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1. Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: a propensity score matching study from the Italian VATS Group Registry

Author

Dell'Amore, A., Lomangino, I., Cannone, G., Terzi, S., Pangoni, A., Lorenzoni, G., Nicotra, S., Schiavon, M., Zuin, A., Gregori, D., Crisci, R., Curcio, C., Rea, F., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Solli, P., Brandolini, I., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Iurilli, S., Surrente, C., Lopez, C., Droghett, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Nosotti, M., Rosso, L., Negri, G. P., Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Amore, D., Baietto, G., Casadio, C., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, N., Rotolo, A., Terzi, A., Viti, A., Infante, M., and Benato, C.

Subjects
Segmentectomy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, VATS lobectomy, Video-assisted thoracic surgery, Context (language use), Mastectomy, Segmental, Postoperative outcome, Postoperative Complications, Lobectomy, Non-small-cell lung cancer, Carcinoma, Non-Small-Cell Lung, Humans, Medicine, Registries, Thoracotomy, Pneumonectomy, Propensity Score, Lung cancer, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, Confounding, Postoperative complication, General Medicine, medicine.disease, Surgery, Propensity score matching, Non small cell, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

Published
2021

2. Erratum: Airway management in anesthesia for thoracic surgery: a 'real life' observational study

Author

Muzzi, R., Morelli, A., Aresu, G., Pravisani, C., Brazzoni, M., Granzotti, S., Toretti, I., Barbariol, F., Battezzi, A., Cattaruzza, A., Rufolo, D., Comi, D., Del Grande, E., Rosboch, G. L., Cortese, G., Galietti, E., Melchiorri, C., Maietta, S., Micheletto, S., Pedrazzoli, R., Prizio, G., Belcio, W., Amodio, R., Cascella, M., Cuomo, A., Rocco, G., Melotti, R. M., Mazzoli, C. A., Zangrillo, A., Guarnieri, M., Fasciolo, A., Montagnani, L., Vigo, M., Cataldo, R., Galli, B., Nunziata, J., D'Amora, E., Roberto, M., Miano, M., Di Iorio, C., Leprotti, E., Girardi, G., Geat, E., Serra, E., Feltracco, P., Pittarello, D., Falasco, G., Casirani, R., Papagni, G., Rebuffoni, G., Langer, M., Melchionda, G., De Cristofaro, G., Bruno, K., Ruberto, F., Magnanimi, E., Bergantino, B., Apicella, A., Beretta, E., Delle Cave, M., Ferrario, M., Forastiere, E., Pierconti, F., Mastrobuono, F., Amici, S., Mastrantuono, A., Angeletti, P. M., Cammarota, E., Crisci, R., De Santis, S., Delor, F., Gagliardone, M. P., Paino, R., Buono, S., Nespoli, M. R., Rispoli, M., Esposito, M., Lorini, L. F., Sonzogni, V., Benigni, A., Berlot, G., Lucangelo, U., Bregant, G. M., Zornada, F., Martinello, I., Comuzzi, L., Crisman, M., and Casetta, A.

Published
2022

4. What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry

Author

Infante, Maurizio V, Benato, Cristiano, Silva, Ronaldo, Rocco, Gaetano, Bertani, Alessandro, Bertolaccini, Luca, Gonfiotti, Alessandro, Giovannetti, Riccardo, Bonadiman, Cinzia, Lonardoni, Alessandro, Canneto, Barbara, Falezza, Giovanni, Gandini, Paola, Curcio, Carlo, Crisci, Roberto, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benato, C, Benvenuti, M, Bertani, A, Bertolaccini, L, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Crisci, R, Curcio, C, Dell'Amore, A, Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Gonfiotti, A, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Logiudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, S, Meacci, E, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F., Infante M.V., Benato C., Silva R., Rocco G., Bertani A., Bertolaccini L., Gonfiotti A., Giovannetti R., Bonadiman C., Lonardoni A., Canneto B., Falezza G., Gandini P., Curcio C., Crisci R., Zaraca F., Alloisio M., Amore D., Ampollini L., Andreetti C., Argnani D., Baietto G., Bandiera A., Benvenuti M., Bortolotti L., Bottoni E., Breda C., Camplese P., Carbognani P., Cardillo G., Casadio C., Cavallesco G., Cherchi R., Dell'Amore A., Beffa V., Dolci G., Droghetti A., Ferrari P.A., Fontana D., Gargiulo G., Gasparri R., Gavezzoli D., Ghisalberti M., Giovanardi M., Guerrera F., Imperatori A., Iurilli L., Lausi P., Lo Giudice F., Londero F., Lopez C., Luzzi L., Mancuso M., Maniscalco P., Margaritora S., Meacci E., Melloni G., Morelli A., Mucilli F., Natali P., Negri G., Nicotra S., Nosotti M., Pariscenti G., Perkmann R., Pernazza F., Pirondini E., Poggi C., Puma F., Refai M., Rinaldo A., Rizzardi G., Rosso L., Rotolo N., Russo E., Sabbatini A., Scarci M., Spaggiari L., Stefani A., Solli P., Surrente C., Terzi A., Torre M., Vinci D., Viti A., Voltolini L., Zaccagna G., Infante, M. V., Benato, C., Silva, R., Rocco, G., Bertani, A., Bertolaccini, L., Gonfiotti, A., Giovannetti, R., Bonadiman, C., Lonardoni, A., Canneto, B., Falezza, G., Gandini, P., Curcio, C., Crisci, R., the Italian VATS group, Member, and Negri, G.

Subjects
Male, Registrie, Conversion, Morbidity, Postoperative complications, Video-assisted thoracoscopic surgery lobectomy, Lung Neoplasms, Intraoperative Complication, Aged, Female, Hospitals, Humans, Intraoperative Complications, Lung, Middle Aged, Pneumonectomy, Postoperative Complications, Registries, Retrospective Studies, Risk Factors, Thoracic Surgery, Video-Assisted, medicine.medical_treatment, Interquartile range, Retrospective Studie, Settore MED/21 - CHIRURGIA TORACICA, Conversion, Morbidity, Postoperative complications, Video-assisted thoracoscopic surgery lobectomy, Thoracic Surgery, General Medicine, Video-assisted thoracoscopic surgery, Cardiology and Cardiovascular Medicine, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, Hospital, medicine, business.industry, Risk Factor, Retrospective cohort study, Perioperative, medicine.disease, Comorbidity, Surgery, Postoperative complication, Lung Neoplasm, Complication, business
Abstract

OBJECTIVESInherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons’ ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry.METHODSThe registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications.RESULTSFour thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3–6). Grade 1 and 2 and Grade 3–5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (CONCLUSIONSVATS lobectomy is a safe procedure even in medically compromised patients. An improved classification system for conversions is proposed and prevention strategies are suggested to reduce conversion rates and possibly complications in less-experienced centres.

