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Gooseman MR, Tentzeris V, Bulliment KL, Qadri SSA, Callister MEJ, Milton R, Chaudhuri N, Tcherveniakov P, Papagiannopoulos K, Cowen ME, Brunelli A. Impact of lung cancer screening on surgical stage distribution and surgical practice: a regional analysis of patients operated in and out of a screening program. Interdiscip Cardiovasc Thorac Surg 2024; 38:ivad193. [PMID: 38001026 PMCID: PMC10899811 DOI: 10.1093/icvts/ivad193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/22/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVES The aim of this study was to assess variations in surgical stage distribution in 2 centres within the same UK region. One centre was covered by an active screening program started in November 2018 and the other was not covered by screening. METHODS Retrospective analysis of 1895 patients undergoing lung resections (2018-2022) in 2 centres. Temporal distribution was tested using Chi-squared for trends. A lowess curve was used to plot the proportion of stage 1A patients amongst those operated over the years. RESULTS The surgical populations in the 2 centres were similar. In the screening unit (SU), we observed a 18% increase in the proportion of patients with clinical stage IA in the recent phase compared to the early phase (59% vs 50%, P = 0.004), whilst this increase was not seen in the unit without screening. This difference was attributable to an increase of cT1aN0 patients in the SU (16% vs 11%, P = 0.035) which was not observed in the other unit (10% vs 8.2%, P = 0.41). In the SU, there was also a three-fold increase in the proportion of sublobar resections performed in the recent phase compared to the early one (35% vs 12%, P < 0.001). This finding was not evident in the unit without screening. CONCLUSIONS Lung cancer screening is associated with a higher proportion of lung cancers being detected at an earlier stage with a consequent increased practice of sublobar resections.
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Affiliation(s)
- Michael R Gooseman
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Vasileios Tentzeris
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Kerry L Bulliment
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Syed S A Qadri
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Matthew E J Callister
- Department of Respiratory Medicine, St James's University Hospital, Leeds Teaching Hospitals, Leeds, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - Richard Milton
- Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - Nilanjan Chaudhuri
- Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - Peter Tcherveniakov
- Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - Kostas Papagiannopoulos
- Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - Michael E Cowen
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Alessandro Brunelli
- School of Medicine, University of Leeds, Leeds, UK
- Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, Leeds, UK
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Ravishankar R, Hussain A, Arif S, Khan T, Gooseman M, Tentzeris V, Cowen M, Qadri S. An analysis of long-term survival after pneumonectomy for lung cancer: A retrospective study of 20 years. Asian Cardiovasc Thorac Ann 2024; 32:11-18. [PMID: 38043931 DOI: 10.1177/02184923231212657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
INTRODUCTION The incidence of pneumonectomy for lung cancer in the UK is continuing to decline in the era of minimally invasive thoracic surgery totalling approximately 3.5% of lung cancer resections annually. Literature is lacking for long-term survival of pneumonectomies. This study updates our previous results. Between 1998 and 2008, 206 patients underwent pneumonectomy compared to 98 patients between 2009 and 2018. METHODS From January 1998 until December 2018, 304 patients underwent pneumonectomy. This was a retrospective study; data was analysed for age, gender, laterality, histology and time period. RESULTS Operative mortality was 4.3% overall which was lower than the national average of 5.8%. In the last five years, there were no in-hospital, operative or 30-day mortality. During this period, 90-day mortality was 9.2%. Left-sided pneumonectomies had significantly better overall survival (3.00 vs. 2.03 years; p = 0.0015), squamous cell carcinoma (3.23 vs. 1.54 years; p = 0.00012) as well as those aged less than 70 (2.79 vs. 2.13 years; p = 0.011). There was no significant difference in survival between gender (p = 0.48). Intervention from 1998 to 2008 had significantly greater survival compared to the latter 10 years (2.68 vs. 2.46 years; p = 0.031). The Cox model shows that laterality, age, histology and time period remain significant with multivariate testing. No patient survived after 16 years. DISCUSSION Our updated retrospective study has built on our previous results by reinforcing the success of pneumonectomies. The incidence of pneumonectomies is likely to decrease with the deployment of nation-wide lung cancer screening in the UK due to earlier detection.
