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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. 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

3. Pneumonectomy for lung cancer in the elderly: lessons learned from a multicenter study

Author

Minervini F, Kocher G, Bertoglio P, Kestenholz P, Munoz C, Patrini D, Ceulemans L, Begum H, Lutz J, Shojai M, Shargall Y, and Scarci M

Subjects
lung surgery in the elderly, Pneumonectomy, lung cancer in the elderly
Abstract

Background: 60% of patients diagnosed with lung cancer are older than 65 years and are at risk for substandard treatment due to a reluctance to recommend surgery. Pneumonectomy remains a high risk procedure especially in elderly patients. Nevertheless, the impact of age and neoadjuvant treatment on outcomes after pneumonectomy is still not well described. Methods: We performed a multicentric retrospective study, analyzing outcomes of patients older than 70 years who underwent pneumonectomy for central primary lung malignancy between January 2009 and June 2019 in 7 thoracic surgery departments: Lucerne and Bern (Switzerland), Hamilton (Canada), Alicante (Spain), Monza (Italy), London (UK), Leuven (Belgium). Survival was estimated with Kaplan-Meier, and differences in survival were determined by log-rank analysis. We investigated pre-and post-operative prognostic factors using Cox proportional hazards regression model; multivariable analysis was performed only with variables, which were statistically significant at the invariable analysis. Results: A total of 136 patients were included in the study. Mean age was 73.8 years (SD 3.6). 24 patients (17.6%) had an induction treatment (chemotherapy alone in 15 patients and chemo-radiation in 9). Mean length of stay (LOS) was 12.6 days (SD 10.39) and 74 patients (54.4%) had experienced a post-operative complication: 29 (21.3%) had a pulmonary complication, 33 (24.3%) had a cardiac complication and in 12 cases (8.8%) patients experienced both cardiac and pulmonary complications. 16 patients were readmitted [median LOS 13.7 days (range, 2-39 days)] and of those 14 (10.3%) required redo surgery. Median overall survival (OS) of the entire cohort was 38 months (95% CI: 29.9-46.1 months); in-hospital mortality was 1.5%, 30-day mortality rate was 3.7%, while 90-day mortality was 8.8% accounting for 5 and 12 patients respectively. Patients receiving neo-adjuvant therapy did not experience a higher incidence of postoperative complications (P=0.633), did not have a longer postoperative course (P=0.588), nor did they have an increased mortality rate (P=0.863). Conclusions: Age should not be considered an absolute contraindication for pneumonectomy in elderly patients even after neoadjuvant treatment. It has become apparent that especially in these patients, a patient tailored approach with a careful selection should be used to define the risk-benefit balance.

Published
2021

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. 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

6. Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS)

Author

Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar A, Ng C, Scarci M, Sihoe A, Ugalde P, Abu Akar F, Bedetti B, Nadal S, Brandolini J, Crucitti P, Enyedi A, Fernando H, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas L, Janik M, Juhos P, Libretti L, Lucciarini P, Macri P, Margaritora S, Mahoozi H, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G, UVIG, and ESTS

Subjects
Consensus, Single site incision, Uniportal video-assisted thoracoscopic surgery, Delphi approach, Lung cancer
Abstract

OBJECTIVES: Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training. METHODS: The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds. RESULTS: Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be

Published
2019

7. Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS) (vol 56, pg 224, 2019)

Author

Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar A, Ng C, Scarci M, Sihoe A, Ugalde P, Abu Akar F, Bedetti B, Nadal S, Brandolini J, Crucitti P, Enyedi A, Fernando H, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas L, Janik M, Juhos P, Libretti L, Lucciarini P, Macri P, Margaritora S, Mahoozi H, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G, and Uniportal VATS Interest Grp UVIG

Published
2019

8. The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: Proposals for the T component for the Forthcoming (8th) Edition of the TNM Classification of Malignant Tumors

Author

Okuma, Y, Horio, H, Matsumura, A, Higashiyama, M, Suehisa, H, Onuki, T, Sano, Y, Kondo, K, Al Kattan, K, Cerfolio, R, Gebitekin, C, de Antonio, D, Kernstine, Kh, Altorki, N, Novoa, N, Ruffini, E, Filosso, Pl, Saita, S, Scarci, M, Voltolini, L, Weder, W, Zurek, W, Arame, A, Casadio, C, Carbognani, P, Donati, G, Keshavjee, S, Klepetko, W, Moser, B, Lequaglie, C, Liberman, M, Mancuso, M, Nosotti, M, Spaggiari, L, Thomas, Pa, Rendina, Erino Angelo, Venuta, Federico, Anile, Marco, Schützner, J, Rocco, G., Staging Prognostic Factors Comm, Advisory Boards, Participating Inst Thymic Domain, University of Zurich, and Detterbeck, Frank C

Subjects
Humans, Neoplasm Staging, Neoplasms, Glandular and Epithelial, Prognosis, Thymus Neoplasms, Pulmonary and Respiratory Medicine, Stage classification, Lymphatic metastasis, medicine.medical_specialty, Pathology, Staging, Thymoma, 10255 Clinic for Thoracic Surgery, 610 Medicine & health, M Components, Thymic carcinoma, Neoplasms, medicine, Survival analysis, Nodal involvement, business.industry, Glandular and Epithelial, Cancer, medicine.disease, Oncology, 2740 Pulmonary and Respiratory Medicine, 2730 Oncology, Human medicine, Radiology, business
Abstract

Despite longstanding recognition of thymic epithelial neoplasms, there is no official American Joint Committee on Cancer/Union for International Cancer Control stage classification. This article summarizes proposals for classification of the T component of stage classification for use in the 8th edition of the tumor, node, metastasis classification for malignant tumors. This represents the output of the International Association for the Study of Lung Cancer and the International Thymic Malignancies Interest Group Staging and Prognostics Factor Committee, which assembled and analyzed a worldwide database of 10,808 patients with thymic malignancies from 105 sites. The committee proposes division of the T component into four categories, representing levels of invasion. T1 includes tumors localized to the thymus and anterior mediastinal fat, regardless of capsular invasion, up to and including infiltration through the mediastinal pleura. Invasion of the pericardium is designated as T2. T3 includes tumors with direct involvement of a group of mediastinal structures either singly or in combination: lung, brachiocephalic vein, superior vena cava, chest wall, and phrenic nerve. Invasion of more central structures constitutes T4: aorta and arch vessels, intrapericardial pulmonary artery, myocardium, trachea, and esophagus. Size did not emerge as a useful descriptor for stage classification. This classification of T categories, combined with a classification of N and M categories, provides a basis for a robust tumor, node, metastasis classification system for the 8th edition of American Joint Committee on Cancer/Union for International Cancer Control stage classification.

Published
2014

9. European guidelines on structure and qualification of general thoracic surgery

Author

Brunelli, A, Falcoz, Pe, D'Amico, T, Hansen, H, Lim, E, Massard, G, Rice, Tw, Rocco, G, Thomas, P, Van Raemdonck, D, Congregado, M, Decaluwe, H, Grodzki, T, Lerut, T, Molnar, T, Salati, M, Scarci, M, Van Schil, P, Varela, G, Venuta, Federico, Melfi, F, Gebitekin, C, Kuzdzal, J, Leschber, G, Opitz, I, Papagiannopoulos, K, Patterson, A, Ruffini, E, Klepetko, W, Toker, A, Panel, University of Zurich, Brunelli, A, D'Amico, Thomas, and van Schil, Paul

Subjects
Pulmonary and Respiratory Medicine, Operating Rooms, medicine.medical_specialty, General thoracic surgery, Accreditation, Education, Procedures, Professional affairs, Qualification, Structure, 610 Medicine & health, 142-005 142-005, 2705 Cardiology and Cardiovascular Medicine, Oesophageal surgery, medicine, Humans, media_common.cataloged_instance, Medical physics, European union, Curriculum, Societies, Medical, media_common, Structure (mathematical logic), Scope (project management), business.industry, General Medicine, Thoracic Surgical Procedures, 2746 Surgery, Surgery, Europe, Thoracic surgery, 2740 Pulmonary and Respiratory Medicine, Cardiothoracic surgery, Human medicine, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVE To update the recommendations for the structural characteristics of general thoracic surgery (GTS) in Europe in order to provide a document that can be used as a guide for harmonizing the general thoracic surgical practice in Europe. METHODS A task force was created to set the structural, procedural and qualification characteristics of a European GTS unit. These criteria were endorsed by the Executive Committee of the European Society of Thoracic Surgeons and by the Thoracic Domain of the European Association for Cardio-Thoracic Surgery and were validated by the European Board of Thoracic Surgery at European Union of Medical Specialists. RESULTS Criteria regarding definition and scope of GTS, structure and qualification of GTS unit, training and education and recommendations for subjects of particular interest (lung transplant, oesophageal surgery, minimally invasive thoracic surgery, quality surveillance) were developed. CONCLUSIONS This document will hopefully represent the first step of a process of revision of the modern thoracic surgeons' curricula, which need to be qualitatively rethought in the setting of the qualification process. The structural criteria highlighted in the present document are meant to help and tackle the challenge of cultural and language barriers as well as of widely varying national training programmes

