176 results on '"Faccioli, E."'
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52. Comment on "Domain Reduction Method for Three-Dimensional Earthquake Modeling in Localized Regions, Part I: Theory," by J. Bielak, K. Loukakis, Y. Hisada, and C. Yoshimura, and "Part II: Verification and Applications," by C. Yoshimura, J. Bielak, Y. Hisada, and A. Fernandez
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Faccioli, E., primary
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- 2005
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53. Long Period Strong Ground Motion and Its Use as Input to Displacement Based Design.
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Ansal, Atilla, Pitilakis, Kyriazis D., Faccioli, E., Cauzzi, C., Paolucci, R., Vanini, M., Villani, M., and Finazzi, D.
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Consistently with the use of seismic inertia forces for the verification of structural members, buildings have been traditionally designed for earthquake resistance by relying on ground acceleration from strong earthquakes to describe seismic loading; in most applications this is quantified by acceleration response spectra. However, structural design is increasingly becoming performance based, whereby displacements and deformations of structural and non-structural members, which directly control damage, are brought to the front stage to replace accelerations and inertia forces. Thus, the relative displacement of the structure caused by the imposed ground motion, quantified through the displacement response spectrum (DRS), becomes the primary descriptor of the seismic demand. Methods are available to replace the actual structure (a non-linear multi-degreeof-freedom system) with an equivalent linear 1 DOF system, in which energy dissipation due to the non-linear response is accounted for through a large viscous damping factor. A synthesis of the main steps involved in the (direct) displacement based approach is provided in Figure 2.1. Since the design involves the response of the damaged structure, which is "softer" than the undamaged one, the vibration period T at play is significantly larger than the elastic, or initial, period. Hence, depending on the structure, DRS will have to encompass a broad T range, e.g. up to 10 s, well beyond the typical 0-4 s range of current norms (CEN, 2004). [ABSTRACT FROM AUTHOR]
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- 2007
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54. Comment on “The spectral element method: An efficient tool to simulate the seismic response of 2D and 3D geological structures,” by D. Komatitsch and J.-P. Vilotte
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Faccioli, E., primary and Quarteroni, A., additional
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- 1999
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55. A STUDY OF SITE EFFECTS AND SEISMIC RESPONSE OF AN INSTRUMENTED BUILDING IN MEXICO CITY
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MELI, R., primary, FACCIOLI, E., additional, MURIA-VILA, D., additional, QUAAS, R., additional, and PAOLUCCI, R., additional
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- 1998
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56. Site response analysis in the valley of Mexico: Selection of input motion and extent of non‐linear soil behaviour
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Ordaz, M., primary and Faccioli, E., additional
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- 1994
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57. Spectral multidomain methods for the simulation of wave propagation in heterogeneous media
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Faccioli, E., primary, Quarteroni, A., additional, and Tagliani, A., additional
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- 1994
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58. Studi di Microzonazione sismica e di dinamica dei terreni a San salvador
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Faccioli, E, Battistella, C, Alemani, P, LO PRESTI, DIEGO CARLO, and Tibaldi, A.
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- 1989
59. Seismic Microzoning and Soil Dynamics Studies in San Salvador
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Faccioli, E, Battistella, C, Alemani, P, LO PRESTI, DIEGO CARLO, and Tibaldi, A.
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- 1989
60. Indagini sul terreno
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Faccioli, E, Cavallin, A, Crespellani, T, Schiavone, D, Siro, L, CAVALLIN, ANGELO, Schiavone D, Siro, L., Faccioli, E, Cavallin, A, Crespellani, T, Schiavone, D, Siro, L, CAVALLIN, ANGELO, Schiavone D, and Siro, L.
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- 1986
61. A study on damage scenarios for residential buildings in Catania city
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Faccioli, E., Pessina, V., gian michele calvi, and Borzi, B.
62. Numerical Modelling Approaches for the Analysis of Earthquake Triggered Landslides
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Modaressi, H., Aubry, D., Faccioli, E., Noret, C., Modaressi, H., Aubry, D., Faccioli, E., and Noret, C.
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Different numerical approaches for the analysis of earthquake triggered landslides are studied. Improved simplified models are developed and their performance for evaluating the response of natural slopes subjected to earthquakes is studied. Using more sophisticated numerical techniques the influence of several factors such as the hydro mechanical behavior assumptions, 1D vs. 2D geometry, and the input motion are assessed. 2D computations have shown that the kinematics of the slope motion is largely affected by the geometry of the slope. As far as the soil behavior is concerned, the results indicate that introduction of progressive yielding in the soil model provides larger displacement, progressive pore-pressure generation and more diffuse deformation. For the input motion, the number of peaks and their amplitudes have been identified as being the mains factors for irreversible displacements.
