19 results on '"Roncon, Alberto"'
Search Results
2. Uniportal Video-Assisted Thoracoscopic Anatomic Lung Resection after Neoadjuvant Chemotherapy for Lung Cancer: A Case-Matched Analysis †.
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Andolfi, Marco, Meacci, Elisa, Salati, Michele, Xiumè, Francesco, Roncon, Alberto, Guiducci, Gian Marco, Tiberi, Michela, Nanto, Anna Chiara, Nachira, Dania, Nocera, Adriana, Calabrese, Giuseppe, Congedo, Maria Teresa, Inchingolo, Riccardo, Margaritora, Stefano, and Refai, Majed
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TREATMENT of lung tumors ,VIDEO-assisted thoracic surgery ,CARDIOPULMONARY system physiology ,PROBABILITY theory ,PATIENT readmissions ,TREATMENT effectiveness ,RETROSPECTIVE studies ,OPERATIVE surgery ,SURGICAL complications ,LUNG tumors ,COMBINED modality therapy ,COMPARATIVE studies ,LENGTH of stay in hospitals ,PERIOPERATIVE care ,TIME - Abstract
Simple Summary: In cases of advanced lung cancer after neoadjuvant chemotherapy (nCT), the role of uniportal video-assisted thoracoscopic surgery (U-VATS) is still questionable, with concerns about safety, technical feasibility, and oncological completeness. The aim of this retrospective study was to assess the impact of nCT on patients who had undergone U-VATS anatomic lung resections for lung cancer. We compared the short-term outcomes of 60 patients with case-matched counterparts (treated by surgery alone) selected by propensity score analysis, finding that U-VATS after nCT is a feasible approach with a similar rate of cardiopulmonary complications, length of stay, and readmission when compared with the control group. However, it is still a challenging surgery due to the great technical complexity, which is responsible for the higher incidence of conversion. Background: The advantages of video-assisted thoracic surgery (VATS) are well-recognized in several studies. However, in the cases of advanced lung cancer after neoadjuvant chemotherapy (nCT), the role of VATS is still questionable, with concerns about safety, technical feasibility, and oncological completeness. The aim of this study was to assess the impact of nCT on patients who had undergone uniportal VATS (U-VATS) anatomic lung resections for lung cancer, by comparing the short-term outcomes of patients after nCT with case-matched counterparts (treated by surgery alone). Methods: We performed a retrospective, comparative study enrolling 927 patients (nCT: 60; non-nCT:867) who underwent U-VATS anatomic lung resections from 2014 to 2020 in two centers. Data were collected in a shared database with standardized variables' definition. Propensity score matching using 15 baseline preoperative patients' characteristics was performed in order to minimize selection-confounding factors between the two groups, which then were directly compared in terms of perioperative outcomes. Results: After propensity score matching, two groups of 60 patients had been defined. The nCT-group had a higher conversion rate compared to the control group (13.3% vs. 0%, p = 0.003) without an increase in operation time or cardiopulmonary complications. In addition, no differences between the two groups were recorded in terms of prolonged air leaks, length of stay, and readmission. Conclusions: U-VATS after nCT is a feasible approach, showing a similar rate of cardiopulmonary complications and length of stay when compared with the control group. However, it remains a challenging surgery due to its great technical complexity as well as the clinical status of the patients. [ABSTRACT FROM AUTHOR]
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- 2024
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3. A Machine Learning Approach for Postoperative Outcome Prediction: Surgical Data Science Application in a Thoracic Surgery Setting
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Salati, Michele, Migliorelli, Lucia, Moccia, Sara, Andolfi, Marco, Roncon, Alberto, Guiducci, Gian Marco, Xiumè, Francesco, Tiberi, Michela, Frontoni, Emanuele, and Refai, Majed
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- 2021
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4. Uniportal Video-Assisted Thoracoscopic Surgery Completion Lobectomy Long after Wedge Resection or Segmentectomy in the Same Lobe: A Bicenter Study.
