Abstract:
STUDY OBJECTIVES:We set out to determine whether there is a difference in postoperative pain and recovery after the patient undergoes the axillary muscle-sparing incision (ie, muscle-sparing thoracotomy [MT]) vs the modified posterolateral incision (ie, posterolateral thoracotomy [PT]). DESIGN:Analysis of a database originally collected to determine the effect of the timing of epidural analgesia on long-term outcome after thoracotomy. SETTING:The Hospital of the University of Pennsylvania. PATIENTS:Patients presenting for lobectomy, segmentectomy, or bilobectomy. MEASUREMENTS:Pain, physical activity, and the extent that pain interfered with activities following major thoracotomy were prospectively assessed with standard questionnaires (ie, the brief pain inventory and the Medical Outcomes Study 36-item short form) on postoperative days 1 to 5, and at postoperative weeks 4, 8, 12, 24, 36, and 48 by a blinded research assistant. Perioperative care was standardized and included patient-controlled thoracic epidural analgesia until thoracostomy tube removal. RESULTS:Eighty-two subjects underwent MT and 38 subjects underwent PT during the 16-month accrual period. There were no significant differences in demographics. Pain reported during hospitalization and after hospital discharge did not differ with respect to incision type (p > or = 0.17). Postoperative physical activity levels were significantly less than those reported preoperatively, with a trend toward better functioning in the MT groups after 8 weeks. Incision type did not predict complications, morbidity, or mortality. CONCLUSIONS:When comparing patients who had undergone vertical, axillary, wholly MT to those who had undergone modified serratus muscle-sparing PT, postoperative differences in pain were not apparent. One should not anticipate reduced pain or more rapid overall recovery following MT, at least when epidural analgesia is used aggressively for perioperative pain control.
journal_name
Chestjournal_title
Chestauthors
Ochroch EA,Gottschalk A,Augoustides JG,Aukburg SJ,Kaiser LR,Shrager JBdoi
10.1378/chest.128.4.2664subject
Has Abstractpub_date
2005-10-01 00:00:00pages
2664-70issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)52688-3journal_volume
128pub_type
临床试验,杂志文章,多中心研究,随机对照试验相关文献
CHEST文献大全abstract:OBJECTIVE:To describe the clinical correlates of asthma in a community-based sample of elderly persons. PARTICIPANTS:A community sample of 4,581 persons > or = 65 years old from the Cardiovascular Health Study. MEASUREMENTS:Standardized respiratory, sleep, and quality-of-life (QOL) questions, a medication inventory, ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.3.603
更新日期:1999-09-01 00:00:00
abstract::To validate color Doppler ultrasonography of renal arteries for the assessment of renal blood flow (RBF), we compared left and right RBF estimates and their sum (total RBF) by echo-Doppler with data obtained by iodine 123-123I-p-aminohippuric acid (PAH) scintigraphy in 19 patients with heart failure and 7 normal contr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.4.912
更新日期:1995-10-01 00:00:00
abstract::All aspects of medical education were affected by the Novel Coronavirus Infectious Disease-19 (COVID-19) pandemic. Several challenges were experienced by trainees and programs alike due to the economic repercussions of the pandemic, how social distancing affected the delivery of medical education, testing and intervie...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2020.12.026
更新日期:2020-12-29 00:00:00
abstract::Serum levels of a high molecular weight circulating antigen KL-6, detected by means of a sandwich assay using a monoclonal antibody KL-6 against a sialylated carbohydrate antigen, were evaluated for usefulness in monitoring the activity of interstitial pneumonitis. Abnormally high levels of KL-6 antigen were observed ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.1.68
更新日期:1989-07-01 00:00:00
