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By Giovanni Gambino M.D. Ph.D.
Duilio Divisi, Gabriella Di Leonardo, Roberto Crisci
BACKGROUND: The aim of the study was to analyze the cost-effectiveness outcomes of video-assisted thoracic surgery (VATS) in the treatment of primary spontaneous pneumothorax (PSP), comparing the minimally invasive procedure with pleural drainage (PD). METHODS: Between July 2006 and October 2012, we treated 122 patients with a first episode of PSP by VATS (61 patients) or pleural drainage (61 patients). We established the relationship between costs and quality-adjusted life (QAL) for both techniques...
July 2015: American Journal of Surgery
Derek J Roberts, Simon Leigh-Smith, Peter D Faris, Christopher Blackmore, Chad G Ball, Helen Lee Robertson, Elijah Dixon, Matthew T James, Andrew W Kirkpatrick, John B Kortbeek, Henry T Stelfox
OBJECTIVE: To determine whether the reported clinical presentation of tension pneumothorax differs between patients who are breathing unassisted versus receiving assisted ventilation. BACKGROUND: Animal studies suggest that the pathophysiology and physical signs of tension pneumothorax differ by subject ventilatory status. METHODS: We searched electronic databases through to October 15, 2013 for observational studies and case reports/series reporting clinical manifestations of tension pneumothorax...
June 2015: Annals of Surgery
Luca Bertolaccini, Andrea Viti, Lucia Boschetto, Antonello Pasini, Alessandro Attanasio, Alberto Terzi, Claudio Cassardo
BACKGROUND AND PURPOSE: Primary spontaneous pneumothorax (PSP) tends to cluster. Previous studies have found a correlation between PSP and atmospheric pressure variations or thunderstorms. We conducted this study to analyze the PSP correlations with meteorological variables and the concentrations of air pollutants in the city of Cuneo in Italy (IT). METHODS: We evaluated prospectively 451 consecutive PSP patients treated between 2004 and 2010. For each day within the period analyzed, the meteorological parameters and pollutants data were recorded...
May 2015: Surgery Today
Teruya Komatsu, Atsunari Kino, Mari Inoue, Terumasa Sowa, Koji Takahashi, Takuji Fujinaga
BACKGROUND: Appropriate postoperative analgesia is crucial in fast-track surgery, which is a multimodal therapeutic strategy that aims toward enhanced postoperative recovery and shortened hospital stay. Paravertebral block (PVB) has been reported to be as effective as thoracic epidural blockade (TEB), but PVB is not often employed for video-assisted thoracoscopic surgery (VATS) for 2 reasons. First, TEB is still the gold standard for thoracic surgery, and second, thoracoscopic insertion of a PVB catheter is challenging...
2014: International Journal of Surgery
Forat Swaid, Kobi Peleg, Ricardo Alfici, Oded Olsha, Igor Jeroukhimov, Adi Givon, Boris Kessel
PURPOSE: Rib fractures are a marker of severe injury, predicting a higher incidence of associated injuries. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of liver injury in blunt trauma patients. METHODS: We performed a retrospective cohort study involving blunt trauma patients with concomitant liver injuries and rib fractures who were registered in a national trauma registry. RESULTS: Of 57,130 patients with blunt torso injuries, 14,651 patients sustained rib fractures, and 2,899 patients suffered liver injuries...
July 2015: Surgery Today
M B de Jong, M C Kokke, F Hietbrink, L P H Leenen
BACKGROUND AND AIMS: Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. MATERIAL AND METHODS: Past and current strategies are described according to a review of the medical literature...
June 2014: Scandinavian Journal of Surgery: SJS
Kristen E Miller, Maisha Mims, Douglas E Paull, Linda Williams, Julia Neily, Peter D Mills, Caryl Z Lee, Robin R Hemphill
IMPORTANCE: Despite the recognized value of the Joint Commission's Universal Protocol and the implementation of time-outs, incorrect surgical procedures are still among the most common types of sentinel events and can have fatal consequences. OBJECTIVES: To examine a root cause analysis database for reported wrong-side thoracenteses and to determine the contributing factors associated with their occurrence. DESIGN, SETTING, AND PARTICIPANTS: We searched the National Center for Patient Safety database for wrong-side thoracenteses performed in ambulatory clinics and hospital units other than the operating room reported from January 1, 2004, through December 31, 2011...
August 2014: JAMA Surgery
N Kulvatunyou, L Erickson, A Vijayasekaran, L Gries, B Joseph, R F Friese, T O'Keeffe, A L Tang, J L Wynne, P Rhee
BACKGROUND: Small pigtail catheters appear to work as well as the traditional large-bore chest tubes in patients with traumatic pneumothorax, but it is not known whether the smaller pigtail catheters are associated with less tube-site pain. This study was conducted to compare tube-site pain following pigtail catheter or chest tube insertion in patients with uncomplicated traumatic pneumothorax. METHODS: This prospective randomized trial compared 14-Fr pigtail catheters and 28-Fr chest tubes in patients with traumatic pneumothorax presenting to a level I trauma centre from July 2010 to February 2012...
January 2014: British Journal of Surgery
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