Jens Eckardt

Odense University Hospital, Odense, South Denmark, Denmark

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Publications (19)24.58 Total impact

  • Jens Eckardt, Peter B Licht
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    ABSTRACT: Video-assisted thoracic surgery (VATS) resection of pulmonary metastases has long been questioned because radiologically undetected parenchymal lesions may be missed when bimanual palpation is restricted to the portholes. Technology, however, has improved and advanced VATS resections are now performed routinely worldwide. This prompted us to conduct a prospective observer-blinded study on pulmonary metastasectomy.
    The Annals of thoracic surgery. 06/2014;
  • Article: Response.
    Jens Eckardt, Peter Bjørn Licht
    Chest 06/2013; 143(6):1837. · 7.13 Impact Factor
  • Søren Venø, Stevo Duvnjak, Jens Eckardt
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    ABSTRACT: We report a rare case of a primary schwanoma in trachea causing airway symptoms in a 78-year-old male. Benign tracheal tumours are often misdiagnosed as asthma or chronic lung disease and should be considered in patients who present with symptoms as upper airway obstruction and haemoptysis. In this case story the patient was treated with endoscopic resection of the tumour.
    Ugeskrift for laeger 05/2013; 175(21):1501-1502.
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    Jens Eckardt, Peter B Licht
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    ABSTRACT: Benign tumours in the posterior mediastinum are often asymptomatic until they reach a considerable size. Technically it is easier to remove the tumour when it is small, but these patients are often asymptomatic and therefore the tumours are rarely found before the patients become symptomatic. During 2010 three patients underwent resection of large benign tumours in the posterior mediastinum with a diameter more than 10 centimetres. We discuss, when should large benign tumours in posterior mediastinum be resected. We conclude that symptomatic patients with large benign tumours should be referred directly for surgery independent of size while asymptomatic patients should be followed regularly and referred for surgical treatment if their tumour increases in size because surgery may be hazardous as size of the tumour increases and more likely to be associated with major postoperative morbidity.
    Journal of thoracic disease. 04/2013; 5(2):E28-30.
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    Søren Venø, Jens Eckardt
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    ABSTRACT: Boerhaave's syndrome or spontaneous esophageal perforation is a rare condition, with high mortality. We describe a case of Boerhaave's syndrome presenting with tension pneumothorax. The patient was infected with Norovirus and developed Boerhaave's syndrome, initially thought to be gastroenteritis but later developing with tension pneumothorax, and mediastinitis caused by esophageal perforation. The patient was treated with thoracotomy with primary suture and oesophageal stent placement. He had a long period of recovery and was discharged after 98 days. Boerhaaves syndrome is often delayed and must be considered in any patient with respiratory symptoms and a recent history of vomiting.
    Journal of thoracic disease. 04/2013; 5(2):E38-40.
  • Jens Eckardt
    Thoracic Cancer. 02/2013; 4(1).
  • Jens Eckardt, Peter B Licht
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    ABSTRACT: ABSTRACTBACKGROUND:Patients with limited metastatic disease in the lung may benefit from metastasectomy. Thoracotomy is considered gold standard and video-assisted thoracoscopic surgery (VATS) is controversial because non-imaged nodules may be missed when bimanual palpation is restricted. Against guideline recommendations metastasectomy with therapeutic intent is now performed by VATS in 40% of thoracic surgeons surveyed. The evidence base for optimal surgical approach is limited to case-series and registries and no comparative surgical studies were observer-blinded.METHODS:Patients considered eligible for pulmonary metastasectomy by VATS prospectively underwent high-definition VATS by one surgical team followed by immediate thoracotomy with bimanual palpation and resection of all palpable nodules by a second surgical team during the same anaesthesia. Both surgical teams were blinded during preoperative evaluation of CT-scans and during surgery. Primary endpoints were number and histology of nodules detected.RESULTS:During a 12 months period 37 patients were included. Both surgical teams observed exactly 55 nodules suspicious of metastases on CT-scans. Fifty-one nodules were palpable during VATS(92%) and during subsequent thoracotomy 29 additional nodules were resected: 6(21%) were metastases, 19 (66%) were benign lesions, 3 (10%) were subpleural lymph nodes and one was a primary lung cancer.CONCLUSIONS:Modern VATS technology is increasingly used for pulmonary metastasectomy with therapeutic intent but several non-imaged and therefore unexpected nodules are frequent during subsequent observer blinded thoracotomy. A substantial proportion of these nodules are malignant and despite modern imaging and surgical technology they would have been missed if VATS was used exclusively for metastasectomy with therapeutic intent.
