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Article: A review of the best method of leg wound closure following open harvesting of the long saphenous vein for coronary artery bypass grafting.

Panahi, Pedram / Ilyas, Ali Adeeb / Lloyd, Clinton / Marchbank, Adrian / Unsworth-White, Jonathan

Annals of medicine and surgery (2012)

2021 Volume 70, Page(s) 102855

Abstract: Uncertainty exists around the optimal method of leg wound closure following open long saphenous vein harvesting in adults undergoing coronary artery bypass graft surgery (CABG). Such is evident from the variety observed in the closure approach utilised. ... ...

Abstract	Uncertainty exists around the optimal method of leg wound closure following open long saphenous vein harvesting in adults undergoing coronary artery bypass graft surgery (CABG). Such is evident from the variety observed in the closure approach utilised. Consequently, a best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'following open long saphenous vein harvesting in adults undergoing CABG, is single-layer leg wound closure superior to multiple-layer closure in terms of post-operative complications encountered? '. Altogether 382 papers on Ovid Embase and Ovid Medline, 301 papers on PubMed and 11 papers on the Cochrane database were found using the reported search. From the screened articles, 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the best method of leg closure following open saphenous vein harvesting for CABG is single-layer cutaneous closure. The use of a suction drain to eliminate the dead space should be considered on a case-to-case basis by the lead operating surgeon with the patient's characteristics and their own expertise in mind.
Language	English
Publishing date	2021-09-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2021.102855
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Article: Left lower lobe torsion following upper lobectomy-prompt recognition and treatment improve survival.

Alassar, Aiman / Marchbank, Adrian

Journal of surgical case reports

2014 Volume 2014, Issue 8

Abstract: Lobar torsion is a rare but life-threatening complication after lung resection. We report a case of left lower lobe torsion in 57-year-old women after upper lobectomy for underlying lung cancer. Definitive diagnosis of lung torsion was made at ... ...

Abstract	Lobar torsion is a rare but life-threatening complication after lung resection. We report a case of left lower lobe torsion in 57-year-old women after upper lobectomy for underlying lung cancer. Definitive diagnosis of lung torsion was made at exploratory thoracotomy following abnormal chest radiography and bronchoscopy on the first post-operative day. An emergency completion pneumonectomy was performed and left lower lobe was resected. The post-operative course was uncomplicated and patient was discharged home on the seventh post-operative day. Early recognition and prompt treatment of lobar torsion is essential for preventing potentially catastrophic complications including fatal gangrene of the pulmonary lobe.
Language	English
Publishing date	2014-08-11
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rju078
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Article ; Online: What is the value of topical cooling as an adjunct to myocardial protection?

Alassar, Aiman / Bazerbashi, Samer / Moawad, Nader / Marchbank, Adrian

Interactive cardiovascular and thoracic surgery

2014 Volume 19, Issue 5, Page(s) 856–860

Abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'What is the value of topical cooling as an adjunct to myocardial protection?' Using the reported search, 9 papers represented the best ... ...

Abstract	A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'What is the value of topical cooling as an adjunct to myocardial protection?' Using the reported search, 9 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The studies included four randomized controlled trials (RCTs). Two RCTs demonstrated no cardioprotective effects of topical hypothermia as they found no statistically significant differences in myocardial markers between patients with or without topical cooling. In a randomized study of 249 patients undergoing elective cardiac surgery, phrenic nerve injury and failure of extubation occurred more frequently with the use of topical hypothermia with iced slush (P = 0.009 and P = 0.034, respectively). One retrospective analysis found that patients who received iced topical hypothermia had longer postoperative hospitalization, higher incidence of atelectasis and higher left diaphragms on chest X-ray. Another study showed increased morbidity and mortality associated with postoperative diaphragmatic dysfunction resulting from the use of iced slush topical cooling of the heart. We conclude that topical cooling is an unnecessary adjunct to myocardial protection in patients undergoing cardiac surgery. There is no evidence of any additional cardioprotective benefit. Several studies showed that the use of topical hypothermia is associated with phrenic nerve injury, leading to diaphragmatic paralysis and increased pulmonary complications. Moreover, long-term follow-up data showed often incomplete regression of the phrenic nerve paralysis. However, few randomized studies exist on the value of topical cooling as an adjunct to myocardial protection.
MeSH term(s)	Aortic Valve Stenosis/surgery ; Heart Arrest, Induced/methods ; Heart Valve Prosthesis Implantation/methods ; Humans ; Hypothermia, Induced/methods ; Male ; Middle Aged ; Myocardial Ischemia/prevention & control ; Postoperative Complications/prevention & control
Language	English
Publishing date	2014-11
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivu259
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Article ; Online: Gauze-based negative pressure wound therapy to infected deep sternotomy wound complicated by cardiac tamponade: a case report.