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Meacci, Elisa, Refai, Majed, Nachira, Dania, Salati, Michele, Kuzmych, Khrystyna, Tabacco, Diomira, Zanfrini, Edoardo, Calabrese, Giuseppe, Napolitano, Antonio Giulio, Congedo, Maria Teresa, Chiappetta, Marco, Petracca-Ciavarella, Leonardo, Sassorossi, Carolina, Andolfi, Marco, Xiumè, Francesco, Tiberi, Michela, Guiducci, Gian Marco, Vita, Maria Letizia, Roncon, Alberto, and Nanto, Anna Chiara
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VIDEO-assisted thoracic surgery ,PATIENT safety ,THORACOTOMY ,TISSUE adhesions ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,MULTIVARIATE analysis ,PLEURAL tumors ,SURGICAL blood loss ,SURGICAL complications ,LUNG surgery ,OBSTRUCTIVE lung diseases ,CONFIDENCE intervals ,LENGTH of stay in hospitals ,PNEUMONECTOMY ,EVALUATION - Abstract
Simple Summary: Completion lobectomy (CL) entails the resection of the remaining pulmonary lobe subsequent to wedge resection or segmentectomy. Indications for CL include reoperations for multiple or relapsed lung cancers and metastatic lung tumors, and the prognostic advantage of these procedures has been widely reported. However, ipsilateral surgical treatments, particularly within the same lobe, present challenges due to the development of intrapleural adhesions, rendering reoperation more difficult and time-consuming. VATS has emerged as the gold standard in the surgical treatment of early-stage NSCLC, offering superior postoperative outcomes when compared to thoracotomy. Its efficacy has been well established, even during complex procedures. However, its application in ipsilateral reoperations remains anecdotal, and to the best of our knowledge, no studies have analyzed the safety and efficacy of uniportal-VATS in this setting. This paper aims to evaluate the role of iniportal-VATS in CL long after wedge resection or anatomical segmentectomy in the same lobe. Background: Completion lobectomy (CL) following a prior resection in the same lobe may be complicated by severe pleural or hilar adhesions. The role of uniportal video-assisted thoracoscopic surgery (U-VATS) has never been evaluated in this setting. Methods: Data were collected from two Italian centers. Between 2015 and 2022, 122 patients (60 men and 62 women, median age 67.7 ± 8.913) underwent U-VATS CL at least 4 weeks after previous lung surgery. Results: Twenty-eight (22.9%) patients were affected by chronic obstructive pulmonary disease (COPD) and twenty-five (20.4%) were active smokers. Among the cohort, the initial surgery was performed using U-VATS in 103 (84.4%) patients, triportal-VATS in 8 (6.6%), and thoracotomy in 11 (9.0%). Anatomical segmentectomy was the initial surgery in 46 (37.7%) patients, while hilar lymphadenectomy was performed in 16 (13.1%) cases. CL was performed on 110 (90.2%) patients, segmentectomy on 10 (8.2%), and completion pneumonectomy on 2 (1.6%). Upon reoperation, moderate pleural adhesions were observed in 38 (31.1%) patients, with 2 (1.6%) exhibiting strong adhesions. Moderate hilar adhesions were found in 18 (14.8%) patients and strong adhesions in 11 (9.0%). The median operative time was 203.93 ± 74.4 min. In four (3.3%) patients, PA taping was performed. One patient experienced intraoperative bleeding that did not require conversion to thoracotomy. Conversion to thoracotomy was necessary in three (2.5%) patients. The median postoperative drainage stay and postoperative hospital stay were 5.67 ± 4.44 and 5.52 ± 2.66 days, respectively. Postoperative complications occurred in 34 (27.9%) patients. Thirty-day mortality was null. Histology was the only factor found to negatively influence intraoperative outcomes (p = 0.000). Factors identified as negatively impacting postoperative outcomes at univariate analyses were male sex (p = 0.003), age > 60 years (p = 0.003), COPD (p = 0.014), previous thoracotomy (p = 0.000), previous S2 segmentectomy (p = 0.001), previous S8 segmentectomy (p = 0.008), and interval between operations > 5 weeks (p= 0.005). In multivariate analysis, only COPD confirmed its role as an independent risk factor for postoperative complications (HR: 5.12, 95% CI (1.07–24.50), p = 0.04). Conclusions: U-VATS CL seems feasible and safe after wedge resection and anatomical segmentectomy. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Computed tomography-guided microcoil placement for localizing small pulmonary nodules before uniportal video-assisted thoracoscopic resection
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Refai, Majed, Andolfi, Marco, Barbisan, Francesca, Roncon, Alberto, Guiducci, Gian Marco, Xiumè, Francesco, Salati, Michele, Tiberi, Michela, Giovagnoni, Andrea, and Paci, Enrico
