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Valerie W Rusch - One of the best experts on this subject based on the ideXlab platform.
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a phase iii randomized trial of Pleurectomy decortication plus chemotherapy with or without adjuvant hemithoracic intensity modulated pleural radiation therapy imprint for malignant pleural mesothelioma mpm nrg lu 006
Journal of Clinical Oncology, 2020Co-Authors: Andreas Rimner, Valerie W Rusch, Marjorie G Zauderer, Charles B Simone, E Yorke, Ritu R Gill, Ranh K Voong, Tobias Peikert, Mingsound Tsao, Jeffrey D BradleyAbstract:TPS9079Background: Pleurectomy/Decortication (P/D) with neoadjuvant or adjuvant chemotherapy has become a common lung-sparing surgical approach for MPM. Adjuvant hemithoracic IMPRINT was developed ...
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association of bap1 alterations with malignant pleural mesothelioma treated with trimodality therapy
Journal of Clinical Oncology, 2019Co-Authors: Marjorie G Zauderer, Valerie W Rusch, Hira Rizvi, Mariel Duboff, Prasad S Adusumilli, Jennifer L Sauter, Marc Ladanyi, Andreas RimnerAbstract:8552Background: Trimodality therapy with Pleurectomy/decortication, cytotoxic chemotherapy, and adjuvant pleural intensity modulated radiation therapy (IMPRINT) is an emerging standard of care for ...
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extrapleural pneumonectomy and extended Pleurectomy decortication for malignant pleural mesothelioma the memorial sloan kettering cancer center approach
Annals of cardiothoracic surgery, 2012Co-Authors: Valerie W RuschAbstract:Surgical management for malignant pleural mesothelioma (MPM) remains controversial, but because of the limitations of radiation and chemotherapy in this disease, surgery is still an important part of treatment for these patients (1-13). Operations for MPM can be categorized as those performed with either palliative or curative intent. Palliative procedures such as video-assisted thoracoscopy surgery (VATS) and talc pleurodesis control pleural effusions in patients whose overall medical condition precludes definitive resection (14). In such cases, thoracotomy and partial Pleurectomy is indicated only when the pleural effusion is loculated and cannot be evacuated by VATS. Curative intent operations include extrapleural pneumonectomy (EPP) and extended Pleurectomy/decortication (P/D). This article provides a brief review of preoperative evaluation and the surgical technique for EPP and P/D (15-17).
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extrapleural pneumonectomy versus Pleurectomy decortication in the surgical management of malignant pleural mesothelioma results in 663 patients
The Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Raja M Flores, Joseph Dycoco, Venkatraman E. Seshan, Maureen F. Zakowski, Manjit S Bains, Michele Carbone, Harvey I. Pass, Valerie W RuschAbstract:OBJECTIVE: The optimal procedure for resection of malignant pleural mesothelioma is controversial, partly because previous analyses include small numbers of patients. We performed a multi-institutional study to increase statistical power to detect significant differences in outcome between extrapleural pneumonectomy and Pleurectomy/decortication. METHODS: Patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy or Pleurectomy/decortication at 3 institutions were identified. Survival and prognostic factors were analyzed by the Kaplan-Meier method, log-rank test, and Cox proportional hazards analysis. RESULTS: From 1990 to 2006, 663 consecutive patients (538 men and 125 women) underwent resection. The median age was 63 years (range, 26-93 years). The operative mortality was 7% for extrapleural pneumonectomy (n = 27/385) and 4% for Pleurectomy/decortication (n = 13/278). Significant survival differences were seen for American Joint Committee on Cancer stages 1 to 4 (P < .001), epithelioid versus non-epithelioid histology (P < .001), extrapleural pneumonectomy versus Pleurectomy/decortication (P < .001), multimodality therapy versus surgery alone (P < .001), and gender (P < .001). Multivariate analysis demonstrated a hazard rate of 1.4 for extrapleural pneumonectomy (P < .001) controlling for stage, histology, gender, and multimodality therapy. CONCLUSION: Patients who underwent Pleurectomy/decortication had a better survival than those who underwent extrapleural pneumonectomy; however, the reasons are multifactorial and subject to selection bias. At present, the choice of resection should be tailored to the extent of disease, patient comorbidities, and type of multimodality therapy planned.
