Shanghai chest最新文献

英文中文

Second surgery for complications of major pulmonary resection: the knack of air plombage in thoracoplasty 肺大切除术并发症的二次手术：空气包埋术在胸廓成形术中的技巧

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-22-23

M. Kamiyoshihara, H. Igai, Tomohiro Yazawa

引用次数: 0

The role of haptic feedback in video-assisted thoracic surgery simulation training 触觉反馈在视频辅助胸外科模拟训练中的作用

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-22-18

A. Imperatori, Sarah Grossi, Maria Cattoni, N. Rotolo

引用次数: 0

One-size does not fit all: the challenges of surgical management in stage IV non-small cell lung cancer 不能一刀切：IV期非小细胞肺癌癌症手术治疗的挑战

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-22-54

Nathan J. Alcasid, J. Velotta

引用次数: 0

Exploring the timing and distribution effects of direct cardiac compression in a beating heart model 在心脏跳动模型中探讨直接心脏压迫的时间和分布效应

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-21-24

E. Aranda-Michel, L. Waldman, D. Trumble

引用次数: 1

Lung cancer resection in high-risk patients: a narrative review 高危患者肺癌切除:一项叙述性回顾

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-22-16

Akshay J. Patel, E. Bishay, B. Naidu

"Background and Objective: The National Lung Cancer Audit (NLCA) 2022 report showed that for England in 2019, the curative treatment rates of non-small cell lung cancer (NSCLC) patients with stage I/II disease and good performance status were 81%, this metric fell to 73% in 2020 with resection rates falling from 20% to 15%. The impact of COVID-19 could well have influenced this and indeed lung cancer patients diagnosed in 2020 were more likely to have a worse performance status, diagnosed as emergency presentations and less likely to have a pathological diagnosis. Assessing risk in the current era and defining which patients are high-risk needs formal exploration and definition if we are to improve resection rates in a safe and equitable manner. Methods: We conducted a narrative literature review to explore the paradigm of risk in thoracic surgery and in particular address the concept of what is considered to be ""high risk""for surgery. We searched MEDLINE, EMBASE and Cochrane Library databases using the OVID interface. We reviewed articles between January 1, 2000, and December 31, 2021 and restricted this to full text papers only in the English language. Conference s were not considered. Key Content and Findings: A delineation must be made between the assessment of risk for an individual patient (usually peri-operative complication and death) and the assessment of risk for an entire cohort, i.e., determining safety, efficacy, and feasibility of an intervention for a particular group. Both components are necessary when communicating risk. There is no fixed model of the high-risk patient, but instead an individualised risk profile which should serve to employ pre-operative optimisation strategies, pulmonary rehabilitation, smoking cessation programmes, exercise rehabilitation and post-operative rehabilitation. Conclusions: By understanding risk and benchmarking patients appropriately and in a uniform way, one can be more objective and scientific in assessing suitability for resection. This is but one pillar of a multifaceted approach to help inform patients and healthcare providers in a constructive way and increase surgical rates in an appropriate and safe way. © Shanghai Chest. All rights reserved."

“背景和目的：2022年国家癌症审计（NLCA）报告显示，2019年英格兰非小细胞癌症（NSCLC）的治愈率I/II期疾病和良好表现的患者占81%，2020年这一指标降至73%，切除率从20%降至15%。新冠肺炎的影响很可能会影响这一点，事实上，2020年诊断的癌症患者更有可能表现更差，被诊断为紧急情况，病理诊断的可能性更小。如果我们要以安全和公平的方式提高切除率，就需要对当前时代的风险进行评估，并确定哪些患者是高危患者进行正式的探索和定义。方法：我们进行了一项叙述性文献综述，以探索胸部手术中的风险范式，特别是讨论手术中被认为是“高风险”的概念。我们使用OVID接口搜索MEDLINE、EMBASE和Cochrane Library数据库。我们审查了2000年1月1日至2021年12月31日期间的文章，并将其限制为仅英文全文论文。会议没有得到审议。关键内容和发现：必须在单个患者的风险评估（通常是围手术期并发症和死亡）和整个队列的风险评估之间进行划分，即确定特定群体干预的安全性、有效性和可行性。在传达风险时，这两个组成部分都是必要的。高危患者没有固定的模型，而是有一个个性化的风险档案，用于采用术前优化策略、肺部康复、戒烟计划、运动康复和术后康复。结论：通过了解风险并以统一的方式对患者进行适当的基准测试，可以更客观、更科学地评估是否适合切除。这只是多方面方法的一个支柱，有助于以建设性的方式告知患者和医疗保健提供者，并以适当和安全的方式提高手术率。©上海胸科。保留所有权利。“