Published
2014

10. A diagnostic cohort study on the accuracy of 18-fluorodeoxyglucose (18FDG) positron emission tomography (PET)-CT for evaluation of malignancy in anterior mediastinal lesions: the DECiMaL study

Author

Proli, C, De Sousa, P, Jordan, S, Anikin, V, Devaraj, A, Love, SM, Shackcloth, M, Kostoulas, N, Papagiannopoulos, K, Haqzad, Y, Loubani, M, Sellitri, F, Granato, F, Bush, A, Marchbank, A, Iyer, S, Scarci, M, Lim, E, and UK Thoracic Surgery Research Collaborative

Subjects
Adult, Male, medicine.medical_specialty, Thymoma, mediastinum diagnosis, Malignancy, Mediastinal Neoplasms, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Positive predicative value, medicine, Humans, Aged, Neoplasm Staging, Retrospective Studies, Fluorodeoxyglucose, PET-CT, medicine.diagnostic_test, business.industry, Research, Retrospective cohort study, Thymus Neoplasms, General Medicine, Middle Aged, medicine.disease, United Kingdom, Mediastinal Neoplasm, UK Thoracic Surgery Research Collaborative, mediastinum abnormalities, positron emission tomography computed tomography, Oncology, ROC Curve, sensitivity and specificity, Positron emission tomography, 030220 oncology & carcinogenesis, Female, Radiology, Radiopharmaceuticals, business, mediastinum surgery, Cohort study, medicine.drug
Abstract

ObjectivesThe aim of this study is to collate multi-institutional data to determine the value by defining the diagnostic performance of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for malignancy in patients undergoing surgery with an anterior mediastinal mass in order to ascertain the clinical utility of PET/CT to differentiate malignant from benign aetiologies in patients presenting with an anterior mediastinal massSettingDECiMaL Study is a multicentre, retrospective, collaborative cohort study in seven UK surgical sites.ParticipantsBetween January 2002 and June 2015, a total of 134 patients were submitted with a mean age (SD) of 55 years (16) of which 69 (51%) were men. We included all patients undergoing surgery who presented with an anterior mediastinal mass and underwent PET/CT. PET/CT was considered positive for any reported avidity as stated in the official report and the reference was the resected specimen reported by histopathology using WHO criteria.Primary and secondary outcome measuresSensitivity, specificity, positive and negative predicted values of [18F]-FDG PET in determining malignant aetiology for an anterior mediastinal mass.ResultsThe sensitivity and specificity of PET/CT to correctly classify malignant disease were 83% (95% CI 74 to 89) and 58% (95% CI 37 to 78). The positive and negative predictive values were 90% (95% CI 83% to 95%) and 42% (95% CI 26% to 61%).ConclusionsThe results of our study suggest reasonable sensitivity but no specificity implying that a negative PET/CT is useful to rule out the diagnosis of malignant disease whereas a positive result has no value in the discrimination between malignant and benign diseases of the anterior mediastinum.

Published
2018

11. The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Rosenberg, M, Tomulescu, V, Huang, J, Foroulis, C, Lang Lazdunski, L, Billè, A, Maessen, Jg, Keijzers, M, van Veer, H, Wright, C, Marino, M, Facciolo, F, Palmieri, G, Buonerba, C, Ferguson, M, Marulli, G, Lucchi, M, Loehrer, P, Kalkat, M, Rohrberg, K, Daugaard, G, Toker, A, Erus, S, Kimmich, M, Brunelli, A, Refai, M, Nicholson, A, Lim, E, Park, Ik, Wagner, J, Tieu, B, Fang, W, Zhang, J, Yu, Z, Han, Y, Li, Y, Chen, K, Chen, G, Okumura, M, Fujii, Y, Asamura, H, Nagai, K, Nakajima, J, Ikeda, N, Haraguchi, S, Onuki, T, Suzuki, K, Yoshino, I, Tsuchida, M, Takahashi, S, Yokoi, K, Hanyuda, M, Niwa, H, Date, H, Maniwa, Y, Miyoshi, S, Kondo, K, Iwasaki, A, Okamoto, T, Nagayasu, T, Tanaka, F, Suzuki, M, Yoshida, K, Okuma, Y, Horio, H, Matsumura, A, Higashiyama, M, Suehisa, H, Sano, Y, Al Kattan, K, Cerfolio, R, Gebitekin, C, de Antonio, D, Kernstine, Kh, Altorki, N, Novoa, N, Ruffini, E, Filosso, Pl, Saita, S, Scarci, M, Voltolini, L, Weder, W, Zurek, W, Arame, A, Casadio, C, Carbognani, P, Donati, G, Keshavjee, S, Klepetko, W, Moser, B, Lequaglie, C, Liberman, M, Mancuso, M, Nosotti, M, Spaggiari, L, Thomas, Pa, Rendina, Erino Angelo, Venuta, Federico, Anile, Marco, Schützner, J, Rocco, G, Crowley, J, Detterbeck, F, Falkson, C, Filosso, L, Giaccone, G, Giroux, D, Kim, J, Marom, Em, Nicholson, Ag, Brompton, R, Van Schil, P, Stratton, K., University of Zurich, Detterbeck, Frank C, Eberhardt, Wilfried (Beitragende*r), Prognostic Factors Comm, Advisory Boards, and Participating Inst Thymic Domain

Subjects
Pulmonary and Respiratory Medicine, Stage classification, Oncology, medicine.medical_specialty, Pathology, Staging, Thymoma, Evidence-based practice, 10255 Clinic for Thoracic Surgery, Medizin, 610 Medicine & health, Metastasis, Thymic carcinoma, Cohort Studies, Neoplasms, Internal medicine, medicine, Humans, Neoplasms, Glandular and Epithelial, Stage (cooking), Lung cancer, Neoplasm Staging, Retrospective Studies, Evidence-Based Medicine, business.industry, Glandular and Epithelial, Cancer, Thymus Neoplasms, Prognosis, medicine.disease, 2740 Pulmonary and Respiratory Medicine, 2730 Oncology, Human medicine, business
Abstract

A universal and consistent stage classification system, which describes the anatomic extent of a cancer, provides a foundation for communication and collaboration. Thymic epithelial malignancies have seen little progress, in part because of the lack of an official system. The International Association for the Study of Lung Cancer and the International Thymic Malignancies Interest Group assembled a large retrospective database, a multispecialty international committee and carried out extensive analysis to develop proposals for the 8th edition of the stage classification manuals. This tumor, node, metastasis (TNM)-based system is applicable to all types of thymic epithelial malignancies. This article summarizes the proposed definitions of the T, N, and M components and describes how these are combined into stage groups. This represents a major step forward for thymic malignancies.