    Chest 06/2012; · 7.13 Impact Factor
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    Jens Eckardt, Mads Nybo
    Journal of thoracic disease. 06/2012; 4(3):242-3.
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    Jens Eckardt, Peter B Licht
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    ABSTRACT: Aggressive intravenous thrombolysis of pulmonary emboli after major thoracic surgery has rarely been reported and is controversial because of an assumed risk of fatal bleeding. We report a 62-year old female who underwent left upper lobectomy. Her postoperative course was complicated with symptomatic pulmonary embolism and on postoperative day 5 she was successfully treated with intravenous thrombolysis using alteplase (Actilyse(®)) without signs of bleeding. She was discharged from the hospital 12 days postoperatively.
    Interactive Cardiovascular and Thoracic Surgery 02/2012; 14(5):660-1. · 1.11 Impact Factor
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    ABSTRACT: A 59-year-old man with previous anaplastic large cell T-cell lymphoma stage 3A was admitted with an isolated positron emission tomography(PET)-positive spot in a subcarinal lymph node. Diagnosis was achieved with endobronchial ultrasound-guided fine-needle aspiration demonstrating a well-differentiated squamous cell carcinoma but no primary tumor was visible on PET-computed tomography. Because of his previous lymphoma the patient was scheduled for mediastinoscopy where the diagnosis was confirmed. Subsequent gastroscopy was normal and a right-sided thoracotomy showed no evidence of cancer elsewhere, only an inoperable metastasis in a subcarinal lymph node which infiltrated the trachea, esophagus and aorta. Such isolated squamous cell carcinoma in a subcarinal lymph node without a primary tumor despite invasive work-up has not been reported before.
    Thoracic Cancer. 05/2011; 2(2).
  • Jens Eckardt, Peter Bjørn Licht
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    European Journal of Emergency Medicine 02/2011; 18(1):55-56. · 0.73 Impact Factor
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    ABSTRACT: A 71-year-old female was referred with three right-sided intrathoracic tumours. In 2003, she underwent radical left nephrectomy for renal cell cancer (RCC) clinical stage 1. She was since followed at her local hospital with annual computed tomography (CT)-scans during the first five years and did not present any symptoms until October 2009 when she was admitted with shortness of breath, cough and tiredness. The patient was scheduled for a diagnostic thoracoscopy when it was discovered that her lesions were not located in the lung parenchyma but were protruding nodules from the parietal pleura. Histology demonstrated metastases from RCC which apparently can reach the parietal pleura without lung metastases.
    Interactive Cardiovascular and Thoracic Surgery 11/2010; 12(2):301-2. · 1.11 Impact Factor
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    Jens Eckardt
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    ABSTRACT: Lesions in mediastinum can represent malignancy and warrants further workup. Commonly a diagnosis is achieved by conventional bronchoscopy, transbronchial needle aspiration or CT guided fine needle aspiration, however a number of patients remain undiagnosed despite these common investigations During a period of 36 months 601 patients underwent EBUS at our institution. Two hundred ninety three patients had an established diagnosis of lung cancer and were referred to us for mediastinal staging. The remaining patients had a radiologically suspicious intrathoracic lesion of which 107 had an undiagnosed lesion in mediastinum. All patients had been investigated by previous chest CT and bronchoscopy including brush cytology but remained undiagnosed. Of the 107 patients with undiagnosed lesions in the mediastinum 89 enlarged lymph nodes and 18 mediastinal tumours. Forty-eight of the 89 patients (54%) with enlarged mediastinal lymph nodes were diagnosed by EBUS of the remaining 41 patients 11 went on to more invasive methods. In patients with undiagnosed tumours in mediastinum we achieved a final diagnosis by EBUS in 14 of the 18 patients (78%) and 3 went on to more invasive methods. EBUS provides a final diagnosis in 78% of patients with tumour in mediastinum and in more than half of patients with enlarged lymph nodes despite previous workup.
