Single center experience of laser tracheobronchoplasty and review of the literature.

Background: Excessive central airway collapse can significantly impact quality of life and put patients at risk of respiratory complications. For patients with moderate or mild symptomatic disease, or those that are not candidates for surgical approaches, limited treatment modalities have been described for management of ECAC. However, case reports support the use of endoscopic approaches, specifically, laser assisted tracheobronchoplasty.

Left Thoracoscopic Robot-Assisted Excision of a Left Lower Paratracheal Parathyroid Adenoma for Cure of Primary Hyperparathyroidism.

We present a case of a 38-year-old male patient with symptomatic hypercalcemia secondary to primary hyperparathyroidism. After evaluation, the source of the excess parathyroid hormone was found to be an adenoma localized to the middle mediastinum. Specifically, it was located in the left paratracheal space along the lesser curve of the aortic arch.

Evaluating the accuracy of lung-RADS score extraction from radiology reports: Manual entry versus natural language processing.

Introduction: Radiology scoring systems are critical to the success of lung cancer screening (LCS) programs, impacting patient care, adherence to follow-up, data management and reporting, and program evaluation. LungCT ScreeningReporting and Data System (Lung-RADS) is a structured radiology scoring system that provides recommendations for LCS follow-up that are utilized (a) in clinical care and (b) by LCS programs monitoring rates of adherence to follow-up. Thus, accurate reporting and reliable collection of Lung-RADS scores are fundamental components of LCS program evaluation and improvement.

Ultralow-Dose Dynamic Expiratory CT and Repeated Imaging Enhance Evaluation for Tracheomalacia.

Objective: This study aims to determine if a novel imaging protocol (ultralow-dose dynamic expiratory computed tomography [CT] with repeated imaging) identifies tracheomalacia (TM) more reliably than traditional dynamic tracheal CT.

Methods: We performed a retrospective evaluation of 184 consecutive ultralow-dose dynamic CTs for TM during 2017. The protocol obtains images during 1 inspiration and 2 forced expirations.

Outcomes and Direct Cost of Isolated Nonemergent CABG in Patients With Low Ejection Fraction.

Objective: Preoperative left ventricular ejection fraction (LVEF) is one of the main predictors of outcomes in cardiac surgery. We present current era outcomes and associated direct cost in nonemergent isolated coronary artery bypass surgery (CABG) patients with LVEF <20% over the past 6 years and compare it with higher EF subgroups.

Methods: Six-year data from 2016 to 2022 at hospitals sharing Society of Thoracic Surgeons and financial data with Biome Analytics were analyzed based on 3 EF subgroups (EF ≤20%, EF 21% to 35%, and EF >35%).

Long-term Outcomes After Lung Cancer Resection in Smokers: Analysis of the National Lung Screening Trial.

Background: Smoking is a known risk factor for perioperative complications after lung resection; however, little data exists looking at the impact of smoking status (current versus former) on long-term oncologic outcomes after lung cancer surgery. We sought to compare overall survival (OS), progression-free survival (PFS), and cancer-specific mortality (CSM) in current and former smokers using data from the National Lung Screening Trial (NLST). Additionally, we performed subset analysis in current smokers in order to evaluate the effect of modern surgical techniques on long-term outcomes.

Impact of postoperative complications on long-term survival after esophagectomy in older adults: A SEER-Medicare analysis.

Background: Esophagectomy is a complex procedure associated with a high rate of postoperative complications. It is not clear whether postoperative complications effect long-term survival. Most studies report the results from single institutions.

Effect of On-Site Cardiac Surgery Program on General Thoracic Surgery Outcomes.

Objective: Limited data exist exploring the relationship between multispecialty surgical collaboration and outcomes in general thoracic surgery. To address this, the Nationwide Inpatient Sample (NIS) was analyzed to determine whether the presence of an on-site cardiac surgery program is associated with improved general thoracic surgery outcomes.

Methods: The NIS (1999-2008) was utilized to identify 389,959 patients who had a lobectomy, pneumonectomy, or esophagectomy.

Decrease in Hospital Admissions for Acute Surgical Conditions During the COVID-19 Pandemic.

The nature of emergency room admissions for acute surgical conditions changed during the COVID-19 pandemic with less admissions for potentially life threatening conditions.

Morbidity and mortality after general surgery in heart and lung transplant patients.

Background: Heart and lung transplant patients can develop conditions necessitating general surgery procedures. Their postoperative morbidity and mortality remain poorly characterized and limited to case series from select centers.

Methods: The National Inpatient Sample (1998-2015) was used to identify 6433 heart and 3015 lung transplant patient admissions for general surgery procedures.

Fibrosing Mediastinitis Requiring Multimodality Treatment to Maintain Pulmonary Vein Patency.

Fibrosing mediastinitis is a rare condition with limited epidemiologic data. We detail a case of a 43-year-old female with no past medical history, who presented with chest pain and dyspnea on exertion. Chest computed tomography revealed a large mediastinal mass that was invading into the anterior chest as well as encasing the pulmonary hilum.

Disparities in utilization of services for racial and ethnic minorities with hepatocellular carcinoma associated with hepatitis C.

Background: Hepatitis C affects racial minorities disproportionately and is greatest among the black population. The incidence of hepatocellular carcinoma has increased with the largest increase observed in black and Hispanic populations, but limited data remain on whether hepatitis C hepatocellular carcinoma in racial-ethnic minorities have the same utilization of services compared with the white population.

Methods: We used the database of the National Inpatient Sample to identify hepatitis C-hepatocellular carcinoma patients (N = 200,163) who underwent liver transplantation (n = 11,491), liver resection (n = 4,896), or ablation of liver lesions (n = 6,933) from 2005 to 2015.

A Comparative Analysis of Long-Term Survival of Robotic Versus Thoracoscopic Lobectomy.

Background: Minimally invasive lobectomy can be performed robotically or thoracoscopically. Short-term outcomes between the 2 approaches are reported to be similar; however, the comparative oncological effectiveness is not known. We sought to compare long-term survival after robotic and thoracoscopic lobectomy.

Modified Blood Patch Used to Treat a High Output Chyle Leak After McKeown Esophagectomy.

Chyle leaks after esophagectomy are associated with significant morbidity and mortality. High-output fistulas are particularly difficult to manage, as the likelihood of spontaneous closure with conservative management is low. Leaks that fail to resolve with conservative management are referred for thoracic duct ligation or embolization.

Disparities in Follow-Up After Low-Dose Lung Cancer Screening.

The National Lung Cancer Screening Trial (NLST) demonstrated an improvement in overall survival with lung cancer screening. Achieving follow-up for a positive screen is essential to impact early intervention for lung cancer. The objective of this study was to determine predictors of follow-up after a positive lung cancer screening test.

Outcomes Following Major Oncologic Operations for Non-AIDS-Defining Cancers in the HIV Population: A Matched Comparison to the General Population.

Introduction: Human immunodeficiency virus (HIV) patients are living longer due to the availability of antiretroviral therapies, and non-AIDS-defining cancers are becoming more prevalent in this patient population. A paucity of data remains on post-operative outcomes following resection of non-AIDS-defining cancers in the HIV population.

Methods: The National Inpatient Sample was utilized to identify patients who underwent surgical resection for malignancy from 2005 to 2015 (HIV, N = 52,742; non-HIV, N = 11,885,184).