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Affiliation(s)
| | - Azar Hussain
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
| | - Salman Arif
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
| | - Tanveer Khan
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
| | - Michael Gooseman
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
| | | | - Michael Cowen
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
| | - Syed Qadri
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
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Shafiq M, Qadeer T, Tentzeris V, Kastelik J. Rare presentation of pneumothorax in a young woman with underlying congenital pulmonary airway malformation. BMJ Case Rep 2023; 16:e254294. [PMID: 38050398 PMCID: PMC10693894 DOI: 10.1136/bcr-2022-254294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/06/2023] Open
Abstract
Congenital pulmonary airway malformation (CPAM) is the most common among a rare group of congenital anomalies of the lower respiratory tract. It has variable presentation depending on its subtype and the patient's age. It may lead to respiratory distress in neonates. It can be a particularly challenging diagnosis in children born asymptomatic but present with complications later in life such as haemoptysis, recurrent chest infections, breathlessness and pneumothorax. Prenatal ultrasound, chest X-ray, CT scan and MRI are helpful in making a radiological diagnosis.A woman in her late teens presented with shortness of breath and right pleuritic chest pain. CT's chest showed a number of bullae of varying sizes on the right, including one huge bulla compressing all three lobes. She underwent lung volume reduction surgery via video-assisted thoracoscopy, and the histology specimen confirmed the diagnosis of CPAM type 1.
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Affiliation(s)
- Muhammad Shafiq
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
- Department of Respiratory Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Tariq Qadeer
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
| | - Vasileios Tentzeris
- Thoracic Surgery, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, UK
| | - Jack Kastelik
- Department of Respiratory Medicine, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
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Gooseman MR, Tentzeris V, Cowen ME. The benefits of combining the latest technology in thoracic surgery. J Thorac Dis 2023; 15:5256-5257. [PMID: 37868842 PMCID: PMC10586966 DOI: 10.21037/jtd-23-754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/28/2023] [Indexed: 10/24/2023]
Affiliation(s)
- Michael R Gooseman
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Vasileios Tentzeris
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | - Michael E Cowen
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
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Gooseman MR, Cowen ME, Tentzeris V, Qadri SSA, Brunelli A, Pompili C. Patient reported outcomes in thoracic trauma-lesson learned from thoracic oncology. J Thorac Dis 2023; 15:4151-4153. [PMID: 37691672 PMCID: PMC10482647 DOI: 10.21037/jtd-23-576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/10/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Michael R. Gooseman
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Michael E. Cowen
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Vasileios Tentzeris
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Syed S. A. Qadri
- Department of Thoracic Surgery, Castle Hill Hospital, Hull University Teaching Hospitals, Cottingham, UK
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research, St James’s University of Leeds, Leeds, UK
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Jenner LC, Rotchell JM, Bennett RT, Cowen M, Tentzeris V, Sadofsky LR. Detection of microplastics in human lung tissue using μFTIR spectroscopy. Sci Total Environ 2022; 831:154907. [PMID: 35364151 DOI: 10.1016/j.scitotenv.2022.154907] [Citation(s) in RCA: 262] [Impact Index Per Article: 131.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 05/09/2023]
Abstract
Airborne microplastics (MPs) have been sampled globally, and their concentration is known to increase in areas of high human population and activity, especially indoors. Respiratory symptoms and disease following exposure to occupational levels of MPs within industry settings have also been reported. It remains to be seen whether MPs from the environment can be inhaled, deposited and accumulated within the human lungs. This study analysed digested human lung tissue samples (n = 13) using μFTIR spectroscopy (size limitation of 3 μm) to detect and characterise any MPs present. In total, 39 MPs were identified within 11 of the 13 lung tissue samples with an average of 1.42 ± 1.50 MP/g of tissue (expressed as 0.69 ± 0.84 MP/g after background subtraction adjustments). The MP levels within tissue samples were significantly higher than those identified within combined procedural/laboratory blanks (n = 9 MPs, with a mean ± SD of 0.53 ± 1.07, p = 0.001). Of the MPs detected, 12 polymer types were identified with polypropylene, PP (23%), polyethylene terephthalate, PET (18%) and resin (15%) the most abundant. MPs (unadjusted) were identified within all regions of the lung categorised as upper (0.80 ± 0.96 MP/g), middle/lingular (0.41 ± 0.37 MP/g), and with significantly higher levels detected in the lower (3.12 ± 1.30 MP/g) region compared with the upper (p = 0.026) and mid (p = 0.038) lung regions. After subtracting blanks, these levels became 0.23 ± 0.28, 0.33 ± 0.37 and 1.65 ± 0.88 MP/g respectively. The study demonstrates the highest level of contamination control and reports unadjusted values alongside different contamination adjustment techniques. These results support inhalation as a route of exposure for environmental MPs, and this characterisation of types and levels can now inform realistic conditions for laboratory exposure experiments, with the aim of determining health impacts.