Published
2014

12. The IASLC/ITMIG thymic malignancies staging project: development of a stage classification for thymic malignancies

Author

Detterbeck, Fc1, Asamura, H, Crowley, J, Falkson, C, Giaccone, G, Giroux, D, Huang, J, Kim, J, Kondo, K, Lucchi, M, Marino, M, Marom, Em, Nicholson, A, Okumura, M, Ruffini, E, van Schil, P, Stratton, K, Staging, Prognostic Factors Committee, Members of the Advisory Boards, Goldstraw P, Participating Institutions of the Thymic D. o. m. a. i. n., Rami Porta, R, Ball, D, Beer, D, Beyruti, R, Bolejack, V, Chansky, K, Detterbeck, F, Eberhardt, W, Edwards, J, Galateau Sallé, F, Gleeson, F, Groome, P, Kennedy, C, Kim, Y, Kingsbury, L, Kondo, H, Krasnik, M, Kubota, K, Lerut, A, Lyons, G, Marom, E, van Meerbeeck, J, Mitchell, A, Nakano, T, Newman, J, Nowak, A, Peake, M, Rice, T, Rosenzweig, K, Rusch, V, Sculier, Jp, Suzuki, K, Tachimori, Y, Thomas CF Jr, Travis, W, Tsao, M, Turrisi, A, Vansteenkiste, J, Watanabe, H, Wu, Yi, Zielinski, M, Filosso, L, Baas, P, Erasmus, J, Hasegawa, S, Inai, K, Kernstine, K, Kindler, H, Krug, L, Nackaerts, K, Pass, H, Rice, D, Blackstone, E, Call Caja, S, Ahmad, U, Girard, N, Haam, Sj, Bae, Mk, Gomez, Dr, Ströbel, P, Marx, A, Saita, S, Wakelee, H, Bertolaccini, L, Vallieres, E, Scott, W, Su, S, Park, B, Marks, J, Khella, S, Shen, R, Rosenberg, M, Aires, B, Tomulescu, V, Foroulis, C, Lang Lazdunski, L, Billè, A, Maessen, Jg, Keijzers, M, van Veer, H, Wright, C, Palmieri, G, Buonerba, C, Ferguson, M, Marulli, G, Loehrer, P, Kalkat, M, Rohrberg, K, Daugaard, G, Toker, A, Erus, S, Kimmich, M, Brunelli, A, Refai, M, Lim, E, Park, Ik, Wagner, J, Tieu, B, Fang, W, Zhang, J, Yu, Z, Han, Y, Li, Y, Chen, K, Chen, G, Fujii, Y, Nagai, K, Nakajima, J, Ikeda, N, Haraguchi, S, Onuki, T, Yoshino, I, Tsuchida, M, Takahashi, S, Yokoi, K, Hanyuda, M, Niwa, H, Date, H, Maniwa, Y, Miyoshi, S, Iwasaki, A, Okamoto, T, Nagayasu, T, Tanaka, F, Suzuki, M, Yoshida, K, Okuma, Y, Horio, H, Matsumura, A, Higashiyama, M, Suehisa, H, Sano, Y, Kattan, K, Cerfolio, R, Gebitekin, C, de Antonio, D, Kernstine, Kh, Altorki, N, Novoa, N, Filosso, Pl, Scarci, M, Voltolini, L, Weder, W, Zurek, W, Arame, A, Casadio, C, Toracica, C, Carbognani, P, Donati, G, Keshavjee, S, Klepetko, W, Moser, B, Lequaglie, C, Liberman, M, Mancuso, M, Nosotti, M, Spaggiari, L, Thomas, Pa, Rendina, Erino Angelo, Venuta, F, Anile, M, Schützner, J, Rocco, G., Staging Prognostic Factors Comm, University of Zurich, Detterbeck, Frank C, and Eberhardt, Wilfried (Beitragende*r)

Subjects
Pulmonary and Respiratory Medicine, Oncology, Stage classification, medicine.medical_specialty, Pathology, Lung Neoplasms, Thymoma, 10255 Clinic for Thoracic Surgery, Medizin, 610 Medicine & health, Thymic carcinoma, Internal medicine, medicine, Humans, Project management, Program Development, Lung cancer, Neoplasm Staging, business.industry, International Agencies, Thymus Neoplasms, Staging of stage classification, medicine.disease, 2740 Pulmonary and Respiratory Medicine, Interest group, 2730 Oncology, Program development, Human medicine, business
Abstract

The lack of an official-stage classification system for thymic malignancies is an issue that hampers progress in this rare disease. A collaborative effort by the International Association for the Study of Lung Cancer and the International Thymic Malignancies Interest Group is underway to develop proposals for such a system. A database of more than 10,000 cases worldwide has been assembled to provide a solid basis for analysis. This report outlines the structure of the effort and the process that has been designed.

Published
2014

13. The IASLC/ITMIG thymic epithelial tumors staging project: Proposals for the N and M components for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Kondo, K., Schil, P., Detterbeck, F. C., Okumura, M., Giroux, D., Asamura, H., Crowley, J., Falkson, C., Pier Luigi Filosso, Giaccone, G., Huang, J., Kim, J., Lucchi, M., Marino, M., Marom, E. M., Nicholson, A. G., Ruffini, E., Goldstraw, P., Rami-Porta, R., Ball, D., Beer, D., Beyruti, R., Bolejack, V., Chansky, K., Eberhardt, W. E. E., Edwards, J., Galateau-Sallé, F., Gleeson, F., Groome, P., Kennedy, C., Kingsbury, L., Kim, Y. T., Kondo, H., Krasnik, M., Kubota, K., Lerut, A., Lyons, G., Meerbeeck, J., Mitchell, A., Nakano, T., Nowak, A., Peake, M., Rice, T., Rosenzweig, K., Rusch, V., Saijo, N., Sculier, J. -P, Shemanski, L., Stratton, K., Suzuki, K., Tachimori, Y., Thomas, C. F., Travis, W., Tsao, M. S., Turrisi, A., Vansteenkiste, J., Watanabe, H., Wu, Y. -L, Baas, P., Erasmus, J., Hasegawa, S., Inai, K., Kernstine, K., Kindler, H., Krug, L., Nackaerts, K., Pass, H., Rice, D., Blackstone, E., Call Caja, S., Ahmad, U., Detterbeck, F., Girard, N., Haam, S. J., Gomez, D. R., Bae, M. K., Ströbel, P., Marx, A., Saita, S., Wakelee, H., Bertolaccini, L., Vallieres, E., Scott, W., Su, S., Park, B., Marks, J., Khella, S., Shen, R., Rosenberg, M., Tomulescu, V., Foroulis, C., Lang-Lazdunski, L., Billè, A., Maessen, J. G., Keijzers, M., Veer, H., Wright, C., Facciolo, F., Palmieri, G., Buonerba, C., Ferguson, M., Marulli, G., Loehrer, P., Kalkat, M., Rohrberg, K., Daugaard, G., Toker, A., Erus, S., Kimmich, M., Brunelli, A., Refai, M., Nicholson, A., Lim, E., Park, I. K., Wagner, J., Tieu, B., Fang, W., Zhang, J., Yu, Z., Han, Y., Li, Y., Chen, K., Chen, G., Nagai, K., Fujii, Y., Nakajima, J., Ikeda, N., Haraguchi, S., Onuki, T., Yoshino, I., Tsuchida, M., Takahashi, S., Yokoi, K., Hanyuda, M., Niwa, H., Date, H., Maniwa, Y., Miyoshi, S., Iwasaki, A., Okamoto, T., Nagayasu, T., Tanaka, F., Suzuki, M., Yoshida, K., Okuma, Y., Horio, H., Matsumura, A., Higashiyama, M., Suehisa, H., Sano, Y., Al Kattan, K., Cerfolio, R., Gebitekin, C., Gomez Antonio, D., Kernstine, K. H., Altorki, N., Novoa, N., Filosso, P. L., Scarci, M., Voltolini, L., Weder, W., Zurek, W., Arame, A., Casadio, C., Carbognani, P., Donati, G., Keshavjee, S., Klepetko, W., Moser, B., Lequaglie, C., Liberman, M., Mancuso, M., Nosotti, M., Spaggiari, L., Thomas, P. A., Rendina, E., Venuta, F., Anile, M., Schützner, J., and Rocco, G.

