Open Journal of Thoracic Surgery

Journal Information
ISSN / EISSN : 21643059 / 21643067
Current Publisher: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 131
Archived in
SHERPA/ROMEO
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Latest articles in this journal

Amorim Elias, Antunes Sousa Filho Nilo, Abrantes Sarmento Petrucio, Silva Lacerda Joseval, Campos Ferreira Wildel, Roberto Mocelin Paulo, Vieira Dias Filho Antonio, Hugo Dorigo Castilho Victor, Fernando Sodré Bayma Silva Joel, Albuquerque Rejane, et al.
Open Journal of Thoracic Surgery, Volume 10, pp 1-5; doi:10.4236/ojts.2020.101001

Abstract:
Introduction: Pentalogy of Cantrell is a rare disorder described by Cantrell in 1958 and characterized by heart anomalies, involving defects of the diaphragm, abdominal wall, supraumbilical region and pericardium. Methods: We report a case of the disease that presented with agenesis of the sternum and partial absence of costal cartilage, treated by a multi-disciplinary team. Results: The patient underwent median sternotomy. An enlarged heart, compromising the pulmonary trunk and the right ventricle, and a left superior vena cava were identified. The right atrium was opened and an interventricular communication of around 10 mm in diameter was seen through the tricuspid valve. Following the repair of the heart defects, chondroplasty and placement of biological mesh (Bioway of Gore) were performed. Conclusion: A Successful surgical treatment for Cantrell Syndrome includes correction of the cardiac malformation, a good repair of thoracoabdominal wall.
Isaac Okyere, Samuel Gyasi Brenu, Perditer Okyere
Open Journal of Thoracic Surgery, Volume 10, pp 32-40; doi:10.4236/ojts.2020.101004

Abstract:
Introduction: Esophageal foreign bodies are important and serious cause of morbidity and mortality in both children and adults, usually as a result of serious complications, such as perforation, necrosis, mediastinitis, and fistulation. Therefore, rapid and accurate diagnosis with subsequent removal is very important. Clinical Case: We present and discuss the presentation, diagnosis and surgical management of a 6-year-old with a 2-year history of ingested coin locked in the oesophagus. Discussion: Diagnosis was established by upper gastrointestinal endoscopy, barium swallow and chest x-ray. The coin was removed by open surgery via oesophagotomy through right thoracotomy after failed retrieval via rigid oesophagoscopy. Conclusion: Surgical treatment in the form of esophagotomy via thoracotomy may be necessary in some cases of impacted foreign bodies in the esophagus where endoscopic removal is unsuccessful.
Isaac Okyere, Sanjeev Singh, Perditer Okyere, Samuel Gyasi Brenu, Samuel Kontor Amoabeng
Open Journal of Thoracic Surgery, Volume 10, pp 56-68; doi:10.4236/ojts.2020.102006

Abstract:
Gastric perforation into the thoracic cavity through a diaphragmatic rupture is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present our experience of two rare and unusual cases of traumatic diaphragmatic rupture from penetrating chest injury associated with herniated intrathoracic gastric perforation over a five-year period from January 2015 to December 2020 at the cardiovascular and thoracic surgery department of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Both patients underwent successful surgical repair through standard posterolateral thoracotomy with one having earlier negative exploratory laparotomy. The essence of the paper is to share and discuss the clinical presentation, diagnostic challenges, surgical management and the postoperative care of this very rare complication of traumatic diaphragmatic rupture.
Cecilie Enevoldsen, Britt Borregaard, Sara Schoedt Riber, Lars Schoedt Riber
Open Journal of Thoracic Surgery, Volume 10, pp 19-31; doi:10.4236/ojts.2020.101003

Abstract:
Objectives: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery and might be avoided with amiodarone prophylaxis. We investigated the long-term effect of prophylactic amiodarone, in patients undergoing isolated, elective coronary artery bypass grafting (CABG), as well as the long-term prognosis of patients with POAF. Methods: We retrospectively analysed patients included in the randomized, control trial RASCABG allocated to either placebo or amiodarone as POAF prophylaxis. Several outcomes were evaluated using national databases. Patients were stratified and compared by prophylactic groups and rhythm. Cox proportional hazard analysis was used for multivariable analysis. Kaplan-Meier survival curves were constructed to assess the probability of survival and cumulative incidence curves. Results: Prophylactic amiodarone was not related to long-term side effects in comparison to placebo. Patients who developed POAF, were more likely to develop late AF, and had a worse overall survival. There was no difference in the overall survival between prophylactic groups. In the competing risk analysis, amiodarone and POAF was not associated with an increased risk of readmission, but POAF was associated with an increased risk of late AF HR 2.28 [95% CI 1.15; 4.55]. In the multivariable analysis, amiodarone was not associated with late AF, readmission or long-term mortality. Further, no association was found between POAF and late AF, readmission or long-term mortality. Conclusion: Amiodarone is a safe drug for the prevention of POAF in the RASCABG-setting. POAF is related to long-term worse prognosis regarding late AF and mortality.
Cecilie Enevoldsen, Britt Borregaard, Sara Schødt Riber, Lars Peter Schødt Riber
Open Journal of Thoracic Surgery, Volume 10, pp 6-18; doi:10.4236/ojts.2020.101002