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Affiliation(s)
- Lauren C Jenner
- Hull York Medical School, University of Hull, Hull HU6 7RX, United Kingdom
| | - Jeanette M Rotchell
- Department of Biological and Marine Sciences, University of Hull, Hull HU6 7RX, United Kingdom
| | - Robert T Bennett
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham HU16 5JQ, United Kingdom
| | - Michael Cowen
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham HU16 5JQ, United Kingdom
| | - Vasileios Tentzeris
- Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham HU16 5JQ, United Kingdom
| | - Laura R Sadofsky
- Hull York Medical School, University of Hull, Hull HU6 7RX, United Kingdom.
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Amran R, Hussain A, Din AC, Cowen M, Chaudhry M, Loubani M, Tentzeris V, Qadri SS. 372 Short- And Long-Term Outcome of Pneumonectomy for Lung Cancer: 20 Years’ Experience of a Single Centre. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Surgery is the most important therapeutic modality for the treatment of primary lung cancer. Studies normally reported as 30-days or 90-days post-operative mortality or 5-years survival. However, survival for ≥10-years is rarely mentioned.
Method
Retrospective data collection from a tertiary centre database was implemented which include patients who underwent pneumonectomy from January 1998 until November 2019. The data was analysed for short and long-term outcomes including their respective Thoracoscore.
Results
268 patients who had pneumonectomy were selected, in majority for lung cancer. 79.1% were male with mean age is 63. Overall operative mortality in this cohort was 4.9% while reported national mortality for pneumonectomy for lung cancer is 7%. No 30-days post-operative mortality in the last 5 years. The 5,10- and 15-years survival rate for patients are 36.9%, 23.9% and 20.3% respectively. This showed significant increase in the survival rate for 5- and 10-years post-pneumonectomy in comparison to previous study. Long-term survival was better in female with age <70 years. The overall survival rate >15 years is 0.4%.
Conclusions
This study shows that our operative mortality for pneumonectomy is significantly lower (30% less) than national mortality. This confirms that pneumonectomy is still an effective modality in the treatment of lung cancer.