Published
2019

5. Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database

Author

Tosi, D, Nosotti, M, Bonitta, G, Mazzucco, A, Righi, I, Mendogni, P, Rosso, L, Palleschi, A, Rocco, G, Crisci, R, Mancuso, M, Pernazza, F, Refai, M, Bortolotti, L, Rizzardi, G, Gargiulo, G, Dolci, Gp, Perkmann, R, Zaraca, F, Benvenuti, M, Gavezzoli, D, Cherchi, R, Ferrari, P, Mucilli, F, Camplese, P, Melloni, G, Mazza, F, Cavallesco, G, Maniscalco, P, Voltolini, L, Gonfiotti, A, Stella, F, Argnani, D, Pariscenti, Gl, Lurilli, Surrente, C, Lopez, C, Droghetti, A, Giovanardi, M, Breda, C, Lo Giudice, F, Alloisio, M, Bottoni, E, Spaggiari, L, Gasparri, R, Torre, M, Rinaldo, A, Negri, Gp, Bandiera, A, Stefani, A, Natali, P, Scarci, M, Pirondini, E, Curcio, C, Amore, D, Baietto, G, Casadio, C, Nicotra, S, Dell'Amore, A, Bertani, A, Russo, E, Ampollini, L, Carbognani, P, Puma, F, Vinci, D, Andreetti, C, Poggi, C, Cardillo, G, Margaritora, S, Meacci, Elisa, Luzzi, L, Ghisalberti, M, Zaccagna, G, Lausi, P, Guerrera, F, Fontana, D, Della Beffa, V, Morelli, A, Londero, F, Imperatori, A, Rotolo, N, Terzi, A, Viti, A, Infante, M, Benato, C, Tosi, D., Nosotti, M., Bonitta, G., Mazzucco, A., Righi, I., Mendogni, P., Rosso, L., Palleschi, A., Rocco, G., Crisci, R., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Gargiulo, G., Dolci, G. P., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Surrente, C., Lopez, C., Droghetti, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Negri, G, Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Curcio, C., Amore, D., Baietto, G., Casadio, C., Nicotra, S., Dell'Amore, A., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, A., Rotolo, N., Terzi, A., Viti, A., Infante, M., Benato, C., Tosi D., Nosotti M., Bonitta G., Mazzucco A., Righi I., Mendogni P., Rosso L., Palleschi A., Rocco G., Crisci R., Mancuso M., Pernazza F., Refai M., Bortolotti L., Rizzardi G., Gargiulo G., Dolci G.P., Perkmann R., Zaraca F., Benvenuti M., Gavezzoli D., Cherchi R., Ferrari P., Mucilli F., Camplese P., Melloni G., Mazza F., Cavallesco G., Maniscalco P., Voltolini L., Gonfiotti A., Stella F., Argnani D., Pariscenti G.L., Surrente C., Lopez C., Droghetti A., Giovanardi M., Breda C., Lo Giudice F., Alloisio M., Bottoni E., Spaggiari L., Gasparri R., Torre M., Rinaldo A., Negri G.P., Bandiera A., Stefani A., Natali P., Scarci M., Pirondini E., Curcio C., Amore D., Baietto G., Casadio C., Nicotra S., Dell'amore A., Bertani A., Russo E., Ampollini L., Carbognani P., Puma F., Vinci D., Andreetti C., Poggi C., Cardillo G., Margaritora S., Meacci E., Luzzi L., Ghisalberti M., Zaccagna G., Lausi P., Guerrera F., Fontana D., Della Beffa V., Morelli A., Londero F., Imperatori A., Rotolo N., Terzi A., Viti A., Infante M., and Benato C.

Subjects
Male, Lung Neoplasms, Thoracic, Italian VATS Group, computer.software_genre, Postoperative pain, Settore MED/21 - CHIRURGIA TORACICA, Carcinoma, Non-Small-Cell Lung, Lobectomy, Three-portal, Uniportal, Video-assisted thoracic surgery, Aged, Equipment Design, Female, Humans, Neoplasm Staging, Operative Time, Pneumonectomy, Retrospective Studies, Thoracic Surgery, Video-Assisted, Tomography, X-Ray Computed, Stage (cooking), Non-Small-Cell Lung, Tomography, Database, Thoracic Surgery, X-Ray Computed, Cardiothoracic surgery, Cohort, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Italian VATS Group, Lobectomy, Postoperative pain, Three-portal, Uniportal, Video-assisted thoracic surgery, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, medicine, Lung cancer, business.industry, Carcinoma, Odds ratio, medicine.disease, Confidence interval, Propensity score matching, Surgery, business, computer
Abstract

OBJECTIVES This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of dissected lymph nodes and length of stay. METHODS This was an observational, retrospective, cohort, multicentre study on data collected by 49 Italian thoracic units. Inclusion criteria were clinical stage I–II non-small-cell lung cancer, uniportal or 3-portal VATS lobectomy and R0 resection. Exclusion criteria were cT3 disease, previous thoracic malignancy, induction therapy, significant comorbidities and conversion to other techniques. The pain parameter was dichotomized: the numeric rating scale ≤3 described mild pain, whereas the numeric rating scale score >3 described moderate/severe pain. The propensity score-adjusted generalized estimating equation was used to compare the uniportal with 3-portal lobectomy. RESULTS Among 4338 patients enrolled from January 2014 to July 2017, 1980 met the inclusion criteria; 1808 patients underwent 3-portal lobectomy and 172 uniportal surgery. The adjusted generalized estimating equation regression model using the propensity score showed that over time pain decreased in both groups (P CONCLUSIONS Data from the Italian VATS Group Database showed that in clinical practice uniportal lobectomy seems to entail a higher risk of moderate/severe pain on second and third postoperative days.