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extrapleural pneumonectomy versus Pleurectomy decortication in the surgical management of malignant pleural mesothelioma results in 663 patients
The Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Raja M Flores, Joseph Dycoco, Venkatraman E. Seshan, Maureen F. Zakowski, Manjit S Bains, Michele Carbone, Harvey I. Pass, Valerie W RuschAbstract:Objective The optimal procedure for resection of malignant pleural mesothelioma is controversial, partly because previous analyses include small numbers of patients. We performed a multi-institutional study to increase statistical power to detect significant differences in outcome between extrapleural pneumonectomy and Pleurectomy/decortication. Methods Patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy or Pleurectomy/decortication at 3 institutions were identified. Survival and prognostic factors were analyzed by the Kaplan–Meier method, log-rank test, and Cox proportional hazards analysis. Results From 1990 to 2006, 663 consecutive patients (538 men and 125 women) underwent resection. The median age was 63 years (range, 26–93 years). The operative mortality was 7% for extrapleural pneumonectomy (n = 27/385) and 4% for Pleurectomy/decortication (n = 13/278). Significant survival differences were seen for American Joint Committee on Cancer stages 1 to 4 ( P P P P P P Conclusion Patients who underwent Pleurectomy/decortication had a better survival than those who underwent extrapleural pneumonectomy; however, the reasons are multifactorial and subject to selection bias. At present, the choice of resection should be tailored to the extent of disease, patient comorbidities, and type of multimodality therapy planned.
Florian Augustin - One of the best experts on this subject based on the ideXlab platform.
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vats partial Pleurectomy versus vats pleural abrasion significant reduction in pneumothorax recurrence rates after Pleurectomy
World Journal of Surgery, 2018Co-Authors: Herbert Maier, Florian Kocher, Silvia Jud, Paolo Lucciarini, Dietmar Ofner, Thomas Schmid, Florian AugustinAbstract:Surgical treatment of primary spontaneous pneumothorax (PSP) usually consists of bullectomy and any form of pleurodesis to reduce risk of disease recurrence. Whether Pleurectomy is superior to pleural abrasion is still a matter of debate with recurrence rates especially high when performed with a video-assisted thoracoscopic (VATS) approach. Aim of this study was to compare the efficacy of the two methods in prevention of recurrence of pneumothorax in a minimally invasive setting. Between 01/2005 and 12/2015, 107 patients younger than 40 years with PSP underwent VATS bullectomy and either partial Pleurectomy or pleural abrasion. Medical records of patients were reviewed retrospectively. Pleural abrasion was performed in 34/107 patients, 73/107 patients underwent partial Pleurectomy. There were no statistically significant differences in age, sex, body mass index or smoking history at time of surgery. There was no significant difference in major postoperative complications (p = 0.3022). Nine (8.4%) patients had a recurrence of pneumothorax during follow-up. Incidence of recurrence in those undergoing pleural abrasion was significantly higher than those undergoing apical Pleurectomy (8/34 vs. 1/73, p < 0.001). Surgical technique was the only factor associated with a recurrence of PSP after surgical intervention. In our analysis, a VATS partial Pleurectomy proved to be effective for prevention of recurrent PSP. Recurrence rates were low despite a minimally invasive approach and significantly lower than in the pleural abrasion group. According to these findings, VATS Pleurectomy might be considered as the primary choice for surgical pleurodesis in patients with PSP.
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VATS Partial Pleurectomy Versus VATS Pleural Abrasion: Significant Reduction in Pneumothorax Recurrence Rates After Pleurectomy.
