Vijay Joshi

University Hospital Of South Manchester NHS Foundation Trust | UHSM · Department of Cardiothoracic Surgery

Background: A preoperative type and screen (T&S) is traditionally routinely obtained prior to noncardiac thoracic surgery; however, an intraoperative blood transfusion is rare. This practice is overly cautious and expensive. Methods: We included adult patients undergoing major thoracic surgery at Mayo Clinic from 2007-2016. Receipt of a T&S bloo...

Background Intraoperative mediastinal lymph node sampling (MLNS) is a crucial component of lung cancer surgery. Whilst several sampling strategies have been clearly defined in guidelines from international organizations, reports of adherence to these guidelines are lacking. We aimed to assess our center's adherence to guidelines and determine wheth...

Objectives: Complete thymectomy is a key component of the optimal treatment for myasthenia gravis. Unilateral, minimally invasive approaches are increasingly utilized with debate about the optimal laterality approach. A right-sided approach has a wider field of view, while a left-sided approach accesses potentially more thymic tissue. We aimed to...

Adolescent idiopathic scoliosis affects children aged 11-18 years. Severe disease may necessitate spinal fusion. Vertebral body tethering gradually corrects scoliosis as the patients grow. The application of video-assisted thoracic surgery to the thoracic spine is a new area for further development.

Rosai-Dorfman disease (RDD) is a rare benign histiocytic proliferative disease that can present as a pseudotumour of soft tissue. We describe the first chest wall resection and reconstruction.

Introduction: The incidental early-stage thymic mass presents a diagnostic challenge. Video-assisted thoracoscopic (VAT) thymectomy is an attractive but potentially morbid solution. The aim was to show it can be safely applied as a first-line modality in those with undiagnosed thymic enlargement with acceptable long-term results. Methods: A tota...

Objectives: Neonates with severe congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation (ECMO) have a high rate of mortality. There is controversy regarding optimal time of surgical intervention. We present our data over a 26-year period. Methods: We analysed data from our Extracorporeal Life Support Organization registry...

Objective: The use of antibiotic-impregnated sponges (Collatamp) during cardiac surgery is controversial. We analysed the cost-effectiveness of its selective use in patients at high-risk of sternal wound infection (SWI). Method: Postoperative costs were analysed in two groups of patients undergoing heart surgery between 2011 and 2013: those with S...

Mobile extracorporeal membrane oxygenation (ECMO) is reserved for critically unstable patients who may not otherwise survive transfer to the ECMO center. We describe our experience with mobile ECMO. We retrospectively reviewed adult patients between 2010 and 2014 who were referred for ECMO support and were too unwell for conventional transfer. They...

Introduction Mobile extracorporeal membrane oxygenation (ECMO) is reserved for critically unstable patients who may not otherwise survive transfer to the ECMO center. We describe our experience with mobile ECMO. Methods We retrospectively reviewed adult patients between 2010 and 2014 who were referred for ECMO support and were too unwell for conve...

We describe a case of a 66-year-old woman with severe mitral regurgitation secondary to posterior leaflet atresia of the mitral valve. Perioperative transesophageal echocardiography suggested the possibility of an absent posterior leaflet with complete prolapse of the anterior leaflet. We questioned the functional outcome if repair was attempted; t...

Introduction Histological subtype is an independent prognostic factor in malignant pleural mesothelioma (MPM). Accurate typing is required to offer appropriate therapy, with surgery generally being reserved for epithelioid disease due to the poor survival in biphasic and sarcomatoid MPM. Preoperative tissue can be obtained by a variety of methods w...

Objectives: Current practice is to refer patients with blunt thoracic trauma directly to a thoracic surgical unit regardless of the nature of the injury. We wished to audit our practice over the last year to identify the types of injuries actually receiving surgical intervention in the acute phase. Methods: Our practice from January 2013 to Januar...

Introduction: The incidental early stage thymic mass presents a diagnostic challenge. Right-sided Video Assisted Thoracoscopic (VAT) thymectomy is an attractive but potentially morbid solution. The aim was to show that it can be safely applied as a first line modality in those with undiagnosed thymic enlargement with acceptable long-term results....

We describe a cluster of early valve degeneration (EVD) in a series of 281 Mitroflow valves implanted during 1999-2013. Patients with EVD were identified as having symptomatic stenosis or regurgitation within 6 years of implantation leading to reoperation. Freedom from reoperation was estimated by Kaplan-Meier actuarial analysis. Patient and valve...

Objectives: Current practice is to refer patients with blunt thoracic trauma directly to a thoracic surgical unit regardless of the nature of the injury. We wished to audit our practice over the last year to identify the types of injuries actually receiving surgical intervention in the acute phase. Methods: Our practice from January 2013 to Januar...

Objectives: Patients on extracorporeal membrane oxygenation (ECMO) are at risk from thoracic complications such as bleeding or pneumothorax, which may subsequently necessitate thoracic surgical intervention. We aimed to: 1) analyse the indication and nature of thoracic surgical intervention in these patients and 2) analyse the effect of a change i...

The 2010 British Thoracic Society guidelines recommend that a weighted decision be made by clinicians with regard to surgical intervention for pneumothorax as the video assisted thoracoscopic surgery (VATS) approach is better tolerated by patients but carries a higher rate of recurrence (5% vs 1%). Overall, 163 patients underwent surgical intervent...

A 35-year-old woman was seen as an outpatient with a 3-month history of pain in the right iliac fossa. A CT scan of her abdomen revealed the presence of a mucocele of the appendix. Intra-operatively, an appendico-appendicular intussusception was found. Histology confirmed the presence of a mucinous cystadenoma with the presence of acellular mucin o...

Little data exist as to the long-term outcome of non-small cell lung cancer that extends across the fissure into the adjacent lobe that requires either a bilobectomy or a lobectomy and wedge resection. Lobectomy survival data was benchmarked with the International Association for the Study of Lung Cancer (IALSC) dataset. Matched analysis of a prosp...

In an effort to improve the current lung cancer treatment outcomes in Britain, National guidelines were published followed by the introduction of National Lung Cancer Audit (LUCADA) project. LUCADA has defined active treatment as any therapeutic intervention with the aim of improving the quality or length of patients' survival irrespective of wheth...

We present the first case of hepatic actinomycosis requiring both medical and surgical intervention due to liver dissemination from a primary colonic abscess. A 52-year-old white male had a computerised (CT) abdominal scan following an episode of collapse and was found to have peri-colonic and hepatic abscesses. Prior to this episode, he suffered w...

Upper extremity arterial trauma may lead to significant disability with a poor functional outcome. This study represents a retrospective review of all trauma patients presenting to a university-affiliated medical center. Patients suffering from upper extremity arterial injuries requiring treatment were identified. The injured vessels were identifie...