Trials In Thoracic Surgery Research Articles

Intraoperative fluorescence imaging in thoracic surgery.

Intraoperative fluorescence imaging (IFI) can improve real-time identification of cancer cells during an operation. Phase I clinical trials in thoracic surgery have demonstrated that IFI with second window indocyanine green (TumorGlow® ) can identify subcentimeter pulmonary nodules, anterior mediastinal masses, and mesothelioma, while the use of a folate receptor-targeted near-infrared agent, OTL38, can improve the specificity for diagnosing tumors with folate receptor expression. Here, we review the existing preclinical and clinical data on IFI in thoracic surgery.

Energizing trials in thoracic surgery

The paper by Goudie et al . (1) on the safety of energy devices for the ligation of pulmonary artery (PA) branches during VATS lobectomy should leave us all energized. It’s not because the authors have discovered something new.

Clinical Trials in Thoracic Surgery: A Report From Ginsberg Day 2017 and Early Risers at STS 2017

No unified source lists clinical trials relevant to general thoracic surgery. This description summarizes the current offerings across the National Cancer Institute Cooperative Group-sponsored clinical trials, and includes trials involving surgery for lung cancer and esophageal cancer, and in some instances, perioperative management of patients undergoing thoracic surgery.

Has the quality of reporting of randomized controlled trials in thoracic surgery improved?

To evaluate the quality of reporting of randomized controlled trials (RCTs) in the thoracic surgery literature according to Consolidated Standard for Reporting of Trials (CONSORT) and to determine predictors of quality. All RCTs published in four principal journals between 1998 and 2013 were identified in PubMed. Two independent reviewers assessed each trial using the CONSORT checklist (1996) with discrepancies resolved by a third reviewer. Mean checklist scores were compared between trials published from 1998 to 2005 and 2006 to 2013. The κ statistic for inter-rater agreement was calculated. Stepwise multivariable linear regression was then performed to identify independent predictors of quality. After 2 rounds of review, 203 of the 2838 identified articles met inclusion criteria. The overall κ coefficient was 0.95 indicating very good agreement between reviewers. The mean CONSORT score was significantly higher in 2006-13 [mean 10.8; 95% confidence interval (CI): 10.3-11.2] than in 1998-2005 (mean 9.3; 95% CI: 8.7-9.6). On multivariable analysis, there was strong evidence of an increased mean CONSORT score in studies comparing non-surgical interventions, multicentre trials, publications after 2006, studies with increased number of authors and studies funded by industries. Our study suggests that the quality of reporting in the thoracic surgery literature is improving with time and is predicted by factors including number of authors, multicentre trials, type of comparison, time period of publication and industry sponsorship. Ongoing efforts should be made to improve the quality of reporting in thoracic surgery.

2015 Canadian Surgery Forum Abstracts.

The Canadian Surgery Forum Steering Committee acknowledges and thanks the following organizations for their support of the 2015 Forum: # 02 The usefulness and costs of routine contrast studies after laparoscopic sleeve gastrectomy for detecting staple line leaks {#article-title-2} Although

How long is a transurethral catheter necessary in patients undergoing thoracotomy and receiving thoracic epidural analgesia? Literature review.

DESPITE THE AGING POPULATION and new lung cancer cases being on the rise, clinicians are forced to be more efficient and more productive without additional resources. Fast-track pathways have been described showing outstanding results, such as a faster recovery process and shorter length of hospital stay, but mainly for abdominal 1 Gravante G. Elmussareh M. Enhanced recovery for colorectal surgery: Practical hints, results and future challenges. World J Gastrointest Surg. 2012; 4: 190-198 Crossref PubMed Google Scholar , 2 Carli F. Charlebois P. Baldini G. et al. An integrated multidisciplinary approach to implementation of a fast-track program for laparoscopic colorectal surgery. Can J Anaesth. 2009; 56: 837-842 Crossref PubMed Scopus (71) Google Scholar and orthopedic 3 Kehlet H. Thienpont E. Fast-track knee arthroplasty—Status and future challenges. Knee. 2013; 20: S29-S33 Abstract Full Text PDF PubMed Scopus (93) Google Scholar surgeries. Although enhanced recovery paths might seem to be an excellent option to solve this problem, there is a scarcity of trials in thoracic surgery in general on this subject. 4 Jones N.L. Edmonds L. Ghosh S. et al. A review of enhanced recovery for thoracic anaesthesia and surgery. Anaesthesia. 2013; 68: 179-189 Crossref PubMed Scopus (72) Google Scholar Therefore, it is essential to implement recovery pathway programs for patients undergoing thoracic surgery. Thoracic epidural analgesia (TEA) is the gold standard to relieve pain after thoracotomy because of its association with severe pain. 5 Ochroch E.A. Gottschalk A. Augosutides J. et al. Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia. Anesthesiology. 2002; 97: 1234-1244 Crossref PubMed Scopus (150) Google Scholar Thus, a crucial point to implement a fast-track pathway in thoracic surgery is to offer TEA. It reduces significantly the incidence of postoperative morbidity compared with other types of analgesia. 6 Ng A. Swanevelder J. Pain relief after thoracotomy: Is epidural analgesia the optimal technique?. Br J Anaesth. 2007; 98: 159-162 Crossref PubMed Scopus (40) Google Scholar In contrast, TEA encompasses important side effects. Postoperative urinary retention (POUR) is one of the most frequent, with an average incidence of 26%. 7 Baldini G. Bagry H. Aprikian A. et al. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009; 110: 1139-1157 Crossref PubMed Scopus (404) Google Scholar To avoid this complication, it is a common practice to place a transurethral catheter, as long as the epidural is in situ and functioning well. 8 Zaouter C. Kaneva P. Carli F. Less urinary tract infection by earlier removal of bladder catheter in surgical patients receiving thoracic epidural analgesia. Reg Anesth Pain Med. 2009; 34: 542-548 Crossref PubMed Scopus (111) Google Scholar , 9 Ladak S.S. Katznelson R. Muscat M. et al. Incidence of urinary retention in patients with thoracic patient-controlled epidural analgesia (TPCEA) undergoing thoracotomy. Pain Manag Nurs. 2009; 10: 94-98 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar Nevertheless, a urinary bladder catheter impedes early ambulation and can lead to urinary tract infection (UTI), which increases patients’ hospital length of stay and governmental costs.

Cooperative Group Clinical Trials in General Thoracic Surgery: Report From the 2012 Robert Ginsberg Clinical Trials Meeting of the General Thoracic Surgical Club

At the 25th Annual General Thoracic Surgical Club meeting in March 2012, the major cooperative groups presented updates on clinical trials at the Robert Ginsberg Clinical Trials Meeting. There were 57 members in attendance. Representatives from the Radiation Treatment Oncology Group (RTOG), American College of Surgeons Oncology Group (ACOSOG), Cancer and Leukemia Group B (CALGB), Southwest Oncology Group (SWOG), National Cancer Institute of Canada Clinical Trials Group (NCIC), and the Eastern Cooperative Oncology Group (ECOG) presented an overview of trials currently accruing or in development. These include oncologic trials that thoracic surgeons are currently accruing patients to in North America. The purpose of this review is to centralize the information to assist surgeons enrolling patients into oncologic clinical trials in thoracic surgery.