14. The IASLC/ITMIG thymic epithelial tumors staging project: Proposals for the N and M components for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Kondo, K., Schil, P., Detterbeck, F. C., Okumura, M., Giroux, D., Asamura, H., Crowley, J., Falkson, C., Filosso, P. L., Giuseppe Giaccone, Huang, J., Kim, J., Lucchi, M., Marino, M., Marom, E. M., Nicholson, A. G., Ruffini, E., Goldstraw, P., Rami-Porta, R., Ball, D., Beer, D., Beyruti, R., Bolejack, V., Chansky, K., Eberhardt, W. E. E., Edwards, J., Galateau-Sallé, F., Gleeson, F., Groome, P., Kennedy, C., Kingsbury, L., Kim, Y. T., Kondo, H., Krasnik, M., Kubota, K., Lerut, A., Lyons, G., Meerbeeck, J., Mitchell, A., Nakano, T., Nowak, A., Peake, M., Rice, T., Rosenzweig, K., Rusch, V., Saijo, N., Sculier, J. -P, Shemanski, L., Stratton, K., Suzuki, K., Tachimori, Y., Thomas, C. F., Travis, W., Tsao, M. S., Turrisi, A., Vansteenkiste, J., Watanabe, H., Wu, Y. -L, Baas, P., Erasmus, J., Hasegawa, S., Inai, K., Kernstine, K., Kindler, H., Krug, L., Nackaerts, K., Pass, H., Rice, D., Blackstone, E., Call Caja, S., Ahmad, U., Detterbeck, F., Girard, N., Haam, S. J., Gomez, D. R., Bae, M. K., Ströbel, P., Marx, A., Saita, S., Wakelee, H., Bertolaccini, L., Vallieres, E., Scott, W., Su, S., Park, B., Marks, J., Khella, S., Shen, R., Rosenberg, M., Tomulescu, V., Foroulis, C., Lang-Lazdunski, L., Billè, A., Maessen, J. G., Keijzers, M., Veer, H., Wright, C., Facciolo, F., Palmieri, G., Buonerba, C., Ferguson, M., Marulli, G., Loehrer, P., Kalkat, M., Rohrberg, K., Daugaard, G., Toker, A., Erus, S., Kimmich, M., Brunelli, A., Refai, M., Nicholson, A., Lim, E., Park, I. K., Wagner, J., Tieu, B., Fang, W., Zhang, J., Yu, Z., Han, Y., Li, Y., Chen, K., Chen, G., Nagai, K., Fujii, Y., Nakajima, J., Ikeda, N., Haraguchi, S., Onuki, T., Yoshino, I., Tsuchida, M., Takahashi, S., Yokoi, K., Hanyuda, M., Niwa, H., Date, H., Maniwa, Y., Miyoshi, S., Iwasaki, A., Okamoto, T., Nagayasu, T., Tanaka, F., Suzuki, M., Yoshida, K., Okuma, Y., Horio, H., Matsumura, A., Higashiyama, M., Suehisa, H., Sano, Y., Al Kattan, K., Cerfolio, R., Gebitekin, C., Gomez Antonio, D., Kernstine, K. H., Altorki, N., Novoa, N., Scarci, M., Voltolini, L., Weder, W., Zurek, W., Arame, A., Casadio, C., Carbognani, P., Donati, G., Keshavjee, S., Klepetko, W., Moser, B., Lequaglie, C., Liberman, M., Mancuso, M., Nosotti, M., Spaggiari, L., Thomas, P. A., Rendina, E., Venuta, F., Anile, M., Schützner, J., and Rocco, G.

15. The IASLC/ITMIG thymic epithelial tumors staging project: Proposals for the T component for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Nicholson, A. G., Detterbeck, F. C., Marino, M., Kim, J., Stratton, K., Giroux, D., Asamura, H., Crowley, J., Falkson, C., Filosso, P. L., Giaccone, G., Huang, J., Kondo, K., Lucchi, M., Marom, E. M., Okumura, M., Ruffini, E., Schil, P., Goldstraw, P., Rami-Porta, R., Ball, D., Beer, D., Beyruti, R., Bolejack, V., Chansky, K., Eberhardt, W. E. E., Edwards, J., Galateau-Sallé, F., Gleeson, F., Groome, P., Kennedy, C., Kingsbury, L., Kim, Y. T., Kondo, H., Krasnik, M., Kubota, K., Lerut, A., Lyons, G., Meerbeeck, J., Mitchell, A., Nakano, T., Nowak, A., Peake, M., Rice, T., Rosenzweig, K., Rusch, V., Saijo, N., Sculier, J. -P, Shemanski, L., Suzuki, K., Tachimori, Y., Thomas, C. F., William Travis, Tsao, M. S., Turrisi, A., Vansteenkiste, J., Watanabe, H., Wu, Y. -L, Baas, P., Erasmus, J., Hasegawa, S., Inai, K., Kernstine, K., Kindler, H., Krug, L., Nackaerts, K., Pass, H., Rice, D., Blackstone, E., Call Caja, S., Ahmad, U., Detterbeck, F., Girard, N., Haam, S. J., Gomez, D. R., Bae, M. K., Ströbel, P., Marx, A., Saita, S., Wakelee, H., Bertolaccini, L., Vallieres, E., Scott, W., Su, S., Park, B., Marks, J., Khella, S., Shen, R., Rosenberg, M., Tomulescu, V., Foroulis, C., Lang-Lazdunski, L., Billè, A., Maessen, J. G., Keijzers, M., Veer, H., Wright, C., Facciolo, F., Palmieri, G., Buonerba, C., Ferguson, M., Marulli, G., Loehrer, P., Kalkat, M., Rohrberg, K., Daugaard, G., Toker, A., Erus, S., Kimmich, M., Brunelli, A., Refai, M., Nicholson, A., Lim, E., Park, I. K., Wagner, J., Tieu, B., Fang, W., Zhang, J., Yu, Z., Han, Y., Li, Y., Chen, K., Chen, G., Nagai, K., Fujii, Y., Nakajima, J., Ikeda, N., Haraguchi, S., Onuki, T., Yoshino, I., Tsuchida, M., Takahashi, S., Yokoi, K., Hanyuda, M., Niwa, H., Date, H., Maniwa, Y., Miyoshi, S., Iwasaki, A., Okamoto, T., Nagayasu, T., Tanaka, F., Suzuki, M., Yoshida, K., Okuma, Y., Horio, H., Matsumura, A., Higashiyama, M., Suehisa, H., Sano, Y., Al Kattan, K., Cerfolio, R., Gebitekin, C., Gomez Antonio, D., Kernstine, K. H., Altorki, N., Novoa, N., Scarci, M., Voltolini, L., Weder, W., Zurek, W., Arame, A., Casadio, C., Carbognani, P., Donati, G., Keshavjee, S., Klepetko, W., Moser, B., Lequaglie, C., Liberman, M., Mancuso, M., Nosotti, M., Spaggiari, L., Thomas, P. A., Rendina, E., Venuta, F., Anile, M., Schützner, J., and Rocco, G.

16. The IASLC/ITMIG thymic epithelial tumors staging project: Proposals for the T component for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Nicholson, A. G., Detterbeck, F. C., Marino, M., Kim, J., Stratton, K., Giroux, D., Asamura, H., Crowley, J., Falkson, C., Filosso, P. L., Giaccone, G., Huang, J., Kondo, K., Lucchi, M., Marom, E. M., Okumura, M., Ruffini, E., Schil, P., Goldstraw, P., Rami-Porta, R., Ball, D., Beer, D., Beyruti, R., Bolejack, V., Chansky, K., Eberhardt, W. E. E., Edwards, J., Galateau-Sallé, F., Gleeson, F., Groome, P., Kennedy, C., Kingsbury, L., Kim, Y. T., Kondo, H., Krasnik, M., Kubota, K., Lerut, A., Lyons, G., Meerbeeck, J., Mitchell, A., Nakano, T., Nowak, A., Peake, M., Rice, T., Rosenzweig, K., Rusch, V., Saijo, N., Sculier, J. -P, Shemanski, L., Suzuki, K., Tachimori, Y., Thomas, C. F., Travis, W., Tsao, M. S., Turrisi, A., Vansteenkiste, J., Watanabe, H., Wu, Y. -L, Baas, P., Erasmus, J., Hasegawa, S., Inai, K., Kernstine, K., Kindler, H., Krug, L., Nackaerts, K., Pass, H., Rice, D., Blackstone, E., Call Caja, S., Ahmad, U., Detterbeck, F., Girard, N., Haam, S. J., Gomez, D. R., Bae, M. K., Ströbel, P., Marx, A., Saita, S., Wakelee, H., Bertolaccini, L., Vallieres, E., Scott, W., Su, S., Park, B., Marks, J., Khella, S., Shen, R., Rosenberg, M., Tomulescu, V., Foroulis, C., Lang-Lazdunski, L., Billè, A., Maessen, J. G., Keijzers, M., Veer, H., Wright, C., Facciolo, F., Palmieri, G., Buonerba, C., Ferguson, M., Marulli, G., Loehrer, P., Kalkat, M., Rohrberg, K., Daugaard, G., Toker, A., Erus, S., Kimmich, M., Brunelli, A., Refai, M., Nicholson, A., Lim, E., Park, I. K., Wagner, J., Tieu, B., Fang, W., Zhang, J., Yu, Z., Han, Y., Li, Y., Chen, K., Chen, G., Nagai, K., Fujii, Y., Nakajima, J., Ikeda, N., Haraguchi, S., Onuki, T., Yoshino, I., Tsuchida, M., Takahashi, S., Yokoi, K., Hanyuda, M., Niwa, H., Date, H., Maniwa, Y., Miyoshi, S., Iwasaki, A., Okamoto, T., Nagayasu, T., Tanaka, F., Suzuki, M., Yoshida, K., Okuma, Y., Horio, H., Matsumura, A., Higashiyama, M., Suehisa, H., Sano, Y., Al Kattan, K., Cerfolio, R., Gebitekin, C., Gomez Antonio, D., Kernstine, K. H., Altorki, N., Novoa, N., Scarci, M., Voltolini, L., Weder, W., Zurek, W., Arame, A., Casadio, C., Carbognani, P., Donati, G., Keshavjee, S., Klepetko, W., Moser, B., Lequaglie, C., Liberman, M., Mancuso, M., Nosotti, M., Spaggiari, L., Thomas, P. A., Rendina, E., Federico Venuta, Anile, M., Schützner, J., and Rocco, G.