63. Seismic Amplification in the Presence of Geological and Topographic Irregularities
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Faccioli, E. and Faccioli, E.
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Following some introductory remarks on the key aspects of seismic site effects evaluation and on new data of special interest from recent earthquakes, the first part of the paper discusses and compares the performance of numerical 2D and 1D models, as well as of simple exact solutions, in problems of local soil response and of topographic amplification. The second part is devoted to the illustration of a very promising computational tool, i.e. the Fourier (or pseudo spectral) method, for time-domain analyses of seismic wave propagation in heterogeneous elastic media.
64. Engineering Seismology Aspects of the M-6.5, Southern Italy Earthquake of Nov. 23, 1980: A Preliminary Review
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Faccioli, E. and Faccioli, E.
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The paper provides an overview of salient engineering seismology features of the earthquake, which was one of the major seismic catastrophes occurring in Italy in this century. After a short description of the characteristics of the earthquake source and of the historical seismicity of the region, preliminary strong-motion and intensity data are presented. Aspects of geotechnical engineering interest include some large landslides in inhabited areas, and notable cases of correlation between severity of damage and local soil conditions and topography.
65. Measures of strong ground motion derived from a stochastic source model
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Faccioli, E., primary
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- 1983
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66. A discrete Eulerian model of spherically symmetric compressible media
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Faccioli, E., primary and Ang, A.H.-S., additional
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- 1968
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67. A finite element, linear programming methods for the limit analysis of thin plates
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Faccioli, E., primary and Vitiello, E., additional
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- 1973
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68. (1003) - Evaluation of Plasma Donor-Derived Cell-Free DNA and the LASHA Scoring System as Complementary Tools in Lung Transplantation: Insights from a Prospective Single-Center Experience.
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Pezzuto, F., Tauro, V., De Chellis, C., Lunardi, F., Loy, M., Faccioli, E., Vadori, M., Biondini, D., Marinello, S., Braccioni, F., Schiavon, M., Levine, D., Cozzi, E., Rea, F., and Calabrese, F.
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CELL-free DNA , *LUNG transplantation , *CIRCULATING tumor DNA - Published
- 2024
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69. 1D and 2D site amplification effects at Tarcento (Friuli, NE Italy), 30 years later
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Ezio Faccioli, Giovanni Costa, Carlo Cauzzi, Cauzzi, C., Faccioli, E., and Costa, Giovanni
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Ground motion ,Hydrogeology ,Parametric simulation ,complex site effects ,microzonation ,Structural basin ,alluvium-filled valleys ,Seismic networks ,Microzonation ,Alluvium-filled valleys ,Complex site effects ,Linear array ,Seismic networks · Microzonation · Alluvium-filled valleys · Complex site effects ,Geophysics ,Geochemistry and Petrology ,Section (archaeology) ,Alluvium ,Structural geology ,Geology ,Seismology - Abstract
Journal of Seismology, 15 (1), ISSN:1383-4649, ISSN:1573-157X
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- 2010
70. Vulnerability and probability of collapse for classes of masonry buildings
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ZUCCARO, GIULIO, BERNARDINI A., GORI R., MUNERATTI E., PAGGIARIN C., PARISI O., FACCIOLI E., PESSINA V., Zuccaro, Giulio, Bernardini, A., Gori, R., Muneratti, E., Paggiarin, C., and Parisi, O.
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- 2000
71. Seismic characterization of the representative soils of Catania
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NUNZIATA, CONCETTINA, COSTA G., NATALE M., SICA A., SPAGNUOLO R., Faccioli E., Pessina V., Nunziata, Concettina, Costa, G., Natale, M., Sica, A., and Spagnuolo, R.
