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The Journal of Thoracic and... Jan 2022
Topics: Cardiac Surgical Procedures; Clinical Competence; Education; Emotional Intelligence; Humans; Internship and Residency; Leadership; Social Responsibility; Thoracic Surgery
PubMed: 34217532
DOI: 10.1016/j.jtcvs.2021.06.016 -
The Journal of Thoracic and... Nov 2020
Topics: Accreditation; Humans; Internship and Residency; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 32014324
DOI: 10.1016/j.jtcvs.2019.12.062 -
The Indian Medical Gazette Aug 1952
Topics: Humans; Thoracic Surgery; Thoracic Surgical Procedures; Thorax
PubMed: 13022082
DOI: No ID Found -
European Journal of Cardio-thoracic... Jan 2013At least every ten years, each specialty should reflect upon its past, its present and its future, in order to be able to reconfirm the direction in which it is headed,... (Review)
Review
At least every ten years, each specialty should reflect upon its past, its present and its future, in order to be able to reconfirm the direction in which it is headed, to adopt suggestions from inside and outside and, consequently, to improve. As such, the aim of this manuscript is to provide the interested reader with an overview of how aortic surgery and (perhaps more accurately) aortic medicine has evolved in Europe, and its present standing; also to provide a glimpse into the future, trying to disseminate the thoughts of a group of people actively involved in the development of aortic medicine in Europe, namely the Vascular Domain of the European Association of Cardio-Thoracic Surgery (EACTS).
Topics: Aorta; Aortic Diseases; Europe; Forecasting; Humans; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 23148072
DOI: 10.1093/ejcts/ezs413 -
The Journal of Thoracic and... May 2022
Topics: Cardiology; Humans; Societies, Medical; Thoracic Surgery; Thoracic Surgical Procedures; United States
PubMed: 35307216
DOI: 10.1016/j.jtcvs.2022.03.001 -
Minerva Surgery Aug 2023
Topics: Humans; Chylothorax; Thoracic Surgery; Thoracic Surgical Procedures; Thoracic Duct
PubMed: 35708446
DOI: 10.23736/S2724-5691.22.09621-6 -
Journal of Cardiac Surgery Dec 2022Chest X-rays are routinely obtained after the removal of chest drains in patients undergoing cardiac and thoracic surgical procedures. However, a lack of guidelines and... (Review)
Review
BACKGROUND
Chest X-rays are routinely obtained after the removal of chest drains in patients undergoing cardiac and thoracic surgical procedures. However, a lack of guidelines and evidence could question the practice. Routine chest X-rays increase exposure to ionizing radiation, increase health-care costs, and lead to overutilisation of available resources. This review aims to explore the evidence in the literature regarding the routine use of chest X-rays following the removal of chest drains.
MATERIALS & METHOD
A systematic literature search was conducted in PubMed, Medline via Ovid, Cochrane central register of control trials (CENTRAL), and ClinicalTrials. gov without any limit on the publication year. The references of the included studies are manually screened to identify potentially eligible studies.
RESULTS
A total of 375 studies were retrieved through the search and 18 studies were included in the review. Incidence of pneumothorax remains less than 10% across adult cardiac, and pediatric cardiac and thoracic surgical populations. The incidence may be as high as 50% in adult thoracic surgical patients. However, the reintervention rate remains less than 2% across the populations. Development of respiratory and cardiovascular symptoms can adequately guide for a chest X-ray following the drain removal. As an alternative, bedside ultrasound can be used to detect pneumothorax in the thorax after the removal of a chest drain without the need for ionizing radiation.
CONCLUSION
A routine chest X-ray following chest drain removal in adult and pediatric patients undergoing cardiac and thoracic surgery is not necessary. It can be omitted without compromising patient safety. Obtaining a chest X-ray should be clinically guided. Alternatively, bedside ultrasound can be used for the same purpose without the need for radiation exposure.
