Osbornestarr1895

rostheses is crucial to ensure optimal postoperative outcome.

The factors affecting the surgical margin distance in resection of small lung lesions after preoperative marking are still unclear. The purpose of this study was to identify these factors in wedge lung resection using a localization technique.

The subjects were 45 patients with small pulmonary nodules who underwent preoperative computed tomography-guided lipiodol marking followed by video-assisted thoracoscopic surgery between April 2017 and December 2019. Data were obtained for nodule size, depth from the pleural surface, imaging features, and procedure-related factors that could affect the surgical margin. Subjects were divided into groups with margin distances <10 and ≥10 mm. Logistic regression analysis was used to identify factors associated with the margin distance.

Preoperative marking was performed using lipiodol prior to resection of 52 nodules (median size, 10.1 mm; range, 6.75-12.3 mm) in 45 patients (23 men, 22 women; median age, 65.4 years). The mean distance from the pleural surface to the pulmonary lesion was 13.8 mm (range, 5.44-22.2 mm). The 3D deviation of the radio-opaque nodule (lipiodol spot) from the lesion was the only significant difference in nodule- and procedure-related factors between the two groups. Multivariate analysis also showed that this 3D deviation was the most significant factor affecting the margin distance (odds ratio, 0.26; 95% CI, 0.08-0.81; P=0.02).

The findings in this study may help to ensure a sufficient surgical margin after preoperative lipiodol marking, through recognition that the 3D deviation of the radio-opaque nodule from the target lesion has a particularly important influence on the margin distance.

The findings in this study may help to ensure a sufficient surgical margin after preoperative lipiodol marking, through recognition that the 3D deviation of the radio-opaque nodule from the target lesion has a particularly important influence on the margin distance.

In general practice (GP), the diagnosis of obstructive airway diseases much relies on diagnostic questions, in view of the limited availability of lung function. We systematically assessed the relative importance of such questions for diagnosing asthma and chronic obstructive pulmonary disease (COPD), either without or with information from spirometry.

We used data obtained in a pulmonary practice to ensure the validity of diagnoses and assessments. Subjects with a diagnosis of COPD (n=260), or asthma (n=433), or other respiratory diseases (n=230), and subjects without respiratory diseases (n=364, controls) were included. The diagnostic questions comprised eight items, covering smoking history, self-attributed allergic rhinitis, dyspnea, cough, phlegm and wheeze. Optionally standard parameters of the flow-volume-curve were included. Decision trees for the diagnosis of COPD and asthma were constructed, moreover a probabilistic diagnostic network based on the results of path analyses describing the relationorithms may be helpful as a starting point in the standardisation of diagnostic strategies in GP practices.

The study is registered under DRKS00013935 at German Clinical Trials Register (DRKS, Date of registration 01/03/2018).

The study is registered under DRKS00013935 at German Clinical Trials Register (DRKS, Date of registration 01/03/2018).

This study aimed to investigate the early and late outcomes of mechanical tricuspid valve replacement (mTVR).

We evaluated 113 patients (82 women; median age, 53 years) who underwent mTVR between 1995 and 2017. Based on a history of cardiac surgery, patients were divided into primary (n=42) and reoperative mTVR (n=71) groups. The median follow-up duration was 12.7 years in primary and 9.3 years in reoperative mTVR, respectively (P=0.045).

Patients in the reoperative group were older (54

46 years; P=0.007) and showed higher central venous pressure (16±6

13±6 mmHg; P=0.002) than the primary group. Early mortality occurred in 2 patients in the reoperative group (2

0; P=0.529). There was no significant difference in overall survival between the primary and reoperation groups (15-year survival rate 86%

78%; P=0.215). The independent risk factors of overall survival were age [P<0.001; hazard ratio (HR), 1.11; 95% confidential interval (CI), 1.05-1.18], left ventricular ejection fraction of less than 40% (P=0.001; HR, 5.1; 95% CI, 2.21-28.2), and central venous pressure over 20 mmHg (P=0.016; HR, 3.7; 95% CI, 1.28-10.7). Overall survival did not differ between the age groups (<60

60-70 years) in the reoperative group (P=0.772). Tricuspid valve thrombosis occurred in 8 patients (7 primary, 1 reoperative; P=0.004).

The incidence of tricuspid valve thrombosis was significantly higher in the primary mTVR group compared with the reoperative mTVR group. see more The patients who underwent mTVR at a relatively young age showed good early and late outcomes in both groups.

The incidence of tricuspid valve thrombosis was significantly higher in the primary mTVR group compared with the reoperative mTVR group. The patients who underwent mTVR at a relatively young age showed good early and late outcomes in both groups.

A prolonged air leak (PAL) is the most frequent complication after pulmonary resection. This study aimed to assess the safety and efficacy of autologous blood patch pleurodesis (ABPP) to treat PAL.

A prospectively maintained database identified patients with a PAL after pulmonary resection for lung cancer between 2015-2019. In this observational cohort study, clinical data were collected to retrospectively compare patients undergoing ABPP to no ABPP in a propensity-matched analysis. Kaplan Meier estimates and Cox models accounting for inverse probability weighting (IPTW) were used to assess the association of ABPP with each outcome.

Of the 740 patients undergoing lung resection, 110 (15%) were identified as having a PAL at postoperative day (POD) 5. There was no difference between baseline characteristics among those undergoing ABPP (n=34) versus no ABPP (n=76). Propensity-weighted analysis did not reveal a significant association of ABPP treatment with in-hospital complication (P=0.18), hospital length of stay (LOS) (P=0.