Rescue Surgery for Advanced Stage Lung Cancer: A Systematic Review.

Patients with advanced lung cancer are candidates for systemic therapies. In the context of improved tumor responses and prolonged survival periods, the treatment of tumor/therapy-related complications must be taken into account. Rescue surgery consists of a surgical resection without oncologic purpose but with the aim of controlling an acute and life-threatening complication.

Intraoperative Repair of Bronchial Damage Following Robotic Segmentectomy.

Herein, we reported the damage of the B6 bronchial segment following apical segmentectomy of the left lower lobe for management of a typical carcinoid tumor. The defect was localized distally to the B6 origin and was successfully repaired by re-stapling the proximal side of the B6 bronchus. Before firing, the intraoperative bronchoscopy confirmed the closure of the B6 bronchus alone and the normal patency of the bronchial pyramid basal.

Application of Telepathology for Rapid On-Site Evaluation of Touch Imprint Cytology in CT-Guided Percutaneous Transthoracic Core Needle Biopsy of Pulmonary Nodules: The Experience of Our Multidisciplinary Thoracic Tumor Board.

Background: Lung cancer remains the leading cause of cancer-related mortality, often diagnosed at advanced stages, where minimally invasive tissue sampling is essential for diagnosis and molecular profiling. Rapid On-Site Evaluation (ROSE) enhances the diagnostic yield of small biopsies, but is frequently limited by a shortage of pathologists and logistical constraints. Telepathology offers a potential solution by enabling remote real-time assessment.

Endoscopic management of subglottic stenosis with innovative transcordal stent.

Single-stage tracheal resection and anastomosis represents the gold standard for benign subglottic stenosis' management. Nevertheless, also considering the complexity of the surgical procedure, some patients are considered unfit for tracheal surgery (stenosis involving vocal cords, comorbidities, and relapse after surgery). Until now, the only alternative was tracheostomy which represents the only real alternative to secure the patency of the airway.

Thoracoscopic Massive Bleeding After Firing Mediastinal Trunk of the Pulmonary Artery With Calcified Lymph Node.

The thoracoscopic management of hilar calcified lymph nodes is a technical challenge as the dense adhesions with the bronchus and vessels prevented a safe dissection. Herein, we reported the unexpected bleeding after firing the mediastinal trunk of the pulmonary artery with calcified lymph nodes during the completion of thoracoscopic right upper lobectomy for the management of lung cancer. The bleeding was successfully fixed by an emergent thoracotomy.

Assessing Surgical Approaches and Postoperative Complications for Thoracic Schwannomas: A Multicenter Retrospective Observational Analysis of 106 Cases.

Thoracic schwannomas are benign nerve sheath tumors that can cause neurological and respiratory symptoms depending on their location and extension. The optimal surgical approach remains debated, particularly regarding resection extent, complication rates, and postoperative morbidity. This retrospective multicenter study analyzed 106 patients treated between 2011 and 2024, classifying tumors according to the Eden system and comparing surgical strategies.

Single-port compared to multi-port video-assisted thoracoscopic esophagectomy: a propensity-matched study.

Background: The advent of minimally invasive techniques, such as video-assisted thoracoscopic surgery (VATS), has revolutionized esophageal cancer surgery by reducing surgical trauma, accelerating recovery, and improving postoperative quality of life. Multi-port VATS has emerged as a widely adopted approach, offering technical feasibility and oncological efficacy. However, recent advancements in minimally invasive surgery (MIS) have introduced single-port VATS, which further minimizes incisions and may enhance cosmetic outcomes, reduce postoperative pain, and shorten hospital stays.

Three-dimensional tracheo-bronchial reconstruction to plan endoscopic stent insertion for malignant upper airway stenosis.

Objectives: Malignant central airway obstruction (MCAO) is a condition characterized by severe dyspnoea and high mortality. Tracheo-bronchial stents have emerged as an effective treatment to restore airway patency. Our study aimed to evaluate the efficacy of 3D reconstruction of the upper airways to plan tracheo-bronchial stent insertion for MCAO.

Robotic Treatment of Postoperative Chylothorax.

A high-output chyle leak developed in a 69-year-old man who had undergone pleurectomy and decortication for malignant pleural mesothelioma. Conservative treatment was unsuccessful while a clear area of leakage could not be identified on lymphangiography. Right-sided robotic reexploration with ligation of the thoracic duct was successfully performed.

New perspectives on inoperable early-stage lung cancer management: Clinicians, physicists, and biologists unveil strategies and insights.

This work provides a comprehensive overview of the current landscape of lung cancer, emphasizing the global significance of the disease and the challenges associated with its diagnosis and treatment. The authors highlight the prevalence of lung cancer, with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCC) being the predominant histological subtypes. Advanced-stage diagnosis is common due to the asymptomatic nature of the disease, leading to a systemic treatment approach involving chemotherapy and radiotherapy.

Diagnostic Challenges in the Pathological Approach to Pleural Mesothelioma.

Malignant pleural mesothelioma (MPM) still represents a complex diagnostic challenge for pathologists in routine practice. This diagnosis requires a multidisciplinary approach, and pathological evaluation is mandatory. The histopathological diagnosis is stepwise and should be based on morphological and immunohistochemical assessment, sometimes associated with molecular tests, and supported by clinical and radiological findings.