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- 2020
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6. Non-small cell lung cancer in surgically treated women
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Rena, Ottavio, Massera, Fabio, Boldorini, Renzo, Papalia, Esther, Turello, Davide, Davoli, Fabio, Baietto, Guido, Roncon, Alberto, Robustellini, Mario, and Casadio, Caterina
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- 2013
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7. Extralobar Pulmonary Sequestration Presenting with Recurring Massive Pleural Effusion in a Young Woman: A Challenging Case
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Davoli, Fabio, Turello, Davide, Valente, Guido, Rena, Ottavio, Roncon, Alberto, Baietto, Guido, and Casadio, Caterina
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- 2016
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8. Delayed Pulmonary Fibrosis (Usual Interstitial Pneumonia) in a Patient With Previous Uncomplicated H1N1-Associated Pneumonia
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Baietto, Guido, Davoli, Fabio, Turello, Davide, Rena, Ottavio, Roncon, Alberto, Papalia, Esther, Massera, Fabio, and Casadio, Caterina
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- 2015
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9. Mediastinal Vagus Nerve Schwannoma Successfully Treated by a Biportal VATS Approach
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Roncon, Alberto, Davoli, Fabio, Casadio, Caterina, Baietto, Guido, Rena, Ottavio, and Turello, Davide
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- 2015
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10. Endovascular Treatment of Blunt Thoracic Aortic Injury by Fractured Rib
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Pagliariccio, Gabriele, Salati, Michele, Roncon, Alberto, Gironi, Giulia, and Carbonari, Luciano
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- 2019
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11. Metastasis to Subsegmental and Segmental Lymph Nodes in Patients Resected for Non-Small Cell Lung Cancer: Prognostic Impact.
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Rena, Ottavio, Boldorini, Renzo, Papalia, Esther, Turello, Davide, Massera, Fabio, Davoli, Fabio, Roncon, Alberto, Baietto, Guido, and Casadio, Caterina
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Background: We investigated the prognostic significance of segmental and subsegmental (level 13 and 14) lymph nodes metastasis in patients with resected non-small cell lung cancer (NSCLC). Methods: The pattern of lymph nodal metastasis was analyzed in 124 patients with pN1 NSCLC. Long-term outcomes were compared for 390 pN0, 124 pN1, and 82 pN2 consecutive patients submitted to planned pulmonary resection for NSCLC between 2000 and 2006. The pN1 status was stratified into 3 groups according to the highest level of lymph node involvement: level 10 (hilar); level 11+12 (lobar + interlobar); and level 13+14 (segmental + subsegmental). Results: The 5-year overall survival (OS) rates for pN0, pN1, and pN2 patients were 93%, 66%, and 25%, respectively. The highest level of lymph node involvement was a significant prognostic indicator; the 5-year OS rate for level 13+14, level 11+12, level 10 pN1, and pN2 was 81%, 58%, 48%, and 25%, respectively. Significant differences were recorded in long-term outcome when pN0 and pN1 level 13+14, pN1 level 13+14, and pN1 level 11+12, pN1 level 11+12 and pN1 level 10 were compared (p < 0.05). The median number of examined level 13+14 lymph nodes was 2 (range 0 to 6) and 57% pN1 patients had metastasis at level 13+14 lymph nodes. Conclusions: The highest level of lymph node metastases may be used to stratify outcome of patients with pN1 disease. Routine examination of level 13+14 lymph nodes is to be recommended to correctly identify patients at risk of relapse and predict long-term prognosis. [Copyright &y& Elsevier]
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- 2014
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12. Single Thymic Gland Metastasis From Resected Non-small-cell Lung Cancer
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Rena, Ottavio, Sacchetti, Gian Mauro, Ramponi, Antonio, Roncon, Alberto, Baietto, Guido, and Casadio, Caterina
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- 2012
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13. Thoracoscopic Water Pleurectomy in Pneumothorax: Some Concerns.