Rajakaruna, Chanaka / Marchbank, Adrian

International wound journal

2010 Volume 8, Issue 1, Page(s) 96–98

Abstract: Negative pressure wound therapy is the standard of care for infections after median sternotomy. Foam-based systems are commonly used even in scenarios when the myocardium is exposed. Gauze-based systems have recently gained popularity. We describe a case ...

Abstract	Negative pressure wound therapy is the standard of care for infections after median sternotomy. Foam-based systems are commonly used even in scenarios when the myocardium is exposed. Gauze-based systems have recently gained popularity. We describe a case of deep sternal dehiscence that lead to a life-threatening complication secondary to wound filler choice.
MeSH term(s)	Aged ; Bandages ; Cardiac Tamponade/etiology ; Follow-Up Studies ; Humans ; Male ; Negative-Pressure Wound Therapy/methods ; Staphylococcal Infections/complications ; Staphylococcal Infections/therapy ; Sternotomy/adverse effects ; Surgical Wound Infection/complications ; Surgical Wound Infection/therapy ; Wound Healing
Language	English
Publishing date	2010-09-30
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2170920-8
ISSN	1742-481X ; 1742-4801
ISSN (online)	1742-481X
ISSN	1742-4801
DOI	10.1111/j.1742-481X.2010.00738.x
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Article ; Online: Current practice of antiplatelet and anticoagulation management in post-cardiac surgery patients: a national audit.

Hosmane, Sharath / Birla, Rashmi / Marchbank, Adrian

Interactive cardiovascular and thoracic surgery

2012 Volume 14, Issue 4, Page(s) 474–475

Abstract: The Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery recently published a guideline on antiplatelet and anticoagulation management in cardiac surgery. We aimed to assess the awareness of the current guideline and ... ...

Abstract	The Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery recently published a guideline on antiplatelet and anticoagulation management in cardiac surgery. We aimed to assess the awareness of the current guideline and adherence to it in the National Health Service through this National Audit. We designed a questionnaire consisting of nine questions covering various aspects of antiplatelet and anticoagulation management in post-cardiac surgery patients. A telephonic survey of the on-call cardiothoracic registrars in all the cardiothoracic centres across the UK was performed. All 37 National Health Service hospitals in the UK with 242 consultants providing adult cardiac surgical service were contacted. Twenty (54%) hospitals had a unit protocol for antiplatelet and anticoagulation management in post-cardiac surgery. Only 23 (62.2%) registrars were aware of current European Association for Cardio-Thoracic Surgery guidelines. Antiplatelet therapy is variable in the cardiac surgical units across the country. Low-dose aspirin is commonly used despite the recommendation of 150-300 mg. The loading dose of aspirin within 24 h as recommended by the guideline is followed only by 60.7% of surgeons. There was not much deviation from the guideline with respect to the anticoagulation therapy.
MeSH term(s)	Anticoagulants/therapeutic use ; Awareness ; Cardiac Surgical Procedures/standards ; Clinical Protocols ; Drug Utilization ; Guideline Adherence ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Medical Audit ; Medical Staff, Hospital/standards ; Platelet Aggregation Inhibitors/therapeutic use ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/standards ; State Medicine ; Surveys and Questionnaires ; United Kingdom
Chemical Substances	Anticoagulants ; Platelet Aggregation Inhibitors
Language	English
Publishing date	2012-01-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivr138
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Article ; Online: Occult penetrating trauma mimicking acute coronary syndrome.

Connor, Andrew / Lloyd, Simon / Asopa, Sanjay / Bothma, Nanette / Marchbank, Adrian

The Annals of thoracic surgery

2014 Volume 97, Issue 4, Page(s) 1454

MeSH term(s)	Acute Coronary Syndrome/diagnosis ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Thoracic Injuries/diagnosis ; Wounds, Penetrating/diagnosis
Language	English
Publishing date	2014-04
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2013.09.048
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Article ; Online: Surgical factors associated with new-onset postoperative atrial fibrillation after lung resection: the EPAFT multicentre study.

