Abstract:
:Vertebral body resection for locally advanced lung cancer can be performed with acceptable morbidity and mortality rates, and with improved long-term survival, when combined with chemotherapy and radiation. A consensus has not been reached on either the optimal extent of vertebral resection or the optimal treatment regimen. Should total vertebrectomies be the standard of care for all patients, even those with minimal spine involvement? Can the extended operative times and multiple incisions and anatomic limitations that place some of the mediastinal organs at risk be justified for potential improvement in local control, or are the quicker and potentially safer endolesional resections appropriate for these tumors? Is local control, and ultimately survival, improved when additional chemotherapy and radiation therapy is given up front, or is an uninterrupted course of a higher dose of concurrent chemotherapy and radiation therapy following surgery preferred? Ideally, these questions will be answered by means of prospective randomized trials; however, because of the small number of patients who actually present with vertebral body involvement by lung cancer, physicians may have to rely on phase 2 studies and series reports from high-volume institutions to guide their treatment algorithms in the future.
journal_name
Thorac Surg Clinjournal_title
Thoracic surgery clinicsauthors
Martin LW,Walsh GLdoi
10.1016/S1547-4127(04)00009-Xkeywords:
subject
Has Abstractpub_date
2004-05-01 00:00:00pages
241-54issue
2eissn
1547-4127issn
1558-5069pii
S1547-4127(04)00009-Xjournal_volume
14pub_type
杂志文章,评审abstract::The role of surgical resection in malignant pleural mesothelioma (MPM) is based on the principle of macroscopic resection of a solid tumor with adjuvant therapy to treat micrometastatic disease. Extrapleural pneumonectomy (EPP) and pleurectomy decortication (P/D) have been developed in this context. Cancer-directed su...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2016.04.003
更新日期:2016-08-01 00:00:00
abstract::Despite a prospective randomized trial that reported decreased locoregional recurrence for the intentional use of sublobar resection for stage IA non-small cell lung cancer, it continues to be a point of considerable debate. Improved imaging techniques have introduced a large group of smaller and more indolent tumors ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2016.04.007
更新日期:2016-08-01 00:00:00
abstract::Practically, hiatal hernias are divided into sliding hiatal hernias (type I) and PEH (types II, III, or IV). Patients with PEH are usually symptomatic with GERD or obstructive symptoms, such as dysphagia. Rarely, patients present with acute symptoms of hernia incarceration, such as severe epigastric pain and retching....
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2009.08.006
更新日期:2009-11-01 00:00:00
abstract::Endoscopic thoracic sympathectomy (ETS) is an effective treatment of primary hyperhidrosis of the face, upper extremities, and axillae. The major limitation is the side effect of compensatory sweating severe enough that patients request reversal in up to 10% of cases. When ETS is performed by cutting the sympathetic c...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2016.06.006
更新日期:2016-11-01 00:00:00
abstract::The benefits derived from comprehensive PR, when applied to patients who have lung cancer, should have significant impact on both survival and health status. Because PR is known to improve exercise capacity, it is reasonable to expect that this treatment modality may provide more patients with a potential cure. In add...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2007.10.003
更新日期:2008-02-01 00:00:00
abstract::Nonintubated video-assisted thoracoscopic surgery for the treatment of primary and secondary pneumothorax was first reported in 1997 by Nezu. However, studies on this technique are few. Research in the past 20 years has focused on the perioperative outcomes, including the surgical duration, length of hospital stay, an...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2019.08.001
更新日期:2020-02-01 00:00:00
abstract::European studies have contributed significantly to the understanding of lung cancer screening. Smoking within screening, quality of life, nodule management, minimally invasive treatments, cancer prevention programs, and risk models have been extensively investigated by European groups. Mortality data from European scr...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2014.12.002
更新日期:2015-05-01 00:00:00
abstract::Unilateral vocal-cord paralysis after esophagectomy involving a cervical anastomosis is uncommon in experienced hands but can cause marked morbidity because of pulmonary complications. It is important for the surgeon to understand the anatomy of the recurrent laryngeal nerve to avoid this complication. The diagnosis i...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2006.01.006
更新日期:2006-02-01 00:00:00
abstract::Most cases of hemothorax are related to blunt or penetrating chest trauma. Criteria for surgical intervention for initial hemothorax are well defined. Appropriate management of retained hemothorax following initial trauma management is critical, and the best approach remains controversial. Spontaneous hemothorax is mu...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2012.10.003
更新日期:2013-02-01 00:00:00
abstract::The incorporation of research into a career in thoracic surgery is a complex process. Ideally, the preparation for a career in academic thoracic surgery begins with a research fellowship during training. In the academic setting, a research portfolio might include clinical research, translational research, or basic res...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章
doi:10.1016/j.thorsurg.2011.04.004
更新日期:2011-08-01 00:00:00
abstract::Surgical treatment of locally advanced or recurrent breast cancer involving the chest wall continues to play a role in the therapeutic armamentarium as part of the multidisciplinary treatment regimen. Significant progress has been made in chest wall resections and reconstructions, thanks to the availability of novel m...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2017.01.009
更新日期:2017-05-01 00:00:00
abstract::As we enter the 21st century, thoracic surgeons can look back with pride and gratitude to their predecessors who placed a high premium on clinical practice and certification. Thoracic surgery, however, is dynamic, not static. So, too, should be thoracic surgery recertification. In recent years, considerable effort has...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2007.07.001
更新日期:2007-08-01 00:00:00
abstract::A thorough knowledge of thoracic anatomy is of fundamental importance to the thoracic surgeon. Surface anatomy is an often-neglected component of traditional topographic anatomic teaching, but a proper understanding of the relationship of surface features to deeper structures is invaluable in the clinical assessment o...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2006.12.002
更新日期:2007-11-01 00:00:00