Published
2019

6. Does morbid obesity influence perioperative outcomes after video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer? Analysis of the Italian VATS group registry

Author

Guerrera, F., Lyberis, P., Lausi, P. O., Cristofori, R. C., Giobbe, R., Molinatti, M., Filosso, P. L., Curcio, C., Crisci, R., Ruffini, E., Maurizio, M., Fausto, P., Majed, R., Franco, S., Desideria, A., Giuseppe, M., Angela, D. P., Luigi, B., Giovanna, R., Piergiorgio, S., Giampiero, D., Reinhold, P., Francesco, Z., Roberto, B. M., Diego, G., Roberto, C., Albino, F. P., Felice, M., Pierpaolo, C., Giulio, M., Federico, M., Giorgio, C., Pio, M., Luca, V., Alessandro, G., Francesco, S., Pia, A. N., Luca, P. G., Carlo, R., Corrado, S., Camillo, L., Andrea, D., Michele, G., Cristiano, B., Fabio, L. G., Marco, A., Edoardo, B., Lorenzo, S., Roberto, G., Massimo, T., Alessandro, R., Mario, N., Davide, T., Giampeiro, N., Alessandro, B., Federico, R., Alessandro, S., Pamela, N., Marco, S., Emanuele, P., Carlo, C., Dario, A., Ottavio, R., Samuele, N., Andrea, D. A., Giorgia, T., Luca, A., Paolo, C., Francesco, P., Damiano, V., Giuseppe, C., Francesco, C., Stefano, M., Elisa, M., Piero, P., Marco, G., Duilio, D., Diego, F., Vittorio, D. B., Angelo, M., Francesco, L., Andrea, I., Nicola, R., Alberto, Andrea, V., and Maurizio, I.

Subjects
medicine.medical_specialty, Surgical margin, Lung Neoplasms, medicine.medical_treatment, VATS lobectomy, Video-assisted thoracic surgery, Blood Loss, Surgical, Lobectomy, Lung Cancer, Morbidity, Mortality, Obesity, Postoperative Complications, Carcinoma, Non-Small-Cell Lung, medicine, Humans, Thoracotomy, Registries, Lung cancer, Pneumonectomy, Retrospective Studies, business.industry, Thoracic Surgery, Video-Assisted, Margins of Excision, Perioperative, Length of Stay, medicine.disease, Surgery, Obesity, Morbid, Chest tube, Treatment Outcome, Cardiothoracic surgery, business, Abdominal surgery
Abstract

Objectives Obesity in Europe, and worldwide, has been an increasing epidemic during the past decades. Moreover, obesity has important implications regarding technical issues and the risks associated with surgical interventions. Nevertheless, there is a lack of evidence assessing the influence of obesity on video-assisted thoracic surgery (VATS) lobectomy results. Our study aimed to assess the impact of morbid obesity on perioperative clinical and oncological outcomes after VATS lobectomy using a prospectively maintained nationwide registry. Methods The Italian VATS lobectomy Registry was used to collect all consecutive cases from 55 Institutions. Explored outcome parameters were conversion to thoracotomy rates, complication rates, intra-operative blood loss, surgical time, hospital postoperative length of stay, chest tube duration, number of harvested lymph-node, and surgical margin positivity. Results From 2016 to 2019, a total of 4412 patients were collected. 74 patients present morbid obesity (1.7%). Multivariable-adjusted analysis showed that morbid obesity was associated with a higher rate of complications (32.8% vs 20.3%), but it was not associated with a higher rate of conversion, and surgical margin positivity rates. Moreover, morbid obesity patients benefit from an equivalent surgical time, lymph-node retrieval, intraoperative blood loss, hospital postoperative length of stay, and chest tube duration than non-morbid obese patients. The most frequent postoperative complications in morbidly obese patients were pulmonary-related (35%). Conclusion Our results showed that VATS lobectomy could be safely and satisfactorily conducted even in morbidly obese patients, without an increase in conversion rate, blood loss, surgical time, hospital postoperative length of stay, and chest tube duration. Moreover, short-term oncological outcomes were preserved.

Published
2021

7. Predictors of nodal upstaging in patients with cT1-3N0 non-small cell lung cancer (NSCLC): results from the Italian VATS Group Registry

Author

Marulli, G., Faccioli, E., Mammana, M., Nicotra, S., Comacchio, G., Verderi, E., De Palma, A., Curcio, C., Rea, F., Bertani, A., Russo, E., Voltolini, L., Gonfiotti, A., Nosotti, M., Rosso, L., Muriana, G., Droghetti, A., Crisci, R., Zaccagna, G., Amore, D., di Rienzo, G., Lopez, C., Morelli, A., Londero, F., Spaggiari, L., Gasparri, R., Baietto, G., Casadio, C., Infante, M., Benato, C, Alloisio, M., Bottoni, E, Cardillo, G., Carleo, F., Stella, F., Dolci, G., Puma, F., Vinci, D., Cavallesco, G., Maniscalco, P., Ampollini, L., Carbognani, P., Terzi, A., Viti, A, Negri, G., Bandiera, A., Perkmann, R., Zaraca, F., Andreetti, C., Poggi, C., Mucilli, F., Camplese, P., Luzzi, L., Ghisalberti, M., Imperatori, A., Rotolo, N., Bortolotti, L., Rizzardi, G., Torre, M., Rinaldo, A., Sabbatini, A., Refai, M., Benvenuti, M. R., Benetti, D., Stefani, A., Natali, P., Lausi, P., Guerrera, F., Melloni, G., Mazza, F., Argnani, D., Sanna, S., Fontana, D., Beffa, V. D., Meda, S., Pernazza, F. a, and Italian VATS Group

Subjects
Oncology, Male, Lung Neoplasms, medicine.medical_treatment, non-small cell lung cancer (NSCLC), Nodal upstaging, VATS lobectomy, 0302 clinical medicine, Risk Factors, Carcinoma, Non-Small-Cell Lung, 80 and over, Registries, Non-Small-Cell Lung, Child, Pneumonectomy, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Aged, 80 and over, Thoracic Surgery, Video-Assisted, Thoracic Surgery, General Medicine, Middle Aged, Lymph node dissection, Mediastinal staging, Predictive risk factors, Adolescent, Adult, Aged, Disease Progression, Female, Humans, Italy, Lymph Node Excision, Neoplasm Staging, Predictive Value of Tests, Young Adult, 030220 oncology & carcinogenesis, Predictive value of tests, 030211 gastroenterology & hepatology, Lymph node dissection, Mediastinal staging, Nodal upstaging, Predictive risk factors, VATS lobectomy, medicine.medical_specialty, Video-Assisted, NO, 03 medical and health sciences, Internal medicine, medicine, In patient, business.industry, Disease progression, Carcinoma, medicine.disease, Surgery, Neoplasm staging, business
Abstract

Accurate staging of early non-small cell lung cancer is fundamental for selecting the best treatment. The aim of this study was to identify risk factors for nodal upstaging after video-assisted thoracoscopic lobectomy for clinical T1-3N0 tumors.From 2014 to 2017, 3276 thoracoscopic lobectomies were recorded in the prospective database "Italian VATS Group". Linear and multiple logistic regression models were adapted to identify independent predictors of nodal upstaging and factors associated with progression in postoperative N status.Nodal upstaging was found in 417 cases (12.7%), including 206 cases (6.2%) of N1-positive nodes, 81 cases of N2 nodes (2.4%), and 130 cases (4%) of involvement of both N1 + N2 nodes. A total of 241 (7.3%) patients had single-station nodal involvement, whereas 176 (5.3%) had multiple-station involvement. In the final regression model, the tumor grade, histology, pathologic T status, and 12 resected nodes were independent predictors of nodal upstaging.The number of resected lymph nodes seems to predict nodal upstaging better than the type of intraoperative lymph node management. Other preoperative risk factors correspond to those for which the current guidelines of the European Society of Thoracic Surgery recommend more extensive preoperative mediastinal staging.

