ABSTRACT
@#Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.
ABSTRACT
@#This study reports the surgical treatment of a female patient at age of 64 years with novel coronavirus (SARS-CoV-2) latent infection complicated with esophageal foreign body perforation with no significant changes in the lung CT. The patient was confirmed as SARS-CoV-2 infection on the 4th day after surgery and then was transferred into the Department of Infectious Disease in our hospital for treatment. This case has guiding value for the operation of thoracic surgery during the outbreak of novel coronavirus pneumonia.
ABSTRACT
The association between atrial fibrillation (AF) after coronary artery bypass grafting (CABG) and the surgical techniques selected has been extensively reported.However,no consistent results were obtained.In the present study,a meta-analysis was conducted by searching the electronic databases PubMed,Embase,Web of Science,and Cochrane to identify the association of post-CABG AF with on-pump (conventional CABG,cCABG) or off-pump CABG (OPCABG).Outcomes from randomized clinical trials (RCTs) and propensity score matching (PSM) trials were pooled by using the fixed-effect or the random-effect modeling method,and verified by the quality-effect modeling method.There were 35 studies with 36 independent reports that met the inclusion criteria and were eventually included in our meta-analysis.The total odds ratio (OR) of the incidence of post-CABG AF between OPCABG and cCABG was 0.80 (95％ CI 0.71-0.91).The 25 randomized clinical trials (RCTs) had an OR of 0.69 (95％ CI 0.56-0.86),while the OR of the 11 PSM trials was 0.88 (95％ CI 0.77-1.00).Twenty-six studies involving the patients at a mean age no more than 65 years showed an OR of 0.76 (95％ CI 0.64-0.90),whereas 10 studies with patients greater than 65 years old showed an OR of 0.90 (95％ CI 0.78-1.05).The results of this meta-analysis suggest that OPCAB surgery may reduce the incidence of post-CABG AF when compared to cCABG and that younger patients may benefit more from OPCAB and have a lower incidence ofpost-CABG AF.