Abstract:
Background: The preventive effect of prophylactic amiodarone on postoperative atrial fibrillation (POAF) in patients undergoing thoracic surgery has previously been demonstrated. Meanwhile, the long-term effect remains unknown. We investigated the long-term effect of prophylactic amiodarone, in patients undergoing surgery for lung cancer, along with the long-term prognosis of patients with POAF within 6 years of follow-up. Methods: Using data from national databases, we retrospectively analysed 250 patients included and randomized, in the randomized control trial, PASCART, in which patients were allocated to receive either amiodarone or placebo as prophylaxis for POAF. Prophylactic groups, and subgroups, were compared on a number of outcomes. Long-term overall survival was evaluated using Kaplan-Meier survival curves, and Cox proportional hazards models were used for multivariable analysis. Competing risk analysis was used to evaluate time-to-event data in presence of competing risk. Results: When comparing the prophylactic groups, prophylaxis with amiodarone was not convincingly related to a higher frequency of long-term side effects. Patients who developed POAF, were more likely to develop late atrial fibrillation (AF) and POAF was associated with an increased risk of late AF in both the competing risk analysis hazard rate (HR) 4.80 [95% 1.75; 13.18] and multivariable analysis of the Cox regression, HR 5.03 [95% 1.80; 14.10]. When comparing the Kaplan Meier survival curves between groups, we found no statistically significant difference in the long-term overall survival. Conclusions: Intravenous prophylactic amiodarone is safe in patients undergoing lung cancer surgery. POAF is associated with an increased risk of late AF.
Eshonkhodjaev Otabek, Khudaybergenov Shuhrat, Ibadov Ravshan, Hayaliev Rustem, Yormuhammedov Anvar, Otabek Eshonkhodjaev, Shuhrat Khudaybergenov, Ravshan Ibadov, Rustem Hayaliev, Anvar Yormuhammedov
Open Journal of Thoracic Surgery, Volume 10, pp 41-55; doi:10.4236/ojts.2020.102005

Abstract:
The article presents a new technique developed by RSCS named after acad. V. Vakhidov for performing percutaneous dilatational tracheostomy by using the improved Howard-Kelly forceps, which ensures stable traction of the guidewire and reduces the risk of trauma to surrounding tissues. In order to assess the feasibility and necessity of carrying out a modified method of tracheostomy, a comparative analysis of the frequency and structure of complications after various options for tracheostomy was carried out, taking into account the presence or absence of risk factors for an adverse outcome.
Karoline Korsholm Jeppesen, Sara Schødt Riber, Lars Peter Riber
Open Journal of Thoracic Surgery, Volume 9, pp 43-58; doi:10.4236/ojts.2019.94005

Abstract:
Objectives: Exploring the long-term consequences of elevated postoperative creatine phosphokinase MB as a surrogate measure of cardiac tissue damage subsequent to coronary artery bypass graft surgery (CABG). Methods: Prospective cohort study including 414 patients subjected to solitary CABG at Odense University Hospital from September 30, 2007, and backwards in time. According to individual postoperative peak creatine phosphokinase MB, patients were assigned to five subgroups. Kaplan Meier survival analysis and Cox proportional-hazard regression evaluated the predictive value of creatine phosphokinase MB on late death from cardiac cause and diagnosis of paroxysmal or persistent atrial fibrillation within 10-years after CABG. Results: There was a general numeric decrease in time to cardiac death with increasing postoperative creatine phosphokinase MB (Log-Rank 0.285). Creatine phosphokinase MB p p p = 0.002) increase in paroxysmal or persistent atrial fibrillation in patients with postoperative atrial fibrillation compared to patients in postoperative sinus rhythm. Conclusions: Postoperative creatine phosphokinase MB was not found predictive of late cardiac death or diagnosis of paroxysmal or persistent atrial fibrillation within 10 years after CABG. However, patients with postoperative atrial fibrillation had increased risk of later developing paroxysmal or persistent atrial fibrillation compared to patients in postoperative sinus rhythm.
Kayo Sugiyama, Yasuhiro Futamura, Hirotaka Watanuki, Masaho Okada, Genri Tagami, Katsuhiko Matsuyama
Open Journal of Thoracic Surgery, Volume 9, pp 1-7; doi:10.4236/ojts.2019.91001

Isaac Okyere, Samuel Gyasi Brenu, Perditer Okyere
Open Journal of Thoracic Surgery, Volume 9, pp 9-16; doi:10.4236/ojts.2019.92002

Isaac Okyere, Samuel Gyasi Brenu, Perditer Okyere
Open Journal of Thoracic Surgery, Volume 9, pp 31-41; doi:10.4236/ojts.2019.93004

Abstract:
Achalasia cardia is a primary oesophageal motility disorder of unknown aetiology characterized manometrically by insufficient relaxation of the lower oesophageal sphincter (LES) and loss of oesophageal peristalsis; radiographically by aperistalsis, oesophageal dilation with minimal LES opening, bird-beak appearance, poor emptying of barium; and endoscopically by dilated oesophagus with retained saliva, liquid and undigested food particles in the absence of mucosal stricturing or tumour. Achalasia cardia patients usually present with difficulty in swallowing both solids and liquids and this may be associated with regurgitation, heartburn and chest pains. Treatment options include medical or pharmacologic therapy, botulinum toxin injection, pneumatic dilation and oesophagocardiomyotomy or the Heller myotomy with or without antireflux procedure and recently the POEM (Perioral oesophageal myotomy). Herein, we present our experience with four cases managed surgically via thoracotomy without antireflux surgery over a 5-year period, from January 2015 to June 2019 at the Komfo Anokye Teaching Hospital, the second largest teaching hospital in Ghana.
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