Topics: Humans; Adult; Child; X-Rays; Pneumothorax; Thoracic Surgery; Thoracic Surgical Procedures; Heart; Radiography, Thoracic
PubMed: 36335600
DOI: 10.1111/jocs.17114 -
The Journal of Thoracic and... Jun 2020
Topics: Internship and Residency; Surveys and Questionnaires; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 32007242
DOI: 10.1016/j.jtcvs.2019.12.047 -
Tomography (Ann Arbor, Mich.) Aug 2022There is growing evidence that supports the use of chest ultrasound (CUS) versus conventional chest X-ray (CXR) in order to diagnose postoperative complications.... (Meta-Analysis)
Meta-Analysis Review
There is growing evidence that supports the use of chest ultrasound (CUS) versus conventional chest X-ray (CXR) in order to diagnose postoperative complications. However, data regarding its use after thoracic surgery are scarce and contradictory. The aim of this study was to conduct a systematic review to evaluate the accuracy of CUS after thoracic surgery. An electronic search in MEDLINE (via PubMed), complemented by manual searches in article references, was conducted to identify eligible studies. Six studies with a total of 789 patients were included in this meta-analysis. Performing CXR decreased in up to 61.6% of cases, with the main reasons for performing CXR being massive subcutaneous emphysema or complex hydrothorax. Agreement between CUS and routine-based therapeutic options was, in some studies, up to 97%. The selectively postoperative use of CUS may reduce the number of routinely performed CXR. However, if CUS findings are inconclusive, further radiological examinations are obligatory.
Topics: Humans; Radiography; Radiography, Thoracic; Thoracic Surgery; Thoracic Surgical Procedures; X-Rays
PubMed: 36006073
DOI: 10.3390/tomography8040175 -
World Journal of Surgery Jan 2019Benchmarking operative volume and resources is necessary to understand current efforts addressing thoracic surgical need. Our objective was to examine the impact on...
BACKGROUND
Benchmarking operative volume and resources is necessary to understand current efforts addressing thoracic surgical need. Our objective was to examine the impact on thoracic surgery volume and patient access in Rwanda following a comprehensive capacity building program, the Human Resources for Health (HRH) Program, and thoracic simulation training.
METHODS
A retrospective cohort study was conducted of operating room registries between 2011 and 2016 at three Rwandan referral centers: University Teaching Hospital of Kigali, University Teaching Hospital of Butare, and King Faisal Hospital. A facility-based needs assessment of essential surgical and thoracic resources was performed concurrently using modified World Health Organization forms. Baseline patient characteristics at each site were compared using a Pearson Chi-squared test or Kruskal-Wallis test. Comparisons of operative volume were performed using paired parametric statistical methods.
RESULTS
Of 14,130 observed general surgery procedures, 248 (1.76%) major thoracic cases were identified. The most common indications were infection (45.9%), anatomic abnormalities (34.4%), masses (13.7%), and trauma (6%). The proportion of thoracic cases did not increase during the HRH program (2.07 vs 1.78%, respectively, p = 0.22) or following thoracic simulation training (1.95 2013 vs 1.44% 2015; p = 0.15). Both university hospitals suffer from inadequate thoracic surgery supplies and essential anesthetic equipment. The private hospital performed the highest percentage of major thoracic procedures consistent with greater workforce and thoracic-specific material resources (0.89% CHUK, 0.67% CHUB, and 5.42% KFH; p < 0.01).
CONCLUSIONS AND RELEVANCE
Lack of specialist providers and material resources limits thoracic surgical volume in Rwanda despite current interventions. A targeted approach addressing barriers described is necessary for sustainable progress in thoracic surgical care.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesiology; Child; Child, Preschool; Equipment and Supplies, Hospital; Female; Health Workforce; Hospitals, Private; Hospitals, University; Humans; Infant; Infant, Newborn; Male; Middle Aged; Needs Assessment; Retrospective Studies; Rwanda; Simulation Training; Thoracic Surgery; Thoracic Surgical Procedures; Young Adult
PubMed: 30132227
DOI: 10.1007/s00268-018-4771-y