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  1. Article ; Online: Minimal-Access Coronary Revascularization: Past, Present, and Future.

    Purmessur, Rushmi / Wijesena, Tharushi / Ali, Jason

    Journal of cardiovascular development and disease

    2023  Volume 10, Issue 8

    Abstract: Minimal-access cardiac surgery appears to be the future. It is increasingly desired by cardiologists and demanded by patients who perceive superiority. Minimal-access coronary artery revascularisation has been increasingly adopted throughout the world. ... ...

    Abstract Minimal-access cardiac surgery appears to be the future. It is increasingly desired by cardiologists and demanded by patients who perceive superiority. Minimal-access coronary artery revascularisation has been increasingly adopted throughout the world. Here, we review the history of minimal-access coronary revascularization and see that it is almost as old as the history of cardiac surgery. Modern minimal-access coronary revascularization takes a variety of forms-namely minimal-access direct coronary artery bypass grafting (MIDCAB), hybrid coronary revascularisation (HCR), and totally endoscopic coronary artery bypass grafting (TECAB). It is noteworthy that there is significant variation in the nomenclature and approaches for minimal-access coronary surgery, and this truly presents a challenge for comparing the different methods. However, these approaches are increasing in frequency, and proponents demonstrate clear advantages for their patients. The challenge that remains, as for all areas of surgery, is demonstrating the superiority of these techniques over tried and tested open techniques, which is very difficult. There is a paucity of randomised controlled trials to help answer this question, and the future of minimal-access coronary revascularisation, to some extent, is dependent on such trials. Thankfully, some are underway, and the results are eagerly anticipated.
    Language English
    Publishing date 2023-07-31
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2777082-5
    ISSN 2308-3425 ; 2308-3425
    ISSN (online) 2308-3425
    ISSN 2308-3425
    DOI 10.3390/jcdd10080326
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Trans-fissure and trans-lobar coil insertion technique for small lesions positioned inside the fissure.

    Purmessur, Rushmi / Waugh, James / Crawford, Michael / Kouritas, Vasileios

    Updates in surgery

    2023  Volume 75, Issue 8, Page(s) 2377–2381

    Abstract: The objective of this study is to present a technique of localization of difficult-to-locate lesions inside the fissure by deploying a coil with one of its ends left inside the fissure, and also, to evaluate the safety and the efficiency of this ... ...

    Abstract The objective of this study is to present a technique of localization of difficult-to-locate lesions inside the fissure by deploying a coil with one of its ends left inside the fissure, and also, to evaluate the safety and the efficiency of this localization technique. Ten (10) patients with lesions in the fissure were identified during discussion at the multidisciplinary team meeting (MDT) and were recruited in the study. Attending surgeons verified that the lesions were unable to be located with minimally invasive approaches. These patients underwent localization of their lesion/s inside the fissure with a coil which was inserted through an adjacent lobe, through the fissure and inside the lesion with the other end protruding inside the fissure. All patients were next subjected to resection of their lesions with minimally invasive approaches. All patients had their lesions resected (with wedge resection or segmentectomies) with adequate margins (R0 resection). No conversion to thoracotomy was necessitated to attempt to palpate the lesion. Small, localized pneumothorax was noted in 7 patients; whereas, all patients had small laceration of their lung parenchyma along the course of the needle without, however, any action needed for these sequalae. The presented technique offers precise localization which leads to successful and safe resection of difficult-to-locate lesions inside the fissure via minimally invasive approaches. The clinical implications of this technique are numerous and its utilization can augment the successful performance of minimally invasive techniques for lesions situated inside the fissure.
    MeSH term(s) Humans ; Lung ; Lung Neoplasms/surgery
    Language English
    Publishing date 2023-07-26
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-023-01590-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 101: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: From 6-wk Lungs to 6 y: Increasing the Donor Pool for Pediatric Lung Transplantation.

    Purmessur, Rushmi / Spencer, Helen / Onwuka, Nkechi Bliss / Muthialu, Nagarajan / Berman, Marius

    Transplantation

    2023  Volume 108, Issue 1, Page(s) e3–e7

    Abstract: Background: Lung transplantation in the pediatric population is a challenge. With the donor pool being so small and lungs from young donors rare and precious, every organ available needs to be utilized to its best potential.: Case: Here, we describe ... ...