Published
2020

8. Correction to: Predictors of nodal upstaging in patients with cT1-3N0 non-small cell lung cancer (NSCLC): results from the Italian VATS Group Registry (Surgery Today, (2020), 50, 7, (711-718), 10.1007/s00595-019-01939-x)

Author

Marulli, G., Faccioli, E., Mammana, M., Nicotra, S., Comacchio, G., Verderi, E., De Palma, A., Curcio, C., Rea, F., Bertani, A., Russo, E., Voltolini, L., Gonfiotti, A., Nosotti, M., Rosso, L., Muriana, G., Droghetti, A., Crisci, R., Zaccagna, G., Amore, D., di Rienzo, G., Lopez, C., Morelli, A., Londero, F., Spaggiari, L., Gasparri, R., Baietto, G., Casadio, C., Infante, M., Benato, C., Alloisio, M., Bottoni, E., Cardillo, G., Carleo, F., Stella, F., Dolci, G., Puma, F., Vinci, D., Cavallesco, G., Maniscalco, P., Ampollini, L., Carbognani, P., Terzi, A., Viti, A., Negri, G., Bandiera, A., Perkmann, R., Zaraca, F., Andreetti, C., Poggi, C., Mucilli, F., Camplese, P., Luzzi, L., Ghisalberti, M., Imperatori, A., Rotolo, N., Bortolotti, L., Rizzardi, G., Torre, M., Rinaldo, A., Sabbatini, A., Refai, M., Benvenuti, M. R., Benetti, D., Stefani, A., Natali, P., Lausi, P., Guerrera, F., Melloni, G., Mazza, F., Argnani, D., Sanna, S., Fontana, D., Beffa, V. D., Meda, S., and Pernazza, F.

Subjects
NO
Published
2020

9. National adoption of video-assisted thoracoscopic surgery (VATS) lobectomy: The Italian VATS register evaluation

Author

Divisi D., Bertolaccini L., Barone M., Amore D., Argnani D., Zaccagna G., Solli P., Di Rienzo G., Curcio C., Crisci R., Ampollini L., Alloisio M., Andreetti C., Baietto G., Bandiera A., Benato C., Benetti D., Benvenuti M., Bertani A., Bortolotti L., Bottoni E., Camplese P., Carbognani P., Cardillo G., Carleo F., Casadio C., Cavallesco G., Negri A. D., Dolci G., Droghetti A., Gasparri R., Ghisalberti M., Gonfiotti A., Guerrera F., Imperatori A., Infante M., Lausi P., Londero F., Lopez C., Luzzi L., Maineri P., Maniscalco P., Marulli G., Monteverde M., Morelli A., Mucilli F., Natali P., Negri G., Nicotra S., Nosotti M., Perkmann R., Poggi C., Puma F., Refai M., Rinaldo A., Rizzardi G., Rosso L., Rotolo N., Russo E., Sabatini A., Spaggiari L., Stefani A., Stella F., Terzi A., Torre M., Vinci D., Viti A., Voltolini L., Zaraca F., Divisi D., Bertolaccini L., Barone M., Amore D., Argnani D., Zaccagna G., Solli P., Di Rienzo G., Curcio C., Crisci R., Ampollini L., Alloisio M., Andreetti C., Baietto G., Bandiera A., Benato C., Benetti D., Benvenuti M., Bertani A., Bortolotti L., Bottoni E., Camplese P., Carbognani P., Cardillo G., Carleo F., Casadio C., Cavallesco G., Negri A.D., Dolci G., Droghetti A., Gasparri R., Ghisalberti M., Gonfiotti A., Guerrera F., Imperatori A., Infante M., Lausi P., Londero F., Lopez C., Luzzi L., Maineri P., Maniscalco P., Marulli G., Monteverde M., Morelli A., Mucilli F., Natali P., Negri G., Nicotra S., Nosotti M., Perkmann R., Poggi C., Puma F., Refai M., Rinaldo A., Rizzardi G., Rosso L., Rotolo N., Russo E., Sabatini A., Spaggiari L., Stefani A., Stella F., Terzi A., Torre M., Vinci D., Viti A., Voltolini L., Zaraca F., Divisi, Duilio, Bertolaccini, Luca, Barone, Mirko, Amore, Dario, Argnani, Desideria, Zaccagna, Gino, Solli, Piergiorgio, Di Rienzo, Gaetano, Curcio, Carlo, Crisci, Roberto, Italian VATS, Group, and Negri, G

Subjects
Database, Learning curve, Learning tools, Non-small cell lung cancer, Training, Video-assisted thoracoscopic surgery lobectomy (VATS lobectomy), Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, VATS lobectomy, Air leak, NO, 03 medical and health sciences, 0302 clinical medicine, Learning tool, database, learning curve, learning tools, non-small cell lung cancer, training, medicine, Thoracotomy, business.industry, General surgery, Database, Learning curve, Learning tools, Non-small cell lung cancer, Training, Video-assisted thoracoscopic surgery lobectomy (VATS lobectomy), 030228 respiratory system, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Video-assisted thoracoscopic surgery, Operative time, Original Article, business
Abstract

Background: The expertise curve of video-assisted thoracoscopic surgery (VATS) lobectomies still stirs debate and controversy both because of the number of procedures to carry out and of the evaluation of the learning threshold. The purpose of our study was the examination of the variables related to the learning curve of the video-assisted approach, to establish what may be an expression of the technical maturity of the surgeon. Methods: The National Register for VATS lobectomy built in 2013 was used to collect data from 65 Thoracic Surgery Units. Out of more than 3,700 patients enrolled, only information from Units with ≥100 VATS lobectomies were retrospectively analysed. Unpaired Student’s t-tests, Fisher’s exact tests, Pearson’s χ 2 were applied as needed. Cumulative summative analysis and one-way ANOVA were used to identify the expertise curve of VATS lobectomy. Results: Ten institutions contributed a total of 1,679 patients, who were divided into three uniform groups according to the chronological sequence of surgery. The length of utility incision, the number of dissected lymph nodes and the operative time were not statistically significant (P=0.999, P=0.972 and P=0.307, respectively) among groups. Conversion to thoracotomy and postoperative air leaks occurred in 125 (7.44%) and 109 (6.49%) patients, gradually declined in Group 3 with statistical signi cance (P=0.048 and P=0.00086). Conclusions: The conversion rate and the percentage of air leaks seem to de ne the expertise of VATS lobectomy, being linked to the ability to manage more complicated surgical cases or intraoperative adverse events.