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Rena, Ottavio, Papalia, Esther, Turello, Davide, Massera, Fabio, Roncon, Alberto, Baietto, Guido, and Casadio, Caterina
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- 2014
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14. Thymomaptysis: unusual presentation of invasive thymoma.
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Rena, Ottavio, Ramponi, Antonio, Roncon, Alberto, and Casadio, Caterina
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- 2012
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15. Giant Cervico-mediastinal Well-differentiated Liposarcoma.
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Rena, Ottavio, Davoli, Fabio, Pia, Francesco, Roncon, Alberto, Papalia, Esther, and Casadio, Caterina
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LIPOSARCOMA , *SURGICAL excision , *TRACHEOTOMY , *NEURODEGENERATION , *MEDIASTINUM , *DYSPNEA , *DIAGNOSIS ,MEDIASTINAL tumors - Abstract
Liposarcomas are rare entities and those located in the neck and mediastinum are exceptional. We report the case of a 58 year-old Caucasian male who presented with dysphonia, mild dysphagia to solids, dyspnoea at exertion and cough due to a giant mass of the neck originating from the deep cervical space at C6 vertebral level spreading into the posterior mediastinum. The lesion, that was associated with a right vocal cord palsy, caused severe lateral displacement of the trachea and oesophagus. The case has been managed by complete surgical resection through a combined cervical and thoracic approach associated with a tracheostomy due to the risk of bilateral recurrent nerve dysfunction at the end of the intervention. The tumour was diagnosed as a encapsulated low-grade liposarcoma. Six months after surgery the tracheostomy was closed. At 24 months clinical and radiological follow-up the patient is doing well and disease free. [ABSTRACT FROM AUTHOR]
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- 2015
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16. Uniportal video-assisted thoracoscopic thymectomy: the glove-port with carbon dioxide insufflation.
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Refai M, Gonzalez-Rivas D, Guiducci GM, Roncon A, Tiberi M, Xiumè F, Salati M, and Andolfi M
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Background: Since 2004, uniportal video-assisted thoracic surgery (VATS) approach was progressively widespread and also applied in the treatment of thymoma, with promising results. We report the first series of patients who undergone uniportal VATS thymectomy using a homemade glove-port with carbon dioxide (CO
2 ) insufflation. The aim of this article is to analyze the safety and feasibility to perform an extended thymectomy (ET)., Methods: A prospective, single-centre, short-term observational study including patients with mediastinal tumours undergoing scheduled uniportal VATS resection using a glove-port with CO2 . Operations were performed through a single incision of 3.5 cm at the fifth intercostal space, right or left anterior axillary line. A 5 mm-30° camera and working instruments were employed through a glove-port with CO2 ., Results: Thirty-eight patients (20 men; mean age 61.6 years) underwent ET between September 2016 and October 2019. Thirteen patients had a history of Myasthenia Gravis (MG) with thymoma and 8 had incidental findings of thymoma. Additionally, 8 mediastinal cysts and 9 thymic hyperplasia were included. Mean diameter of the tumor was 5.1 cm (range, 1.6-14 cm) and mean operation time was 143 minutes. Mean postoperative drainage duration and hospital stay were 2.3 and 4.3 days, respectively. Mean blood loss was 41 mL. There was no occurrence of surgical morbidity or mortality. During the follow-up period (1-36 months), no recurrence was noted., Conclusions: Our results suggest that uniportal VATS thymectomy through glove-port and CO2 is safe and feasible procedure, even with large thymomas. Furthermore, the glove-port system represents a valid, cheap and widely available alternative to the commercial devices usually adopted in thoracic surgery., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-19-521). The authors have no conflicts of interest to declare., (2020 Gland Surgery. All rights reserved.)- Published
- 2020
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17. Uniportal video-assisted thoracoscopic left superior segmentectomy.
