logo
episode-header-image
Nov 2022
29m 22s

Clinical Challenges in Thoracic Surgery:...

Behind The Knife: The Surgery Podcast
About this episode
In this episode, our team provides a comprehensive review of the differential diagnosis for mediastinal masses, their workup, and biopsy considerations. Listen as we dive deeper into the perioperative planning and operative approach for resection of these masses with special considerations for patients with thymoma. 

Learning Objectives:

-Discuss the differential diagnosis of a mediastinal mass

-Review the workup of a mediastinal mass

-Outline indications for biopsy and describe the various approaches

-Describe the operative techniques for thymectomy, pearls & potential pitfalls  

Hosts:

 Megan Lenihan MD, Kelly Daus MD, Peter White MD, and Brian Louie MD

Referenced Material

https://pubmed.ncbi.nlm.nih.gov/21847052/

Detterbeck FC, Nicholson AG, Kondo K, Van Schil P, Moran C. The Masaoka-Koga stage classification for thymic malignancies: clarification and definition of terms. J Thorac Oncol. 2011 Jul;6(7 Suppl 3):S1710-6. doi: 10.1097/JTO.0b013e31821e8cff. PMID: 21847052.

https://pubmed.ncbi.nlm.nih.gov/33468329/

Ahmad U. The eighth edition TNM stage classification for thymic tumors: What do I need to know? J Thorac Cardiovasc Surg. 2021 Apr;161(4):1524-1529. doi: 10.1016/j.jtcvs.2020.10.131. Epub 2020 Nov 13. PMID: 33468329.

https://pubmed.ncbi.nlm.nih.gov/34695605/

Marx A, et al. The 2021 WHO Classification of Tumors of the Thymus and Mediastinum: What Is New in Thymic Epithelial, Germ Cell, and Mesenchymal Tumors? J Thorac Oncol. 2022 Feb;17(2):200-213. doi: 10.1016/j.jtho.2021.10.010. Epub 2021 Oct 22. PMID: 34695605.

https://pubmed.ncbi.nlm.nih.gov/22882218/

Meriggioli MN, Sanders DB. Muscle autoantibodies in myasthenia gravis: beyond diagnosis? Expert Rev Clin Immunol. 2012 Jul;8(5):427-38. doi: 10.1586/eci.12.34. PMID: 22882218; PMCID: PMC3505488.

https://pubmed.ncbi.nlm.nih.gov/34339670/

Raja SM, Guptill JT, McConnell A, Al-Khalidi HR, Hartwig MG, Klapper JA. Perioperative Outcomes of Thymectomy in Myasthenia Gravis: A Thoracic Surgery Database Analysis. Ann Thorac Surg. 2022 Mar;113(3):904-910. doi: 10.1016/j.athoracsur.2021.06.071. Epub 2021 Jul 30. PMID: 34339670.

Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed general surgery procedures. If you are a PGY4/5 general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com, for more information on how you could be compensated up to $400 for recording and submitting those videos.

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

If you liked this episode, check out other clinical challenge episodes here: https://behindtheknife.org/podcast-series/clinical-challenges/
Up next
Today
Clinical Challenges in Vascular Surgery: The Risk & Reality of EVAR Complications
It’s 2 a.m. The on-call resident’s voice is shaky. The CT shows an 18cm abdominal aortic aneurysm with a Type 1B endoleak. There’s gas in the sac, fluid in the belly, and the patient has a defibrillator on both sides of his chest. Is it a rupture? A graft infection? An aortoenter ... Show More
26m 55s
Jul 7
Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!
In the corner of the ICU, on multiple pressors, distended, oliguric, and intubated you’ll find the necrotizing pancreatitis patient. Sounds intimidating, but with the persistence, patience, and the proper care these patients can make it! In this episode from the HPB team at Behin ... Show More
31 m
Jul 5
Intern Bootcamp: Dominate Intern Year
RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. In this last episode of the intern bo ... Show More
12m 46s
Recommended Episodes
Jul 2023
35. Does spinal anesthesia decrease the risk of postoperative delirium?
Dr. Mark Neuman and Dr. Sam Falkson join the show to discuss the literature around risks of regional versus general anesthesia for postoperative delirium. Dr. Neuman is the founding Director of the Center for Perioperative Outcomes Research and Transformation and Professor of Ane ... Show More
58m 7s
Apr 2024
Optimizing Novel Therapies and Surgery in Early-Stage NSCLC
Doctors Vamsi Velcheti, Sandip Patel, and Michael Zervos discuss recent updates on the management of early-stage non-small cell lung cancer (NSCLC), including the optimization of neoadjuvant and adjuvant treatment options for patients and the role of surgery in the era of targete ... Show More
31m 31s
Jan 2024
Nekrotisierende Fasziitis – radikales Operieren ist die einzige Option
mit Marielle Hummels, Chirurgin (01:27) Krankheitsbild & Ursachen | (04:06) Pathophysiologie | (04:56) Symptome & Risikofaktoren | (07:27) Fallbericht: 62-Jähriger Patient mit Fieber und Hautveränderung - Anamnese und Diagnostik | (10:12) Fallbericht: Differentialdiagnosen | (11: ... Show More
20m 45s
Nov 2023
Nov 03 2023 This Week in Cardiology
Tricuspid regurgitation therapy, two more left atrial appendage trials, and reflections on being too soft on medical science are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcrip ... Show More
26m 27s
Oct 2023
Moyamoya Disease by W. Northam, E. Smith, J. Laird-Gion, J. Perez | OPENPediatrics
This podcast discusses the preoperative, operative, and postoperative considerations for patients undergoing surgical treatment for moyamoya disease including: anatomy and pathophysiology, clinical presentation, diagnosis, preoperative evaluation, anesthetic management, operative ... Show More
18m 47s
Jan 2024
E126: Craniotomy (CarePlan: Sachi & Rhea)
In this Care Plan episode, Rhea and Sachi delve into the intricate details of craniotomies for brain tumors. This episode focuses on preoperative considerations, anesthetic types, specialized monitoring, positioning, and postoperative care.  From neurological assessments to anest ... Show More
19m 11s
Aug 2022
Treating Sacroiliac (SI Joint) vs. Chronic Lower Back Pain
Host: Sanjeev (Sanj) Kakar, M.D. (sanjkakar) Guest: William W. Cross, III, M.D. (@WilliamCross3MD) Did you know the lifetime prevalence of generalized low back pain is estimated at 60% to 70% in industrialized countries? Often overlooked, the sacroiliac or SI joint can cause appr ... Show More
21m 16s
Jun 2024
Jun 14 2024 This Week in Cardiology
Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial trans ... Show More
30m 52s
May 2024
Cholestase: Knifflige Diagnosen und neue Therapien
Prof. Markus Lerch, München, im Gespräch mit Prof. Verena Keitel-Anselmino, Magdeburg In der Diagnostik und Therapie häufiger cholestatischer Erkrankungen, wie der primär biliären Cholangitis, hat sich die letzten Jahre einiges getan. Und auch bei Seltenheiten gibt es Neues zu be ... Show More
34m 4s