{"title":"Lung cancer resection in high-risk patients: a narrative review","authors":"Akshay J. Patel, E. Bishay, B. Naidu","doi":"10.21037/shc-22-16","DOIUrl":"https://doi.org/10.21037/shc-22-16","url":null,"abstract":"\"Background and Objective: The National Lung Cancer Audit (NLCA) 2022 report showed that for England in 2019, the curative treatment rates of non-small cell lung cancer (NSCLC) patients with stage I/II disease and good performance status were 81%, this metric fell to 73% in 2020 with resection rates falling from 20% to 15%. The impact of COVID-19 could well have influenced this and indeed lung cancer patients diagnosed in 2020 were more likely to have a worse performance status, diagnosed as emergency presentations and less likely to have a pathological diagnosis. Assessing risk in the current era and defining which patients are high-risk needs formal exploration and definition if we are to improve resection rates in a safe and equitable manner. Methods: We conducted a narrative literature review to explore the paradigm of risk in thoracic surgery and in particular address the concept of what is considered to be \"\"high risk\"\"for surgery. We searched MEDLINE, EMBASE and Cochrane Library databases using the OVID interface. We reviewed articles between January 1, 2000, and December 31, 2021 and restricted this to full text papers only in the English language. Conference s were not considered. Key Content and Findings: A delineation must be made between the assessment of risk for an individual patient (usually peri-operative complication and death) and the assessment of risk for an entire cohort, i.e., determining safety, efficacy, and feasibility of an intervention for a particular group. Both components are necessary when communicating risk. There is no fixed model of the high-risk patient, but instead an individualised risk profile which should serve to employ pre-operative optimisation strategies, pulmonary rehabilitation, smoking cessation programmes, exercise rehabilitation and post-operative rehabilitation. Conclusions: By understanding risk and benchmarking patients appropriately and in a uniform way, one can be more objective and scientific in assessing suitability for resection. This is but one pillar of a multifaceted approach to help inform patients and healthcare providers in a constructive way and increase surgical rates in an appropriate and safe way. © Shanghai Chest. All rights reserved.\"","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42240668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Selection of the population in lung cancer screening studies: a narrative review 癌症筛查研究人群的选择：叙述性综述

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-21-33

L. Pilz

引用次数: 0

Uniportal video-assisted thoracoscopic surgery right upper lobectomy by bronchus-artery-vein procedure: a case report 单门电视胸腔镜支气管动静脉右上叶切除术1例

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-21-19

Tianxiang Chen, Hang Zhao, Junwei Ning, Xiaocheng Zhang, Q. Luo

引用次数: 0

Lung volume reduction surgery—a narrative review of clinical evidence, patient selection and peri-operative care 肺减容手术——临床证据、患者选择和围手术期护理的叙述性综述

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-22-24

T. Hayes, M. Charlesworth

引用次数: 0

Spontaneous resolution of metastatic thymoma with prednisone in a patient with juvenile myasthenia gravis: a case report 原发性重症肌无力患者转移性胸腺瘤经强的松治疗后自发性消退1例

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-22-15

N. Ramesh, J. Velotta

Background: Juvenile myasthenia gravis is a rare autoimmune condition affecting children. Similar to myasthenia in adults, juvenile myasthenia gravis is associated with thymomas and many of these patients undergo thymectomy. However, there is no clear consensus on which patients could benefit from surgical intervention and how to manage refractory disease. Case Description: In this report, we describe a young boy who was diagnosed with myasthenia gravis and found to have stage IVa type B2 metastatic thymoma. Despite numerous pharmaceutical interventions, including neoadjuvant chemotherapy, his disease continued to progress. He ultimately underwent an extended radical parietal and visceral pleurectomy with decortication, total thymectomy, partial pericardial resection, and diaphragm resection and reconstruction. However, he had recurrence of his thymoma and was started on prednisone for palliative intent. Remarkably, within a few months he was noted to have interval decrease in his thoracic tumor burden and near resolution of his metastatic disease. Conclusions: Although spontaneous remission has been described in pediatric myasthenia, this report sheds light on possible management strategies post-thymectomy. This case additionally underscores the varied outcomes in patients treated for juvenile myasthenia gravis. Ultimately, this case, when added to both existing and future studies, will inform the development of guidelines on pediatric myasthenia gravis treatment. been well characterized. In this report, we describe a rare case of severe JMG and metastatic thymoma that responded to steroid therapy, highlighting the potential role of corticosteroids for JMG and thymoma refractory to thymectomy. We present the following case in accordance with the CARE reporting checklist (available at https://shc.