    Abstract Background: Lung transplantation in the pediatric population is a challenge. With the donor pool being so small and lungs from young donors rare and precious, every organ available needs to be utilized to its best potential.
    Case: Here, we describe the case of a 6-wk-old donor of double lungs to a 5-mo-old baby girl diagnosed with alveolar capillary dysplasia with misalignment of the pulmonary veins. The recipient is doing very well, 6 y after the transplant, now following normal growth.
    Discussion: The challenges facing pediatric cardiothoracic transplantation in terms of organ supply and demand are enormous.
    Conclusions: In this article, we discuss some of the issues around the shortage of organs and alternatives to increase the organ donor pool.
    MeSH term(s) Female ; Infant, Newborn ; Humans ; Child ; Tissue and Organ Procurement ; Lung/surgery ; Tissue Donors ; Lung Transplantation ; Persistent Fetal Circulation Syndrome
    Language English
    Publishing date 2023-10-04
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000004815
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 488: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 509: Show issues

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  4. Article: Uniportal video-assisted thoracoscopic segmentectomy.

    Hernandez-Arenas, Luis Angel / Purmessur, Rushmi D / Gonzalez-Rivas, Diego

    Journal of thoracic disease

    2018  Volume 10, Issue Suppl 10, Page(s) S1205–S1214

    Abstract: Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is a technically more complex procedure than uniportal VATS lobectomy, since a detailed comprehension of the segmental anatomy is required. Anatomic sublobar resection can achieve ... ...

    Abstract Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is a technically more complex procedure than uniportal VATS lobectomy, since a detailed comprehension of the segmental anatomy is required. Anatomic sublobar resection can achieve outcomes equivalent to lobectomy in selected patients with stage IA non-small cell lung carcinoma (NSCLC). In this paper we describe our clinical experiences and introduce the technical details of uniportal VATS segmentectomy, including expertise advice ("tips and tricks") in patient selection, positioning and incisions and technical highlights of the most common types of segmentectomies. Uniportal VATS segmentectomy is a demanding technique, safe and feasible in selected patients with good results in the literature that seems to be an acceptable alternative to conventional VATS or open thoracotomy when the surgeon completed the training period and learning curve.
    Language English
    Publishing date 2018-05-14
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2018.02.47
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Uniportal video-assisted thoracoscopic early learning curve for major lung resections in a high volume training center.

    Hernandez-Arenas, Luis Angel / Lin, Lei / Purmessur, Rushmi D / Zhou, Yiming / Jiang, Gening / Zhu, Yuming

    Journal of thoracic disease

    2018  Volume 10, Issue Suppl 31, Page(s) S3670–S3677

    Abstract: Background: Uniportal video-assisted thoracoscopic surgery (VATS) for major lung resections is a novel upcoming approach, with increasing popularity worldwide. However, there is little literature regarding this technique's learning curve. We present our ...

    Abstract Background: Uniportal video-assisted thoracoscopic surgery (VATS) for major lung resections is a novel upcoming approach, with increasing popularity worldwide. However, there is little literature regarding this technique's learning curve. We present our experience of the early learning curve of the uniportal VATS major lung resections in a high volume training centre, whilst analysing the advantages.
    Methods: Sixty selected consecutive patients underwent uniportal VATS major lung resections, for early stage disease of NSCLC and benign disease during the learning curve of a single surgeon in a high volume training centre from July to October 2015. The perioperative variables and outcomes were collected prospectively and analysed retrospectively.
    Results: The 60 patients undergoing a uniportal VATS approach included 47 lobectomies and 13 segmental resections, among which 56 cases of lung cancer and 4 of benign pulmonary disease were noted. Right upper lobectomy (RUL) was the most common procedure (42%). The mean operation time was 192.3±45.4 minutes, average blood loss was 167.9±94.4 mL. For patients with lung cancer, the total amount of lymph node stations sampled or dissected were 4.2±0.8. Chest drain duration was 2.9±0.9 days and length of hospital stay (LOS) was 4.38±1 days. Prolonged air leak (PAL) was the most common complication in 8.3% of the cases. PAL was the cause of prolonged hospital stay. One case was converted to thoracotomy for major bleeding. There were no deaths 30 days after surgery or readmissions. All cases had a R0 complete cancer resection on histology.
    Conclusions: The uniportal VATS lobectomy and segmentectomy early learning curve in a high volume training centre is a safe venture, allowing surgeons to reach an expert level faster and perform more complex resections with a shorter training time.
    Language English
    Publishing date 2018-06-25
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2018.04.16
    Database MEDical Literature Analysis and Retrieval System OnLINE

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