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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 -
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... Oct 2019
Topics: Social Media; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 31422855
DOI: 10.1016/j.jtcvs.2019.06.100 -
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... 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 -
Anaesthesia Apr 2023This review of 19 studies (39,783 patients) of atrial fibrillation after thoracic surgery addresses the pathophysiology, incidence, and consequences of atrial... (Review)
Review
This review of 19 studies (39,783 patients) of atrial fibrillation after thoracic surgery addresses the pathophysiology, incidence, and consequences of atrial fibrillation in this population, as well as its prevention and management. Interestingly, atrial fibrillation was most often identified in patients not previously known to have the disease. Rhythm control with amiodarone was the most commonly used treatment and nearly all patients were discharged in sinus rhythm. Major predictors were age; male sex; history of atrial fibrillation; congestive heart failure; left atrial enlargement; elevated brain natriuretic peptide level; and the invasiveness of procedures. Overall, patients with atrial fibrillation stayed 3 days longer in hospital. We also discuss the importance of standardising research on this subject and provide recommendations that might mitigate the impact postoperative atrial fibrillation on hospital resources.
Topics: Humans; Male; Atrial Fibrillation; Anti-Arrhythmia Agents; Thoracic Surgery; Amiodarone; Thoracic Surgical Procedures
PubMed: 36632006
DOI: 10.1111/anae.15957 -
The Journal of Thoracic and... May 2017
Topics: Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 28274554
DOI: 10.1016/j.jtcvs.2017.02.006 -
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 -
The Annals of Thoracic Surgery May 2022Randomized trials in surgery face additional challenges compared with those in medicine. Some of the challenges are intrinsic to the nature of the field (eg, issues with... (Review)
Review
Randomized trials in surgery face additional challenges compared with those in medicine. Some of the challenges are intrinsic to the nature of the field (eg, issues with blinding, learning curve and surgeons' experience, and difficulties in defining the appropriate timing for comparative trials). Other issues are related to the surgical culture, the attitude of surgeons toward randomized trials, and the lack of support by professional and national bodies. In this review, a group of investigators with experience in trials in congenital and adult cardiac and thoracic surgery discusses the key issues with surgical trials and suggests potential solutions.
Topics: Adult; Humans; Learning Curve; Randomized Controlled Trials as Topic; Surgeons; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 33412133
DOI: 10.1016/j.athoracsur.2020.11.042 -
Minerva Anestesiologica Nov 2023Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management... (Review)
Review
Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management is to promote effective coughing and early mobilization to reduce atelectasis and ventilation disorders induced by pulmonary contusion. The incidence of chronic pain can affect more than 35% of patients after both thoracotomy and thoracoscopy as well as after chest trauma. As the severity of acute pain is associated with the incidence of chronic pain, early and effective pain management is very important. In this narrative review, we propose to detail systemic and regional analgesia techniques to minimize postoperative pain, while reducing transitional pain, surgical stress response and opioid side effects. We provide the reader with practical recommendations based on both literature and clinical practice experience in a referral level III thoracic trauma center.
Topics: Humans; Pain Management; Thoracic Surgery; Chronic Pain; Thoracic Surgical Procedures; Thoracoscopy; Pain, Postoperative; Thoracotomy
PubMed: 37671536
DOI: 10.23736/S0375-9393.23.17291-9