World journal of surgery, 2018Co-Authors: Herbert Maier, Florian Kocher, Silvia Jud, Paolo Lucciarini, Dietmar Ofner, Thomas Schmid, Florian AugustinAbstract:Surgical treatment of primary spontaneous pneumothorax (PSP) usually consists of bullectomy and any form of pleurodesis to reduce risk of disease recurrence. Whether Pleurectomy is superior to pleural abrasion is still a matter of debate with recurrence rates especially high when performed with a video-assisted thoracoscopic (VATS) approach. Aim of this study was to compare the efficacy of the two methods in prevention of recurrence of pneumothorax in a minimally invasive setting. Between 01/2005 and 12/2015, 107 patients younger than 40 years with PSP underwent VATS bullectomy and either partial Pleurectomy or pleural abrasion. Medical records of patients were reviewed retrospectively. Pleural abrasion was performed in 34/107 patients, 73/107 patients underwent partial Pleurectomy. There were no statistically significant differences in age, sex, body mass index or smoking history at time of surgery. There was no significant difference in major postoperative complications (p = 0.3022). Nine (8.4%) patients had a recurrence of pneumothorax during follow-up. Incidence of recurrence in those undergoing pleural abrasion was significantly higher than those undergoing apical Pleurectomy (8/34 vs. 1/73, p
Harish Mithiran - One of the best experts on this subject based on the ideXlab platform.
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Video-Assisted Thoracic Surgery (VATS) Talc Pleurodesis Versus Pleurectomy for Primary Spontaneous Pneumothorax: A Large Single-Centre Study with No Conversion
World Journal of Surgery, 2019Co-Authors: Harish Mithiran, Lowell Leow, Kingsfield Ong, Terence Liew, Daveraj Siva, Shen Liang, John Kit Chung TamAbstract:Background Primary spontaneous pneumothorax (PSP) is a relatively common clinical entity with high incidence in the young population. Video-Assisted Thoracic Surgery (VATS) bullectomy and chemical or mechanical pleurodesis are two primary modalities of treatment. There has been much debate on the ideal mode of pleurodesis, but the literature on surgical outcomes comparing VATS Pleurectomy with talc pleurodesis has been inconclusive. Methods We performed a single-centre 5-year observational retrospective study of 202 patients who underwent VATS bullectomy with talc pleurodesis or parietal Pleurectomy. Results There were no significant differences in the demographics, pre-operative and intra-operative characteristics in both groups. Recurrence of pneumothorax, chest tube duration and hospital stay were similar in both groups. However, talc pleurodesis had a shorter operative time compared to Pleurectomy. Conclusion Our study demonstrated comparable outcomes between talc pleurodesis and Pleurectomy following VATS bullectomy for patients with PSP.
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video assisted thoracic surgery vats talc pleurodesis versus Pleurectomy for primary spontaneous pneumothorax a large single centre study with no conversion
World Journal of Surgery, 2019Co-Authors: Harish Mithiran, Lowell Leow, Kingsfield Ong, Terence Liew, Daveraj Siva, Shen Liang, John TamAbstract:Primary spontaneous pneumothorax (PSP) is a relatively common clinical entity with high incidence in the young population. Video-Assisted Thoracic Surgery (VATS) bullectomy and chemical or mechanical pleurodesis are two primary modalities of treatment. There has been much debate on the ideal mode of pleurodesis, but the literature on surgical outcomes comparing VATS Pleurectomy with talc pleurodesis has been inconclusive. We performed a single-centre 5-year observational retrospective study of 202 patients who underwent VATS bullectomy with talc pleurodesis or parietal Pleurectomy. There were no significant differences in the demographics, pre-operative and intra-operative characteristics in both groups. Recurrence of pneumothorax, chest tube duration and hospital stay were similar in both groups. However, talc pleurodesis had a shorter operative time compared to Pleurectomy. Our study demonstrated comparable outcomes between talc pleurodesis and Pleurectomy following VATS bullectomy for patients with PSP.
Herbert Maier - One of the best experts on this subject based on the ideXlab platform.
