JTCVS open最新文献

{"title":"Healthcare economic burden of unresolved slipping rib syndrome","authors":"Adam J. Hansen MD,&nbsp;J.W.Awori Hayanga MD, MPH,&nbsp;Alper Toker MD,&nbsp;Vinay Badhwar MD","doi":"10.1016/j.xjon.2024.09.022","DOIUrl":"10.1016/j.xjon.2024.09.022","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the healthcare costs associated with unresolved slipping rib syndrome (SRS).</div></div><div><h3>Methods</h3><div>Data pertaining to patients who underwent operative repair for SRS at our academic institution were analyzed retrospectively. Duration of symptoms, previous management efforts, number of healthcare provider consultations, imaging studies, adjunctive surgical and pain management procedures performed to treat the symptoms, and prior unsuccessful SRS operations were catalogued. US Medicare billing standards were used to average costs for provider visits and overall cost of surgical and interventional pain management procedures. Analgesic medication costs were determined using generic pricing.</div></div><div><h3>Results</h3><div>Between February 2019 and January 2024, a total of 435 consecutive patients spent a median of 36 months searching for a diagnosis and symptom relief prior to evaluation at our institution. The median number of physicians consulted was 6 (range, 0-75). The total cost of physician visits was $2,990,434 USD. The median number of imaging studies was 5 (range, 0-55), at a total cost of $965,949. Cholecystectomy was performed in 47 patients (11%), at a cost of $716,750. Previous SRS surgery had been attempted 150 times at various institutions and accounted for $4,500,000 (estimated $30,000 per operation in billing). Intercostal nerve block, ablation, and spinal cord stimulator placement had been performed in 30%, 15%, and 5% of the patients, respectively, at a total cost of $963,821. The median number of analgesic medications used per patient was 1 (mean, 1.3; range, 0-5); the total medication cost was $1,111,860. The total preoperative healthcare cost in our series was $12,445,173, for an average of $28,610 per patient.</div></div><div><h3>Conclusions</h3><div>SRS remains poorly understood. Symptoms can be severe and debilitating, and patients frequently consume significant healthcare resources. With recognition and definitive surgical management, SRS may be addressed successfully. Prompt treatment has the potential for significant healthcare savings.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 485-490"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart transplant survival and the use of donors with intracranial bleeding: United Network for Organ Sharing Registry propensity-score matched analysis","authors":"J. Sam Meyer MSc ,&nbsp;Nancy Sweitzer MD ,&nbsp;Dan Aravot MD ,&nbsp;Carmelo A. Milano MD, MHS ,&nbsp;Yaron D. Barac MD, PhD","doi":"10.1016/j.xjon.2024.09.028","DOIUrl":"10.1016/j.xjon.2024.09.028","url":null,"abstract":"<div><h3>Objective</h3><div>The transplantation of hearts from donors who experienced intracranial bleeding (ICB) has been associated with inferior long-term survival in both single-center analyses and, more recently, with the United Network for Ogan Sharing Registry. The purpose of this study was to further explore this relationship through propensity score matching in recipients receiving donor hearts from ICB and non-ICB donors in a large national registry.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort analysis of the United Network for Organ Sharing Registry Organ Procurement and Transplantation Network between 2006 and 2018 for adult candidates wait-listed for isolated heart transplantation. Recipients were stratified into 2 groups: ICB and non-ICB donors. Propensity score matching was performed to estimate causal effects by using observational data. Kaplan-Meier analysis was used to estimate survival posttransplant. Cox proportional hazards modeling was used to evaluate the independent effect of ICB as a cause of death.</div></div><div><h3>Results</h3><div>A total of 25,315 candidates met inclusion criteria. ICB heart donors (n = 5529) were older (median age, 42 vs 27 years; <em>P</em> &lt; .001), less likely men (54.5% vs 75.2%; <em>P</em> &lt; .001), and more often had a history of smoking (20.1% vs 11.7%; <em>P</em> &lt; .001), and hypertension (34.2% vs 9.5%; <em>P</em> &lt; .001). Before matching there was a significant difference in long-term posttransplant survival; for example, the non-ICB (60.7% [interquartile range, 59.5%-61.9%] vs 56.8% (interquartile range, 54.7%-59.0%]; <em>P</em> &lt; .0001). However, when analyzing the propensity-score matched groups for outcomes, no difference was found between the cohorts both in terms of long-term survival as well as in rates of rejection.