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The Journal of Thoracic and... Jun 2017
Review
Topics: Anti-Bacterial Agents; Consensus; Drainage; Empyema, Pleural; Evidence-Based Medicine; Fibrinolytic Agents; Humans; Societies, Medical; Thoracentesis; Thoracic Surgery; Thoracic Surgery, Video-Assisted; Thoracic Surgical Procedures; Thoracotomy; Treatment Outcome
PubMed: 28274565
DOI: 10.1016/j.jtcvs.2017.01.030 -
The Journal of Thoracic and... Nov 2020
Topics: Education, Medical, Graduate; History, 21st Century; Humans; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 32245669
DOI: 10.1016/j.jtcvs.2019.12.132 -
Brazilian Journal of Cardiovascular... Oct 2021Despite being one of the main vacation destinations in the world, health care in the Caribbean faces many difficulties. The challenges involved in these islands' medical... (Review)
Review
INTRODUCTION
Despite being one of the main vacation destinations in the world, health care in the Caribbean faces many difficulties. The challenges involved in these islands' medical care range from low-resource institutions to lack of specialized care. In the field of thoracic and cardiac surgery, many limitations exist, and these include the lack of access to cardiac surgery for many small islands and little governmental funding for minimally invasive approaches in thoracic surgery.
METHODS
Literature review was done using PubMed/MEDLINE and Google Scholar databases to identify articles describing the characteristics of thoracic and cardiac surgery departments on Caribbean islands. Articles on the history, current states of practice, and advances in cardiothoracic surgery in the Caribbean were reviewed.
RESULTS
Regardless of the middle to high-income profile of the Caribbean, there are significant differences in the speed of technological growth in cardiothoracic surgery from island to island, as well as disparities between the quality of care and resources. Many islands struggle to advance the field of cardiothoracic surgery both through lack of local cardiac surgery centers and limited financial funding for minimally invasive thoracic surgery.
CONCLUSIONS
Cardiac and thoracic surgery in the Caribbean depend not only on the support from local government policies and proper distribution of healthcare budgets, but efforts by the surgeons themselves to change and improve institutional cultures. Although resource availability still remains a challenge, the Caribbean remains an important region that deserves special attention with regard to the unmet needs for long-term sustainability of chest surgery.
Topics: Cardiac Surgical Procedures; Caribbean Region; Humans; Minimally Invasive Surgical Procedures; Surgeons; Thoracic Surgery
PubMed: 33577262
DOI: 10.21470/1678-9741-2020-0377 -
The Journal of Thoracic and... Jun 2017
Topics: Cardiac Surgical Procedures; Diffusion of Innovation; History, 20th Century; History, 21st Century; Humans; Periodicals as Topic; Societies, Medical; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 28341470
DOI: 10.1016/j.jtcvs.2017.02.026 -
The Journal of Thoracic and... May 2017
Topics: Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 28274554
DOI: 10.1016/j.jtcvs.2017.02.006 -
The Journal of Thoracic and... Oct 2019
Topics: Social Media; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 31422855
DOI: 10.1016/j.jtcvs.2019.06.100 -
Current Oncology (Toronto, Ont.) Jan 2021Diagnosis and surgical treatment decision making for thoracic cancers is complex. Moreover, there is demonstrated variability in how each province in Canada delivers...
BACKGROUND
Diagnosis and surgical treatment decision making for thoracic cancers is complex. Moreover, there is demonstrated variability in how each province in Canada delivers cancer care, resulting in disparities in patient outcomes. Recently, the Canadian Partnership Against Cancer (CPAC) published pan-Canadian evidence-based standards for the care of thoracic surgery cancer patients. This study was undertaken to assess the degree to which these standards were currently met in practice and to further understand the determinants to their implementation nationally.
METHODS
This study was undertaken in two parts: (1) a national survey of thoracic surgeons to assess the perceived extent of implementation of these standards in their institution and province; and (2) formation of a focus group with a representative sample of thoracic surgeons across Canada in a qualitative study to understand the determinants of successful standards implementation.
RESULTS
37 surgeons (33% response rate) participated in the survey; 78% were from academic hospitals. The top categories of standards that were under-implemented included (a) quality assurance processes, data collection and clinician audit and feedback, and (b) ongoing regional planning and workload assessments for thoracic surgeons, and (c) pathology turnaround time target of two weeks and the use of a standardized synoptic pathology report format. Enablers, barriers, and opportunities for standards implementation contextualized the discussion within the focus group.
CONCLUSION
Study results demonstrated variation in the implementation of surgery standards across Canada and identified the determinants to the delivery of high quality surgical care. Future work will need to include the promotion and development of quality improvement strategies and effective resource allocation that is aligned with the implementation of thoracic cancer surgery standards in order to improve patient outcomes.
Topics: Canada; Humans; Quality Improvement; Quality of Health Care; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 33450804
DOI: 10.3390/curroncol28010043 -
The Journal of Thoracic and... Sep 2021
Topics: Anger; Attitude of Health Personnel; Cooperative Behavior; Education, Medical, Graduate; Health Knowledge, Attitudes, Practice; Humans; Internship and Residency; Leadership; Mentors; Patient Care Team; Societies, Medical; Surgeons; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 34127277
DOI: 10.1016/j.jtcvs.2021.05.026 -
The Journal of Thoracic and... Nov 2020
Topics: Humans; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 32057455
DOI: 10.1016/j.jtcvs.2020.01.011 -
Interactive Cardiovascular and Thoracic... Jan 2022Extended reality (XR), encompassing both virtual reality (VR) and augmented reality, allows the user to interact with a computer-generated environment based on reality....
OBJECTIVES
Extended reality (XR), encompassing both virtual reality (VR) and augmented reality, allows the user to interact with a computer-generated environment based on reality. In essence, the immersive nature of VR and augmented reality technology has been warmly welcomed in all aspects of medicine, gradually becoming increasingly feasible to incorporate into everyday practice. In recent years, XR has become increasingly adopted in thoracic surgery, although the extent of its applications is unclear. Here, we aim to review the current applications of XR in thoracic surgery.
METHODS
A systematic database search was conducted of original articles that explored the use of VR and/or augmented reality in thoracic surgery in EMBASE, MEDLINE, Cochrane database and Google Scholar, from inception to December 2020.
RESULTS
Our search yielded 1494 citations, of which 21 studies published from 2007 to 2019 were included in this review. Three main areas were identified: (i) the application of XR in thoracic surgery training; (ii) preoperative planning of thoracic procedures; and (iii) intraoperative assistance. Overall, XR could produce progression along the learning curve, enabling trainees to reach acceptable standards before performing in the operating theatre. Preoperatively, through the generation of 3D-renderings of the thoracic cavity and lung anatomy, VR increases procedural accuracy and surgical confidence through familiarization of the patient's anatomy. XR-assisted surgery may have therapeutic use particularly for complex cases, where conventional methods would yield inadequate outcomes due to inferior accuracy.
CONCLUSION
XR represents a salient step towards improving thoracic surgical training, as well as enhancing preoperative planning and intraoperative guidance.
Topics: Augmented Reality; Humans; Operating Rooms; Thoracic Surgery; Thoracic Surgical Procedures; Virtual Reality
PubMed: 34542639
DOI: 10.1093/icvts/ivab241