17. The IASLC/ITMIG thymic epithelial tumors staging project: Proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Detterbeck, F. C., Stratton, K., Giroux, D., Asamura, H., Crowley, J., Falkson, C., Filosso, P. L., Frazier, A. A., Giaccone, G., Huang, J., Kim, J., Kondo, K., Lucchi, M., Marino, M., Marom, E. M., Nicholson, A. G., Okumura, M., Ruffini, E., Schil, P., Goldstraw, P., Rami-Porta, R., Ball, D., Beer, D., Beyruti, R., Bolejack, V., Chansky, K., Eberhardt, W. E. E., Edwards, J., Galateau-Sallé, F., Gleeson, F., Groome, P., Kennedy, C., Kingsbury, L., Kim, Y. T., Kondo, H., Krasnik, M., Kubota, K., Lerut, A., Lyons, G., Meerbeeck, J., Mitchell, A., Nakano, T., Anna Nowak, Peake, M., Rice, T., Rosenzweig, K., Rusch, V., Saijo, N., Sculier, J. -P, Shemanski, L., Suzuki, K., Tachimori, Y., Thomas, C. F., Travis, W., Tsao, M. S., Turrisi, A., Vansteenkiste, J., Watanabe, H., Wu, Y. -L, Baas, P., Erasmus, J., Hasegawa, S., Inai, K., Kernstine, K., Kindler, H., Krug, L., Nackaerts, K., Pass, H., Rice, D., Blackstone, E., Call Caja, S., Ahmad, U., Detterbeck, F., Girard, N., Haam, S. J., Gomez, D. R., Bae, M. K., Ströbel, P., Marx, A., Saita, S., Wakelee, H., Bertolaccini, L., Vallieres, E., Scott, W., Su, S., Park, B., Marks, J., Khella, S., Shen, R., Rosenberg, M., Tomulescu, V., Foroulis, C., Lang-Lazdunski, L., Billè, A., Maessen, J. G., Keijzers, M., Veer, H., Wright, C., Facciolo, F., Palmieri, G., Buonerba, C., Ferguson, M., Marulli, G., Loehrer, P., Kalkat, M., Rohrberg, K., Daugaard, G., Toker, A., Erus, S., Kimmich, M., Brunelli, A., Refai, M., Nicholson, A., Lim, E., Park, I. K., Wagner, J., Tieu, B., Fang, W., Zhang, J., Yu, Z., Han, Y., Li, Y., Chen, K., Chen, G., Nagai, K., Fujii, Y., Nakajima, J., Ikeda, N., Haraguchi, S., Onuki, T., Yoshino, I., Tsuchida, M., Takahashi, S., Yokoi, K., Hanyuda, M., Niwa, H., Date, H., Maniwa, Y., Miyoshi, S., Iwasaki, A., Okamoto, T., Nagayasu, T., Tanaka, F., Suzuki, M., Yoshida, K., Okuma, Y., Horio, H., Matsumura, A., Higashiyama, M., Suehisa, H., Sano, Y., Al Kattan, K., Cerfolio, R., Gebitekin, C., Gomez Antonio, D., Kernstine, K. H., Altorki, N., Novoa, N., Scarci, M., Voltolini, L., Weder, W., Zurek, W., Arame, A., Casadio, C., Carbognani, P., Donati, G., Keshavjee, S., Klepetko, W., Moser, B., Lequaglie, C., Liberman, M., Mancuso, M., Nosotti, M., Spaggiari, L., Thomas, P. A., Rendina, E., Venuta, F., Anile, M., Schützner, J., and Rocco, G.

18. The IASLC/ITMIG thymic epithelial tumors staging project: Proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors

Author

Detterbeck, F. C., Stratton, K., Giroux, D., Asamura, H., Crowley, J., Falkson, C., Filosso, P. L., Frazier, A. A., Giaccone, G., Huang, J., Kim, J., Kondo, K., Lucchi, M., Marino, M., Marom, E. M., Nicholson, A. G., Okumura, M., Ruffini, E., Schil, P., Goldstraw, P., Rami-Porta, R., Ball, D., Beer, D., Beyruti, R., Bolejack, V., Chansky, K., Eberhardt, W. E. E., Edwards, J., Galateau-Sallé, F., Gleeson, F., Groome, P., Kennedy, C., Kingsbury, L., Kim, Y. T., Kondo, H., Krasnik, M., Kubota, K., Lerut, A., Lyons, G., Meerbeeck, J., Mitchell, A., Nakano, T., Nowak, A., Peake, M., Rice, T., Rosenzweig, K., Rusch, V., Saijo, N., Sculier, J. -P, Shemanski, L., Suzuki, K., Tachimori, Y., Thomas, C. F., Travis, W., Tsao, M. S., Turrisi, A., Vansteenkiste, J., Watanabe, H., Wu, Y. -L, Baas, P., Erasmus, J., Hasegawa, S., Inai, K., Kernstine, K., Kindler, H., Krug, L., Nackaerts, K., Pass, H., Rice, D., Blackstone, E., Call Caja, S., Ahmad, U., Detterbeck, F., Girard, N., Haam, S. J., Gomez, D. R., Bae, M. K., Ströbel, P., Marx, A., Saita, S., Wakelee, H., Bertolaccini, L., Vallieres, E., Scott, W., Su, S., Park, B., Marks, J., Khella, S., Shen, R., Rosenberg, M., Tomulescu, V., Foroulis, C., Lang-Lazdunski, L., Billè, A., Maessen, J. G., Keijzers, M., Veer, H., Wright, C., Facciolo, F., Palmieri, G., Buonerba, C., Ferguson, M., Marulli, G., Loehrer, P., Kalkat, M., Rohrberg, K., Daugaard, G., Toker, A., Erus, S., Kimmich, M., Brunelli, A., Refai, M., Nicholson, A., Lim, E., Park, I. K., Wagner, J., Tieu, B., Fang, W., Zhang, J., Yu, Z., Han, Y., Li, Y., Chen, K., Chen, G., Nagai, K., Fujii, Y., Nakajima, J., Ikeda, N., Haraguchi, S., Onuki, T., Yoshino, I., Tsuchida, M., Takahashi, S., Yokoi, K., Hanyuda, M., Niwa, H., Date, H., Maniwa, Y., Miyoshi, S., Iwasaki, A., Okamoto, T., Nagayasu, T., Tanaka, F., Suzuki, M., Yoshida, K., Okuma, Y., Horio, H., Matsumura, A., Higashiyama, M., Suehisa, H., Sano, Y., Al Kattan, K., Cerfolio, R., Gebitekin, C., Gomez Antonio, D., Kernstine, K. H., Altorki, N., Novoa, N., Scarci, M., Voltolini, L., Weder, W., Zurek, W., Arame, A., Casadio, C., Carbognani, P., Donati, G., Keshavjee, S., Klepetko, W., Moser, B., Lequaglie, C., Liberman, M., Mancuso, M., Nosotti, M., Spaggiari, L., Thomas, P. A., Rendina, E., Federico Venuta, Anile, M., Schützner, J., and Rocco, G.

