Contributors
VIRGINIA R. LITLE, MD (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - November 18, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research
Contents
Virginia R. Litle (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - November 18, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research
Forthcoming Issues
Lung Transplantation (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - November 18, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research
Social Disparities in Thoracic Surgery: Actionable Items
We are excited to bring you this focused issue for the Thoracic Surgery Clinics on “Social Disparities in Thoracic Surgery.” An established expert on this topic, Dr Cherie Erkmen, our guest editor, created a primer for how to address disparities not only in the management of lung cancer screening (LCS) but also in designing health disparities research projects, diversifying ou r thoracic surgery workforce, and working to level the playing field in health care delivery. Thanks to the novel coronavirus pandemic, these have become timely subjects, and the energy to make a difference is palpable not only in our clinical ar...
Source: Thoracic Surgery Clinics - November 18, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Virginia R. Litle Tags: Foreword Source Type: research
Systemic Therapy in Nonsmall Cell Lung Cancer and the Role of Biomarkers in Selection of Treatment
Increasingly, systemic treatment decisions in nonsmall cell lung cancer require the determination of predictive biomarkers on biopsy or surgical specimens. Although currently these have their major role in the advanced setting, these tumor-specific treatments are increasingly moving into earlier stage disease. As part of the multidisciplinary team managing those with nonsmall cell lung cancer, thoracic surgeons need to be aware of these biomarkers and in particular of the need for adequate biopsy specimens containing sufficient tissue to perform the necessary analyses that guide treatment selection. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Bryan Lo, Scott A. Laurie Source Type: research
Neuroendocrine Tumors of the Lung
Pulmonary neuroendocrine tumors (NETs) are relatively rare; however, their incidence is steadily increasing. They now comprise 1% to 2% of all lung cancers. Lung NETs are classified based on the World Health Organization classification into low-, intermediate-, and high-grade tumors. Most patients present with nonspecific symptoms that can result in delayed diagnosis. Bronchoscopy and biopsy are essential to diagnose and classify pulmonary NETs. Surgery is the mainstay of therapy and R0 resection is key. Lung preservation surgery, whenever possible, is preferred. There is little role of systemic therapy in NETs. Survival a...
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Simran Randhawa, Nikolaos Trikalinos, G. Alexander Patterson Source Type: research
Aerogenous Metastasis and Spread Through the Air Spaces – Distinct Entities or Spectrum of the Same Process?
Clinicopathological and imaging studies indicate that metastatic spread of cancer cells through the airways may occur in primary lung cancer. The term aerogenous metastasis was been proposed years before the concept of spread through the airspaces (STAS) was introduced in the current World Health Organization classification. The pathogenesis of STAS has not been fully elucidated. The current definition of STAS is controversial and limited to early stage adenocarcinomas. In this article, existing knowledge on the pathogenesis, histology, imaging findings, and clinical and prognostic significance of these 2 entities is prese...