Retrograde Simultaneous Ligation of Apico-ventral Vessels during VATS RUL.

Thoracoscopic right upper lobectomy is a demanding procedure especially in case of hilar adhesions. Herein, we reported a simple technique of simultaneous ligation of hilar structures to facilitate thoracoscopic right upper lobectomy. After resections of fissures and of hilar lymph nodes, the following structures were sequentially isolated and simultaneously resected in their natural position: V2 + A2 vessels; right upper bronchus; and V1 + V3 + A1 + A3 vessels.

Efficacy of Methylene Blue Thoracic Paravertebral Block in Postoperative Pain After VATS Lobectomy.

Background: Paravertebral block (PVB) is effective in controlling postoperative pain after video-assisted thoracoscopic surgery (VATS) lobectomy but is subject to a high rate of failure because of incorrect site of injection. We compared methylene blue PVB with thoracic epidural anesthesia (TEA) for postoperative pain after VATS lobectomy.

Methods: We conducted a prospective randomized trial of patients undergoing VATS lobectomy; 120 patients were randomly assigned to the PVB or TEA group.

3D Computed Tomography Reconstruction for Pre-Operative Diagnosis of Anomalous Venous Drainage of the Right Upper Lobe.

Anatomical variation of the pulmonary vessels poses challenges to thoracoscopic lung resection and may be associated with an increased risk of intraoperative bleeding and damage to pulmonary circulation. Herein, we reported a rare and dangerous variation as the partial anomalous venous drainage of the right upper lobe into the superior vena cava in a patient undergoing thoracoscopic lobectomy for management of lung cancer of right upper lobe. The preoperative identification of such variation by 3D computed tomography scan allowed to plan a safe and accurate resection, and to prepare additional strategies for overcome unexpected intraoperative bleeding.

Functional effect of adiponectin and body composition assessment in lung cancer subjects after video-assisted thoracoscopic surgery (VATS) lobectomy.

Background: Lung cancer is a pathology with an important incidence. It is a multifactorial disease characterized by epigenetic and nutritional factors. Indeed, there is a strong association between adipose tissue and the pulmonary system, and low-grade inflammation of obese and/or overweight subjects have a pivotal role in lung cancer establishment.

ECMO support for endoscopic resection of postpneumonectomy critical central airway obstruction.

A 73-year-old woman was admitted to our hospital with severe respiratory distress due to postpneumonectomy neoplastic central airway obstruction. An emergency recanalization with rigid bronchoscopy (RB) was planned. Controlled and jet ventilation are routinely used to assure ventilation during RB, but the risk of inadequate oxygenation and removal of carbon dioxide was prohibitively high in this case due to the presence of a single lung.

The Impact of Assessment of Nurses' Experiences in Thoracic Surgery in Onco-Hematological Patients.

Nowadays, Thoracic Surgery is technologically advanced; therefore, it also focuses its attention on nursing care. The aim of the study is to evaluate the effect of the assessment of a dedicated team of nurses (DTN) in all onco-hematological patients undergoing VATS lobectomy for lung cancer on the outcome of the patient, preventing pressure injuries, reducing perioperative stress, duration of operations, complications, and hospital stay times. We performed a single-center observational retrospective study, including 31 DTN and 760 onco-hematological patients who underwent thoracic surgery between 30 October 2018 and 30 June 2023 at "Vanvitelli" University of Naples.

Clinical significance of postoperative thrombocytosis after vats lobectomy for NSCLC.

Objectives: Thrombocytosis is a clinical condition generally associated with poor prognosis in patients with cancer. Thrombocytosis may be present after lung cancer resection, but the clinical significance of thrombocytosis remains unclear. Herein, we evaluated whether postoperative thrombocytosis was a negative prognostic factor in patients undergoing thoracoscopic lobectomy for lung cancer.

Acute myocardial infarction as presenting symptom of thymoma with compression on a coronary stent.

We report the clinical case of a patient with acute myocardial infarction due to coronary stent compression as first manifestation of a large thymoma. The patient underwent a coronarography and thrombus aspiration + plain old balloon angioplasty restoring the stent patency. The mass resection was performed through left robotic-assisted thoracic surgery (RATS), resulting in a type A thymoma pT1a, IIb Masaoka-Koga.

Challenge of concomitant thymoma resection and myocardial revascularization: A Case Report.

Myocardial revascularization in patients presenting with an anterior mediastinal mass poses considerable challenges. In this report, we outline two cases involving patients with anterior mediastinal masses who underwent surgical resection alongside concurrent myocardial revascularization. One patient underwent coronary artery bypass graft surgery, while the other was treated by percutaneous coronary intervention with drug-eluting stent placement.

Lung transplantation: Current insights and outcomes.

Until now, the ability to predict or retard immune-mediated rejection events after lung transplantation is still limited due to the lack of specific biomarkers. The pressing need remains to early diagnose or predict the onset of chronic lung allograft dysfunction (CLAD) and its differential phenotypes that is the leading cause of death. Omics technologies (mainly genomics, epigenomics, and transcriptomics) combined with advanced bioinformatic platforms are clarifying the key immune-related molecular routes that trigger early and late events of lung allograft rejection supporting the biomarker discovery.