Published
2018

10. Corrigendum to: What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry (European Journal of Cardio-thoracic Surgery (2019) DOI: 10.1093/ejcts/ezz187)

Author

Infante, M. V., Benato, C., Silva, R., Rocco, G., Bertani, A., Bertolaccini, L., Gonfiotti, A., Giovannetti, R., Bonadiman, C., Lonardoni, A., Canneto, B., Falezza, G., Gandini, P., Curcio, C., Crisci, R., Zaraca, F., Alloisio, M., Amore, D., Ampollini, L., Andreetti, C., Argnani, D., Baietto, G., Bandiera, A., Benvenuti, M., Bortolotti, L., Bottoni, E., Breda, C., Camplese, P., Carbognani, P., Cardillo, G., Casadio, C., Cavallesco, G., Cherchi, R., Dell'Amore, A., Beffa, V., Dolci, G, Droghetti, A, Ferrari, P. A., Fontana, D., Gargiulo, G., Gasparri, R., Gavezzoli, D., Ghisalberti, M., Giovanardi, M., Guerrera, F., Imperatori, A., Iurilli, L., Lausi, P., Lo Giudice, F., Londero, F., Lopez, C., Luzzi, L., Mancuso, M., Maniscalco, P., Margaritora, S., Meacci, E., Melloni, G., Morelli, A., Mucilli, F., Natali, P., Negri, G., Nicotra, S., Nosotti, M., Pariscenti, G., Perkmann, R., Pernazza, F., Pirondini, E., Poggi, C., Puma, F., Refai, M., Rinaldo, A., Rizzardi, G, Rosso, L., Rotolo, N., Russo, E., Sabbatini, A., Scarci, M., Spaggiari, L., Stefani, A., Solli, P., Surrente, C., Terzi, A., Torre, M., Vinci, D., Viti, A., Voltolini, L., Zaccagna, G., and the Italian VATS group members

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Thoracic, medicine.medical_treatment, MEDLINE, NO, Postoperative Complications, Risk Factors, Pulmonary lobectomy, Humans, Medicine, Registries, Intraoperative Complications, Pneumonectomy, Lung, Aged, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, General surgery, General Medicine, Perioperative, Middle Aged, Corrigenda, Hospitals, Video-assisted thoracoscopic surgery, Female, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES: Inherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons’ ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry. METHODS: The registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications. RESULTS: Four thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3–6). Grade 1 and 2 and Grade 3–5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (

Published
2019

14. Controllo del dolore post-­‐toracotomia

Author

Angeletti, C., Guetti, C., Angeletti, P. M., Crisci, R. M., Mastrobuono, S. Amici F., Blanco, M., Ciccozzi, A., Marinangeli, Franco, and Pilotti, L.

Published
2013

21. [Current role of open window thoracostomy]

Author

Torresini G, Di Francescantonio W, Battaglia C, Divisi D, Di Pietrantonio F, and Crisci R

Subjects
Male, Humans, Middle Aged, Thoracostomy, Aged
Abstract

The Open Window Thoracostomy (OWT) surgical method find its origin in the treatment of chronic tuberculous empyemas, in the cases where the drainage alone not permitted a sufficient cleaning of pleural cavity. In the recent years the indications for the execution of this method are extended also to metapneumoniae and post-pneumonectomy empyemas (for benign and malignant pathology), with or without bronco-pleural fistula, when these pathologies produces a general severe decline in the patient (septic shock). This method permit to effect a daily cleaning of a pleural cavity, through the introduction of a sterile gauzes imbued of specific antibiotic, reducing at least the purulent infection effects's previously present and favouring the reduction of the same cavity, in prevision of other reconstructive operations (thoracoplasty). Generally not many beloved by surgeons and patients (for the difficult management, aesthetic outcomes, the long stay in hospital), the OWT can often reestablish a dangerous situation, especially in the patients with a risk of septic shock. This study aims to analyse present indications, problems and therapeutics outcomes of this method, through the evaluation of 27 cases of OWT treated in the Department of Thoracic Surgery University of L'Aquila between the 1984 and the 1998.

Published
2000

22. [The role of fiberoptic bronchoscopy in the diagnosis of pulmonary cancer]

Author

Paolini, Antonio, Tosato, Filippo, Casella, M. C., Ruggieri, Massimo, and Crisci, R.

Subjects
Radiography, Lung Neoplasms, Cytodiagnosis, Bronchoscopy, Carcinoma, Carcinoma, Squamous Cell, Sputum, Fiber Optic Technology, Humans, Adenocarcinoma, Carcinoma, Small Cell
Abstract

Cancer of the lung is becoming increasingly common. In the U.S., it has the highest mortality of the neoplastic diseases, well ahead of cancer of the colon and rectum. Surgical and/or complementary management is poorly effective because it comes too late. Early diagnosis and treatment are essential, therefore. Preclinical diagnosis may be possible radiographically in certain fortunate cases, but this is never an early diagnosis. The latter is only possible through active bronchial cytology (bronchial brushing, selective washing, PBS) during and after flexible fibrobronchoscopy, which can be carried out under local anaesthesia at the outpatient level and causes very little distress to the patient. Data from a personal series are cited in support of the view that cytodiagnosis should be routinely employed in subjects at high risk (heavy smokers, persons with chronic bronchitis, emphysema, etc.).

Published
1979

25. Laparoscopic repair of diaphragmatic iatrogenic hernia

Author

Guido Torresini, Sozio, L., Crisci, R., and Amicucci, G.

Subjects
Hernia, Diaphragmatic, Male, Reoperation, Lung Neoplasms, Postoperative Complications, Diaphragm, Iatrogenic Disease, Carcinoma, Squamous Cell, Humans, Laparoscopy, Middle Aged, Surgical Mesh, Pneumonectomy

27. [Combined surgical treatment of pulmonary neoplasms with single brain metastasis]

Author

Torresini G, Crisci R, Lococo A, Cardelli M, Giusti L, Renato Galzio, and Gf, Coloni

Subjects
Male, Lung Neoplasms, Brain Neoplasms, Cause of Death, Carcinoma, Squamous Cell, Humans, Female, Adenocarcinoma, Middle Aged, Aged
Abstract

The combined surgical treatment of primitive lung cancer with single brain metastasis is a frequently debated but still controversial problem. Up to day several therapeutic approaches are generally integrated (surgery, radiotherapy, chemotherapy) according to the clinical patterns and the technical possibilities. In general, the combined surgical operation (thoracotomy + craniotomy) when it is possible to be done, followed or proceeded by chemo-radiotherapy, has allowed to achieve a prolonged survival in these patients, maintaining an acceptable quality of life. The authors analyze 10 cases treated by thoracotomy and craniotomy at the Chair of Thoracic Surgery of University of L'Aquila. Although consisting of a small number of cases, this experience allows to detect the particular problems concerning these patients. The indications to the combined surgical treatment are considered, evaluating the surgical operation which is to be performed as first on the basis of lung cancer staging and of the location and size of the brain metastases. Finally the patients survival and their quality of life are considered.

28. Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database

Author

Bongiolatti, Stefano, Gonfiotti, Alessandro, Viggiano, Domenico, Borgianni, Sara, Politi, Leonardo, Crisci, Roberto, Curcio, Carlo, Voltolini, Luca, Italian Vats Group, Carlo, Curcio, Dario, Amore, Giuseppe, Marulli, Samuele, Nicotra, Andrea De Negri, Paola, Maineri, Gaetano Di Rienzo, Camillo, Lopez, Roberto, Crisci, Duilio, Divisi, Angelo, Morelli, Alessandro, Bertani, Francesco, Londero, Lorenzo, Rosso, Lorenzo, Spaggiari, Roberto, Gasparri, Guido, Baietto, Caterina, Casadio, Maurizio, Infante, Cristiano, Benato, Marco, Alloisio, Edoardo, Bottoni, Andrea, Droghetti, Andrea, Giovanardi, Giuseppe, Cardillo, Francesco, Carleo, Luca, Bertolaccini, Piergiorgio, Solli, Franco, Stella, Giampiero, Dolci, Francesco, Puma, Damiano, Vinci, Giorgio Cavallesco Pio Maniscalco, Desideria, Argnani, Luca, Ampollini, Paolo, Carbognani, Alberto, Terzi, Andrea, Viti, Giampiero, Negri, Alessandro, Bandiera, Reinhold, Perkmann, Francesco, Zaraca, Ibrahim, Mohsen, Poggi, Camilla, Felice, Mucilli, Pierpaolo, Camplese, Luca, Luzzi, Marco, Ghisalberti, Andrea, Imperatori, Nicola, Rotolo, Luigi, Bortolotti, Giovanna, Rizzardi, Massimo, Torre, Alessandro, Rinaldo, Armando, Sabbatini, Majed, Refai, Mauro Roberto Benvenuti, Diego, Benetti, Alessandro, Stefani, Pamela, Natali, Paolo, Lausi, Francesco, Guerrera, Bongiolatti S., Gonfiotti A., Viggiano D., Borgianni S., Politi L., Crisci R., Curcio C., Voltolini L., Amore D., Marulli G., Nicotra S., De Negri A., Maineri P., DiRienzo G., Lopez C., Divisi D., Morelli A., Bertani A., Russo E., Londero F., Rosso L., Spaggiari L., Gasparri R., Baietto G., Casadio C., Infante M., Benato C., Alloisio M., Bottoni E., Droghetti A., Giovanardi A., Cardillo G., Carleo F., Bertolaccini L., Solli P., Stella F., Dolci G., Puma F., Vinci D., Cavallesco G., Maniscalco P., Argnani D., Ampollini L., Carbognani P., Terzi A., Viti A., Negri G., Bandiera A., Perkmann R., Zaraca F., Ibrahim M., Poggi C., Mucilli F., Camplese P., Luzzi L., Ghisalberti M., Imperatori A., Rotolo N., Bortolotti L., Rizzardi G., Torre M., Rinaldo A., Sabbatini A., Refai M., Benvenuti M.R., Benetti D., Stefani A., Natali P., Lausi P., Guerrera F., Bongiolatti, S., Gonfiotti, A., Viggiano, D., Borgianni, S., Politi, L., Crisci, R., Curcio, C., Voltolini, L., Amore, D., Marulli, G., Nicotra, S., De Negri, A., Maineri, P., Dirienzo, G., Lopez, C., Divisi, D., Morelli, A., Bertani, A., Russo, E., Londero, F., Rosso, L., Spaggiari, L., Gasparri, R., Baietto, G., Casadio, C., Infante, M., Benato, C., Alloisio, M., Bottoni, E., Droghetti, A., Giovanardi, A., Cardillo, G., Carleo, F., Bertolaccini, L., Solli, P., Stella, F., Dolci, G., Puma, F., Vinci, D., Cavallesco, G., Maniscalco, P., Argnani, D., Ampollini, L., Carbognani, P., Terzi, A., Viti, A., Negri, G., Bandiera, A., Perkmann, R., Zaraca, F., Ibrahim, M., Poggi, C., Mucilli, F., Camplese, P., Luzzi, L., Ghisalberti, M., Imperatori, A., Rotolo, N., Bortolotti, L., Rizzardi, G., Torre, M., Rinaldo, A., Sabbatini, A., Refai, M., Benvenuti, M. R., Benetti, D., Stefani, A., Natali, P., Lausi, P., and Guerrera, F.

Subjects
Male, Lung Neoplasms, Complications, Databases, Factual, medicine.medical_treatment, Sex Factor, Conversion, Lobectomy, Lung cancer, Video-assisted thoracic surgery, 0302 clinical medicine, Risk Factors, Retrospective Studie, Carcinoma, Non-Small-Cell Lung, Age Factor, Thoracotomy, Non-Small-Cell Lung, Pneumonectomy, Thoracic Surgery, Video-Assisted, Mortality rate, Age Factors, Thoracic Surgery, Middle Aged, Conversion to Open Surgery, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Human, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, Databases, 03 medical and health sciences, Sex Factors, Internal medicine, medicine, Humans, Factual, Retrospective Studies, Aged, Complications, Conversion, Lobectomy, Lung cancer, Video-assisted thoracic surgery, business.industry, Risk Factor, Carcinoma, Lymphatic Metastasi, Retrospective cohort study, Video-assisted thoracic surgery · Lobectomy · Lung cancer · Conversion · Complications, Lung Neoplasm, Chest tube, Surgery, Complication, business, Abdominal surgery
Abstract

