robotic-assisted-left-pneumonectomy-for-vanishing-lung-syndrome

Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome

Vanishing Lung Syndrome (VLS) is a rare, severe form of bullous pulmonary disease characterized by giant bullae occupying more than 30% of the hemithorax, ...

University of North Carolina School of Medicine

Patient-reported outcomes and epidemiological studies in adults with tetralogy of Fallot are lacking. Recruitment and longitudinal follow-up investigation across institutions is particularly challenging. Objectives of this study were to assess the feasibility of recruiting adult patients with tetralogy of Fallot for a patient-reported outcomes study, describe challenges for recruitment, and create an interactive, online tetralogy of Fallot registry.

Feasibility of a healthcare system-based tetralogy of Fallot patient registry.

Antiretroviral therapy (ART) has prolonged lives of persons living with HIV/AIDS (PLWHA), resulting in greater incidence of aging-related diseases and disability. Physical activity (PA) is recommended for healthy aging, but little is known about PA in older PLWHA. The purpose of this study was to objectively assess PA levels in older PLWHA and the associations with physical function. Twenty-one PLWHA, ≥50 years old, on ART with undetectable HIV-1 viral loads, wore an accelerometer to assess PA, including number of steps, activity intensity, and energy expenditure over 7 days. A physical function performance battery assessing aerobic capacity, strength, and gait speed was also completed. Average age was 66, and 67% were male. An average of 3,442 (interquartile range: 4,613) steps were walked daily, with 254.9 kcals expended. Participants spent most waking hours (75%) sedentary, with minimal hours (24%) in light-intensity activity. Only 5 min per day (35 min per week), on average, were spent in moderate-to-vigorous physical activity (MVPA). Maximal gait speed and 6-min walk test significantly correlated (p < .05) with all PA outcomes. Usual gait speed significantly correlated with all PA outcomes, except for daily kcals and light-intensity activity. Greater PA was associated with better physical performance, while high sedentary time was associated with poorer performance. To our knowledge, this is the first study to objectively measure PA in older PLWHA. Our findings indicate that older PLWHA accumulate substantial sedentary time. Most (86%) do not achieve recommended MVPA levels. This activity profile was associated with poor physical function. Providers should promote PA among PLWHA.

Low Levels of Physical Activity Among Older Persons Living with HIV/AIDS Are Associated with Poor Physical Function.

Our case is a 73-year-old male with persistent ventricular tachycardia (VT) leading to recent syncopal episodes despite VT ablation and multiple stellate ganglion blocks, frequent hospital admissions, and acute on chronic congestive heart failure requiring intra-aortic balloon pump. The decision was made to proceed with left ventricular assist device placement and bilateral sympathectomies simultaneously. After performing the sternotomy and widely opening bilateral pleural spaces, the lower third of the stellate ganglia to the level of T4 was removed using a combination of the thoracoscope with the sternotomy incision. The use of thoracoscopy greatly assisted with visualization during the sympathectomy.

Bilateral Thoracoscopic Sympathectomy after Sternotomy for Left Ventricular Assist Device Insertion.

ERATS decreased length of stay, postoperative complications, and readmission.

Enhanced recovery after thoracic surgery: Systematic review and meta-analysis.

Microvascular cutaneous flap for treatment of complications of black esophagus and complex esophageal reconstruction.

Sternal closure after median sternotomy traditionally uses a stainless steel wire cerclage. Sternal wires are placed through or around the sternum, and the wire ends are twisted together to bring the sternum back together. Complications of this technique include sternal instability, dehiscence, non-union, and increased pain. Compared to traditional wire cerclage, the Figure 8 FlatWire Sternal Closure System has been demonstrated to be stronger and significantly reduce sternal cut-through and postoperative pain. There was no significant difference in hospital length of stay or mean hospitalization cost. Operative time was slightly longer in the FlatWire group, but this difference has been attributed to the learning curve of mastering the FlatWire technique. This article and supplemental video will demonstrate the technique of FlatWire Sternal Closure System. Briefly, the FlatWire is placed around the sternum, and the FlatWire end is fed through the security box. Once all of the wires are placed, the Figure 8 tensioning device is used to tighten each wire through the security box to the appropriate tensile force. Next, the FlatWires are rotated 90 degrees to hold the sternal position temporarily. Once sternal approximation is achieved, each FlatWire is twisted 120 degrees, and any excess length of the FlatWire is clipped.

FlatWire Sternal Closure System technique for median sternotomy closure.

The goal of this study was to assess predictive factors for receiving interviews and matching in general surgery (GS), cardiothoracic surgery (TS), vascular surgery (VS), and plastic surgery (PS).

General Surgery Versus Integrated Surgical Sub-specialties: Predictors for Residency Match and Interview Invites Among Surgical Candidates.

Serious mental illness (SMI) is associated with increased complications and worse outcomes in a variety of surgical diseases, however, SMI as a risk factor in thoracic surgery patients is incompletely understood. We aimed to investigate if comorbid SMI would impact mortality and morbidity following lung cancer resection.

Article	Year
Feasibility of a healthcare system-based tetralogy of Fallot patient registry. Cardiology in the young\| PubMed ID: 28847322	2018
Low Levels of Physical Activity Among Older Persons Living with HIV/AIDS Are Associated with Poor Physical Function. AIDS research and human retroviruses\| PubMed ID: 29984584	2018
Bilateral Thoracoscopic Sympathectomy after Sternotomy for Left Ventricular Assist Device Insertion. The Annals of thoracic surgery\| PubMed ID: 35085520	2022
Enhanced recovery after thoracic surgery: Systematic review and meta-analysis. JTCVS open\| PubMed ID: 36003715	2021
Microvascular cutaneous flap for treatment of complications of black esophagus and complex esophageal reconstruction. JTCVS techniques\| PubMed ID: 37096105	2023
FlatWire Sternal Closure System technique for median sternotomy closure. Journal of thoracic disease\| PubMed ID: 37868890	2023
General Surgery Versus Integrated Surgical Sub-specialties: Predictors for Residency Match and Interview Invites Among Surgical Candidates. Journal of surgical education\| PubMed ID: 39489064	2025
Serious mental illness prolongs hospital admission following lung cancer resection. Journal of thoracic disease\| PubMed ID: 39831237	2024

Audrey L. Khoury

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