Difficult Decisions in Thoracic Surgery

1. Introduction.- 2. Evidence based medicine: levels of evidence and evaluation systems.- 3. Decision analytic techniques and other decision processes.- 4. Decision making - the surgeon's perspective.- 5. Decision making - the patient's perspective.- 6. EBUS vs mediastinoscopy for initial pathologic mediastinal staging in NSCLC.- 7. Is preoperative smoking cessation for lung resection patients effective in reducing surgical morbidity.- 8. Is low tech as good as high tech exercise testing in assessing healthy candidates for lung resection.- 9. Does assessment of frailty and sarcopenia in lung resection candidates affect oatient selection.- 10. Can frailty and sarcopenia be mitigated in lung resection candidates.- 11. Is antibiotic prophylaxis necessary for major lung resection.- 12. Uniportal vs multiportal VATS lobectomy.- 13. Robotic vs VATS for major lung resection.- 14. Does intrapleural therapy for persistent postoperative air leak reduce air leak duration.- 15. Segmentectomy vs lobectomy in patients with good pulmonary function.- 16. Is resection of persistent N2 disease after induction therapy effective.- 17. N2 disease discovered at the time of lung resection - resect or abort?.- 18. Is lung resection safe after immunotherapy.- 19. Is an enhanced recovery programs for lobectomy patients effective in improving surgical outcomes.- 20. Resection vs SBRT for stage I NSCLC in patients with good pulmonary function.- 21. Do endobronchial valves assist in resolution of postoperative persistent air leak.- 22. Is long-term surveillance effective after resection of stage I NSCLC.- 23. Does ECMO for lung failure in ICU patients improve survival.- 24. Does resection of oligometastatic disease in lung cancer patients improve survival.- 25. Is pulmonary metastasectomy effective in prolonging survival.- 26. Resection vs endoscopic therapy for T1bN0 esophageal adenocarcinoma.- 27. Does induction therapy for T2N0 esophageal adenocarcinoma improve survival.- 28. Do enhanced recovery programs for esophagectomy patients improve outcomes.- 29. Does jejunostomy after esophagectomy improve outcomes.- 30. Surgery vs definitive chemoradiotherapy for regionally advanced esophageal squamous cell cancer.- 31. Open vs robotic resection for esophageal adenocarcinoma.- 32. Two-field vs three-field lymphadenectomy for esophageal adenocarcinoma.- 33. Is resection of more nodes better for treating esophageal cancer.- 34. Salvage esophagectomy for persistent disease after definitive chemoradiotherapy.- 35. Early postoperative feeding after esophagectomy.- 36. Stent vs primary repair for esophageal perforation.- 37. Sump therapy vs stenting for esophageal anastomotic leak.- 38. Thoracoscopic vs endoscopic therapy for small submucosal esophageal tumors.- 39. Laparoscopic vs endoscopic therapy for achalasia.- 40. Laparoscopy or endoscopic therapy for recurrent symptoms from achalasia.- 41. Laparoscopy or thoracotomy for symptomatic recurrent paraesophageal hernia.- 42. Does diaphragm pacing for bilateral phrenic nerve paralysis improve function or quality of life.- 43. Does phrenic nerve reconstruction for unilateral diaphragm paralysis improve function or quality of life.- 44. Is plication for diaphragmatic eventration effective in improving function.- 45. Is temporary transvenous pacing effective in ventilator weaning.- 46. Does temporary diaphragm paralysis aid in eliminanting residual pleural space after lung resection.- 47. Is long-term stenting for benign airway obstruction effective.- 48. Are engineered tissues useful for tracheal reconstruction.- 49. Are positive margins acceptable in resection for low grade malignancies.- 50. Optimal management of posttransplant brochial stenosis - stenting or reoperation.- 51. Is tPA/Dnase therapy effective for managing pleural empyema.- 52. VATS vs open management of pleural empyema.- 53. Indewlling catheter vs chemical pleurodesis for symptomatic malignant pleural effusion.- 54. Extended pleurectomy sparing the diaphragm for malignant pleural mesothelioma.- 55. Quality of life: EPD vs EPP.- 56. Does thymectomy improve outcomes for myasthenia gravis.- 57. MRI for evaluation of suspected encapsulated thymoma.- 58. Lobectomy vs thymectomy for encapsulated thymoma.- 59. Robotic vs VATS thymectomy for thymoma.- 60. Resection of mediastinal parathyroid adenomas.- 61. Thymectomy in the setting of pleural metastases.- 62. Sympathectomy for malignant ventricular arrhythmias.- 63. Extent of surgery for palmar hyperhidrosis.- 64. Synthetic vs biologic reconstruction of bony chest wall defects.- 65. Traumatic rib fracture: conservative therapy or surgical fixation?.- 66. Is surgical management of flail chest effective.- 67. Epidural vs regional blocks for VATS and thoracotomy.- 68. Pectus deformities in adults - when is surgery indicated?.- 69. Pectus deformities in adults - Nuss bar vs open repair.