Objective: The objective of the study is to analyse the causes and impact of conversion from VATS to thoracotomy identifying any possible pre-operative risk factors and related consequences. Methods: Data from patient who underwent VATS lobectomy (VATS-L) for NSCLC at VATS Group participating centres were retrospectively analysed and divided in two groups: patients treated with VATS-L and patients who suffered from conversion. Predictors of conversion were assessed with univariate and multivariable exact logistic regression. Complications were evaluated as dependent variables of conversion in a Cox multivariable logistic regression model. Results: A total of 4629 patients underwent planned VATS-L for NSCLC and of these, 432 (9.3%) required conversion; the most frequent causes were bleeding (30.4%) and fibro-calcified hilar lymph nodes (23.9%). The independent risk factors at multivariable analysis model were sex male (OR 1.458, p < 0.01), age older than 70years (OR 1.248, p = 0.036) and the clinically node-positive disease (OR 2.258, p < 0.01). The mortality rate was similar, but the percentage of patients who suffered from any complication (41.7% vs 24.4%, p < 0.01), the complication rate (65% vs 32.2%, p < 0.01), chest tube duration (p < 0.01) and the hospitalisation rate (p < 0.01) were higher for patients converted. Atrial fibrillation (OR 1.471, p = 0.019), prolonged air leak (OR 1.403, p = 0.043), blood transfusions (OR 4.820, p < 0.01), sputum retention (OR 1.80, p = 0.027) and acute kidney failure (OR 2.758, p = 0.03) were significantly associated with conversion at multivariable analysis. Conclusions: Conversion is associated with increased surgical morbidity, blood loss and hospital stay. Sex male, old age and the clinical involvement of lymph nodes were the strongest predictors of conversion.

Published
2019

29. MA01.03 PREC Multicentre Restrospective Study: A Preoperative Risk Classification for Synchronous Oligometastatic Non-Small Cell Lung Cancer

Author

Roberto Crisci, Paolo Mendogni, Francesco Facciolo, Stefano Margaritora, Enrico Ruffini, Lorenzo Spaggiari, Francesco Londero, Maria Teresa Congedo, A. De Palma, Edoardo Bottoni, Marco Alloisio, Giuseppe Marulli, Marco Schiavon, Angelo Carretta, Nicola Tamburini, Stefano Bongiolatti, Federico Rea, Giovanni Muriana, Angelo Morelli, Sara Ricciardi, Luca Voltolini, Silvia Ceccarelli, A. De Vico, Francesco Puma, Marco Lucchi, Ilaria Ceccarelli, Laura Ventura, Luca Bertolaccini, Lorena Costardi, Pio Maniscalco, Domenico Viggiano, Giampiero Negri, Filippo Tommaso Gallina, G. Cardillo, Michele Rusca, Lorenzo Rosso, Bertolaccini, L., Spaggiari, L., Facciolo, F., Gallina, F., Rea, F., Schiavon, M., Margaritora, S., Congedo, M. T., Lucchi, M., Ceccarelli, I., Alloisio, M., Bottoni, E., Negri, G., Carretta, A., Cardillo, G., Ricciardi, S., Ruffini, E., Costardi, L., Muriana, G., Viggiano, D., Rusca, M., Ventura, L., Marulli, G., De Palma, A., Rosso, L., Mendogni, P., Crisci, R., De Vico, A., Maniscalco, P., Tamburini, N., Puma, F., Ceccarelli, S., Voltolini, L., Bongiolatti, S., Morelli, A., and Londero, F.

Subjects
Pulmonary and Respiratory Medicine, Oncology, medicine.medical_specialty, business.industry, Internal medicine, Preoperative risk, medicine, Non small cell, Lung cancer, medicine.disease, business
Published
2021

30. Age and Clinical Presentation for Primary Spontaneous Pneumothorax

Author

Alfonso Fiorelli, Piero Paladini, Mario Nosotti, Enrico Ruffini, Marco Ghisalberti, Francesco Guerrera, Angela De Palma, Roberto Crisci, Paolo Mendogni, Luca Bertolaccini, Andrea De Vico, Ghisalberti, M., Guerrera, F., De Vico, A., Bertolaccini, L., De Palma, A., Fiorelli, A., Paladini, P., Ruffini, E., Crisci, R., Nosotti, M., and Mendogni, P.

Subjects
Pulmonary and Respiratory Medicine, Clinical presentation, Epidemiology, Pneumothorax, Age Distribution, Age Factors, Global Health, Humans, Morbidity, Risk Assessment, Risk Factors, Pediatrics, medicine.medical_specialty, Population, Disease, 030204 cardiovascular system & hematology, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Risk factor, education, education.field_of_study, business.industry, medicine.disease, eye diseases, Etiology, Age of onset, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract

Primary spontaneous pneumothorax (PSP) is a commonly known condition due to the accumulation of air in the pleural space in otherwise healthy people, without apparent underlying lung disease. To date, the exact pathogenesis of PSP is unclear, but it still represents a public health issue. We performed a review of the literature concerning the epidemiology of PSP, examining age of onset and presentation symptoms, in order to assess the possible correlation between these characteristics and its occurrence. Data concerning age, signs, and symptoms were collected. For description purposes, information regarding aetiological and anthropomorphic data was also gathered. In total, 265 papers were evaluated. Regarding age of onset, PSP is a disease that can occur in a broad age group with a double cluster (15-30 and 40-45 yr). Regarding symptoms, pain and dyspnoea (in its various forms) are the most described in PSP. Pain was recorded in 69.25% (range, 9-100%) of the population studied, whereas dyspnoea was present in an average of 54.55% (range, 27-77.1%). Tobacco exposure seems to play an important role in the early onset of PSP. Concerning age at presentation, this review highlights that PSP can occur over a broad age range. The literature appears to be consistent in reporting PSP occurrence mostly below 45 years of age. Asymptomatic PSP is an almost unseen entity. Finally, of pollutants, cigarette smoking should be considered as the most significant exogenous risk factor in the development of PSP.

Published
2020

31. Conversion due to vascular injury during video-assisted thoracic surgery lobectomy: A multicentre retrospective analysis from the Italian video-assisted thoracic surgery group registry

