.03.91.]. PMID: 30963008 [PubMed - in process] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - April 10, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

The reason for an idea.
Authors: Filosso PL PMID: 30906575 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Benigno lectori salutem.
Authors: Molnar TF PMID: 30906576 [PubMed] (Source: Journal of Thoracic Disease)
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Surgical stabilization for multiple rib fractures: whom the benefit? -a prospective observational study.
Authors: Olland A, Puyraveau M, Guinard S, Seitlinger J, Kadoche D, Perrier S, Renaud S, Falcoz PE, Massard G Abstract Background: Surgical repair has demonstrated a beneficial effect on outcome for patients presenting with flail chest or with multiple rib fractures. We hypothesized that benefit on outcome parameters concerns predominantly patients being extubated within 24 hours post-operatively. Methods: We prospectively recorded all patients presenting with chest traumatism eligible for surgical repair with anticipated early extubation according to our institutional consensus (flail chest, major deformity, p...
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Pulmonary contusion.
Authors: Rendeki S, Molnár TF Abstract Lung contusion resulting from chest trauma may be present various clinical pictures. It quite often remains unrecognized and is only suspected later when severe complications have developed. Lung contusion may present in association with chest trauma but may also occur alone. It has to be emphasized, that lung contusion as a clinical identity does not necessarily require a blunt or penetrating chest to be in the background. Nowadays, as a result of traffic accidents, following high energy deceleration, lung contusion may present without an actual tissue damage in the ch...
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Diaphragm and transdiaphragmatic injuries.
Authors: Furák J, Athanassiadi K Abstract The incidence of traumatic diaphragmatic rupture (TDR) is around 0.5% of all trauma patients, located more frequently on the left side (80%), with penetrating trauma being more predominantly the cause (63%) than blunt injuries (37%). TDR typically develops during thoracoabdominal injuries and outcome depends on the severity of the associated organ lesion. Diagnosis is sometimes very difficult: chest X-ray can verify TDR in only 25-70% of cases, although the specificity of a multidetector computed tomography (MDCT) is 100% and 83% for left and right-sided ruptures, re...
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Thoracic damage control surgery.
Authors: Molnar TF Abstract Thoracic damage control surgery (TDCS) is a decision making tool and derivate of the damage control concept (DCC), where physiological stabilization has a priority over anatomical reconstruction under the pressure of time. Intrathoracic haemorrhage control and pleural decompression are the two main immediate tasks of TDCS, while definitive procedures follow when the patient is stabilised in 24-48 hours. The focus of the thoracic surgeon is on the prevention of the haemorrhage induced coagulopathy, metabolic acidosis and hypothermy formed triad of death. Surgical haemorrhage control and p...
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Blast injures to the thorax.
Authors: Sziklavari Z, Molnar TF Abstract One out of 10 of military casualties and 6-9 out of 10 civilian victims of terror incidents suffer pulmonary blast injuries when the attackers use explosives as weapon. No specific therapy exists for the primary, shock-wave injury to the lung. The treatment protocols are based on mechanical ventilation, intensive therapy and supportive care. Secondary and tertiary blast structural injuries to the thorax require damage control surgery, dominated by pleural space management (drainage) and haemorrhage control (thoracotomy if needed). Parenchyma resection of irreversibly destro...
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Management of traumatic esophageal injuries.
Authors: Sudarshan M, Cassivi SD Abstract Traumatic esophageal perforations are rare but difficult to treat injuries. We review the principles of work-up, anatomy and treatment of cervical, thoracic and abdominal traumatic esophageal perforations. Management is dictated by location of the perforation and any concurrent injuries. The majority of cases are amenable to primary repair with flap re-enforcement. Other principles include adequate drainage around the repair, decompression of the esophagus and stomach (via nasogastric tube or gastrostomy tube) and distal enteral nutrition (feeding jejunostomy). PMID: 30...
Source: Journal of Thoracic Disease - March 26, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research