19. The SUPER reporting guideline suggested for reporting of surgical technique: explanation and elaboration

Author

Zhang, Kaiping, Wu, Jinlin, Su, Zhanhao, Ma, Yanfang, Shi, Qianling, Barchi, Leandro Cardoso, Laisaar, Tanel, Ng, Calvin S H, Gilbert, Sebastien, Zhang, Xianzhuo, Štupnik, Tomaž, Lerut, Toni, Jiao, Panpan, Elkhayat, Hussein, Novoa, Nuria M, Fruscio, Robert, Waseda, Ryuichi, Petersen, Rene Horsleben, Fiorelli, Alfonso, Sihoe, Alan D L, Gonzalez-Rivas, Diego, Scarci, Marco, Jimenez, Marcelo F, Li, Grace S, Tang, Xueqin, Wang, Stephen D, Chen, Yaolong, Zhang, K, Wu, J, Su, Z, Ma, Y, Shi, Q, Barchi, L, Laisaar, T, Ng, C, Gilbert, S, Zhang, X, Štupnik, T, Lerut, T, Jiao, P, Elkhayat, H, Novoa, N, Fruscio, R, Waseda, R, Petersen, R, Fiorelli, A, Sihoe, A, Gonzalez-Rivas, D, Scarci, M, Jimenez, M, Li, G, Tang, X, Wang, S, and Chen, Y

Subjects
surgery, SUPER, Surgical technique, guideline, reporting checklist
Abstract

Background: Surgical technique plays an essential role in achieving good health outcomes. However, the quality of surgical technique reporting remains heterogeneous. Reporting checklists could help authors to describe the surgical technique more transparently and effectively, as well as to assist reviewers and editors evaluate it more informatively, and promote readers to better understand the technique. We previously developed SUPER (surgical technique reporting checklist and standards) to assist authors in reporting their research that contains surgical technique more transparently. However, further explanation and elaboration of each item are needed for better understanding and reporting practice.Methods: We searched surgical literature in PubMed, Google Scholar and journal websites published up to January 2023 to find multidiscipline examples in various article types for each SUPER item.Results: We explain the 22 items of the SUPER and provide rationales item by item alongside. We provide 69 examples from 53 literature that present optimal reporting of the 22 items. Article types of examples include pure surgical technique, and case reports, observational studies and clinical trials that contain surgical technique. Examples are multidisciplinary, including general surgery, orthopaedical surgery, cardiac surgery, thoracic surgery, gastrointestinal surgery, neurological surgery, oncogenic surgery, and emergency surgery etc.Conclusions: Along with SUPER article, this explanation and elaboration file can promote deeper understanding on the SUPER items. We hope that the article could further guide surgeons and researchers in reporting, and assist editors and peer reviewers in reviewing manuscripts related to surgical technique.

Published
2023

20. Reporting guidelines for surgical technique could be improved: a scoping review and a call for action

Author

Qianling Shi, Yanfang Ma, Xianzhuo Zhang, Panpan Jiao, Kaiping Zhang, Leandro Cardoso Barchi, Benedetta Bedetti, Jinlin Wu, Benjamin Wei, Calvin S.H. Ng, Alper Toker, Jianfei Shen, Robert Fruscio, Sebastien Gilbert, Rene Horsleben Petersen, Steven Hochwald, Tomaž Štupnik, Hussein Elkhayat, Marco Scarci, Giovanni Battista Levi Sandri, Firas Abu Akar, Ryuichi Waseda, Alan D.L. Sihoe, Alfonso Fiorelli, Michel Gonzalez, Fabio Davoli, Grace S. Li, Xueqin Tang, Bin Qiu, Stephen D. Wang, Yaolong Chen, Shugeng Gao, Shi, Q, Ma, Y, Zhang, X, Jiao, P, Zhang, K, Barchi, L, Bedetti, B, Wu, J, Wei, B, Ng, C, Toker, A, Shen, J, Fruscio, R, Gilbert, S, Petersen, R, Hochwald, S, Stupnik, T, Elkhayat, H, Scarci, M, Levi Sandri, G, Abu Akar, F, Waseda, R, Sihoe, A, Fiorelli, A, Gonzalez, M, Davoli, F, Li, G, Tang, X, Qiu, B, Wang, S, Chen, Y, and Gao, S

Subjects
Epidemiology, methodology, Surgery, scoping review, quality control, reporting guideline, surgical technique
Abstract

Objectives: To identify reporting guidelines related to surgical technique and propose recommendations for areas that require improvement. Study Design and Setting: A protocol-guided scoping review was conducted. A literature search of MEDLINE, the EQUATOR Network Library, Google Scholar, and Networked Digital Library of Theses and Dissertations was conducted to identify surgical technique reporting guidelines published up to December 31, 2021. Results: We finally included 55 surgical technique reporting guidelines, vascular surgery (n = 18, 32.7%) was the most common among the clinical specialties covered. The included guidelines generally showed a low degree of international and multidisciplinary cooperation. Few guidelines provided a detailed development process (n = 14, 25.5%), conducted a systematic literature review (n = 13, 23.6%), used the Delphi method (n = 4, 7.3%), or described post-publication strategy (n = 6, 10.9%). The vast majority guidelines focused on the reporting of intraoperative period (n = 50, 90.9%). However, of the guidelines requiring detailed descriptions of surgical technique methodology (n = 43, 78.2%), most failed to provide guidance on what constitutes an adequate description. Conclusion: Our study demonstrates significant deficiencies in the development methodology and practicality of reporting guidelines for surgical technique. A standardized reporting guideline that is developed rigorously and focuses on details of surgical technique may serve as a necessary impetus for change.

Published
2023

21. Evidence on reporting guidelines for surgical technique in clinical disciplines: a scoping review protocol

Author

Shugeng Gao, Fabio Davoli, Steven N. Hochwald, Grace Li, Benedetta Bedetti, Stephen D. Wang, Xueqin Tang, Alan D.L. Sihoe, Leandro Cardoso Barchi, Alper Toker, Bin Qiu, Nuria M. Novoa, Diego Gonzalez-Rivas, Guillaume Piessen, Giovanni Battista Levi Sandri, Xianzhuo Zhang, Ryuichi Waseda, Panpan Jiao, Calvin S.H. Ng, Yaolong Chen, Jianfei Shen, Yanfang Ma, Sebastien Gilbert, Marco Scarci, Kaiping Zhang, Jinlin Wu, Robert Fruscio, Qianling Shi, Toni Lerut, René Horsleben Petersen, Alfonso Fiorelli, Zhang, K, Ma, Y, Shi, Q, Shen, J, Wu, J, Zhang, X, Jiao, P, Li, G, Tang, X, Petersen, R, Ng, C, Fiorelli, A, Novoa, N, Bedetti, B, Sandri, G, Hochwald, S, Lerut, T, Sihoe, A, Barchi, L, Gilbert, S, Waseda, R, Toker, A, Gonzalez-Rivas, D, Fruscio, R, Scarci, M, Davoli, F, Piessen, G, Qiu, B, Wang, S, Chen, Y, and Gao, S

Subjects
Protocol (science), medicine.medical_specialty, Science & Technology, business.industry, media_common.quotation_subject, Surgical technique, reporting guideline, reporting guidelines, Rigour, Study Protocol, Presentation, TRIALS, Data extraction, Multidisciplinary approach, QUALITY, Medicine, Surgery, Research questions, Medical physics, protocol, Trial registration, business, Life Sciences & Biomedicine, media_common
Abstract

BACKGROUND: The reporting of surgical techniques is of mixed quality, with most at a very minimal level. Reporting guidelines that could be applied to guide surgical technique reporting vary in methodology for development, discipline coverage, dimension coverage and detail requested. However, a scoping review that could indicate the gaps and efforts needed in surgical technique reporting guidelines is lacking and warranted. This study aims to design a methodological rigour protocol to guide the development of a scoping review of surgical technique reporting guidelines. METHODS: This protocol is designed following the 2020 manual proposed by the Joanna Briggs Institute. To further ensure the soundness of the protocol, we also included multidisciplinary professionals (including methodologists, clinicians, and journal editors) to refine the protocol. DISCUSSION: Seven key steps for developing the scoping review are identified and presented in detail, including (I) identifying the research questions; (II) inclusion criteria; (III) search strategy; (IV) source of evidence selection; (V) data extraction; (VI) analysis of the evidence; and (VII) presentation of the results. Guided by this protocol, the subsequent scoping review will inform us the overview of surgical technique reporting guidelines and precisely guide our direction and next steps in improving surgical technique reporting guidelines. TRIAL REGISTRATION: This protocol is not registered as the PROSPERO database only accepts registration of systematic review protocols while does not accept registration of scoping review protocols. ispartof: GLAND SURGERY vol:10 issue:7 pages:2325-2333 ispartof: location:China (Republic : 1949- ) status: published