abstract::Standardized clinical care pathways for the investigation of patients with lung cancer allow for a reduction in the time interval between suspicion of lung cancer and treatment, lower costs, increased patient satisfaction, and quality of care. It may also be associated with a modest increase in survival. ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2013.01.012
更新日期:2013-05-01 00:00:00
abstract::Recurrent symptomatic paraesophageal hernias (PEHs) can lead to significant morbidity if untreated. Surgical treatment of recurrent PEH can pose a great challenge. Several different surgical options are available and need to be considered on an individual basis. Before embarking on the repair of a recurrent hernia, a ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2019.07.011
更新日期:2019-11-01 00:00:00
abstract::Surgery for tuberculosis is becoming more relevant today. This article discusses the main indications, contraindications, features of operations, and perioperative period. This information is useful for practicing surgeons and specialists in the treatment of pulmonary tuberculosis. ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2018.09.003
更新日期:2019-02-01 00:00:00
abstract::Thoracoscopic lobectomy is emerging as the procedure of choice for patients with early stage non-small cell lung cancer, based on advantages in quality of life as well as long-term outcomes. In addition, thoracoscopic lobectomy has been demonstrated to be safe and effective for selected patients with locally advanced ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2008.04.002
更新日期:2008-08-01 00:00:00
abstract::Research on surgically implanted devices not only can raise issues familiar from drug studies, but also can raise special challenges. This article suggests some ways in which device trials can raise distinctive ethical issues. The AbioCor artificial heart trial is used as an example. Although this particular trial sho...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2005.06.009
更新日期:2005-11-01 00:00:00
abstract::Pulmonary metastasis occurs in as many as 88% and 80% of stage IV patients with sarcoma and germ cell tumors, respectively. Pulmonary metastatectomy may be the only means of rendering a patient disease free. Sublobar resection (wedge or segmentectomy), lobectomy, and pneumonectomy achieve complete resection. Bilateral...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2015.09.007
更新日期:2016-02-01 00:00:00
abstract::MPM is an uncommon disease with limited treatment options. Early diagnosis, a standardized staging system, early referral to centers experienced in MPM, and efforts to develop collaborative multicenter trials are essential to improving treatment for patients with MPM. Efforts to manage this malignancy, which is projec...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2004.06.009
更新日期:2004-11-01 00:00:00
abstract::Gastroesophageal reflux disease (GERD) is a well-defined disease characterized by symptoms or complications caused by an abnormal amount of GER, which is a retrograde movement of gastric contents into the esophagus. Laryngopharyngeal reflux (LPR) is a subset of GERD and given its own identity, because the main symptom...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2011.08.001
更新日期:2011-11-01 00:00:00
abstract::The search for clinically applicable biologic markers or tumor signatures sufficiently powered as prognosticators of tumor behaviors or responses to therapeutic interventions has significantly advanced in scope and sophistication in the last 10 years. The TNM system, examining of tumor tissues to identify histopatholo...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2006.07.004
更新日期:2006-11-01 00:00:00
abstract::In recent years, the subxiphoid approach has been used to avoid intercostal nerve damage in the field of thoracic surgery. A subxiphoid single-port thymectomy does not require sternotomy; it is associated with lesser pain because there is no intercostal nerve damage; and it provides excellent cosmetic outcomes. Furthe...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2017.06.006
更新日期:2017-11-01 00:00:00
abstract::Despite the potential differences in patient characteristics, study designs, and types of instruments used, this review of the literature showed several common findings. Important improvements in QOL are reported after lung transplantation. These improvements were observed when cross-sectional comparisons were made ac...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/S1547-4127(04)00025-8
更新日期:2004-08-01 00:00:00
abstract::Assessment for thoracic surgery in elderly patients should be based on physiologic rather than chronologic age. Thoracic surgery has been shown to be safe in selected elderly patients, and age should not be a contraindication to a therapy that offers the best chance of cure for patients with early-stage cancer. A targ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2014.07.001
更新日期:2014-11-01 00:00:00
abstract::The venous side of the systemic vascular circulation returns the left ventricular cardiac output in a converging fashion to the superior and inferior vena cava and hence to the right atrium. Oxygenated blood is returned to the left atrium. The volumes of these 2 systems are in balance in a normal physiologic state. ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章
doi:10.1016/j.thorsurg.2010.12.010
更新日期:2011-05-01 00:00:00
abstract::Video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early stage 1 lung cancer. However, concerns still remain regarding certain clinical situations, such as potential damage to the heart or bypass grafts when VATS is performed after median sternotomy for cardiac surgery. In this article...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2015.04.004
更新日期:2015-08-01 00:00:00
abstract::This article summarizes the pertinent points of tracheal and bronchial anatomy, including the relationships to surrounding structures. Tracheal and bronchial anatomy is essential knowledge for the thoracic surgeon, and an understanding of the anatomic relationships surrounding the airway is crucial to the safe perform...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2006.12.006
更新日期:2007-11-01 00:00:00
abstract::The few long-term survivors of MPM have been cured with radical surgical extirpation often followed by radiation therapy and adjuvant chemotherapy. The combination of pemetrexed and cisplatin recently was shown to improve survival over treatment with cisplatin alone. Given the size and robustness of that trial, the co...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2004.06.010
更新日期:2004-11-01 00:00:00
abstract::With appropriate planning and operative technique, the risk of pulmonary artery injury and bleeding during video-assisted thoracoscopic surgery (VATS) lobectomy can be minimized. However, the risk cannot be completely eliminated; surgeons should always ensure that they are prepared to manage this situation if it occur...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2015.04.007
更新日期:2015-08-01 00:00:00