The following is a collection of featured thoracic articles from the Journal of Thoracic and Cardiovascular Surgery (JTCVS). To read the latest issue, or browse the feature video library and other journal highlights, please visit www.jtcvs.org. Sign up for monthly AATS Journal Alerts here. (Please note you will be asked to login or create an account for AATS Online.)
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LUNG CANCER
Assessment of preoperative noninvasive ventilation before lung cancer surgery: The preOVNI randomized controlled study
Nicolas Paleiron, MD, Frédéric Grassin, MD, Christophe Lancelin, MD, Cécile Tromeur, MD, Jacques Margery, MD, PhD, Claudia Natale, MD, Francis Couturaud, MD, PhD, the GFPC Group
In this randomized controlled study, preoperative NIV before lung cancer surgery did not reduce postoperative complications.
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Commentary: Work in progress—Defining optimal surgical prehabilitation before lung resection
Erin M. Corsini, MD, Mara B. Antonoff, MD
Surgical prehabilitation may improve outcomes in patients undergoing lung resection. Additional novel investigations are necessary.
Commentary: Positive pressure toward a negative trial?
Todd L. Demmy, MD
Rigorous study design constraints may have made it difficult to detect therapeutic benefits of preoperative external ventilatory support therapy in high-risk pulmonary patients.
MESOTHELIOMA
Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma
Luis E. De León, MD, Carlos E. Bravo-Iñiguez, MD, Sam Fox, BS
Jeffrey Tarascio, BA, Samuel Freyaldenhoven, MD, Moshe Lapidot, MD, Michael T. Jaklitsch, MD, Raphael Bueno, MD
Routine surveillance with upper- and lower-extremity noninvasive studies is effective and may help to diagnose and treat asymptomatic DVT before it progresses to symptomatic or fatal PE.
Commentary: Mesothelioma: The Guinness world record holder in thromboembolism
Robert B. Cameron, MD
The risk of thromboembolic events in patients with mesothelioma undergoing surgery is staggering; more attention needs to be paid to early detection and treatment but most importantly to prevention.
Commentary: Focused attention on proactive identification of deep venous thrombosis after pleurectomy/decortication for malignant pleural mesothelioma
Shawn S. Groth, MD, MS, FACS, R. Taylor Ripley, MD, Philip W. Carrott, MD, Bryan M. Burt, MD
The patient’s outcome correlates directly with the surgeon’s attention to a myriad of minor details.
Commentary: To scan or not to scan: No longer the question for mesothelioma patients after pleurectomy
Elizabeth A. David, MD, MAS, Scott M. Atay, MD
Routine noninvasive screening for deep venous thrombosis should be performed in patients undergoing pleurectomy/decortication for mesothelioma.
ESOPHAGEAL CANCER
Effect of thoracic versus cervical anastomosis on anastomotic leak among patients who undergo esophagectomy after neoadjuvant chemoradiation
Alexis Pluscherie Chidi, MD, PhD, MSPH, Eric Wayne Etchill, MD, MPH, Jinny Suk Ha, MD, MHS, Errol Lovester Bush, MD, Stephen Clyde Yang, MD, Richard James Battafarano, MD, PhD, Stephen Robert Broderick, MD, MPHS
In patients with locally advanced esophageal cancer, anastomosis location does not affect leak rate after neoadjuvant chemoradiation. Patient factors and surgeon experience should determine approach.
Commentary: Where is the leak? From the anastomosis or the database?
Nasser Altorki, MD, Brendon Stiles, MD
Anastomotic leaks after esophagectomy are associated with high mortality. Implementation of failure to rescue protocols is required to improve patients' outcomes.
Commentary: Does the location of the anastomosis affect leak rate after esophagectomy?
K. Robert Shen, MD
The location of the anastomosis is not the major driver of leak rate after esophagectomy.
FEATURE VIDEO
Esophageal anastomotic technique in a patient with esophageal cancer undergoing Ivor Lewis esophagectomy after neoadjuvant chemoradiation.
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TRANSPLANTATION
Single running suture technique is associated with low rate of bronchial complications after lung transplantation
Thomas Schweiger, MD, PhD, Ioannis Nenekidis, MD, PhD, Jakob Elias Stadler, Stefan Schwarz, MD, Alberto Benazzo, MD, Peter Jaksch, MD, Konrad Hoetzenecker, MD, PhD, Walter Klepetko, MD, the Vienna Lung Transplant Program
The use of a single-running suture technique results in a low incidence of airway complications after lung transplantation.
Commentary: Bronchial anastomosis for lung transplantation—one suture fits all
Stephanie H. Chang, MD, Zachary N. Kon, MD
Single running suture for bronchial anastomoses in lung transplant is a good technique, with a low incidence of bronchial complications at a high-volume center.
Commentary: Running bronchial anastomotic suture in lung transplantation: Should we run before we walk?
Jules Lin, MD
Although many surgeons hesitate to use a single running suture bronchial anastomotic technique, this large series reports a low rate of bronchial complications.
PERIOPERATIVE MANAGEMENT
Positive end-expiratory pressure and recruitment maneuvers during one-lung ventilation: A systematic review and meta-analysis
John K. Peel, MD, Duane J. Funk, MD, Peter Slinger, MD, Sadeesh Srinathan, MD, MSc, Biniam Kidane, MD, MSc
Recruitment maneuvers and PEEP have physiologic advantages during one-lung ventilation with yet-unclear clinical outcomes.
Commentary: Measure what matters in one lung ventilation
Mariya Geube, MD, FASE, Eduardo Mireles-Cabodevila, MD
The meta-analysis confirms the beneficial effect of recruitment maneuvers and positive end-expiratory pressure on physiological respiratory parameters and demonstrates the lack of knowledge about patient-centered clinical outcomes.
Commentary: To PEEP, or not to PEEP, that is no longer a question
Elena Ashikhmina, MD, PhD
The application of positive end-expiratory pressure and recruitment maneuvers during one-lung ventilation is associated with greater PaO2, pulmonary compliance, and reduced dead space.