</div></div><div><h3>Conclusions</h3><div>In the largest propensity score matching analysis of heart transplants from donors who had experienced ICB, we found similar survival and rejection rates in heart transplant recipients.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 306-317"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A posterior pericardial chest tube is associated with reduced incidence of postoperative atrial fibrillation after cardiac surgery: A propensity score–matched study","authors":"Luis Gisli Rabelo BS ,&nbsp;Igor Zindovic MD, PhD ,&nbsp;Daniel Oudin Astrom PhD ,&nbsp;Egill Gauti Thorsteinsson BS ,&nbsp;Johan Sjogren MD, PhD ,&nbsp;Kristjana Lind Olafsdottir BS ,&nbsp;Matthildur Maria Magnusdottir BS ,&nbsp;Anders Jeppsson MD, PhD ,&nbsp;Tomas Gudbjartsson MD, PhD","doi":"10.1016/j.xjon.2024.09.003","DOIUrl":"10.1016/j.xjon.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery that is associated with other adverse outcomes. Recent studies have shown that drainage of pericardial effusion by a posterior pericardial incision reduces the incidence of POAF. An alternative approach is a chest tube placed posteriorly in the pericardium. We evaluated whether the use of a posterior pericardial drain was associated with reduced risk of POAF in patients undergoing coronary artery bypass graft (CABG) and/or aortic valve replacement (AVR).</div></div><div><h3>Methods</h3><div>This observational study included 2535 patients who underwent CABG (n = 1997), AVR (n = 293), or combined CABG and AVR (n = 245) in Iceland from 2002 to 2020. From our study population, 553 (22%) received a 20-Fr posterior pericardial chest tube in addition to standard mediastinal and left pleural drains. The incidence of POAF in patients with and without a posterior pericardial drain was compared before and after 1:1 propensity score matching.</div></div><div><h3>Results</h3><div>Of 2535 patients, 1100 were included in the matched cohort. The incidence of POAF was lower in patients receiving posterior pericardial chest tube drainage compared with the control group, both before (34% vs 43%, <em>P</em> &lt; .001) and after (33% vs 43%, <em>P</em> = .002) matching. In a multivariable analysis, posterior pericardial chest tube drainage was independently associated with a reduced risk for POAF (adjusted odds ratio 0.67; 95% confidence interval, 0.52-0.88; <em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>This observational study suggested that posterior pericardial chest tube drainage is associated with a significant reduction of POAF after routine CABG and/or AVR procedures. The results are hypothesis-generating and must be confirmed in prospective randomized trials.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 244-254"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noniatrogenic hypoglycemia: A universal marker for poor outcomes","authors":"Hannah Rando MD, MPH,&nbsp;Matthew Acton MD,&nbsp;Ifeanyi Chinedozi MD,&nbsp;Zachary Darby MD,&nbsp;Jin Kook Kang MD,&nbsp;Glenn Whitman MD","doi":"10.1016/j.xjon.2024.05.005","DOIUrl":"10.1016/j.xjon.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>Previous retrospective studies have established a relationship between postoperative hypoglycemia and adverse outcomes after cardiac surgery, but none have accounted for the cause of hypoglycemia.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of patients who underwent cardiac surgery at a single institution between 2016 and 2021. Patients were categorized as hypoglycemic if they had 1 or more postoperative blood glucose measurement less than 70 mg/dL and normoglycemic otherwise. Hypoglycemia was subcategorized as noniatrogenic (underlying liver failure, adrenal insufficiency, sepsis, or shock) or iatrogenic (insulin infusion continued while nil per os or infusion protocol violated) via manual chart review. Baseline characteristics were compared between groups using Pearson χ², analysis of variance, and Kruskal-Wallis testing, and outcomes were compared using multivariable logistic regression.</div></div><div><h3>Results</h3><div>In total, 5373 patients and 183,346 glucose measurements were included. Hypoglycemia occurred in 5% (267) of patients, of whom 63% (169) were iatrogenic and 37% (98) were noniatrogenic. In a multivariate analysis adjusting for age, sex, case urgency, pre-existing diabetes, and bypass time, both iatrogenic and noniatrogenic hypoglycemia were associated with greater odds of renal failure, prolonged ventilation, and prolonged intensive care unit length of stay relative to normoglycemia, but the magnitude was substantially lower in iatrogenic hypoglycemia. Patients with noniatrogenic hypoglycemia had 68.6 times greater odds of mortality relative to patients who were normoglycemic (odds ratio, 68.6; confidence interval, 39.5-119), but patients with iatrogenic hypoglycemia had no increased odds of mortality (odds ratio, 1.45; confidence interval, 0.77-2.73).