Dalgaard Staal (dragondoll68)

55 mm diaphragm thickness loss in reintubation). As a result, less loss of diaphragm thickness was a protective factor for the rate of reintubation [33% vs. 12%; adjusted odds ratio (aOR) 0.001; 95% confidence interval (CI), 0.001-0.271; P=0.018] and hospital mortality (18% vs. 4%; aOR 0.001; 95% CI, 0.001-0.035; P=0.007). However, no significant difference was found in the ICU LOS after extubation between the two groups. Conclusions Less diaphragm thickness loss was related to a lower rate of reintubation and hospital mortality. 2020 Journal of Thoracic Disease. All rights reserved.Backgrounds The number of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) cases is increasing due to its less-invasiveness and usefulness. However, there are several unresolved issues, including the existence of incomplete cases and complications. This study aimed to investigate the frequency and diagnostic management of incomplete EBUS-TBNA cases. Methods Between July 2009 and December 2017, 424 patients underwent EBUS-TBNA for the diagnosis of suspected malignancy. Among them, we retrospectively reviewed the frequency, characteristics and diagnostic managements of incomplete cases of EBUS-TBNA. Results EBUS-TBNA was not completed in 16 patients (3.8%), all of whom underwent EBUS-TBNA cases under conscious sedation. The factors for incompleteness of EBUS-TBNA under conscious sedation were divided into two groups impossibility to perform EBUS-TBNA under conscious sedation (n=8) and impossibility to perform safe needle biopsy (n=8). The former factor consisted of strong coughing reflex and insufficient sedation (n=5), frequent desaturation during EBUS-TBNA (n=2), and allergy to lidocaine (n=1), while the latter factor consisted of anatomical reasons (n=4), abundant blood flow in the target lesion (n=3), and invisibility of the target lesion due to airway deformation (n=1). Eventually, 10 out of 16 cases were histologically diagnosed as having malignancy by a surgical approach (n=5) and EBUS-TBNA under general anesthesia (n=5). Conclusions Although the number was small, we did note some incomplete cases of EBUS-TBNA under conscious sedation. In incomplete cases under conscious sedation, EBUS-TBNA under general anesthesia and other surgical approaches can be considered as additional options. 2020 Journal of Thoracic Disease. All rights reserved.Background With the view to compare the outcomes between primary and secondary lung decortication, we examined all the patients admitted with empyema thoracis in our unit. The primary decortication was defined as a primary procedure, without prior attempt of pleural space evacuation with either chest tube or previous decortication. Secondary decortication was defined as a failed lung re-expansion after initial pleural space drainage or failed primary decortication. Anecdotally, secondary decortication is associated with increased complications and length of hospital stay. From literature search, there is currently no study that directly compared outcomes of these two procedures; hence, the rationale to conduct this study. Methods All patients presented to our unit with empyema thoracis from 1st January 2011-31st December 2014, were included in a retrospective quantitative descriptive study. A total number of 160 patients were analyzed and eighty patients underwent each of the procedures (primary and secondaryon. There were increased frequencies of complication in secondary decortication group, though without statistical significant difference (P=0.456). The patients who underwent secondary decortication had poor nutritional state compared to those who had primary decortication, with significant statistical difference (P=0.0370). 2020 Journal of Thoracic Disease. All rights reserved.Background Reflux symptoms including various extra-esophageal manifestations are commonly reported after esophagectomy. However, the intensity and presentation of reflux are both diverse and variable by