Crispi, Vassili / Isaac, Emmanuel / Abah, Udo / Shackcloth, Michael / Lopez, Eileen / Eadington, Thomas / Taylor, Marcus / Kandadai, Rammohan / Marshall, Neil R / Gurung, Anil / Rogers, Luke J / Marchbank, Adrian / Qadri, Suhail / Loubani, Mahmoud

Postgraduate medical journal

2020 Volume 98, Issue 1157, Page(s) 177–182

Abstract: Purpose of the study: Postoperative atrial fibrillation (POAF) is a recognised complication in approximately 10% of major lung resections. In order to best target preoperative treatment, this study aimed at determining the association of incidence of ... ...

Abstract	Purpose of the study: Postoperative atrial fibrillation (POAF) is a recognised complication in approximately 10% of major lung resections. In order to best target preoperative treatment, this study aimed at determining the association of incidence of POAF in patients undergoing lung resection to surgical and anatomical factors, such as surgical approach, extent of resection and laterality. Study design: Evaluation of Post-operative Atrial Fibrillation in Thoracic surgery (EPAFT): a multicentre, population-based, retrospective, cross-sectional, observational study including 1367 patients undergoing lung resections between April 2016 and March 2017. The primary outcome was the presence of POAF following resection. POAF was defined as at least one episode of symptomatic or asymptomatic AF confirmed by ECG within 7 days from the thoracic procedure or prior to discharge from the hospital. Results: POAF was observed in 7.4% of patients: 3.1% in minor resection (video-assisted thoracoscopic surgery (VATS): 2.5%; thoracotomy: 3.8%), 9.0% in simple lobectomy (VATS: 7.3%, thoracotomy: 9.9%), 6.0% in complex resection (thoracotomy: 6.3%) and 11.4% in pneumonectomy. POAF was higher in left (4.0%) vs right (2.4%) minor resections, and in left (9.9%) vs right (8.3%) lobectomy, but higher in right (7.5%) complex resections, and the highest in right pneumonectomy (17.6%). No significant variations were observed as per sex, laterality or resected lobes. A positive univariable and multivariable association was observed for increasing age and increasing extent of resection, but not thoracotomy. Median (Q1-Q3) hospital stay was 9 (7-14) days in POAF and 5 (4-7) days in non-AF patients (p<0.001), with an increased cerebrovascular accident burden (p<0.001) and long-term mortality (p<0.001). Conclusions: Among patients undergoing lung resection, POAF was significantly associated with age, increasing invasiveness of approach and increasing extent of resection. In addition, POAF carried a significant long-term mortality rate and burden of cerebrovascular accident. Appropriate prophylaxis should be targeted at these groups.
MeSH term(s)	Atrial Fibrillation/epidemiology ; Atrial Fibrillation/etiology ; Cross-Sectional Studies ; Humans ; Lung ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Retrospective Studies ; Risk Factors ; Thoracic Surgery, Video-Assisted/methods
Language	English
Publishing date	2020-12-11
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2020-138904
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Article: Prevalence and outcome of central airway obstruction in patients with lung cancer.

Daneshvar, Cyrus / Falconer, William Euan / Ahmed, Mohammed / Sibly, Abdul / Hindle, Madeleine / Nicholson, Thomas W / Aldik, Ghanem / Telisinghe, Lilanganee A / Riordan, Richard D / Marchbank, Adrian / Breen, David

BMJ open respiratory research

2019 Volume 6, Issue 1, Page(s) e000429

Abstract: Introduction: Central airway obstruction (CAO) is a life-threatening complication of lung cancer. The prevalence of CAO in lung cancer patients is unknown. We audited CAO burden to inform our local cancer service.: Methods: This is a cohort review of ...