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Andolfi M, Guiducci G, Xiumè F, Salati M, Roncon A, and Refai M
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- Adenocarcinoma diagnostic imaging, Adenocarcinoma secondary, Aged, Colorectal Neoplasms pathology, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms secondary, Male, Adenocarcinoma surgery, Lung Neoplasms surgery, Pneumonectomy methods, Thoracic Surgery, Video-Assisted methods
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Obtaining adequate margins when performing lung cancer resection is crucially important. Therefore, during thoracoscopic segmentectomy, where the direct palpation of the tumor is not always possible, it is mandatory to accurately identify the intersegmental plane in order to achieve a satisfactory oncological and surgical result. In this video tutorial, we demonstrate a uniportal video-assisted thoracoscopic (VATS) superior segmentectomy of the left lower lobe, adopting two different techniques for identifying the intersegmental plane: the inflation-deflation method and selective resected segmental inflation, and we present the pros and cons of each. With the inflation/deflation technique, which is the most common maneuver used, we inflated the whole lung after occlusion of the target segmental bronchus, inducing collapse of the superior segment and inflation of the remaining lobe. However, this inexpensive and easy method often makes identification of the intersegmental plane unreliable because of the collateral ventilation. Moreover, because of the expansion of inflated segments, it limits thoracic working space during the VATS procedure. In contrast, selective resected segmental inflation guarantees an optimal surgical space even during a VATS procedure. In this case, we directly inflated the segmental bronchus of the superior segment through a butterfly needle in order to selectively expand only the selected segment. The careful demarcation of the intersegmental plane is mandatory in order to obtain adequate margins and achieve a high success rate for thoracoscopic segmentectomy. Although a one-size-fits-all method is not feasible, we strongly recommend making every effort for identifying it as best as possible; indeed, its inadequate demarcation may be the main cause of unsatisfactory surgical and oncological results in terms of locoregional recurrence and long-term survival., (© The Author 2016. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
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- 2020
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18. Novel double-stapling technique for distal oesophageal resection and oesophago-jejunal anastomosis.
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Gentilli S, Portigliotti L, Davoli F, Roncon A, Rena O, and Oldani A
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- Aged, Anastomosis, Roux-en-Y methods, Anastomotic Leak etiology, Anastomotic Leak surgery, Equipment Design, Female, Gastrectomy, Gastric Stump, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, Myocardial Infarction epidemiology, Postoperative Complications epidemiology, Surgical Staplers, Adenocarcinoma surgery, Esophageal Neoplasms surgery, Esophagogastric Junction surgery, Esophagoplasty methods, Jejunum surgery, Surgical Stapling methods
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Aim: The restoration of the digestive tract by performing an esophago-jejunal anastomosis (EJA) is a crucial step of the total gastric and distal esophagus surgical resection for esophago-gastric junction (EGJ) cancer. We have already ideated and tested on a cadaver model an innovative technique which could be useful to minimize the risk of complications related to the phase of securing the anvil of the circular stapler prior to perform the EJA. This surgical technique was derived from the well-known "double-stapling Knight and Griffen" one that was described for the rectal resection. We used the following described technique in 20 patients with EGJ cancer and it is efficient, reliable, safe, easy to learn and easy to perform., Materials and Methods: From August 2014 to May 2015, 20 patients (14 male and 6 female) underwent surgery for esophagogastric junction cancer: In all patients a distal esophageal resection and total gastrectomy was performed. Through the trans-hiatal access, the free margins of the esophageal stump were suspended and the anvil of a circular stapler on a new dedicated and registered support bar was inserted into the lumen. Subsequently, the linear suturing stapler is closed over the bar and then fired to suture the distal stump of the esophagus; after the confirmation of a negative margin, the bar is retracted and the push-rod of the anvil is pulled out through the linear suture. Finally, the anastomosis is performed with the classic technique by using a circular stapler., Results: No postoperative mortality occurred; postoperative course has been uneventful for 18 patients. One patient developed anastomotic fistula that has been treated conservatively with endoscopic prothesis, removed after 20 days. One patient developed in 3 POD myocardial infarction Mean Hospital stay has been 14 days (range 7-20 days)., Conclusions: The aim of our new procedure is the insertion the anvil of a common circular stapler without handsewn securing; this is to reduce the technical difficulties related to the hand-sewn securing into a deep and narrow anatomic location, typical of the trans-hiatal approach., Key Words: Anastomosis, Oesophago-gastric junction cancer, Stapler, Trans-hiatal.
