Classification of recurrence patterns in surgically treated non-small cell lung cancer - A systematic review and a call for standardization.

Background: Despite significant advancements in early detection and treatment, cancer recurrence remains a major challenge, affecting 30-55 % of patients within two years following surgery. Tumor recurrence is commonly classified as local, locoregional, regional or distant, yet a unified consensus on these definitions is still lacking.

Materials And Methods: A systematic review of the recent literature (2020-2024) was conducted in accordance with PRISMA guidelines to collect site-specific recurrence definitions.

Analysis of clinical and oncological outcomes after simple and intentional lung segmentectomies: the deceptive simplicity of the S6 segment.

Background: Currently, few studies analyze postoperative outcomes for different types of segmental resections. Therefore, our aim was to compare lower lobe apex with other simple and intentional segmentectomies, in terms of clinical and oncological outcomes.

Methods: A retrospective and multicenter study was conducted on patients who underwent simple and intentional segmentectomies from 2015 to 2020.

Impact of pre-operative inflammatory markers on overall and disease-free survival of octogenarian patients undergoing video-assisted thoracoscopic lobectomy for early-stage lung cancer: a multicenter study.

Background: The proportion of octogenarian patients who undergo surgery for lung cancer is growing over recent years. Elderly patients are characterized by age-related changes, such as inflammatory modifications of the lower respiratory tract, responsible for structural and functional alterations and tumor progression. Inflammatory markers (IMs) are a well-known prognostic factor in several tumor types, but they have not been analyzed extensively in octogenarian patients submitted to thoracoscopic lobectomy for early-stage lung cancer.

Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in lung carcinoid patients after receiving curative surgery. A multicentre study.

Background: Recent evidence suggests that inflammation is relevant to carcinogenesis and tumor progression. Biomarkers of the inflammatory response are increasingly regarded as valuable prognostic indicators for enhancing predictive accuracy in non-small cell lung cancer (NSCLC). Nonetheless, the applicability of these measures in patients with pulmonary carcinoid remains uncertain.

Air leaks management using polymeric hydrogel matrix after thoracoscopic lung segmentectomy: a single-center prospective randomized trial with a cost-effective analysis.

Introduction: Alveolar air leaks are common complications after thoracoscopic lung resections, increasing morbidity, hospital stay, and costs. Polymeric hydrogel matrix (PHM) has shown effectiveness in reducing air leaks and chest tube duration after lobectomy. This study aims to assess PHM's impact on air leaks, chest drain duration, hospital stay, and its cost-effectiveness following thoracoscopic segmentectomies.

Case Report: Thoracic duct ligation for left-sided chylothorax after pneumonectomy with contralateral VATS procedure using indocyanine green fluorescence.

Introduction: Chylothorax is a rare but potentially life-threatening condition characterized by the accumulation of lymphatic fluid in the pleural cavity. It is typically managed with conservative treatments such as fasting and/or thoracic duct embolization via lymphography. However, when these approaches fail, surgical intervention, most commonly thoracic duct ligation (TDL), is often necessary.

A challenging case of a giant thymoma resected using the clamshell approach.

Extensive intrathoracic tumours demand an aggressive surgical approach due to their size and proximity to vital structures, thereby increasing procedural risks. A thymoma can expand substantially before detection and affect surrounding tissues. An operation is the primary therapy, sometimes supplemented by chemotherapy or radiation.

Extended left pneumonectomy with intrapericardial arterial reconstruction under cardiopulmonary bypass.

We present the case of a left pneumonectomy performed under cardiopulmonary bypass for a patient with advanced lung cancer. Given the tumour's proximity to critical structures, this case was particularly complex. We employed cardiopulmonary bypass to ensure haemodynamic stability and to maintain pulmonary and systemic circulation during the resection.

Bilateral Metachronous Typical and Atypical Carcinoid Tumors of the Lung.

Bronchial carcinoids are uncommon neuroendocrine tumors. According to their pathological differentiation, they are divided into typical and atypical forms, with diverse biological behavior and aggressiveness. Bronchial carcinoids may be associated with familial neuroendocrine syndromes, such as MEN-1.

Surgery for Pancoast Tumors in Multimodality Setting: Analysis of Outcomes and Risk Factors.

: Pancoast tumors are a rare subset of lung cancers that require a multimodal approach (induction chemoradiotherapy and surgery), best performed in highly specialized centers. This study analyzes the outcomes and prognostic factors in patients treated at a high-volume center over an extended period. : We retrospectively reviewed 43 patients who underwent surgery for Pancoast tumors, following induction treatment between 2005 and 2023.

Robotic Thymectomy for Myasthenia Gravis: Analysis of the Surgical and Neurological Outcomes After a 20 Years' Experience.

Background: Evidence supporting robotic thymectomy for myasthenia gravis is generally based on small sample-size studies, heterogeneous in patient selection and in reporting outcomes. Therefore, this study was conducted to assess the surgical and neurological outcomes of robotic thymectomy in myasthenic patients and to identify prognostic factors associated with symptoms' remission through a large cohort of patients operated in a 20 years' period.

Methods: A retrospective analysis of a prospectively maintained database was conducted for all patients undergoing robotic thymectomy for myasthenia gravis between 2002 and 2022.

Chylothorax After Thoracic Surgery: How We Manage It.