背景:青少年重症肌无力是一种罕见的影响儿童的自身免疫性疾病。与成人重症肌无力相似，青少年重症肌无力与胸腺瘤有关，许多患者接受胸腺切除术。然而，对于哪些患者可以从手术干预中获益以及如何处理难治性疾病，目前还没有明确的共识。病例描述:在这个报告中，我们描述了一个年轻的男孩，他被诊断为重症肌无力，发现有IVa期B2型转移性胸腺瘤。尽管许多药物干预，包括新辅助化疗，他的疾病继续发展。他最终接受了扩展根治性胸膜壁和内脏切除术，包括去皮、全胸腺切除术、部分心包切除术和膈切除术和重建。然而，他的胸腺瘤复发，并开始使用强的松缓解意图。值得注意的是，在几个月内，他的胸部肿瘤负荷间隔减少，转移性疾病接近消退。结论:虽然在小儿重症肌无力中有自发性缓解的描述，但本报告揭示了胸腺切除术后可能的管理策略。该病例进一步强调了青少年重症肌无力患者治疗的不同结果。最终，当该病例加入到现有和未来的研究中时，将为儿童重症肌无力治疗指南的制定提供信息。被很好地描述了。在这篇报道中，我们描述了一个罕见的严重JMG和转移性胸腺瘤对类固醇治疗有反应的病例，强调了皮质类固醇对JMG和胸腺切除术难治的胸腺瘤的潜在作用。我们根据CARE报告清单(可在https://shc上找到)提出以下病例。

{"title":"Spontaneous resolution of metastatic thymoma with prednisone in a patient with juvenile myasthenia gravis: a case report","authors":"N. Ramesh, J. Velotta","doi":"10.21037/shc-22-15","DOIUrl":"https://doi.org/10.21037/shc-22-15","url":null,"abstract":"Background: Juvenile myasthenia gravis is a rare autoimmune condition affecting children. Similar to myasthenia in adults, juvenile myasthenia gravis is associated with thymomas and many of these patients undergo thymectomy. However, there is no clear consensus on which patients could benefit from surgical intervention and how to manage refractory disease. Case Description: In this report, we describe a young boy who was diagnosed with myasthenia gravis and found to have stage IVa type B2 metastatic thymoma. Despite numerous pharmaceutical interventions, including neoadjuvant chemotherapy, his disease continued to progress. He ultimately underwent an extended radical parietal and visceral pleurectomy with decortication, total thymectomy, partial pericardial resection, and diaphragm resection and reconstruction. However, he had recurrence of his thymoma and was started on prednisone for palliative intent. Remarkably, within a few months he was noted to have interval decrease in his thoracic tumor burden and near resolution of his metastatic disease. Conclusions: Although spontaneous remission has been described in pediatric myasthenia, this report sheds light on possible management strategies post-thymectomy. This case additionally underscores the varied outcomes in patients treated for juvenile myasthenia gravis. Ultimately, this case, when added to both existing and future studies, will inform the development of guidelines on pediatric myasthenia gravis treatment. been well characterized. In this report, we describe a rare case of severe JMG and metastatic thymoma that responded to steroid therapy, highlighting the potential role of corticosteroids for JMG and thymoma refractory to thymectomy. We present the following case in accordance with the CARE reporting checklist (available at https://shc.","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46964744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of blind-end subglottic stenosis following SARS-CoV-2 infection: a case report SARS-CoV-2感染后盲端声门下狭窄的治疗1例

Shanghai chest

Pub Date : 2021-01-01 DOI: 10.21037/shc-21-23

E. Chan, E. Hyzny, Masashi Furukawa, J. Luketich, P. Sanchez

Background: Reports identify rates of prolonged intubation as high as 28% in patients who are hospitalized for worsening respiratory status due the SARS-CoV-2 infection. This has placed a toll on healthcare systems around the world. However, we believe we are only seeing the beginnings of complications associated with the COVID-19 pandemic. Subglottic tracheal stenosis is a known complication of prolonged intubation and may therefore be on the rise in the wake of the current pandemic. The European Laryngology Society created the Laryngotracheal Stenosis Committee to alert the international medical community of the rise in airway complications associated with long-Term intubation and high rates of tracheostomy seen in the recent months during the pandemic. Optimal surgical management of the unique features of subglottic stenosis following COVID-19 disease, especially in severely deconditioned patients, has yet to be reported. Case Description: We report the surgical management of blind-end Myer-Cotton Grade IV subglottic stenoses in two patients who required prolonged mechanical ventilatory support for respiratory failure resulting from the SARS-CoV-2 infection with a two stage minimally invasive recanalization strategy. Patients underwent two-step minimally invasive process for recanalization. The first step is to re-establish a patent tracheal lumen under direct visualization utilizing both a rigid bronchoscope from proximally as well as a flexible bronchoscope distal to the stenosis from the tracheostomy stoma. Once the tracheal lumen is re-established, proper dilation of the airway and hemostasis is achieved in standard fashion. Both patients have had roughly 6 months of follow-up and have tolerated their silicone T-Tubes capped at all times. Neither patient currently require any oxygen supplementation and continue to phonate well. While they are not at their baseline in terms of physical activity, they are continuing their rehabilitation process. Conclusions: While the definitive treatment continues to be surgical resection, the endoscopic approach to re-establishing the tracheal lumen is a safe and effective method with little to no morbidity and mortality. This will allow for uninhibited rehabilitation following prolonged mechanical ventilatory support and hospital stay following severe COVID-19 infection. © 2022 Audiology and Speech Research. All rights reserved.