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- 2016
19. Persistent lung expansion after pleural talc poudrage in non-surgically resected malignant pleural mesothelioma.
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Rena O, Boldorini R, Papalia E, Mezzapelle R, Baietto G, Roncon A, and Casadio C
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- Aged, Biopsy, Needle, Cohort Studies, Confidence Intervals, Disease-Free Survival, Female, Follow-Up Studies, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lung Neoplasms diagnostic imaging, Lung Neoplasms mortality, Lung Neoplasms pathology, Male, Mesothelioma diagnostic imaging, Mesothelioma mortality, Mesothelioma pathology, Mesothelioma, Malignant, Middle Aged, Multivariate Analysis, Neoplasm Staging, Pleural Neoplasms diagnostic imaging, Pleural Neoplasms mortality, Pleural Neoplasms parasitology, Pleurodesis mortality, Radiography, Retrospective Studies, Risk Assessment, Survival Analysis, Thoracic Surgery, Video-Assisted methods, Tissue Expansion methods, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Lung Neoplasms therapy, Mesothelioma therapy, Pleural Neoplasms therapy, Pleurodesis methods, Talc administration & dosage
- Abstract
Background: To investigate the prognostic effect of persistent lung expansion after pleural talcage and other variables in non-surgically resected malignant pleural mesothelioma (MPM) patients., Methods: All consecutive patients submitted to video-assisted thoracoscopic (VAT) pleurodesis by talc poudrage for MPM between 2006 and 2011 were studied. The following parameters were prospectively recorded: age; sex; smoking history; asbestos exposure; C-reactive protein (CRP) levels; platelet (PLT) count; Eastern Cooperative Oncology Group performance status (ECOG PS); histologic subtype; clinical stage (cStage); chemotherapy; pleural fluid volume; and persistence of lung expansion at 3 months follow-up. Survival was assessed in June 2013., Results: A total of 172 patients were considered; 146 of 172 patients demonstrated a complete lung expansion at discharge, whereas only 85 of 172 patients had persistent expanded lung on the affected side at the 3-month follow-up chest x-ray. Median survival was 11.5 months (95% confidence interval [CI], 10% to 14%) and 2-year disease-specific survival was 13% (95% CI, 7% to 24%) for the entire cohort. Multivariate analysis showed that non-epithelioid histology (hazard ratio [HR], 2.81; 95% CI, 1.82% to 5.09%), pleural fluid recurrence (HR 2.54; 95% CI, 1.73% to 4.40%), cStage greater than II (HR 2.36; 95% CI, 1.50% to 4.32%), ECOG PS greater than 1 (HR 2.19; 95% CI, 1.26% to 4.23%), CRP greater than 5 mg/L (HR 2.01; 95% CI, 1.18% to 4.12%), and PLT count greater than 400,000 (HR 1.76; 95% CI 1.14% to 3.92%) were independent predictors of poor prognosis., Conclusions: Persistent lung expansion after pleural talc poudrage and absence of fluid recurrence is demonstrated to be a stronger factor in predicting survival rather than clinical stage and other clinical variables in not surgically resected MPM patients., (Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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