Ann Thorac Surg 2008;85:1501-1502. doi:10.1016/j.athoracsur.2007.10.025
© 2008 The Society of Thoracic Surgeons
Correspondence
Reply
William Brent Keeling, MD,
Keith Eric Sommers, MD
Department of Surgery, H. Lee Moffit Cancer and Research Center, University of South Florida, 12902 Magnolia Dr, Tampa, FL 33612
(Email: williambrentk{at}yahoo.com; sommerek{at}moffitt.usf.edu).
To the Editor:
We would like to thank Dr Ismail and colleagues [1] for their comments regarding our article [2]. They have raised some very interesting points that we would like to address:
- 1 We chose to focus on the results of one surgeon as this was the patient population available to us for the purposes of this project. These patients were accumulated consecutively over a period of months. We are seeking to expand our study with more surgeons, institutions, and patients.
- 2 We would agree that intrathoracic physiology is likely altered to a greater degree after extended resection when compared with more limited resections. Although this data was not included in this article, we have not yet found an increased incidence of aspiration or dysphagia based on extent of pulmonary resection.
- 3 Although we would have preferred to avoid patients with the mentioned preoperative comorbidities, this was simply not possible, as it would have greatly reduced our patient population. Also, these are rather common preoperative comorbidities for this patient population, so to have omitted them would have given an unsatisfactory representation of the true incidence of disease.
- 4 Ismail and colleagues [1] are correct in stating that we did not specifically gather data in regard to the nature of the head and neck malignancy in this series of patients. For a more complete review on this topic, please see the excellent work of Herrera and colleagues [3]. There were no patients with either primary brain tumors or metastatic lesions to the brain in this series of patients.
- 5 As previously stated, we plan to expand the scope of this research to include more surgeons, patients, and institutions. I am sure that Dr Ismail would agree in excluding patients with esophageal resection from this research as it is an entire topic unto itself and has been researched extensively.
Again, we thank Ismail and colleagues [1] for their insight and interest.
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References
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- Ismail MF, El-Refael Hammad RI, El-Sayed Sersar SI, El-Ghoneimy YAF. Aspiration after thoracotomy (letter) Ann Thorac Surg 2008;85:1501.[Free Full Text]
- Keeling WB, Lewis V, Blazick E, Maxey TS, Garrett JR, Sommers KE. Routine evaluation for aspiration after thoracotomy for pulmonary resection Ann Thorac Surg 2007;83:193-196.[Abstract/Free Full Text]
- Herrera LJ, Correa AM, Vaporciyan AA, et al. Increased risk of aspiration and pulmonary complications after lung resection in head and neck cancer patients Ann Thorac Surg 2006;82:1982-1987discussion 1987–8.[Abstract/Free Full Text]
Related Article
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Aspiration After Thoracotomy
- Mohamed F. Ismail, Reda Ibrahim El-Refael Hammad, Sameh Ibrahim El-Sayed Sersar, and Yasser Ahmed Farag El-Ghoneimy
Ann. Thorac. Surg. 2008 85: 1501.
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