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Affiliation(s)
- R Amran
- Castle Hill Hospital, Cottingham, United Kingdom
| | - A Hussain
- Castle Hill Hospital, Cottingham, United Kingdom
| | - A C Din
- Castle Hill Hospital, Cottingham, United Kingdom
| | - M Cowen
- Castle Hill Hospital, Cottingham, United Kingdom
| | - M Chaudhry
- Castle Hill Hospital, Cottingham, United Kingdom
| | - M Loubani
- Castle Hill Hospital, Cottingham, United Kingdom
| | - V Tentzeris
- Castle Hill Hospital, Cottingham, United Kingdom
| | - S S Qadri
- Castle Hill Hospital, Cottingham, United Kingdom
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Tentzeris V, Papagiannopoulos K. The role of video-assisted thoracoscopic surgery in the first rib resection for thoracic inlet syndrome. Ital J Vasc Endovasc Surg 2017. [DOI: 10.23736/s1824-4777.17.01307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Drosos P, Pompili C, Ismail H, Tentzeris V, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis E, Brunelli A. O-015FACTORS ASSOCIATED WITH POSTOPERATIVE COSTS FOLLOWING ANATOMIC LUNG RESECTIONS WITHOUT MAJOR COMPLICATIONS. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Brunelli A, Tentzeris V, Sandri A, McKenna A, Liew SL, Milton R, Chaudhuri N, Kefaloyannis E, Papagiannopoulos K. A risk-adjusted financial model to estimate the cost of a video-assisted thoracoscopic surgery lobectomy programme. Eur J Cardiothorac Surg 2015; 49:1492-6. [DOI: 10.1093/ejcts/ezv339] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/03/2015] [Indexed: 12/25/2022] Open
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Sandri A, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis E, Pompili C, Tentzeris V, Brunelli A. High-risk patients and postoperative complications following video-assisted thoracic surgery lobectomy: a case-matched comparison with lower-risk counterparts†. Interact Cardiovasc Thorac Surg 2015; 21:761-5. [PMID: 26362624 DOI: 10.1093/icvts/ivv254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 08/12/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To assess the postoperative incidence of major complications in high-risk patients following video-assisted thoracoscopic surgery (VATS) lobectomy for lung cancer compared with their lower risk counterparts. METHODS A retrospective analysis on prospectively collected data of 348 consecutive patients subjected to VATS lobectomy (August 2012-September 2014) was performed. Patients were defined as high risk if one or more of the following characteristics were present: age >75 years, forced expiratory volume in 1 s (FEV1) <50%, carbon monoxide lung diffusion capacity (DLCO) <50%, history of coronary artery disease (CAD). Severity of complications was graded using the Thoracic Morbidity and Mortality (TM&M) score; major complications were defined if the TM&M score was greater than 2. The propensity score was used to match high-risk patients with their lower risk counterparts in order to minimize the influence of other confounders on outcome. The following variables were used to construct the propensity score: gender, side of operation, body mass index, American Society of Anaesthesiologists score, Eastern Cooperative Oncology Group score, Charlson's Comorbidity Index, number of functioning segments resected. RESULTS The high-risk group consisted of 141 patients (age >75 years: 84 patients; FEV1 <50: 14 patients; DLCO <50: 25 patients; history of CAD: 37 patients). The propensity score yielded two groups of 135 patients (high-risk vs low-risk) well matched for several baseline characteristics except for a lower performance status in the higher-risk group. Compared with their low-risk counterparts, high-risk patients had a higher incidence of cardiopulmonary complications (28 cases, 21% vs 14 cases, 10%; P < 0.0001) and major cardiopulmonary complications (12 cases, 9% vs 3 cases, 2%; P < 0.0001). Postoperative stay was 3 days longer in high-risk patients (8.6 vs 5.5 days, P = 0.0031). The 30-day or in-hospital mortality rates were not different between the two groups (2 cases, 1.5% vs 3 cases, 2.2%, P = 0.93). CONCLUSIONS The incidence of major complications after VATS lobectomy in high-risk patients is low, but not negligible. This information can be used when discussing surgical risk with the patient during preoperative counselling.