</div></div><div><h3>Conclusions</h3><div>When excluding patients with conditions known to cause hypoglycemia from the analysis, the morbidity and mortality of iatrogenic hypoglycemia from tight postoperative glycemic control is dramatically attenuated.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 323-331"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentator Discussion: Establishment of Mongolia's first independent and sustainable minimally invasive general thoracic surgery program: A Mongolian-Canadian initiative","authors":"","doi":"10.1016/j.xjon.2024.10.019","DOIUrl":"10.1016/j.xjon.2024.10.019","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 528-529"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentator Discussion: Impact of lung allocation policy change on Hispanic lung transplant outcomes: Addressing disparities and improving access","authors":"","doi":"10.1016/j.xjon.2024.10.008","DOIUrl":"10.1016/j.xjon.2024.10.008","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 519-520"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentator Discussion: Pediatric cardiac surgical site infections: A single center quality improvement initiative","authors":"","doi":"10.1016/j.xjon.2024.09.017","DOIUrl":"10.1016/j.xjon.2024.09.017","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 448-449"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional morphometry of the human thoracic aorta using centerline analysis based on least-squares plane fitting","authors":"Hiroshi Nagamine MD,&nbsp;Kenji Kishita MD,&nbsp;Yuta Tsukada MD,&nbsp;Hiroshi Nagano MD,&nbsp;Mitsuru Asano MD","doi":"10.1016/j.xjon.2024.09.016","DOIUrl":"10.1016/j.xjon.2024.09.016","url":null,"abstract":"<div><h3>Objective</h3><div>A novel approach to 3-dimensional morphometry of the thoracic aorta was developed by applying centerline analysis based on least-squares plane fitting, and a preliminary study was conducted using computed tomography imaging data.</div></div><div><h3>Methods</h3><div>We retrospectively compared 3 groups of patients (16 controls without aortic disease, and 16 cases each with acute type B aortic dissection and congenital bicuspid aortic valve). In addition to the standard assessment indices for curvature κ and torsion τ, we conducted coordinate transformation based on the least-squares plane, divided the centerline into 3 representative features (transverse, anterior-posterior, and longitudinal displacements), and analyzed the overall and local displacement in each direction. The transverse displacement, represented by the distance of the centerline from the least-squares plane, was curve-fitted to the damped oscillation waveform. Thereafter, damped oscillation parameters were compared for each group.</div></div><div><h3>Results</h3><div>Curvature κ exhibited a bimodal distribution, with peaks observed in the ascending aorta and aortic arch, and torsion τ exhibited a transition from positive to negative values in the arch. There were significant differences in the mean displacement between the groups for each direction (transverse <em>P</em> = .0083, anteroposterior <em>P</em> = .010, longitudinal <em>P</em> = 1.32 × 10⁻⁶). Furthermore, interval integral analysis revealed that several intervals exhibited significant differences between groups in each direction. The amplitude of damped oscillation parameters was significantly larger in the bicuspid aortic valve group than in the control and type B aortic dissection groups.</div></div><div><h3>Conclusions</h3><div>The novel analytical approach permitted a quantitative assessment of the 3-dimensional morphological differences between the control, type B aortic dissection, and bicuspid aortic valve groups.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 144-155"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative cardiac arrest in patients undergoing congenital cardiac surgery","authors":"Morgan L. Brown MD, PhD ,&nbsp;Steven J. Staffa MS ,&nbsp;Phillip S. Adams DO ,&nbsp;Lisa A. Caplan MD ,&nbsp;Stephen J. Gleich MD ,&nbsp;Jennifer L. Hernandez MD ,&nbsp;Martina Richtsfeld MD ,&nbsp;Lori Q. Riegger MD ,&nbsp;David F. Vener MD ,&nbsp;Quality and Safety Committee of the Congenital Cardiac Anesthesia Society","doi":"10.1016/j.xjon.2024.09.015","DOIUrl":"10.1016/j.xjon.2024.09.015","url":null,"abstract":"<div><h3>Objective</h3><div>To describe intraoperative cardiac arrest in patients undergoing congenital heart surgery.