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- 2000
72. Indagini sul terreno
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CAVALLIN, ANGELO, Crespellani, T, Schiavone D, Siro, L., Faccioli, E, Cavallin, A, Crespellani, T, Schiavone, D, and Siro, L
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Zonazione Sismica ,GEO/05 - GEOLOGIA APPLICATA - Published
- 1986
73. A new vessel filled and heart-beating human corpse model for VATS lobectomy training.
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Verzeletti V, Lione L, Bonis A, Sella N, Cannone G, Melan L, Rebusso A, Faccioli E, Porzionato A, Comacchio GM, Nicotra S, Dell'Amore A, and Rea F
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Background: Nowadays, video-assisted thoracic surgery (VATS) lobectomy represents the treatment of choice for early-stage lung cancer. Over the years, different methods for VATS training have evolved. The aim of this study is to present an innovative beating-heart filled-vessel cadaveric model to simulate VATS lobectomies., Methods: Via selective cannulation of the cadaver heart, the pulmonary vessels were filled with a gel to improve their haptic feedback. An endotracheal tube with a balloon on its tip then allowed movement of the heart chambers, transmitting a minimum of flow to the pulmonary vessels. A simulated OR was created, using all instrumentation normally available during surgery on living patients, with trainees constantly mentored by experienced surgeons. At the end of each simulation, the participants were asked 5 questions on a scale of 1 to 10 to evaluate the effectiveness of the training method ("1" being ineffective and "10" being highly effective)., Results: Eight models were set up, each with a median time of 108 min and a cost of €1500. Overall, 50 surgeons were involved, of which 39 (78%) were consultants and 11 (22%) were residents (PGY 3-5). The median scores for the 5 questions were 8.5 (Q1; IQR
1-3 8-9), 8 (Q2; IQR1-3 7-9), 9 (Q3; IQR1-3 8-10), 9 (Q4; IQR1-3 8-10), and 9 (Q5; IQR1-3 8-10). Overall, the model was most appreciated by young trainees even though positive responses were also provided by senior surgeons., Conclusions: We introduce a new beating-heart filled-vessel cadaveric model to simulate VATS lobectomies. From this initial experience, the model is cost effective, smooth to develop, and realistic for VATS simulation., (© 2024. The Author(s).)- Published
- 2024
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74. A Multicenter Retrospective Case-Control Study on Simple vs Extended Sleeve Lobectomies.
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Campisi A, Dell'Amore A, Faccioli E, Fang W, Chen T, Ji C, Gabryel P, Sielewicz M, Piwkowski C, Park S, Kim YT, Bongiolatti S, Mugnaini G, Voltolini L, Catelli C, Giovannetti R, Infante M, Bertolaccini L, Spaggiari L, Ehrsam J, Schöb O, Inci I, and Rea F
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- Humans, Retrospective Studies, Female, Male, Middle Aged, Aged, Case-Control Studies, Neoplasm Staging, Survival Rate trends, Treatment Outcome, Disease-Free Survival, Pneumonectomy methods, Carcinoma, Non-Small-Cell Lung surgery, Carcinoma, Non-Small-Cell Lung mortality, Carcinoma, Non-Small-Cell Lung pathology, Lung Neoplasms surgery, Lung Neoplasms mortality, Lung Neoplasms pathology
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Background: Sleeve resection is currently the gold standard procedure for centrally located non-small cell lung cancer (NSCLC). Extended sleeve lobectomy (ESL) consists of an atypical bronchoplasty with resection of >1 lobe and carries several technical difficulties compared with simple sleeve lobectomy (SSL). Our study compared the outcomes of ESL and SSL for NSCLC., Methods: This multicenter, retrospective, cohort study included 1314 patients who underwent ESL (155 patients) or SSL (1159 patients) between 2000 and 2018. The primary end points were 30-day and 90-day mortality, overall survival (OS), disease-free survival (DFS), and complications., Results: No differences were found between the 2 groups in general characteristics and surgical and survival outcomes. In particular, there were no differences in early and late complication frequency, 30- and 90-day mortality, R status, recurrence, OS (54.26 ± 33.72 months vs 56.42 ± 32.85 months, P = .444), and DFS (46.05 ± 36.14 months vs 47.20 ± 35.78 months, P = .710). Mean tumor size was larger in the ESL group (4.72 ± 2.30 cm vs 3.81 ± 1.78 cm, P < .001). Stage IIIA was the most prevalent stage in ESL group (34.8%), whereas stage IIB was the most prevalent in SSL group (34.3%; P < .001). The multivariate analyses found nodal status was the only independent predictive factor for OS., Conclusions: ESL gives comparable short- and long-term outcomes to SSL. Appropriate preoperative staging and exclusion of metastases to mediastinal lymph nodes, as well as complete (R0) resection, are essential for good long-term outcomes., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
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- 2024
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75. Tumor inflammatory microenvironment contribution to survival in resected upstaged adenocarcinomas.