Author

Luca Bertolaccini, Fabio Davoli, Alessandro Pardolesi, Jury Brandolini, Desideria Argnani, Alessandro Bertani, Andrea Droghetti, Alessandro Gonfiotti, Duilio Divisi, Roberto Crisci, Piergiorgio Solli, Mario Nosotti, Carlo Curcio, Dario Amore, Giuseppe Marulli, Samuele Nicotra, Andrea De Negri, Paola Maineri, Gaetano di Rienzo, Camillo Lopez, Angelo Morelli, Francesco Londero, Lorenzo Spaggiari, Roberto Gasparri, Guido Baietto, Caterina Casadio, Maurizio Infante, Cristiano Benato, Marco Alloisio, Edoardo Bottoni, Giuseppe Cardillo, Francesco Carleo, Franco Stella, Giampiero Dolci, Francesco Puma, Damiano Vinci, Giorgio Cavallesco, Pio Maniscalco, Luca Ampollini, Paolo Carbognani, Alberto Terzi, Andrea Viti, Giampiero Negri, Alessandro Bandiera, Reinhold Perkmann, Francesco Zaraca, Claudio Andretti, Camilla Poggi, Felice Mucilli, Pierpaolo Camplese, Luca Luzzi, Marco Ghisalberti, Andrea Imperatori, Nicola Rotolo, Luigi Bortolotti, Giovanna Rizzardi, Massimo Torre, Alessandro Rinaldo, Armando Sabbatini, Majed Refai, Mauro Roberto Benvenuti, Diego Benetti, Alessandro Stefani, Pamela Natali, Paolo Lausi, Francesco Guerrera, Bertolaccini, Luca, Davoli, Fabio, Pardolesi, Alessandro, Brandolini, Jury, Argnani, Desideria, Bertani, Alessandro, Droghetti, Andrea, Gonfiotti, Alessandro, Divisi, Duilio, Crisci, Roberto, Solli, Piergiorgio, Nosotti, Mario, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Bertolaccini L., Davoli F., Pardolesi A., Brandolini J., Argnani D., Bertani A., Droghetti A., Gonfiotti A., Divisi D., Crisci R., Solli P., Nosotti M., Curcio C., Amore D., Marulli G., Nicotra S., De Negri A., Maineri P., di Rienzo G., Lopez C., Morelli A., Londero F., Spaggiari L., Gasparri R., Baietto G., Casadio C., Infante M., Benato C., Alloisio M., Bottoni E., Cardillo G., Carleo F., Stella F., Dolci G., Puma F., Vinci D., Cavallesco G., Maniscalco P., Ampollini L., Carbognani P., Terzi A., Viti A., Negri G., Bandiera A., Perkmann R., Zaraca F., Andretti C., Poggi C., Mucilli F., Camplese P., Luzzi L., Ghisalberti M., Imperatori A., Rotolo N., Bortolotti L., Rizzardi G., Torre M., Rinaldo A., Sabbatini A., Refai M., Benvenuti M.R., Benetti D., Stefani A., Natali P., Lausi P., and Guerrera F.

Subjects
Registrie, Male, Complications, Lung Neoplasms, medicine.medical_treatment, Iatrogenic Disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Risk Factors, Thoracotomy, Registries, Pneumonectomy, Video-assisted thoracic surgery lobectomy, Univariate analysis, Thoracic Surgery, Video-Assisted, Thoracic Surgery, General Medicine, Treatment Outcome, Oncology, Italy, Cardiothoracic surgery, Female, Lung cancer, Human, medicine.medical_specialty, Complications, Conversion, Lung cancer, Lymph nodes dissection, Vascular injury, Video-assisted thoracic surgery lobectomy, VATS lobectomy, Video-Assisted, Vascular injury, NO, 03 medical and health sciences, medicine, Conversion, Lymph nodes dissection, Aged, Humans, Retrospective Studies, Vascular System Injuries, business.industry, Risk Factor, nutritional and metabolic diseases, Retrospective cohort study, medicine.disease, Surgery, Lung Neoplasm, 030228 respiratory system, business, Complication
Abstract

Objectives Vascular injuries are among the most severe causes of unplanned conversion during VATS lobectomies. The study aimed to analyse the incidence of vascular injuries and their risk factors during VATS lobectomy. Methods The Italian VATS lobectomy Registry was used to collect data from 66 Thoracic Surgery Units. From 2013 to October 2016 (out of more than 3,700 patients enrolled) only information from Units with an enrollment >100 VATS lobectomies were retrospectively analysed. Logistic regression analysis was performed on selected variables of the univariate analysis. Results Ten institutions contributed a total of 1,679 patients. Vascular injuries leading to conversion occurred in 44 (2.6%) patients. Years of experiences were inversely related to the risk of vascular injuries. Univariate analysis showed age, gender, surgical activity, Charlson Index Score and number of resected lymph nodes like significantly associated variables. Multivariate analysis revealed that number of resected lymph nodes, VATS experience ratio (number of VATS lobectomies/total lobectomies performed in the same year at same centre), and surgical activity of the centre were significantly associated with the risk of conversion. Unplanned thoracotomy was correlated with postoperative morbidity. Conclusion Vascular injuries in VATS lobectomies represented a rare complication which could directly affect the postoperative outcomes. The predictive factors for conversion were multifactorial and depended on characteristics of centres and surgeons’ seniority. Minimally invasive VATS lobectomy approaches did not influence the risk of vascular damages.

Published
2019

32. Nodal management and upstaging of disease: Initial results from the Italian VATS Lobectomy Registry

Author

Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Bertani, A, Gonfiotti, A, Nosotti, M, Ferrari, Pa, De Monte, L, Russo, E, Di Paola, G, Solli, P, Droghetti, A, Bertolaccini, L, Crisci, R, Italian VATS, Group, Negri, G, Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, and Guerrera, Francesco

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lymph node (LN), VATS lobectomy, Nodal upstaging, 030204 cardiovascular system & hematology, Resection, NO, 03 medical and health sciences, 0302 clinical medicine, medicine, Quantitative assessment, Lymph node, Surgical approach, Receiver operating characteristic, business.industry, lymph node (LN), nodal upstaging, Surgery, Dissection, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Original Article, Radiology, business
Abstract

Background: VATS lobectomy is an established option for the treatment of early-stage NSCLC. Complete lymph node dissection (CD), systematic sampling (SS) or resecting a specific number of lymph nodes (LNs) and stations are possible intra-operative LN management strategies. Methods: All VATS lobectomies from the “Italian VATS Group” prospective database were retrospectively reviewed. The type of surgical approach (CD or SS), number of LN resected (RN), the positive/resected LN ratio (LNR) and the number and types of positive LN stations were recorded. The rates of nodal upstaging were assessed based on different LN management strategies. Results: CD was the most frequent approach (72.3%). Nodal upstaging rates were 6.03% (N0-to-N1), 5.45% (N0-to-N2), and 0.58% (N1-to-N2). There was no difference in N1 or N2 upstaging rates between CD and SS. The number of resected nodes was correlated with both N1 (OR =1.02; CI, 1.01–1.04; P=0.03) and N2 (OR =1.02; CI, 1.01–1.05; P=0.001) upstaging. Resecting 12 nodes had the best ability to predict upstaging (6 N1 LN or 7 N2 LN). The finding of two positive LN stations best predicted N2 upstaging [area under the curve (AUC) of receiver operating characteristic (ROC) =0.98]. Conclusions: Nodal upstaging (and, indirectly, the effectiveness of intra-operative nodal management) cannot be predicted based on the surgical technique (CD or SS). A quantitative assessment of intra-operative LN management may be a more appropriate and measurable approach to justify the extension of LN resection during VATS lobectomy.

Published
2017

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