The mean age of these patients was 29.7 +/- 10.8 years (range, 15.3-46.5 years). The mean aortic crossclamp time was 126 +/- 11 minutes (range, 110-142 minutes). The mean follow-up was 4 +/- 1.4 years (range 1.7-5.8 years).
Results: No perioperative deaths were observed, and all patients are alive and doing well. No significant autograft regurgitation was recorded during follow-up. The mean diameters of the autograft annulus and the neosinus of Valsalva were 23.3 +/- 2.6 mm and 32.6 +/- 3.3 mm, respectively, at discharge,
and 24.0 +/- 1.9 mm and 33.6 +/- 3.3 mm, respectively, at the last control (P LY2090314 = .32 and P = .08, respectively).
Conclusion: These results support that this technical modification of the Ross operation might be proposed for patients at risk of autograft dilatation when an inclusion technique is not feasible. (J selleckchem Thorac Cardiovasc Surg 2010;139:1420-3)”
“Objective: The mortality of pneumonectomy after chemotherapy or chemoradiotherapy for locally advanced non-small-cell lung cancer is reported to be as high as 26%. We retrospectively reviewed the medical records of patients undergoing these procedures in 2 specialized thoracic
centers to determine the outcome.
Methods: Retrospective analyses were performed of all patients who underwent pneumonectomy after neoadjuvant chemotherapy or chemoradiotherapy for locally advanced non-small-cell lung cancer from 1998 to 2007. Presurgical treatment consisted of 3-4 platin-based doublets alone in 20% of patients or combined with radiotherapy (45Gy) to the tumor
and mediastinum in 80% of patients.
Results: Of 827 patients who underwent neoadjuvant therapy, 176 pneumonectomies were performed, including 138 (78%) extended resections. Post-induction pathologic stages were 0 in 36 patients (21%), I in 33 patients (19%), II in 38 patients (21%), III in 57 patients (32%), and IV in 12 patients (7%). Three patients died of pulmonary embolism, 2 patients of respiratory failure, and 1 patient of cardiac failure, resulting in a 90 postoperative day mortality rate of 3%; 23 major complications occurred in 22 patients (13%). For the overall population, 3-year survival was 43% and 5-year survival INCB018424 ic50 was 38%.
Conclusion: Pneumonectomy after neoadjuvant therapy for non-small-cell lung cancer can be performed with a perioperative mortality rate of 3%. Thus, the need of a pneumonectomy for complete resection alone should not be a reason to exclude patients from a potentially curative procedure if done in an experienced center. The 5-year survival of 38%, which can be achieved, justifies extended surgery within a multimodality concept for selected patients with locally advanced non-small-cell lung cancer.