abstract::We report a patient in whom presumed vasospasm of an angiographically normal coronary artery led to severe transmural myocardial ischemia. To our knowledge, this is the first case in which an allergic reaction to locally applied chlorhexidine caused such a severe reaction. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.5.1417
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:A novel approach to estimate the severity of COPD exacerbation and predict its outcome is the use of biomarkers. We assessed circulating levels of copeptin, the precursor of vasopressin, C-reactive protein (CRP), and procalcitonin as potential prognostic parameters for in-hospital and long-term outcomes in p...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.06-2336
更新日期:2007-04-01 00:00:00
abstract::We report three cases of organophosphate (OP) poisoning. One patient was a 19-year-old woman who drank OP compounds in an attempt at suicide. The other two patients became intoxicated on the way to the hospital during mouth-to-mouth breathing. The first patient died in the emergency department, and the other two were ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.2.740
更新日期:2002-08-01 00:00:00
abstract::Caveolae are cell plasma membrane microdomains implicated in organizing and concentrating many signaling molecules. In the lung, caveolae are in endothelium, smooth muscle, fibroblasts, and pneumocytes. Caveolin is the main structural protein of caveolae. Caveolin 1 is down-regulated in transformed cells and may be a ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.129.3.696
更新日期:2006-03-01 00:00:00
abstract::A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course. Based on an erroneous neurologic diagnosis of anoxic encephalopathy, pessimism regarding likel...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0471
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Up-to-date estimates of burden of diseases are required for evidence-based decision-making. The objectives of this study were to determine the excess costs of COPD and its trend from 2001 to 2010 in British Columbia, Canada. METHODS:We used British Columbia's administrative health data to construct a cohort...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.15-0721
更新日期:2015-09-01 00:00:00
abstract::The use of physiologic pacing utilizing transvenous atrial and ventricular electrodes has recently taken on increased importance. A simple, safe, technique for electrode implantation has been used in 14 patients and enabled the implanting physicians to establish permanent atrioventricular (A-V) sequential pacing with ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.80.6.745
更新日期:1981-12-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate an association between saprophytic fungal infections occurring at the bronchial anastomosis (BA) and the development of additional complications arising at this site. DESIGN:Retrospective review. SETTING:University lung transplant center. MATERIALS AND METHODS:Review of all single-lung...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.4.1185
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Unlike studies on leg exercise, reports on the regulation of dynamic hyperinflation during arm exercise are scanty. We ascertained the following in patients with COPD: (1) whether and to what extent upper-limb exercise results in dynamic hyperinflation, and (2) the mechanism whereby an arm-training program (...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.3.1225
更新日期:2005-09-01 00:00:00
abstract::Pulmonary torsion is very rare, and usually occurs following lung resection. We report a case of spontaneous middle lobe torsion in a patient presenting with a right pleural effusion. The condition was treated by lobectomy through a totally thoracoscopic approach. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-2373
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To determine the utility of inhaled hypertonic saline solution to treat infants hospitalized with viral bronchiolitis. DESIGN:Randomized, double-blind, controlled trial. Fifty-two hospitalized infants (mean +/- SD age, 2.9 +/- 2.1 months) with viral bronchiolitis received either inhalation of epinephrine, 1....