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Carolina A. Souza, Marcio M. Gomes Source Type: research
Paraneoplastic Syndromes in Lung Cancers
Paraneoplastic syndromes are clinical entities associated with cancers and often overlap with metabolic and endocrine syndromes. The cell types of lung cancer involved are frequently small cell, squamous cell, adenocarcinoma, large cell, and carcinoid tumor. A number of neurologic paraneoplastic syndromes have been described for which the tumor product remains unknown. These include peripheral neuropathies, a myasthenia-like syndrome, and subacute cerebellar degeneration. Although all of these syndromes may improve with successful treatment of the primary tumor, complete resolution is rare. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji, Gilles Beauchamp, Donna E. Maziak, Joel Cooper Source Type: research
The History and Evolution of Surgical Instruments in Thoracic Surgery
Surgery is as old as man, and its evolution has been moulded in every age by current technical and scientific advances, not forgetting the demands made upon it by social circumstances and religion. It is both an art and a science, while its practice largely depends on the human relations between doctor and patient. It is extremely difficult to define where surgery begins or ends, and its separation from medicine is largely based on the very different paths which the two disciplines took in ancient times. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji, Kristin Waddell, Gilles Beauchamp Source Type: research
Medical Audit to Improve the Quality of Patient Care in Thoracic Surgery
The purpose and conduct of medical audit is a means of quality control for medical practice by which the profession shall regulate its activities with the intention of improving overall patient care. The quality assurance depends on patient and physician satisfaction. The medical profession needs to be educated about the structure, process, and outcome. The structure equates to resources found within the hospital. The outcome is when quality of care becomes preeminent. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji, Joel Cooper, Gilles Beauchamp Source Type: research
Delays in Managing Lung Cancer
Early diagnosis in lung cancer is desirable, because surgical resection offers the only hope of cure. In the face of suggestive symptoms, a normal plain chest radiograph does not exclude the diagnosis, and investigation is essential. The various imaging changes seen on computerized tomography and PET scan provide strong suggestive evidence of lung cancer, but proof of diagnosis rests on histologic examination, material that may be obtained by one of the following diagnostic procedures: bronchoscopy, mediastinoscopy, fine needle aspiration biopsy, thoracentesis and pleural biopsy, lymph node biopsy, and exploratory thoracot...
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji, Gilles Beauchamp Source Type: research
Standardized Postoperative Adverse Event Data Collection to Document, Inform, and Improve Patient Care
There is great potential for standardized postoperative adverse events data collection to document, inform, audit, and feedback, all to optimize patient care. Adverse events, defined as any deviation from expected recovery from surgery, have harmful implications for patients, their families, and clinicians. Postoperative adverse events occur frequently in thoracic surgery, predominately due to the high-stakes (ie, high potential for cure) and high-risk (ie, vital physiology and anatomy and preexisting disease) nature of the surgery. As discussed, engaging surgeons in audit and feedback practices informed by standardized da...
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji, Molly Gingrich, Caitlin Anstee, Andrew J.E. Seely Source Type: research
Controversies in Lung Cancer
Lung cancer is the most common cause of cancer-related death worldwide among both men and women. Patients with lung cancer frequently have impaired pulmonary function, usually secondary to smoking-related chronic obstructive lung disease. Numerous techniques have been used to evaluate the postsurgical risk. These techniques include preoperative pulmonary function test, 6-minute walk test, stage 1 cardiopulmonary exercise test, 2D echocardiography, and quantitative ventilation-perfusion scintigraphy. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji Source Type: research
The Lymphatic Spread of Lung Cancer
The knowledge of lymphatic spread of lung cancer permitted the study of anatomy of lymphatic drainage of the lungs. The history of anatomy of lymphatic drainage of the lungs began in the 15th century. In the human, pulmonary lymph flows to the lymph nodes around the lobar bronchi and thence to extrapulmonary lymph nodes located around the main bronchi and trachea and its bifurcation (tracheobronchial lymph nodes). These send their efferents to a right and left mediastinal lymph trunks, which may join the thoracic duct, but usually drain opening directly into the brachiocephalic vein of their own side. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Farid M. Shamji, Gilles Beauchamp, Harman Jatinder S. Sekhon Source Type: research
Superior Vena Cava Resection and Reconstruction with Resection of Primary Lung Cancer and Mediastinal Tumor
The superior vena cava is a short ∼7-cm valveless vessel that brings blood from the upper half of the body to the heart but has connections to the infracardiac venous structures as well. It can become obstructed, mostly by advanced lung cancer but benign conditions account for one-fourth of cases. When possible, reconstruction can be by biological material or via ring reinforced grafts. When perfomed, replacement should be with small caliber grafts to allow for rapid flow of blood, which, with the addition of anticoagulants, reduces the risk of thrombosis. Even with advanced malignancy, treatment may confer reasonable su...
Source: Thoracic Surgery Clinics - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Robert James Cusimano, Farid M. Shamji Source Type: research