Abstract	Introduction: Central airway obstruction (CAO) is a life-threatening complication of lung cancer. The prevalence of CAO in lung cancer patients is unknown. We audited CAO burden to inform our local cancer service. Methods: This is a cohort review of all new lung cancer diagnoses between 1 November 2014 and 30 November 2015. CAO was defined by CT appearance. CT scans and routine patient records were followed up to 30 November 2018 to determine the prevalence of CAO at diagnosis; the characteristics of patients with prevalent CAO; mortality (using survival analysis); and incident CAO over follow-up. Results: Of 342 new lung cancer diagnoses, CAO prevalence was 13% (95% CI 10% to 17%; n=45/342). Dedicated CT scan review identified missed CAO in 14/45 (31%) cases. In patients with prevalent CAO, 27/44 (61%) had a performance status of ≤2, 23/45 (51%) were diagnosed during an acute admission and 36/44 (82%) reported symptoms. Treatments were offered to 32/45 (71%); therapeutic bronchoscopy was performed in only 8/31 (26%) eligible patients. Median survival of patients with prevalent CAO was 94 (IQR 33-274) days. Multivariate analysis, adjusting for age, gender and disease stage, found CAO on index CT scan was independently associated with an increased hazard of death (adjusted HR 1.78 (95% CI 1.27 to 2.48); p=0.001). In total, 15/297 (5%) developed CAO during follow-up (median onset 340 (IQR 114-551) days). Over the audit period, 60/342 (18%; 95% CI 14% to 22%) had or developed CAO. Discussions: This is the first description of CAO prevalence in 40 years. Patients with prevalent CAO had a higher mortality. Our data provide a benchmark for service planning.
MeSH term(s)	Aged ; Aged, 80 and over ; Airway Obstruction/diagnosis ; Airway Obstruction/epidemiology ; Airway Obstruction/etiology ; Airway Obstruction/therapy ; Bronchoscopy/statistics & numerical data ; Cost of Illness ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kaplan-Meier Estimate ; Lung Neoplasms/complications ; Lung Neoplasms/mortality ; Male ; Middle Aged ; Prevalence ; United Kingdom/epidemiology
Language	English
Publishing date	2019-09-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2736454-9
ISSN	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2019-000429
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Article: Cardiopulmonary bypass without ischemic arrest: a myocardial protection strategy for high-risk patients requiring urgent CABG.

Akowuah, Enoch / Allen, Simon / Marchbank, Adrian

Journal of cardiac surgery

2006 Volume 21, Issue 5, Page(s) 496–497

Abstract: For patients requiring emergency coronary artery revascularization, mortality remains high. One of the primary reasons is poor functional and metabolic recovery of the myocardium after ischemic arrest. We describe a hybrid of the off-pump and on-pump ... ...

Abstract	For patients requiring emergency coronary artery revascularization, mortality remains high. One of the primary reasons is poor functional and metabolic recovery of the myocardium after ischemic arrest. We describe a hybrid of the off-pump and on-pump techniques to avoid ischemic arrest during coronary revascularization for this high-risk group.
MeSH term(s)	Aged ; Coronary Artery Bypass/methods ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease/surgery ; Heart Arrest/etiology ; Heart Arrest/prevention & control ; Heart Arrest, Induced/adverse effects ; Humans ; Middle Aged ; Myocardial Infarction/surgery ; Myocardial Reperfusion Injury/etiology ; Myocardial Reperfusion Injury/prevention & control ; Risk Factors ; Survival Analysis ; Treatment Outcome
Language	English
Publishing date	2006-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/j.1540-8191.2006.00254.x
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Article ; Online: Early Video-assisted Thoracoscopic Surgery or Intrapleural Enzyme Therapy in Pleural Infection: A Feasibility Randomized Controlled Trial. The Third Multicenter Intrapleural Sepsis Trial-MIST-3.

Bedawi, Eihab O / Stavroulias, Dionisios / Hedley, Emma / Blyth, Kevin G / Kirk, Alan / De Fonseka, Duneesha / Edwards, John G / Internullo, Eveline / Corcoran, John P / Marchbank, Adrian / Panchal, Rakesh / Caruana, Edward / Kadwani, Owais / Okiror, Lawrence / Saba, Tarek / Purohit, Manoj / Mercer, Rachel M / Taberham, Rhona / Kanellakis, Nikolaos /

American journal of respiratory and critical care medicine

2023 Volume 208, Issue 12, Page(s) 1305–1315

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Humans ; Thoracic Surgery, Video-Assisted/adverse effects ; Feasibility Studies ; Communicable Diseases/etiology ; Pleural Diseases ; Sepsis/drug therapy ; Sepsis/surgery ; Sepsis/etiology ; Enzyme Therapy
Language	English
Publishing date	2023-10-11
Publishing country	United States
Document type	Randomized Controlled Trial ; Clinical Trial, Phase III ; Multicenter Study ; Journal Article
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202305-0854OC
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