Surgical Management of Mycobacterial Infections and Related Complex Pleural Space Problems
Owing to the advent of effective drugs for tuberculosis in the mid-twentieth century, few cases require surgery for active tuberculosis in the present day in areas where effective drugs are available. However, surgical techniques developed to combat tuberculosis in the predrug era are still useful to manage the challenging chest pathology of our time surgically, such as destroyed lung or postresectional empyema. Thoracoplasty and open window thoracostomy are representative procedures and discussed in detail in this review. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Miyako Hiramatsu, Jun Atsumi, Yuji Shiraishi Source Type: research
Teaching Thoracic Surgery in a Low-Resource Setting:
Surgical education and global health partnerships have evolved over the years. There is growing recognition of the importance of in-country training of surgeons and surgeon specialists in low-resource settings to support the local health care system. There are numerous ways in which high-income partners can support local training programs. The Human Resources for Health program was initiated in 2012 to advance in-country training of health care professionals in Rwanda. As there was a limited in-country operative experience for teaching general thoracic surgery, simulation models were developed, influenced by a prior course...
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Edmond Ntaganda, Robinson Ssebuufu, Daniel R. Bacon, Thomas M. Daniel Source Type: research
Global Health Equity: A Vision for Engaging Thoracic Surgeons
Public health priorities are evolving as increased aging populations, injuries, and mental health disorders have led to an urgent need for programs to address chronic and noncommunicable diseases.1 Built on the infrastructure of traditional international priorities (eg, maternal and child health; infectious diseases prevention and treatment), comprehensive health system strengthening has proven fundamental to improved care delivery globally.2 Equity in health regardless of race, income, or geography demands access to surgeons to provide more complete preventative, diagnostic, and therapeutic services. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Gita N. Mody Tags: Preface Source Type: research
Think Globally, Act Globally
The February 2022 issue of Thoracic Surgery Clinics addressed social disparities in Thoracic Surgery and covered our national diversity gaps in multiple areas, including lung cancer screening, recruitment to clinical trials, and lung transplantation donor and recipient pools. This issue of Thoracic Surgery Clinics concerns “Global Thoracic Surgery” and reminds us of the global disparities and needs gaps, including quite significantly a workforce shortage. Per the Lancet Commissions on Global Surgery 2030, more than 2 million surgeons, anesthetists, and obstetric providers will be needed worldwide. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Virginia R. Litle Tags: Foreword Source Type: research
Global Thoracic Surgery
THORACIC SURGERY CLINICS (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Gita N. Mody Source Type: research
Copyright
ELSEVIER (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Source Type: research
Contributors
VIRGINIA R. LITLE, MD, FACS (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Source Type: research
Contents
Virginia R. Litle (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Source Type: research
Forthcoming Issues
Esophageal Cancer (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - August 1, 2022 Category: Cardiovascular & Thoracic Surgery Source Type: research
Donation After Circulatory Death in lung transplantation
The continuing shortage of pulmonary grafts from donors after brain death has led to a resurgence of interest in lung transplantation from donors after circulatory death (DCD). Most lungs from donors after withdrawal from life-sustaining therapy can be recovered rapidly and transplanted directly without ex-vivo assessment in case functional warm ischemic time is limited to 30 to 60 min. The potential of the DCD lung pool is still underutilized and should be maximized in countries with existing legislation. Countries lacking a DCD pathway should be encouraged to develop national ethical, professional, and legal frameworks...
Source: Thoracic Surgery Clinics - May 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Dirk Van Raemdonck, Laurens J. Ceulemans, Arne Neyrinck, Bronwyn Levvey, Gregory I. Snell Source Type: research
Centralized Organ Recovery and Reconditioning Centers
An increased focus on improving efficiency and decreasing costs has resulted in alternative models of donor management and organ recovery. The specialized donor care facility model provides highly efficient and cost-effective donor care at a free-standing facility, resulting in improved organ yield, shorter ischemic times, decreased travel, and fewer nighttime operations. Ex vivo lung perfusion (EVLP) improves utilization of extended criteria donor lungs, and centralized EVLP facilities have the potential to increase transplant volumes for smaller transplant programs in specified geographic regions. These alternative mod...
Source: Thoracic Surgery Clinics - May 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Amit Bery, Aadil Ali, Marcelo Cypel, Daniel Kreisel Source Type: research
Chronic Lung Allograft Dysfunction
Chronic lung allograft dysfunction (CLAD) is a syndrome of progressive lung function decline, subcategorized into obstructive, restrictive, and mixed phenotypes. The trajectory of CLAD is variable depending on the phenotype, with restrictive and mixed phenotypes having more rapid progression and lower survival. The mechanisms driving CLAD development remain unclear, though allograft injury during primary graft dysfunction, acute cellular rejection, antibody-mediated rejection, and infections trigger immune responses with long-lasting effects that can lead to CLAD months or years later. Currently, retransplantation is the o...
Source: Thoracic Surgery Clinics - May 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Aida Venado, Jasleen Kukreja, John R. Greenland Source Type: research
Management of the Potential Lung Donor
The use of donor management protocols has significantly improved recovery rates; however, the inherent instability of lungs after death results in low utilization rates of potential donor lungs. Donor lungs are susceptible to direct trauma, aspiration, neurogenic edema, ventilator-associated barotrauma, and ventilator-associated pneumonia. After irreversible brain injury and determination of futility of care, the goal of medical management of the donor shifts to maintaining hemodynamic stability and maximizing the likelihood of successful organ recovery. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - May 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ashwini Arjuna, Anna Teresa Mazzeo, Tommaso Tonetti, Rajat Walia, Luciana Mascia Source Type: research
Early Postoperative Management of Lung Transplant Recipients
The early postoperative period after lung transplantation is a critical time. Prompt recognition and treatment of primary graft dysfunction can alter long-term allograft function. Cardiovascular, gastrointestinal, renal, and hematologic derangements are common and require close management to limit their negative sequelae. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - May 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Binh N. Trinh, Marek Brzezinski, Jasleen Kukreja Source Type: research
Lung Retransplantation
Lung retransplantation remains the standard treatment of irreversible lung allograft failure. The most common indications for lung retransplantation are acute graft failure, chronic lung allograft dysfunction, and postoperative airway complications. Careful patient selection with regards to indications, anatomy, extrapulmonary organ dysfunction (specifically renal dysfunction), and immunologic consideration are of utmost importance. The conduct of the lung retransplantation operation is arduous with special considerations given to operative approach, type of surgery (single vs bilateral), use of extracorporeal circulatory ...
Source: Thoracic Surgery Clinics - May 1, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Eriberto Michel, Matthew Galen Hartwig, Wiebke Sommer Source Type: research
