Seminars in Thoracic and Cardiovascular Surgery最新文献

{"title":"Integrating Quality Metrics with Enhanced Recovery Pathways in Coronary Artery Bypass Grafting","authors":"Katherine G. Phillips MD,&nbsp;Aubrey Galloway MD,&nbsp;Eugene A. Grossi MD,&nbsp;Daniel Swistel MD,&nbsp;Deane E. Smith III MD,&nbsp;Ralph Mosca MD,&nbsp;Elias Zias MD","doi":"10.1053/j.semtcvs.2025.01.002","DOIUrl":"10.1053/j.semtcvs.2025.01.002","url":null,"abstract":"<div><div>Quality improvement and enhanced recovery initiatives for coronarybypass surgery have reduced complications, shortened hospital stay and recovery times, and improved patient outcomes. Beyond the Society of Thoracic Surgery’s (STS) quality metrics, many other operative measures, such as completeness of revascularization, and patient care measures add quality and value for patients undergoing coronary artery bypass surgery; and Enhanced Recovery after Surgery (ERAS) protocols have improved patient experience and recovery, leading to better outcomes and significant healthcare savings.</div></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 1","pages":"Pages 48-57"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masthead (copyright and information page)","authors":"","doi":"10.1053/S1043-0679(25)00024-3","DOIUrl":"10.1053/S1043-0679(25)00024-3","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 1","pages":"Page I"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Sublobar Resection for Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer","authors":"Robert E. Merritt MD ,&nbsp;Alessandro Brunelli MD ,&nbsp;Garrett Walsh MD ,&nbsp;Sudish Murthy MD, PhD ,&nbsp;Matthew J. Schuchert MD ,&nbsp;Thomas K. Varghese Jr, MD, MS, MBA ,&nbsp;Michael Lanuti MD, MD ,&nbsp;Andrea Wolf MD, MPH ,&nbsp;Homa Keshavarz PhD ,&nbsp;Billy W. Loo Jr, MD, PhD ,&nbsp;Robert D. Suh MD ,&nbsp;Raymond H. Mak MD ,&nbsp;Gerard J. Criner MD ,&nbsp;Peter J. Mazzone MD ,&nbsp;Michael Liptay MD ,&nbsp;Q. Eileen Wafford MSt, MLIS ,&nbsp;M. Blair Marshall MD ,&nbsp;Betty Tong MD ,&nbsp;Brian Pettiford MD ,&nbsp;Gaetano Rocco MD ,&nbsp;Arjun Pennathur MD, Co-Chair Writing Committee","doi":"10.1053/j.semtcvs.2024.11.002","DOIUrl":"10.1053/j.semtcvs.2024.11.002","url":null,"abstract":"<div><div>Sublobar resection offers a parenchymal-sparing surgical alternative to lobectomy and includes wedge resection and segmentectomy. Sublobar resection has been historically utilized in high-risk patients with compromised lung function; however, the technique is becoming more prevalent for normal-risk patients with peripheral stage IA non-small cell lung cancer (NSCLC) &lt;2 cm. In this article, we summarize the technique of sublobar resection, the importance of surgical margins and lymph node sampling, patient selection, perioperative complications, outcomes, and the impact of sublobar resection on the quality of life. There is limited data on short-term and long-term outcomes after sublobar resection for stage I NSCLC in high-risk patients. Results from randomized clinical trials (RCTs) of sublobar resection have been variable. We have summarized the results of the ACOSOG Z4032 RCT, which compared outcomes in high-risk patients who underwent sublobar resection alone versus sublobar resection with brachytherapy for stage I NSCLC. In addition, we have summarized recent findings of the CALGB/Alliance 140503 RCT comparing sublobar resection and lobectomy, which suggested that disease-free survival after sublobar resection in patients with small (&lt;2 cm) peripheral stage IA NSCLC was non-inferior to lobectomy, and another RCT (JCOG 0802) of segmentectomy vs. lobectomy for small peripheral clinical stage IA NSCLC, where segmentectomy was associated with better overall survival despite a higher local recurrence rate. Sublobar resection is primarily performed with minimally invasive approaches, including robotic-assisted and video-assisted thoracoscopic techniques. From an oncologic perspective, obtaining adequate surgical margins and performing an adequate lymph node evaluation are critical for good outcomes after sublobar resection.</div></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 1","pages":"Pages 99-105"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of the Comparative Studies of Image-Guided Thermal Ablation, Stereotactic Radiosurgery, and Sublobar Resection for Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer","authors":"Arjun Pennathur MD, Co-Chair Writing Committee ,&nbsp;Michael Lanuti MD ,&nbsp;Robert E. Merritt MD ,&nbsp;Andrea Wolf MD, MPH ,&nbsp;Homa Keshavarz PhD ,&nbsp;Billy W. Loo Jr, MD, PhD ,&nbsp;Robert D. Suh MD ,&nbsp;Raymond H. Mak MD ,&nbsp;Alessandro Brunelli MD ,&nbsp;Gerard J. Criner MD ,&nbsp;Peter J. Mazzone MD ,&nbsp;Garrett Walsh MD ,&nbsp;Michael Liptay MD ,&nbsp;Q. Eileen Wafford MSt, MLIS ,&nbsp;Sudish Murthy MD, PhD ,&nbsp;M. Blair Marshall MD ,&nbsp;Betty Tong MD ,&nbsp;Brian Pettiford MD ,&nbsp;Gaetano Rocco MD ,&nbsp;James Luketich MD ,&nbsp;Scott J. Swanson MD, Co-Chair Writing Committee","doi":"10.1053/j.semtcvs.2024.11.003","DOIUrl":"10.1053/j.semtcvs.2024.11.003","url":null,"abstract":"<div><div>The