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Propensity score matching yielded 187 matched pairs. NT was associated with a higher risk of having any major postoperative adverse event (adjusted OR=1.731, 95% CI 1.093-2.741, P=0.019), decreased 5-year overall survival (adjusted HR=1.798, 95% CI 1.079-2.995, P=0.024), as well as decreased 5-year BOS-free survival (adjusted HR=1.556, 95% CI 1.098-2.205, P=0.013) in doubly robust multivariable analyses following propensity score matching. Overall cost for NT and DT were similar.

NT was associated with higher risk of major postoperative adverse events, decreased 5-year overall survival and decreased 5-year BOS-free survival. Our findings suggest potential benefits of delaying NT to daytime.

NT was associated with higher risk of major postoperative adverse events, decreased 5-year overall survival and decreased 5-year BOS-free survival. Our findings suggest potential benefits of delaying NT to daytime.

Quality of life (QoL) is increasingly important in the era of patient-centered outcomes and value-based reimbursement. However, most follow-up is limited to 30 days and long-term data on QoL improvement associated with symptom relief are lacking. Therefore, we sought to analyze QoL following cardiac surgery in a non-emergent, all-comers population.

A total of 402 patients undergoing routine cardiac surgery at two large urban hospitals in the Dallas, Texas area were enrolled. Follow-up was complete for 364 patients. Data was collected from 08/2013-01/2017. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was administered at baseline, one month, and one year following surgery. Repeated measures analysis was used for each domain of the KCCQ for all procedures and stratified by procedure. If time was found to be a significant factor, pairwise analysis was performed with p-values adjusted using Tukey-Kramer method.

There was a significant increase across all domains of KCCQ scores for all procedures and for most domains when stratifying by procedure. This increase in QoL is most marked after one month. All domain scores increased through one year except symptom stability which peaked at one month post-surgery and then regressed at one year, suggesting an overall improvement and stabilization of symptoms. The occurrence of complications did not alter this trajectory.

QoL and other patient-centered outcomes are improved at one month and continue to improve throughout the year. Knowledge of these data is important for patient selection, fully informed consent and shared decision making.

QoL and other patient-centered outcomes are improved at one month and continue to improve throughout the year. Knowledge of these data is important for patient selection, fully informed consent and shared decision making.

This study explored the safety and feasibility of uniportal video-assisted thoracoscopic (VATS) decortication in patients presenting with stage III tuberculous empyema with severe rib crowding.

From 8/2017-1/2019, 33 patients of stage III tuberculous empyema and severe rib crowding underwent uniportal VATS decortication with partial rib resection and use of a customized periosteal stripper. GSK2643943A purchase Pre- and post-operative chest computed tomography (CT) imaging and pulmonary function testing were analyzed to evaluate the clinical significance of certain imaging findings and surgical efficacy.

There was one conversion to open thoracotomy. The median operative time was 3.5（2.1-4.5）hours, and the median blood loss was 500（250-1000）ml. There were no perioperative mortalities. The incidence of prolonged air leaks (> 5 days) was 81.8%. The median postoperative hospital stay was 4 (4-5) days. All patients were discharged with 2 chest tubes, and the median duration drainage was 39 (30-60) days. The presence of a "low-density line" between the parietal fibrous pleural rind and chest wall demonstrated on chest CT in 13 patients. Intraoperative blood loss was significantly lower in these patients compared to those without this imaging finding. Follow up was complete in all patients over a median duration of 8 (6, 11.5) months. All patients recovered well and achieved significant improvement in pulmonary function.

Uniportal VATS decortication is a safe and effective. Patients presenting with a "low-density line" around the thickened fibrous pleural rind on preoperative chest CT scan may be good candidates.

Uniportal VATS decortication is a safe and effective. Patients presenting with a "low-density line" around the thickened fibrous pleural rind on preoperative chest CT scan may be good candidates.

Lung volume reduction (LVR) surgery has traditionally been performed as a one-stage bilateral procedure or staged at a predetermined interval. However, to maximise the overall benefit we have allowed the patient to determine the timing of further interventions and have added endobronchial LVR into the protocol. We have reviewed the long-term outcome.

331 LVR procedures were performed on 256 patients (median age 61 [23-79] years) with baseline predicted lung function (mean +/- SD) FEV1 28 (11) %, RV 253 (53) %. The initial procedure was by video-assisted thoracoscopic surgery (VATS) in 236 patients (unilateral 227; bilateral 9); open surgery in 5 and endobronchial valve (EBV) insertion in 13. 64 patients received a second and 13 a third LVR procedure. Median time interval between 1st and 3rd stage was 5.8 (1.9-10) years RESULTS In the subgroup of patients who underwent staged procedures there was a significant improvement in predicted FEV1 from 28% at baseline to 34% up to 6 years. There was sustained reduction in static lung volumes up to 8 years predicted RV remained reduced from 259% to 189%. There were sustained improvements over baseline in health status Euroquol 5D improved from [50 (26) to 62(23), p<0.01] for up to 5 years and SF 36 for up to 9 years. Overall 30-day mortality was 3%. Median survival was 5.6 (95% CI 4.7-6.9) years.

A programme of staged unilateral procedures of LVR has resulted in sustained benefits for up to 9 years in physiology and health status.

A programme of staged unilateral procedures of LVR has resulted in sustained benefits for up to 9 years in physiology and health status.