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1.
J Thorac Cardiovasc Surg ; 160(4): e237-e238, 2020 10.
Article in English | MEDLINE | ID: covidwho-1382590
2.
J Surg Oncol ; 123(7): 1633-1639, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1122192

ABSTRACT

BACKGROUND: For patients with bilateral pulmonary metastases, staged resections have historically been the preferred surgical intervention. During the spring of 2020, the COVID-19 pandemic made patient travel to the hospital challenging and necessitated reduction in operative volume so that resources could be conserved. We report our experience with synchronous bilateral metastasectomies for the treatment of disease in both lungs. METHODS: Patients with bilateral pulmonary metastases who underwent simultaneous bilateral resections were compared with a cohort of patients who underwent staged resections. We used nearest-neighbor propensity score (1:1) matching to adjust for confounders. Perioperative outcomes were compared between groups using paired statistical analysis techniques. RESULTS: Between 1998 and 2020, 36 patients underwent bilateral simultaneous metastasectomies. We matched 31 pairs of patients. The length of stay was significantly shorter in patients undergoing simultaneous resection (median 3 vs. 8 days, p < .001) and operative time was shorter (156 vs. 235.5 min, p < .001) when compared to the sum of both procedures in the staged group. The groups did not significantly differ with regard to postoperative complications. CONCLUSION: In a carefully selected patient population, simultaneous bilateral metastasectomy is a safe option. A single procedure confers benefits for both the patient as well as the hospital resource system.


Subject(s)
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Adolescent , Adult , Aged , Colorectal Neoplasms/pathology , Female , Humans , Lung Neoplasms/pathology , Male , Metastasectomy/methods , Middle Aged , Neoplasm Staging , Pneumonectomy/methods , Retrospective Studies , Thoracic Surgery, Video-Assisted/methods , Thoracotomy/methods
3.
Ann Thorac Surg ; 111(4): 1102-1110, 2021 04.
Article in English | MEDLINE | ID: covidwho-1046575

ABSTRACT

As part of the response to the coronavirus disease 2019 (COVID-19) pandemic, cardiothoracic training programs quickly transitioned midinterview season toward a virtual format. This monumental and rapid undertaking led to the adoption of novel virtual interviewing techniques, many of which have been developed and partially rolled out by other specialties for years. The COVID-19 pandemic is still here, and when the end will be in sight is unclear. However, most, if not all, of the novel interview techniques that were rapidly adopted by cardiothoracic training programs during the 2020 interview season will continue to be relevant even after the pandemic and need for social distancing subsides. In this literature review, we highlight techniques that can be used by cardiothoracic training programs to virtually showcase their attributes and strengths to give applicants as realistic of a view of the program as possible. Such efforts include developing and emphasizing a social media presence, expanding information within training program websites, broadcasting virtual educational content, and creating virtual tours. In addition, we will review approaches toward structuring a virtual interview day to provide candidates with a deeper glimpse into the inner workings of the program. We can use this opportunity provided by the COVID-19 pandemic to develop innovative methods of conducting fellowship interviews that may persist long into the future, as we consider limitations historically caused by finances, scheduling, clinical responsibilities, and family needs.


Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate/methods , Internship and Residency/methods , Pandemics , Thoracic Surgery/education , Virtual Reality , Humans
4.
J Thorac Cardiovasc Surg ; 2020 Sep 18.
Article in English | MEDLINE | ID: covidwho-783340
5.
Ann Thorac Surg ; 110(2): 692-696, 2020 08.
Article in English | MEDLINE | ID: covidwho-701363

ABSTRACT

The extraordinary demands of managing the COVID-19 pandemic has disrupted the world's ability to care for patients with thoracic malignancies. As a hospital's COVID-19 population increases and hospital resources are depleted, the ability to provide surgical care is progressively restricted, forcing surgeons to prioritize among their cancer populations. Representatives from multiple cancer, surgical, and research organizations have come together to provide a guide for triaging patients with thoracic malignancies as the impact of COVID-19 evolves as each hospital.


Subject(s)
Coronavirus Infections/epidemiology , Medical Oncology/organization & administration , Pneumonia, Viral/epidemiology , Thoracic Neoplasms/surgery , Thoracic Surgery/organization & administration , Triage , Betacoronavirus , COVID-19 , Consensus , Humans , Pandemics , SARS-CoV-2 , Thoracic Surgical Procedures
6.
J Thorac Cardiovasc Surg ; 161(3): 758-759, 2021 03.
Article in English | MEDLINE | ID: covidwho-693989
7.
Ann Surg ; 272(2): e106-e111, 2020 08.
Article in English | MEDLINE | ID: covidwho-647430

ABSTRACT

OBJECTIVE: To summarize the multi-specialty strategy and initial guidelines of a Case Review Committee in triaging oncologic surgery procedures in a large Comprehensive Cancer Center and to outline current steps moving forward after the initial wave. SUMMARY OF BACKGROUND DATA: The impetus for strategic rescheduling of operations is multifactorial and includes our societal responsibility to minimize COVID-19 exposure risk and propagation among patients, the healthcare workforce, and our community at large. Strategic rescheduling is also driven by the need to preserve limited resources. As many states have already or are considering to re-open and relax stay-at-home orders, there remains a continued need for careful surgical scheduling because we must face the reality that we will need to co-exist with COVID-19 for months, if not years. METHODS: The quality officers, chairs, and leadership of the 9 surgical departments in our Division of Surgery provide specialty-specific approaches to appropriately triage patients. RESULTS: We present the strategic approach for surgical rescheduling during and immediately after the COVID-19 first wave for the 9 departments in the Division of Surgery at The University of Texas MD Anderson Cancer Center in Houston, Texas. CONCLUSIONS: Cancer surgeons should continue to use their oncologic knowledge to determine the window of opportunity for each surgical procedure, based on tumor biology, preoperative treatment sequencing, and response to systemic therapy, to safely guide patients through this cautious recovery phase.


Subject(s)
Appointments and Schedules , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Surgical Oncology/trends , Betacoronavirus , COVID-19 , Decision Making , Humans , Pandemics , Patient Selection , SARS-CoV-2 , Texas/epidemiology , Triage
8.
Ann Thorac Surg ; 110(6): 2107, 2020 12.
Article in English | MEDLINE | ID: covidwho-343489
10.
J Thorac Cardiovasc Surg ; 160(2): 601-605, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-46092

ABSTRACT

The extraordinary demands of managing the COVID-19 pandemic has disrupted the world's ability to care for patients with thoracic malignancies. As a hospital's COVID-19 population increases and hospital resources are depleted, the ability to provide surgical care is progressively restricted, forcing surgeons to prioritize among their cancer populations. Representatives from multiple cancer, surgical, and research organizations have come together to provide a guide for triaging patients with thoracic malignancies as the impact of COVID-19 evolves as each hospital.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/therapy , Delivery of Health Care, Integrated/organization & administration , Pneumonia, Viral/therapy , Thoracic Neoplasms/surgery , Thoracic Surgical Procedures , Triage/organization & administration , COVID-19 , Clinical Decision-Making , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Health Services Needs and Demand/organization & administration , Host Microbial Interactions , Humans , Needs Assessment/organization & administration , Occupational Health , Pandemics , Patient Safety , Patient Selection , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Risk Assessment , Risk Factors , SARS-CoV-2 , Thoracic Neoplasms/epidemiology , Thoracic Surgical Procedures/adverse effects , Time-to-Treatment
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