背景：报告发现，在因严重急性呼吸系统综合征冠状病毒2型感染导致呼吸系统状况恶化而住院的患者中，延长插管的比率高达28%。这给世界各地的医疗系统带来了损失。然而，我们认为，我们只看到了与新冠肺炎大流行相关的并发症的开始。声门下气管狭窄是长期插管的一种已知并发症，因此在当前的疫情之后可能会增加。欧洲喉科学会成立了喉气管狭窄委员会，以提醒国际医学界，在疫情期间的近几个月里，与长期插管和高气管切开率相关的气道并发症有所增加。新冠肺炎疾病后声门下狭窄独特特征的最佳手术治疗，尤其是在严重病情缓解的患者中，尚待报道。病例描述：我们报告了两名因严重急性呼吸系统综合征冠状病毒2型感染导致呼吸衰竭而需要长期机械通气支持的患者的盲端Myer Cotton IV级声门下狭窄的手术治疗，采用两阶段微创再通策略。患者接受了两步微创再通术。第一步是利用近端的刚性支气管镜和气管造口术口狭窄远端的柔性支气管镜，在直接可视化的情况下重新建立通畅的气管管腔。一旦重建了气管管腔，就可以以标准的方式实现气道的适当扩张和止血。这两名患者都接受了大约6个月的随访，并一直耐受他们的硅胶T型管。目前，两名患者都不需要任何氧气补充，并且继续保持良好的发音。虽然他们的身体活动还没有达到基线，但他们正在继续康复过程。结论：虽然最终的治疗方法仍然是手术切除，但内镜下重建气管管腔是一种安全有效的方法，发病率和死亡率很低甚至没有。这将允许在长期机械通气支持后进行无限制的康复，并在严重新冠肺炎感染后住院。©2022听力学与言语研究。保留所有权利。

{"title":"Management of blind-end subglottic stenosis following SARS-CoV-2 infection: a case report","authors":"E. Chan, E. Hyzny, Masashi Furukawa, J. Luketich, P. Sanchez","doi":"10.21037/shc-21-23","DOIUrl":"https://doi.org/10.21037/shc-21-23","url":null,"abstract":"Background: Reports identify rates of prolonged intubation as high as 28% in patients who are hospitalized for worsening respiratory status due the SARS-CoV-2 infection. This has placed a toll on healthcare systems around the world. However, we believe we are only seeing the beginnings of complications associated with the COVID-19 pandemic. Subglottic tracheal stenosis is a known complication of prolonged intubation and may therefore be on the rise in the wake of the current pandemic. The European Laryngology Society created the Laryngotracheal Stenosis Committee to alert the international medical community of the rise in airway complications associated with long-Term intubation and high rates of tracheostomy seen in the recent months during the pandemic. Optimal surgical management of the unique features of subglottic stenosis following COVID-19 disease, especially in severely deconditioned patients, has yet to be reported. Case Description: We report the surgical management of blind-end Myer-Cotton Grade IV subglottic stenoses in two patients who required prolonged mechanical ventilatory support for respiratory failure resulting from the SARS-CoV-2 infection with a two stage minimally invasive recanalization strategy. Patients underwent two-step minimally invasive process for recanalization. The first step is to re-establish a patent tracheal lumen under direct visualization utilizing both a rigid bronchoscope from proximally as well as a flexible bronchoscope distal to the stenosis from the tracheostomy stoma. Once the tracheal lumen is re-established, proper dilation of the airway and hemostasis is achieved in standard fashion. Both patients have had roughly 6 months of follow-up and have tolerated their silicone T-Tubes capped at all times. Neither patient currently require any oxygen supplementation and continue to phonate well. While they are not at their baseline in terms of physical activity, they are continuing their rehabilitation process. Conclusions: While the definitive treatment continues to be surgical resection, the endoscopic approach to re-establishing the tracheal lumen is a safe and effective method with little to no morbidity and mortality. This will allow for uninhibited rehabilitation following prolonged mechanical ventilatory support and hospital stay following severe COVID-19 infection. © 2022 Audiology and Speech Research. All rights reserved.","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44668708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Shanghai chest

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