    Journal of thoracic disease. 09/2010; 2(3):125-8.
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    ABSTRACT: Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS) is a minimally invasive method used routinely for mediastinal staging of patients with lung cancer. EBUS has also proved to be a valuable diagnostic tool for patients with different intrathoracic lesions who remain undiagnosed despite bronchoscopy and CT-guided fine-needle aspiration. The present study focused on EBUS for diagnosing sarcoidosis. During a 3-year period 308 of 601 patients who underwent EBUS at our institution were referred for further diagnostic of a radiologically suspicious lesion in the lung parenchyma (n = 195), enlarged lymph nodes in the mediastinum (n = 89), a suspicious tumor in the mediastinum or pleural disease (n = 24) but no one had a definite histological diagnosis. All charts were reviewed retrospectively. Of the 308 patients 43 (14%) were eventually diagnosed with sarcoidosis. Thirty-three (77%) were diagnosed with EBUS. In the remaining 10 patients EBUS did not provide adequate tissue samples in 4 (9%) and in 6 patients (14%) EBUS provided adequate tissue but no definite diagnosis. EBUS was significantly better to establish the diagnosis in patients with enlarged mediastinal lymph nodes compared with isolated lung parenchymal involvement (85% vs 63%, p < 0.05). EBUS is a valuable minimally invasive diagnostic modality to establish the diagnosis of sarcoidosis of unselected patients with undiagnosed intrathoracic lesions after conventional work up--particularly if patients have enlarged mediastinal lymph nodes. This minimally invasive procedure provides a final diagnosis without exposing the patient to the risk of complications from more invasive procedures.
    Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders 07/2010; 27(1):43-8. · 1.63 Impact Factor
  • Jens Eckardt, Peter B Licht
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 05/2010; 13(5):403-5.
  • Jens Eckardt, Karen E Olsen, Peter B Licht
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    ABSTRACT: A number of patients with radiologically suspicious chest tumors remain undiagnosed despite bronchoscopy or CT-guided fine-needle aspiration (CT-FNA). Such patients are often referred for mediastinoscopy, which is an invasive surgical procedure that poses a small but significant risk to the patient. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS) is a well-established method for mediastinal staging of lung cancer but may also be used as a diagnostic tool in patients with undiagnosed intrathoracic lesions. During a 36-month period (January 2006 to December 2008), 601 patients underwent EBUS under general anesthesia. Two hundred ninety-three (293) patients had an established diagnosis of lung cancer and were referred to us for mediastinal staging. The remaining 308 patients had a radiologically suspicious lesion and had been investigated previously by CT and bronchoscopy, including brush cytology, but remained undiagnosed. Overall, EBUS was able to diagnose 55% of the 308 patients. Diagnostic yield was significantly higher in central parenchymal lesions (72%) compared with enlarged lymph nodes (54%) or peripheral lesions (43%) (P < 0.05). All patients were examined as outpatients and there was not a single complication in any patient. EBUS is a valuable tool to diagnose chest lesions and yield depends on the anatomical location. We believe that EBUS should be the first choice for further workup in patients who remain undiagnosed after conventional CT and bronchoscopy because it is very safe, fast, and minimally invasive.