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vats partial Pleurectomy versus vats pleural abrasion significant reduction in pneumothorax recurrence rates after Pleurectomy
World Journal of Surgery, 2018Co-Authors: Herbert Maier, Florian Kocher, Silvia Jud, Paolo Lucciarini, Dietmar Ofner, Thomas Schmid, Florian AugustinAbstract:Surgical treatment of primary spontaneous pneumothorax (PSP) usually consists of bullectomy and any form of pleurodesis to reduce risk of disease recurrence. Whether Pleurectomy is superior to pleural abrasion is still a matter of debate with recurrence rates especially high when performed with a video-assisted thoracoscopic (VATS) approach. Aim of this study was to compare the efficacy of the two methods in prevention of recurrence of pneumothorax in a minimally invasive setting. Between 01/2005 and 12/2015, 107 patients younger than 40 years with PSP underwent VATS bullectomy and either partial Pleurectomy or pleural abrasion. Medical records of patients were reviewed retrospectively. Pleural abrasion was performed in 34/107 patients, 73/107 patients underwent partial Pleurectomy. There were no statistically significant differences in age, sex, body mass index or smoking history at time of surgery. There was no significant difference in major postoperative complications (p = 0.3022). Nine (8.4%) patients had a recurrence of pneumothorax during follow-up. Incidence of recurrence in those undergoing pleural abrasion was significantly higher than those undergoing apical Pleurectomy (8/34 vs. 1/73, p < 0.001). Surgical technique was the only factor associated with a recurrence of PSP after surgical intervention. In our analysis, a VATS partial Pleurectomy proved to be effective for prevention of recurrent PSP. Recurrence rates were low despite a minimally invasive approach and significantly lower than in the pleural abrasion group. According to these findings, VATS Pleurectomy might be considered as the primary choice for surgical pleurodesis in patients with PSP.
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VATS Partial Pleurectomy Versus VATS Pleural Abrasion: Significant Reduction in Pneumothorax Recurrence Rates After Pleurectomy.
World journal of surgery, 2018Co-Authors: Herbert Maier, Florian Kocher, Silvia Jud, Paolo Lucciarini, Dietmar Ofner, Thomas Schmid, Florian AugustinAbstract:Surgical treatment of primary spontaneous pneumothorax (PSP) usually consists of bullectomy and any form of pleurodesis to reduce risk of disease recurrence. Whether Pleurectomy is superior to pleural abrasion is still a matter of debate with recurrence rates especially high when performed with a video-assisted thoracoscopic (VATS) approach. Aim of this study was to compare the efficacy of the two methods in prevention of recurrence of pneumothorax in a minimally invasive setting. Between 01/2005 and 12/2015, 107 patients younger than 40 years with PSP underwent VATS bullectomy and either partial Pleurectomy or pleural abrasion. Medical records of patients were reviewed retrospectively. Pleural abrasion was performed in 34/107 patients, 73/107 patients underwent partial Pleurectomy. There were no statistically significant differences in age, sex, body mass index or smoking history at time of surgery. There was no significant difference in major postoperative complications (p = 0.3022). Nine (8.4%) patients had a recurrence of pneumothorax during follow-up. Incidence of recurrence in those undergoing pleural abrasion was significantly higher than those undergoing apical Pleurectomy (8/34 vs. 1/73, p
John Kit Chung Tam - One of the best experts on this subject based on the ideXlab platform.
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Video-Assisted Thoracic Surgery (VATS) Talc Pleurodesis Versus Pleurectomy for Primary Spontaneous Pneumothorax: A Large Single-Centre Study with No Conversion
World Journal of Surgery, 2019Co-Authors: Harish Mithiran, Lowell Leow, Kingsfield Ong, Terence Liew, Daveraj Siva, Shen Liang, John Kit Chung TamAbstract:Background Primary spontaneous pneumothorax (PSP) is a relatively common clinical entity with high incidence in the young population. Video-Assisted Thoracic Surgery (VATS) bullectomy and chemical or mechanical pleurodesis are two primary modalities of treatment. There has been much debate on the ideal mode of pleurodesis, but the literature on surgical outcomes comparing VATS Pleurectomy with talc pleurodesis has been inconclusive. Methods We performed a single-centre 5-year observational retrospective study of 202 patients who underwent VATS bullectomy with talc pleurodesis or parietal Pleurectomy. Results There were no significant differences in the demographics, pre-operative and intra-operative characteristics in both groups. Recurrence of pneumothorax, chest tube duration and hospital stay were similar in both groups. However, talc pleurodesis had a shorter operative time compared to Pleurectomy. Conclusion Our study demonstrated comparable outcomes between talc pleurodesis and Pleurectomy following VATS bullectomy for patients with PSP.