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Affiliation(s)
- Alberto Sandri
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
| | | | - Richard Milton
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
| | - Nilanjan Chaudhuri
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
| | - Emmanuel Kefaloyannis
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
| | - Cecilia Pompili
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
| | - Vasileios Tentzeris
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St James's University Hospital Bexley Wing, Leeds, UK
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Sandri A, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis M, Pompili C, Tentzeris V, Brunelli A. F-146HIGH RISK PATIENTS AND POSTOPERATIVE COMPLICATIONS FOLLOWING VIDEO-ASSISTED THORACOSCOPIC LOBECTOMY: A CASE MATCHED COMPARISON WITH LOWER RISK COUNTERPARTS. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.146] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tentzeris V, Sandri A, Drosos P, Pompili C, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis M, Brunelli A. F-148RISK ADJUSTED FINANCIAL MODEL TO ESTIMATE THE COST OF A VIDEO-ASSISTED THORACOSCOPIC LOBECTOMY PROGRAMME. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tentzeris V, Papagiannopoulos K. O-101 * SURVEY ON ENDOBRONCHIAL TREATMENT OF EMPHYSEMA. PRACTICE VARIATIONS AMONGST ESTS MEMBERSHIP. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tentzeris V, Kefaloyannis E, Begum S, Hristova R, Milton R, Chaudhuri N, Thorpe A, Papagiannopoulos K. F-055 * BUILDING UP A VIDEO-ASSISTED THORACOSCOPIC LUNG RESECTION PROGRAMME: ELEMENTS TO IMPROVE FAST ADOPTION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kouritas V, Begum SSS, Tentzeris V, Milton R, Chaudhuri N, Papagiannopoulos K. P-145 * VIDEO-ASSISTED THORACOSCOPIC LUNG RESECTIONS: CHALLENGING CURRENT FITNESS GUIDELINES. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Hristova R, Pompili C, Begum S, Salati M, Kefaloyannis E, Tentzeris V, Papagiannopoulos K, Brunelli A. O-105 * AN AGGREGATE SCORE TO PREDICT THE RISK OF LARGE PLEURAL EFFUSION AFTER PULMONARY LOBECTOMY. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tentzeris V, Lake B, Cherian T, Milligan J, Sigurdsson A. Poor awareness of symptoms of oesophageal cancer. Interact Cardiovasc Thorac Surg 2010; 12:32-4. [DOI: 10.1510/icvts.2010.247213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Cherian PT, Tentzeris V, Sigurdsson A. Variation of outcome in weight loss with band volume adjustments under clinical and radiological control following laparoscopic adjustable gastric banding. Obes Surg 2009; 20:13-8. [PMID: 19841993 DOI: 10.1007/s11695-009-0003-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 10/06/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Following laparoscopic adjustable gastric banding (LAGB), patients usually undergo follow-up (FU) to optimize weight loss and detect complications, with band-volume adjustment performed either under radiological or clinical guidance with no current consensus on what is the best standard of care. We, therefore, analyzed our patient cohort to identify differences between the two, if any, over a 3-year period. METHODS We retrospectively reviewed our obesity surgery database to find all LAGB patients and grouped them based on method of FU without weight exclusions. We then selected out 70 consecutive patients from each cohort from an arbitrary time-point to achieve sufficient FU and analyzed the results from the data collated. Patients with postoperative complications were excluded to prevent bias. RESULTS From 2003 to 2007, there were 865 LAGB performed in our unit. We identified 70 consecutive patients from January 2004 from each cohort. After review and exclusions, we were left with 50 patients in the radiology group (RG) and 49 in the clinical group (CG) [median BMI 43.8 and 47.1, respectively; median age 43 years in both]. Routine FU was at weekly, then fortnightly, and monthly intervals, but results were analyzed at 3-month intervals until the first year and every 12 months until the third year. The median percentage of excessive weight loss was 22% and 36% at 6 months; 28% and 43% at 12 months; 27% and 47% at 2 years; and 33% and 46% at 3 years in the RG and CG, respectively. There was no difference in difficulties to band fill in either group as per clinical records, although there was a greater incidence of port damage in the CG. CONCLUSIONS Our study suggests that at medium-term follow-up, clinical fill is superior to radiological FU at least in terms of weight loss, with the added benefit of avoiding unnecessary radiation albeit that the difference between the two methods gets smaller with FU beyond 2 years. This topic merits a future randomized control trial to make recommendations without biases inherent to retrospective analysis.
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Affiliation(s)
- P Thomas Cherian
- Shropshire Upper GI and Laparoscopic Surgery Unit, Princess Royal Hospital, Telford, England TF6 1TF, UK.
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