</div></div><div><h3>Methods</h3><div>The Society of Thoracic Surgeons Congenital Heart Surgery Database was queried. Predictors of intraoperative cardiac arrest were assessed using univariate and multivariable analyses. The univariate relationship between intraoperative cardiac arrest was also compared with available outcomes in the database.</div></div><div><h3>Results</h3><div>A total of 92,764 cases had anesthesia adverse event data, and 357 patients (0.38%) had an intraoperative cardiac arrest. Multivariable predictors of an intraoperative cardiac arrest included age (odds ratio [OR], 0.98 per year; 95% confidence interval [CI], 0.97-0.99; <em>P</em> = .036), preoperative cardiac arrest (&lt;48 hours) (OR, 9.6; 95% CI 6.3-14.6, <em>P</em> &lt; .001), preoperative neurologic deficit (OR, 2.0; 95% CI, 1.3-3.1, <em>P</em> = .002), noninsulin-dependent diabetes mellitus (OR, 6.4; 95% CI, 1.9-21.9, <em>P</em> = .003), increasing Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) category (OR, 2.3 for STAT 5 vs STAT 1; 95% CI, 1.3-3.9, <em>P</em> = .003), urgent (OR, 2.0; 95% CI, 1.6-2.6, <em>P</em> &lt; .001) or emergent surgery (OR, 3.1; 95% CI, 1.9-5.0, <em>P</em> &lt; .001), and increasing length of total operating room time (OR, 1.2 per hour; 95% CI, 1.2-1.3, <em>P</em> &lt; .001). Intraoperative cardiac arrest was associated with a greater 30-day mortality (14.6% vs 1.8%, <em>P</em> &lt; .001). There were more morbidities in the intraoperative cardiac arrest group including postoperative neurologic deficits (12% vs 1.0%, <em>P</em> &lt; .001), multisystem organ failure (5.9% vs 0.7%, <em>P</em> &lt; .001), and greater rates of unplanned reoperation (19.3% vs 5.0%, <em>P</em> &lt; .001) or interventional cardiac catheterization (7% vs 3.2%, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The incidence of intraoperative cardiac arrest is low; however, it is an important indicator of significant patient perioperative morbidity and mortality.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 427-437"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracavitary cisplatin-fibrin followed by irradiation improved tumor control compared to the single treatments in a mesothelioma rat model","authors":"Michaela B. Kirschner PhD ,&nbsp;Mayura Meerang PhD ,&nbsp;Vanessa Orlowski ,&nbsp;Katarzyna Furrer MD ,&nbsp;Fabienne Tschanz PhD ,&nbsp;Ivo Grgic PhD ,&nbsp;Virginia Cecconi PhD ,&nbsp;Maries van den Broek PhD ,&nbsp;Matthias Guckenberger MD ,&nbsp;Martin Pruschy MD ,&nbsp;Olivia Lauk MD ,&nbsp;Isabelle Opitz MD","doi":"10.1016/j.xjon.2024.07.024","DOIUrl":"10.1016/j.xjon.2024.07.024","url":null,"abstract":"<div><h3>Objective</h3><div>To test the safety and efficacy of combination treatment for pleural mesothelioma (PM) with intracavitary cisplatin-fibrin (cis-fib) plus hemithoracic irradiation (IR) applied after lung-sparing surgery in an orthotopic immunocompetent rat model.</div></div><div><h3>Methods</h3><div>We randomized male F344 rats into 5 groups: cis-fib (n = 9), 10 Gy IR (n = 6), 20 Gy IR (n = 9), cis-fib+10 Gy IR (n = 6), and cis-fib+20 Gy IR (n = 9). Subpleural tumor implantation was performed on day 0 with 1 million syngeneic rat mesothelioma cells (IL45-luciferase). Tumors were resected on day 9, followed by treatment with intracavitary cis-fib or vehicle control (NaCl-fib). On day 12, computed tomography–guided local irradiation in a single high dose of the former tumor region was applied.</div></div><div><h3>Results</h3><div>We observed only short-term side effects related to 20 Gy radiotherapy. Compared to 20 Gy, 10 Gy IR did not show an impact on tumor growth. At 3 days after treatment with 20 Gy IR (day 15 of the experiment), we detected significantly smaller tumors in the cis-fib+IR group compared to IR alone (mean tumor growth, 252% vs 539%; <em>P</em> = .04). On day 21, there was a significant difference in tumor growth between cis-fib–treated and cis-fib+IR– treated tumors (mean tumor growth, 2295% vs 660%; <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Localized treatment after tumor resection in PM aims to improve local tumor control. Irradiation applied in combination with intracavitary cis-fib in rats is safe up to a dosage of 20 Gy and shows an additive effect on tumor growth delay compared to the single treatments.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"22 ","pages":"Pages 491-503"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}