Published
2021

22. The Role of Surgery in Patients with COVID-19-Related Thoracic Complications

Author

Federico Raveglia, Marco Scarci, Arianna Rimessi, Riccardo Orlandi, Paola Rebora, Ugo Cioffi, Angelo Guttadauro, Enrico Ruffini, Mauro Benvenuti, Giuseppe Cardillo, Davide Patrini, Fernando Vannucci, Nasser Yusuf, Pramoj Jindal, Robert Cerfolio, Raveglia, F, Scarci, M, Rimessi, A, Orlandi, R, Rebora, P, Cioffi, U, Guttadauro, A, Ruffini, E, Benvenuti, M, Cardillo, G, Patrini, D, Vannucci, F, Yusuf, N, Jindal, P, and Cerfolio, R

Subjects
surgery, COVID-19, complication, mortality, thoracic surgery
Abstract

ObjectivePatients with several thoracic complications induced by SARS-CoV-2 infection may benefit from surgery, but its role in this condition is largely unknown, and many surgeons’ advice against any surgical referrals. Our aim is to investigate the efficacy and safety of surgery in COVID-19 patients with thoracic complications requiring surgery.MethodsWe designed a multicenter observational study, involving nine thoracic surgery departments, evaluating patients who developed thoracic complications in hospital, surgically managed from March 1, 2020, to May 31, 2021. An overall 30-day mortality was obtained by using the Kaplan–Meier method. Multivariable Cox regression model and logistic models were applied to identify the variables associated with mortality and postoperative complications.ResultsAmong 83 patients, 33 (40%) underwent surgery for complicated pneumothorax, 17 (20.5%) for pleural empyema, 13 (15.5%) for hemothorax, 8 (9.5%) for hemoptysis, 5 patients (6%) for lung abscess, 4 (5%) for infected pneumatoceles, and 3 (3.5%) for other causes. Within 30 days of surgery, 60 patients (72%) survived. At multivariable analysis, age (HR 1.05 [95% CI, 1.01, 1.09], p = 0.022), pulmonary hypertension (HR 3.98 [95% CI, 1.09, 14.5], p = 0.036), renal failure (HR 2.91 [95% CI, 1.19, 7.10], p-value 0.019), thoracotomy (HR 4.90 [95% CI, 1.84, 13.1], p-value 0.001) and infective affections (HR 0.17 [95% CI, 0.05, 0.58], p-value 0.004) were found to be independent prognostic risk factors for 30-day mortality. Age (OR 1.05 [95% CI, 1.01, 1.10], p = 0.023) and thoracotomy (OR 3.85 [95% CI, 1.35, 12.0] p = 0.014) became significant predictors for 30-day morbidity.ConclusionSurgical management of COVID-19-related thoracic complications is affected by high mortality and morbidity rates, but a 72% survival rate still seems to be satisfactory with a rescue intent. Younger patients without pulmonary hypertension, without renal insufficiency and undergoing surgery for infectious complications appear to have a better prognosis.

Published
2022

23. How to Prevent, Reduce, and Treat Severe Post Sympathetic Chain Compensatory Hyperhidrosis: 2021 State of the Art

Author

Federico, Raveglia, Riccardo, Orlandi, Angelo, Guttadauro, Ugo, Cioffi, Giuseppe, Cardillo, Gerardo, Cioffi, Marco, Scarci, Raveglia, F, Orlandi, R, Guttadauro, A, Cioffi, U, Cardillo, G, Cioffi, G, and Scarci, M

Subjects
compensatory hyperhidrosi, compensatory hyperhidrosis, thoracic sympathicotomy, prevention, RD1-811, Mini Review, primary hyperhidrosi, Surgery, primary hyperhidrosis, thoracic sympathectomy
Abstract

The role of thoracic surgery in the management of hyperhidrosis is well-known and thoracoscopic sympathetic interruption is commonly accepted as being the most effective treatment. However, some concerns still remain regarding the potential to develop compensatory hyperidrosis (CH), the most troublesome and frequent side effect after surgery and its management. Compensatory hyperidrosis prevention may be achieved by identifying subjects at higher risk and/or targeting nerve interruption level on the base of single patient characteristics gathered during the preoperative survey. Furthermore, the surgical treatment may consist of different techniques aimed at reversing the effects of previous sympathetic interruption. To predict CH after sympathectomy, the most interesting proposals in recent literature are a temporary thoracoscopic sympathetic block and the introduction of new and targeted preoperative surveys. If the role of nerve clipping technique vs. the definitive cutting is still intensely under debated, new approaches have been recently proposed to reduce the incidence of CH. In particular, extended sympathicotomy has been described as an alternative to overcome severe forms. Last, among the techniques developed to reverse sympathetic interruption effect, diffuse sympathicotomy (DS) and microsurgical sympathetic trunk reconstruction represent advances in this field. An all-round review of these topics is strongly needed. Our aim is to cover all the above issues point by point. Although sympathectomy represents a small part of thoracic surgery, we believe that it is worthy of interest because of the profound effect that complications for a benign condition can have on patients.

Published
2022

24. Standardization of Procedures to Contain Cost and Reduce Variability of Care After the Pandemic

Author

Ugo Cioffi, Riccardo Orlandi, Matilde De Simone, Marco Scarci, Arianna Rimessi, Angelo Guttadauro, Federico Raveglia, Fabrizio Minervini, Raveglia, F, Orlandi, R, Rimessi, A, Minervini, F, Cioffi, U, De Simone, M, Guttadauro, A, and Scarci, M

Subjects
RD1-811, Standardization, Referral, Coronavirus disease 2019 (COVID-19), Mini Review, media_common.quotation_subject, lean six sigma, 03 medical and health sciences, 0302 clinical medicine, Reading (process), Pandemic, Medicine, In patient, 030212 general & internal medicine, Lean Six Sigma, media_common, business.industry, sigma six, lean, thoracic surgery, lobectomy (lung), pandemic (COVID-19), Risk analysis (engineering), 030220 oncology & carcinogenesis, Spite, Surgery, business
Abstract

The coronavirus disease 2019 (COVID-19) pandemic has changed many aspects of our private and professional routine. In particular, the lockdowns have severely affected the entire healthcare system and hospital activities, forcing it to rethink the protocols in force. We suggest that this scenario, in spite of the new challenges involving so far complex healthcare providers, may lead to the unique opportunity to rethink pathways and management of patients. Indeed, having to resume institutional activity after a long interruption that has completely canceled the previously existing schemes, healthcare providers have the unique opportunity to overcome obsolete and “we have always done in this way” model on the wave of the general desire to resume a normal life. Furthermore, the pandemic has highlighted some flaws in our health system, highlighting those critical issues that most need to be addressed. This article is a review of pre-pandemic literature addressing the use of Lean Six Sigma (LSS) and standardization processes in thoracic surgery to improve efficiency. Our goal is to identify the main issues that could be successfully improved along the entire pathway of a patient from the first referral to diagnosis, hospitalization, and surgical operation up to convalescence. Furthermore, we aim to identify the standardization processes that have been implemented to achieve significant improvements in patient outcomes while reducing costs. The methods and goals that could be used in the near future to modernize our healthcare systems are drawn up from a careful reading and interpretation in light of the pandemic of the most significant review articles in the literature.