    World Journal of Surgery 04/2010; 34(8):1823-7. · 2.23 Impact Factor
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    ABSTRACT: To evaluate the diagnostic yield, the learning curve and the safety of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in mediastinal staging of patients with lung cancer. Mediastinal staging was performed with EBUS-TBNA according to the Danish national guidelines in patients fulfilling one or more of the following criteria: (1) central tumour; (2) enlarged (>10 mm) mediastinal lymph nodes on computed tomography; or (3) positron emission tomography (PET)-positive mediastinal lymph nodes. The study period began in January 2006 when EBUS-TBNA was introduced in the department and ended in December 2007. All records were reviewed retrospectively. None of the four examiners had any previous experience with EBUS-TBNA or ultrasound when the study began. All examinations were performed under general anaesthesia. Patients without useful cytological material from the EBUS-TBNA were subjected to a supplementary standard cervical mediastinoscopy if the mediastinal lymph nodes were found to be enlarged (>10 mm), PET positive or if the examiner was insecure of the result of the EBUS-TBNA. Patients with mediastinal lymph node involvement, detected by EBUS-TBNA or standard cervical mediastinoscopy, were referred to oncological treatment, while those without mediastinal lymph node involvement underwent--if they were otherwise eligible for surgery--resection and systematic lymph node sampling either by thoracotomy or by video-assisted thoracoscopy. Final mediastinal staging was defined as positive if mediastinal lymph node involvement was detected by EBUS-TBNA, standard cervical mediastinoscopy or surgery, or defined as negative otherwise. A total of 157 patients were included in the study. N2/N3 disease was found in 67 patients (42.6%). EBUS-TBNA missed the mediastinal spread in 10 patients. Five of the ten patients had lymph node metastases in station 5, 6 or 8--out of reach of EBUS-TBNA or standard cervical mediastinoscopy. EBUS-TBNA had a sensitivity of 0.85 (0.74-0.93) and a negative predictive value of 0.90 (0.82-0.95). No complications occurred from EBUS-TBNA. The number of supplementary standard cervical mediastinoscopies decreased significantly in the study period. The results of this study suggest that staging of the mediastinum with EBUS-TBNA is safe and easy to learn--even without previous experience with ultrasound. The diagnostic yield of EBUS-TBNA is in accordance with the yield of standard cervical mediastinoscopy reported in the literature. We do not find any indications in the present study of the recommended necessity for mediastinoscopy in all EBUS-TBNA-negative patients.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 06/2009; 36(3):465-8. · 2.40 Impact Factor
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    ABSTRACT: Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-FNA) is a minimally invasive method used routinely for mediastinal staging of patients with lung cancer. We have used it in 135 consecutive patients with a radiologically suspicious intrathoracic lesion that remained undiagnosed despite bronchoscopy and CT-guided fine-needle aspiration (CT-FNA). There was no operative mortality or surgical complications. In 98 patients with a suspicious lesion in the lung parenchyma, adequate tissue was obtained in 83 patients (85%) and in 37 patients with enlarged lymph nodes or a mediastinal tumor adequate tissue was obtained in 35 cases (95%). However, a final diagnosis was only reached in 45% of the patients and further investigations led to malignancy in 13. We believe that EBUS-FNA represents a good alternative to more invasive diagnostic procedures when conventional methods fail, even though the diagnostic yield is lower compared with mediastinal staging in patients with known lung cancer. In almost half of the cases, EBUS-FNA provides the final diagnosis without exposing the patient to the risk of complications from more invasive procedures.
    Interactive Cardiovascular and Thoracic Surgery 06/2009; 9(2):232-5. · 1.11 Impact Factor
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    ABSTRACT: Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-FNA) is a minimally invasive method used routinely for mediastinal staging of patients with lung cancer. We have used it in 135 consecutive patients with a radiologically suspicious intrathoracic lesion that remained undiagnosed despite bronchoscopy and CT-guided fine-needle aspiration (CT-FNA). There was no operative mortality or surgical complications. In 98 patients with a suspicious lesion in the lung parenchyma, adequate tissue was obtained in 83 patients (85%) and in 37 patients with enlarged lymph nodes or a mediastinal tumor adequate tissue was obtained in 35 cases (95%). However, a final diagnosis was only reached in 45% of the patients and further investigations led to malignancy in 13. We believe that EBUS-FNA represents a good alternative to more invasive diagnostic procedures when conventional methods fail, even though the diagnostic yield is lower compared with mediastinal staging in patients with known lung cancer. In almost half of the cases, EBUS-FNA provides the final diagnosis without exposing the patient to the risk of complications from more invasive procedures. 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.