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.123.2.481
更新日期:2003-02-01 00:00:00
abstract::Clotting abnormalities are well-recognized complications that occur with high frequency in patients suffering from underlying malignant diseases. New and highly sensitive molecular markers of hemostasis, thrombin-antithrombin III complex (TAT III), D-dimer fragments (DD), and plasmin-alpha 2-antiplasmin complex (PIC) ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.1.196
更新日期:1993-01-01 00:00:00
abstract::A patient had repetitive ventricular fibrillation preceded by alternating ST segment depression and elevation. The ECG changes were confined to the precordial leads only, reflecting subendocardial and transmural ischemia, respectively. It is speculated that the patient exhibited consecutive episodes of subtotal and to...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.6.1296
更新日期:1988-06-01 00:00:00
abstract::The last 5 years have brought dramatic changes to the care of patients with severe sepsis. While early diagnosis remains a challenge and, regrettably, a rapid, sensitive, and specific diagnostic test is still lacking, the methods to identify those critically ill patients who are likely to die have become clearer. The ...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.06-2535
更新日期:2007-12-01 00:00:00
abstract::We assessed qualitative and quantitative differences in surfactant lipid composition of bronchoalveolar lavage (BAL) fluid in patients with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii (PC) pneumonia. Five normal volunteers and 27 patients with human immunodeficiency virus (HIV) infection underw...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.6.1730
更新日期:1992-12-01 00:00:00
abstract::Fungal endocarditis is a rare complication of permanent pacemaker implantation. In all reports we have identified, this infection has been fatal, diagnosed postmortem. We present a patient in whom early echocardiographic diagnosis resulted in curative surgical and antimicrobial therapy. Fungal endocarditis is an unusu...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.1.283
更新日期:1993-01-01 00:00:00
abstract::The clinical effect of inhaled radio-labeled (Technetium-99m diethylenetriamine-pentaacetic acid) methacholine was studied in two separate experiments performed in eight symptom-free asthmatics with bronchial hyperresponsiveness. Aerosols were formed by two different nebulizers, producing either mainly small aerosol p...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.6.1781
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2016.06.047
更新日期:2016-11-01 00:00:00
abstract::Lung scans with technetium sulfur colloid were performed in ten patients with life-threatening hemoptysis and nondiagnostic chest roentgenograms. Localized deposition of radionuclide was demonstrated in five of the six patients who were studied during active bleeding. These abnormalities were confirmed bronchoscopical...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.86.2.208
更新日期:1984-08-01 00:00:00
abstract:BACKGROUND:Augmentation therapy with pooled human plasma-derived alpha(1)-antitrypsin (AAT) has been shown to have biochemical efficacy in restoring serum AAT levels above the protective threshold. Also, clinical efficacy has been suggested. OBJECTIVE:To evaluate the bioequivalence of a new solvent detergent-treated p...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.122.1.66
更新日期:2002-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the interaction between craniofacial structure and obesity in male patients with obstructive sleep apnea (OSA). DESIGN:Retrospective analysis of a cohort of OSA patients. The relationships between neck circumference (NC), body mass index, apnea severity, and craniofacial and upper airway so...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.2.375
更新日期:1995-08-01 00:00:00
abstract:PURPOSES:To determine the diagnostic capabilities of dynamic high-resolution electron-beam (HREB) CT scanning for diagnosing bronchiolitis obliterans syndrome (BOS) in lung transplant recipients. MATERIALS AND METHODS:At the time of follow-up examinations after lung transplantation, 52 patients were examined by dynami...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.2.447
更新日期:2004-08-01 00:00:00
abstract:STUDY OBJECTIVE:The tuberculin skin test is the best diagnostic method to detect tuberculous infection. How accurate is interpretation of the test? DESIGN:Observational study. SETTING:Both general hospital and university hospital. PARTICIPANTS:One hundred seven health-care professionals, including 52 practicing pedi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.5.1175
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Vasoactive medications are commonly used in the treatment of critically ill patients, but their impact on the development of ICU-acquired weakness is not well described. The objective of this study is to evaluate the relationship between vasoactive medication use and the outcome of ICU-acquired weakness. ME...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.chest.2018.07.016
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:To evaluate the additional information provided by pulse transit time (PTT), a noninvasive tool, when using during polysomnography for the diagnosis of sleep breathing disorders in a pediatric population. MAIN FINDINGS:Respiratory and microarousals events were scored twice. The first scoring was performed u...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.3.722
更新日期:2005-03-01 00:00:00
abstract::To determine the efficacy of doxycycline as a pleural sclerosing agent, we examined the outcomes in 31 patients (aged 31 to 87 years) receiving doxycycline (500 to 1,000 mg) through a chest tube for malignant pleural effusions or persistent bronchopleural fistulae. Of the 27 patients with malignant pleural effusions, ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.6.1743
更新日期:1994-06-01 00:00:00