Clinical Practice Standards Committee of the American Association for Thoracic Surgery assembled an expert panel and conducted a systematic review of the literature detailing studies directly comparing treatment options for high-risk patients with stage I non-small cell lung cancer (NSCLC). A systematic search was performed to identify publications comparing outcomes following image-guided thermal ablation (IGTA), stereotactic ablative radiotherapy (SABR; also called stereotactic body radiation therapy [SBRT] and stereotactic radiosurgery [SRS]), and sublobar resection—the main treatment options applicable to high-risk patients with stage I NSCLC. There were no publications detailing completed randomized controlled trials comparing these treatment options. Several retrospective studies with comparisons were identified, some of which used large, population-based registries. The findings of several of these studies are summarized in this Expert Review article. Registry studies comparing IGTA with SABR in propensity-score matched patients with stage I NSCLC found no difference in overall survival. The use of thermal ablation was less frequent and had wider variation depending on geographic region as compared with SABR, however. Studies yielding high-quality data comparing SABR with sublobar resection have been limited. When comparing sublobar resection with IGTA, sublobar resection was associated with superior primary tumor control and overall survival in the retrospective cohort studies. Retrospective comparative studies are difficult to assess due to the inherent biases or treatment selection and the definitions of loco-regional control. Prospective randomized trials are needed to fully evaluate the outcomes of treatment options applicable to high-risk patients with early-stage lung cancer.</div></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 1","pages":"Pages 106-113"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiothoracic Surgical Trials Network Update.","authors":"J Hunter Mehaffey, Raymond Strobel, Benjamin Kramer, Patrick T O'Gara, Michael J Mack, Nirav C Patel, Brittany A Zwischenberger, Robert S Kramer, Annetine C Gelijns, Alan Moskowitz, A Marc Gillinov, Vinay Badhwar","doi":"10.1053/j.semtcvs.2024.12.004","DOIUrl":"10.1053/j.semtcvs.2024.12.004","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECLS-SHOCK Trial.","authors":"Guillaume Thery, Pierre-Emmanuel Noly, Yiorgos Alexandros Cavayas, Ismail Bouhout, Philippe Demers, Yoan Lamarche","doi":"10.1053/j.semtcvs.2025.01.004","DOIUrl":"10.1053/j.semtcvs.2025.01.004","url":null,"abstract":"<p><p>ECLS-SHOCK is the largest randomized control trial on Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) in Acute Myocardial Infarction-related Cardiogenic Shock (AMI-CS). Unfortunately, ECLS-SHOCK failed to demonstrate a reduction of mortality in AMI-CS with VA-ECMO. Interpretation of these findings must account for frequent crossover to VA-ECMO or other temporary mechanical circulatory support (tMCS) devices in the control group, as well as the exceptionally high severity of illness among participants. We detail here point by point what could explain the outcomes and the unanswered questions. In the light of these results, a liberal use of VA-ECMO might be avoided. Further trials are needed to refine patient selection criteria and determine the optimal timing (\"sweet-spot\") for VA-ECMO implementation. Current practice and future guidelines will have to take in count ECLS-SHOCK results.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Going to Long-Term Acute Care After Cardiac Surgery is Not as Good as Going Home.","authors":"Ahmed K Awad, Haley Jenkins, Fasial Bakaeen, Haytham Elgharably","doi":"10.1053/j.semtcvs.2025.01.005","DOIUrl":"10.1053/j.semtcvs.2025.01.005","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Left Pleural Effusion to Facilitate Ultrasound-Guided Drainage of Postoperative Pericardial Effusion.","authors":"Dale H Marsh","doi":"10.1053/j.semtcvs.2025.01.003","DOIUrl":"10.1053/j.semtcvs.2025.01.003","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should We Repair Moderate Tricuspid Regurgitation? An Expert Opinion.","authors":"Ricky Patil, Matthew Kazaleh, Gorav Ailawadi","doi":"10.1053/j.semtcvs.2025.01.006","DOIUrl":"10.1053/j.semtcvs.2025.01.006","url":null,"abstract":"<p><p>Lack of consensus on the treatment of tricuspid regurgitation (TR) has limited operative management for decades. However, emerging evidence indicates that intervening on moderate tricuspid regurgitation during concomitant cardiac surgery can be beneficial with appropriate patient selection. Furthermore, advances in transcatheter therapies have changed the landscape of managing tricuspid disease.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited Expert Opinion: \"Its My Patient - Surgeon as Team Leader\".","authors":"Thoralf M Sundt","doi":"10.1053/j.semtcvs.2025.01.007","DOIUrl":"10.1053/j.semtcvs.2025.01.007","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}