Published
2021
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25. Developing the surgical technique reporting checklist and standards: a study protocol

Author

Grace Li, Diego Gonzalez-Rivas, Alfonso Fiorelli, Stephen D. Wang, Calvin S.H. Ng, Yanfang Ma, Benedetta Bedetti, Nuria M. Novoa, Robert Fruscio, Sebastien Gilbert, Qianling Shi, Marco Scarci, Xueqin Tang, Leandro Cardoso Barchi, Yaolong Chen, René Horsleben Petersen, Bin Qiu, Kaiping Zhang, Giovanni Battista Levi Sandri, Yulong He, Alan D.L. Sihoe, Xianzhuo Zhang, Alper Toker, Ryuichi Waseda, Guillaume Piessen, Jinlin Wu, Panpan Jiao, Jianfei Shen, Shugeng Gao, Toni Lerut, Steven N. Hochwald, Fabio Davoli, Zhang, K, Ma, Y, Shi, Q, Wu, J, Shen, J, He, Y, Zhang, X, Jiao, P, Li, G, Tang, X, Petersen, R, Ng, C, Fiorelli, A, Novoa, N, Bedetti, B, Levi Sandri, G, Hochwald, S, Lerut, T, Sihoe, A, Barchi, L, Gilbert, S, Waseda, R, Toker, A, Gonzalez-Rivas, D, Fruscio, R, Scarci, M, Davoli, F, Piessen, G, Qiu, B, Wang, S, Chen, Y, and Gao, S

Subjects
medicine.medical_specialty, surgical technique reporting checklist and standards (SUPER), SURGERY, IMPROVEMENT, Study Protocol, Brainstorming, Multidisciplinary approach, Medicine, Medical physics, protocol, Trial registration, computer.programming_language, Protocol (science), Science & Technology, business.industry, Cornerstone, Surgical technique, Checklist, reporting checklist, TRIALS, Surgery, Pilot test, business, Life Sciences & Biomedicine, computer, Delphi
Abstract

BACKGROUND: Standardized and transparent reporting of surgical technique is the cornerstone of effective dissemination, implementation and improvement. However, current reporting of surgical techniques is inadequate. The existing guidelines potentially applied to guide surgical technique reporting are with a minimal highlight of the surgical technique, lack requirements explaining what extent and dimensions need to be described in detail, or are unlikely to extrapolate to a wide range of surgical techniques. This study aims to formulate a rigorous protocol to develop a surgical technique reporting checklist and standards (SUPER) that defines what a clear, comprehensive and detailed surgical technique report should be contained. METHODS: This protocol is designed following the classic guidance for developing reporting guidelines recommended by the EQUATOR network. RESULTS: The development team will consist of surgeons (~80%), methodologists, and journal editors. The draft checklist sources will include a scoping review of existing reporting guidelines related to surgical technique, surgical technique articles from 15 top journals published in the last year, and brainstorming by the multidisciplinary development team. The final SUPER checklist will be formed after three rounds of Delphi surveys, one round of face-to-face meeting, and a month-long pilot test. The SUPER checklist will be published as open-access and be used in combination with existing reporting guidelines related to surgical techniques (e.g., IDEAL). This protocol will steer the SUPER checklist's development, allowing us to further elaborate surgical technique reporting for all surgical specialties, and enabling a more favorable experience for surgeons, nurses, medical students, residents, editors, and reviewers. TRIAL REGISTRATION: This trial is registered at the EQUATOR network on December 18th, 2020. Available at: https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/. ispartof: GLAND SURGERY vol:10 issue:8 pages:2591-2599 ispartof: location:China (Republic : 1949- ) status: published

Published
2021

26. Case Report: Multidisciplinary Approach for a Rare Case of Thymic Vascular Malformation

Author

Maurizio Cariati, Federico Raveglia, Ugo Cioffi, Marco Scarci, Angelo Guttadauro, Alessandro Baisi, Laura Moneghini, Raveglia, F, Moneghini, L, Cariati, M, Baisi, A, Guttadauro, A, Cioffi, U, and Scarci, M

Subjects
medicine.medical_specialty, venous vascular malformation, medicine.medical_treatment, Settore MED/21 - Chirurgia Toracica, lcsh:Surgery, 03 medical and health sciences, 0302 clinical medicine, Surgical removal, Rare case, vessel embolization, medicine, case report, Coil embolization, residual thymu, medicine.diagnostic_test, business.industry, Vascular malformation, residual thymus, lcsh:RD1-811, medicine.disease, Median sternotomy, Uncertain diagnosis, 030220 oncology & carcinogenesis, Angiography, multidisciplinary approach, Surgery, Radiology, Differential diagnosis, business, 030217 neurology & neurosurgery
Abstract

We report the rare case of a 2.5 cm in size mass diagnostic for residual thymus associated with venous vascular malformation (ISSVA classification, 2008) in a 58 years old man. Diagnosis was obtained only after surgical removal that was complicated by a sudden massive bleeding (about 1,500 cc) requiring emergency conversion to median sternotomy. Difficulty in preoperative diagnosis, rarity of histologic pattern, and surgical challenges make this case very interesting for surgeons, pathologists and radiologist. Our message, dealing with mediastinal masses, is: (a) differential diagnosis between the more frequent solid antero-superior mediastinal tumors and vascular malformation should be always considered (b) preoperative angiography should always be performed in case of uncertain diagnosis (c) coil embolization should always be considered to reduce potentially fatal bleeding (d) histologic differentiation with other thymic neoplasms must be always considered.

Published
2021

27. Managing of screening-detected sub-solid nodules — A European perspective

Author

Giuseppe Cardillo, Giulia Veronesi, Richard Booton, René Horsleben Petersen, Marco Scarci, Maurizio Infante, Sara Ricciardi, Ricciardi, S., Booton, R., Petersen, R. H., Infante, M., Scarci, M., Veronesi, G., and Cardillo, G.

Subjects
medicine.medical_specialty, Subsolid nodules, Lung, business.industry, Early lung cancer, respiratory system, Guidelines, medicine.disease, Optimal management, respiratory tract diseases, Ground glass nodules (GGN), medicine.anatomical_structure, Ct screening, Oncology, medicine, National Lung Screening Trial, Intervention trial, Radiology, Lung cancer, Screening trial, business, Lung cancer screening, Review Article on Lung Cancer Screening
Abstract

Since the National Lung Screening Trial in 2011 showed a 20% reduction in lung cancermortality using annual low-dose computed tomography (LDCT), several randomised controlled trials and studies have been started in Europe. These include the Italian lung study (ITALUNG), the Dutch-Belgian lung cancer screening trial (NELSON), the UK lung cancer screening trial (UKLS), the Detection and screening of early lung cancer with novel imaging technology (DANTE), the Danish lung cancer screening trial (DLCST), the German lung cancer screening intervention trial (LUSI), the Multicentric Italian lung detection trial (MILD) and the CT screening for lung cancer study (COSMOS). As a result of the increasing number of screening trials and the growing utilization of LDCT, the high detection of subsolid nodules is an increasingly important clinical problem. In the last few years, several guidelines have been published and providing guidance on the optimal management of subsolid nodules, but many controversies still exist. Follow-up imaging plays an important role in clinical assessment and subsequent management of this particular type of lung nodules, since they can be transient inflammatory lesions, and if persistentthey can be both benign lesions or lung cancers of variable clinical behaviour. However, the vast majority of subsolid nodules retain an indolent course over many years. The aim of this review is to present a European perspective in management of screening detected subsolid nodules

Published
2021

28. Surgical and endoscopic treatment for COPD: patients selection, techniques and results

Author

Peter Kestenholz, Valentina Paolini, Fabrizio Minervini, Lidia Libretti, Alberto Pesci, Marco Scarci, Luca Bertolaccini, Minervini, F, Kestenholz, P, Paolini, V, Pesci, A, Libretti, L, Bertolaccini, L, and Scarci, M

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Endoscopic lung volume reduction (ELVR), Lung volume reduction surgery (LVRS), Copd patients, MED/21 - CHIRURGIA TORACICA, Chronic obstructive pulmonary disease (COPD), Review Article, Disease, 030204 cardiovascular system & hematology, Lung volume reduction surgery, 03 medical and health sciences, High morbidity, 0302 clinical medicine, Medicine, Emphysema, COPD, Lung, MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, business.industry, medicine.disease, respiratory tract diseases, Surgery, Transplantation, medicine.anatomical_structure, 030228 respiratory system, business, Endoscopic treatment
Abstract

Chronic obstructive pulmonary disease (COPD) is a very heterogeneous disease characterised by an obstructive lung pattern that constitutes worldwide a major cause of high morbidity and mortality. In the last decades, lung volume reduction surgery (LVRS) has demonstrated to be a potential good alternative to transplantation in patients affected by COPD. The trend toward minimally invasive techniques resulted not only in surgical procedures better tolerated by the patients but also in several endoscopic treatments modality that are rapidly gaining ground.

Published
2018

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