Chylothorax is a rare but insidious condition, characterized by the accumulation of chyle in the pleural space, which is particularly common after cardiothoracic surgeries. It presents significant challenges in both diagnosis and treatment. In this technical report, we present our experience in managing four cases of postsurgical chylothorax, each one treated with a different approach.

Awake video-assisted surgical lung biopsy for the diagnosis of interstitial lung disease.

In patients with suspected interstitial lung disease, diagnostic confirmation can be achieved through an awake video-assisted surgical lung biopsy. This procedure enables the collection of a substantial amount of parenchymal tissue for diagnostic purposes while minimizing perioperative complications associated with mechanical ventilation with the patient under general anaesthesia, given the impaired lung function due to the underlying condition.

Peripheral Circulating Blood Cells Deviation Based on Tumor Inflammatory Microenvironment Activity in Resected Upstaged Lung Adenocarcinomas.

: The tumour inflammatory microenvironment (TIME) reflects a selective activation of the central immune system (IS), particularly T-cells expansion, which leads to immune cells migrating to the target, such as lung cancer, via the bloodstream and lymphatic vessels. In this study, the aim is to investigate whether the distribution of peripheral blood cells varies based on the immune status of patients with lung adenocarcinoma. : This is a single-center retrospective study conducted in the Thoracic Surgery Unit of the University of Padua (Italy) between 1 January 2016 and 1 April 2024.

Primary pulmonary meningioma mimicking a carcinoid tumor in a middle-aged female.

A 46-year-old female complained of cough and dyspnea. A chest X-ray and CT scan showed a solitary subpleural pulmonary nodule in the left upper lobe. Surgical resection was performed.

Beyond the Barriers of Ex Vivo Lung Perfusion Through an Emblematic Case: A New Way Forward to Expand the Donor Pool.

Lung transplantation is the most effective treatment for end-stage respiratory diseases, but its application is limited by the shortage of organs. Ex vivo lung perfusion (EVLP) has emerged as a promising technique to evaluate and recondition donor lungs previously deemed unsuitable for transplantation. However, limitations such as lung contusions, air leaks, and perfusate extravasation, especially in portable EVLP systems, hinder the procedure.

Early Prone Positioning As a Rescue Therapy for Moderate-to-severe Primary Graft Dysfunction After Bilateral Lung Transplant.

Objectives: Primary graft dysfunction (PGD) affects survival after lung transplant (LT). The current hypothesis was that prone positioning (PP), proposed as a rescue maneuver to treat refractory hypoxemia due to PGD, may improve LT outcomes, especially when applied early.

Design: Bilateral LT recipients developing moderate-to-severe PGD within 24 hours from intensive care unit admission were enrolled.

Surgery for pleural mesothelioma in multimodality setting: comparison between surgical techniques in a high-volume centre.

Objectives: Pleural mesothelioma (PM) is an aggressive disease linked to asbestos exposure, presenting significant treatment challenges. The recommended approach is multimodal treatment, even if the concept of resectable PM and the superiority of one surgical technique over the other [(extended) pleurectomy decortication [(E)PD] vs extra-pleural pneumonectomy (EPP)] are matter of debates. The aim of this study is to compare the 2 techniques in terms of short- and long-term outcomes at a high-volume centre.

Impact of Pulmonary Ligament Resection in Upper Lobectomies: A Multicenter Matched Cohort Study.

: Division of the pulmonary ligament is standard in lower lobectomies, but its application in upper lobectomies remains controversial due to potential complications like atelectasis and bronchial kinking. This retrospective matched cohort study aimed to evaluate the efficacy and safety of ligament resection in upper lobectomies for oncological purposes. : From January 2015 to December 2020, 988 patients who underwent minimally invasive upper lobectomies across multiple centers were identified.

[Italian Society of Interventional Cardiology (SICI-GISE) Position paper: Integrated management and transcatheter interventions for acute pulmonary embolism].

Pulmonary embolism (PE) is commonly treated primarily with pharmacological therapy, while advanced reperfusion therapies (transcatheter or surgical) are considered only in cases of contraindications or failure of standard therapies. Treatment algorithms vary depending on the patient's risk, with patients at intermediate or high risk potentially requiring evaluation for such advanced reperfusion therapies. Critical scenarios, such as contraindications to systemic thrombolysis or failure of pharmacological protocols, necessitate the activation of a multidisciplinary pulmonary embolism response team (PERT) and prompt therapeutic escalation.

Reconstruction of diaphragm with cadaveric fascia lata during extended surgery for pleural mesothelioma: A single-center experience.

Introduction: Synthetic materials have traditionally been used to reconstruct the diaphragm during extensive surgery for pleural mesothelioma. However, new biomaterials have shown promising results in various surgical fields. This study describes our experience using homologous fascia lata for diaphragm reconstruction in patients undergoing surgery with radical intent for pleural mesothelioma.

Unlocking the Potential of Computed Tomography-Guided Tracers in Pinpointing Lung Lesions during Surgery: A Collaborative Multi-Institutional Journey.

Multiple techniques exist for the preoperative localization of small, deeply located solid or subsolid pulmonary nodules to guide limited thoracoscopic resection. This study aims to conduct a multi-institutional comparison of three different tomography-guided tracers' methods. A retrospective multicenter cross-sectional study was conducted.