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Bonis A, Verzeletti V, Lunardi F, Lione L, Cannone G, Faccioli E, Mammana M, Nicotra S, Calabrese F, Dell'Amore A, and Rea F
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- Humans, Male, Female, Retrospective Studies, Aged, Middle Aged, Neoplasm Staging, Adenocarcinoma of Lung surgery, Adenocarcinoma of Lung pathology, Adenocarcinoma of Lung immunology, Adenocarcinoma of Lung mortality, Survival Rate, Pneumonectomy, Adenocarcinoma surgery, Adenocarcinoma pathology, Adenocarcinoma mortality, Adenocarcinoma immunology, Tumor Microenvironment immunology, Lung Neoplasms pathology, Lung Neoplasms surgery, Lung Neoplasms mortality, Lung Neoplasms immunology, Lymphocytes, Tumor-Infiltrating immunology, B7-H1 Antigen metabolism
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Introduction: Tumor Inflammatory microenvironment (TIME) encompasses several immune pathways modulating cancer development and escape that are not entirely uncoded. The results achieved with immunotherapy elicited the scientific debate on TIME also in non-small cell lung cancer (NSCLC). We aimed to investigate whether TIME (in terms of PD-L1 expression and/or Tumor Infiltrating Lymphocytes - TILs) played a separate role in terms of survival (OS) in resected upstaged lung adenocarcinomas (ADCs), excluding other perioperative variables as confounders., Materials and Methods: This retrospective study included 50 patients with a clinically resectable lung ADC, undergoing surgery (lobectomy or segmentectomy) at the Thoracic Unit of Padova University Hospital between 2016 and 2022 and receiving an unexpected pathological upstaging (IIB or higher)., Results: Despite microscopical variables increasing from IIB to IIIB, survival was not significantly related to them. OS was better in TIME-active patients (defined as the presence of positive PD-L1 and/or TILs>10 %) than double negatives (PD-L1-/TILs-) (p = 0.01). In IIB or higher ADCs, TIME-active patients showed an improved survival compared to double negatives, merging the current TIME theories., Conclusion: TIME seems to be associated with survival independently from other microscopical parameter, even in case of resected upstaged adenocarcinomas., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
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- 2024
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76. Pathological complete response in a patient with pleural mesothelioma treated with immunotherapy: a case report.
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Faccioli E, Grosso F, Dell'Amore A, Delfanti S, Zambello G, Cerbone L, Canu G, De Angelis A, Sambataro V, Pezzuto F, Barbieri P, Pasello G, Calabrese F, and Rea F
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The role of immunotherapy in the multimodal treatment for pleural mesothelioma (PM) is still under investigation, particularly in the preoperative setting. Pathological complete response (pCR) has been previously described after chemotherapy and immunotherapy; however, there is no prior experience reported with immunotherapy alone before surgery. We report the case of a 58-year-old male with biphasic PM treated with immunotherapy, resulting in a major clinical partial response. Following a multidisciplinary evaluation between thoracic surgeons, medical oncologists, pathologists, radiologists and radiation oncologists, the patient underwent surgery with radical intent through a right extended pleurectomy/decortication (eP/D). Histopathological examination of the specimen confirmed a pathological Complete Response (pCR). This case supports the feasibility and potential efficacy of combining preoperative immunotherapy with surgery in the management of advanced PM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Faccioli, Grosso, Dell’Amore, Delfanti, Zambello, Cerbone, Canu, De Angelis, Sambataro, Pezzuto, Barbieri, Pasello, Calabrese and Rea.)
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- 2024
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77. Endobronchial solitary fibrous tumors: An enigma for diagnosis.
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Ramalhosa F, Pezzuto F, Fortarezza F, Canu G, Biondini D, Faccioli E, Polverosi R, Giraudo C, and Calabrese F
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- Humans, Female, Middle Aged, Diagnosis, Differential, Bronchi pathology, Solitary Fibrous Tumors diagnosis, Solitary Fibrous Tumors pathology, Soft Tissue Neoplasms diagnosis, Neoplasms, Connective and Soft Tissue diagnosis
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Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms constituting less than 2% of all soft tissue tumors. They typically originate in the thoracic cavity, mainly in the pleura, but can also occur in other various sites such as lung parenchyma, pericardium, and bronchus. In this study, a 49-year-old non-smoking female with a history of allergies presented to our pulmonary clinic with a chronic cough. An explorative bronchoscopy revealed an intrabronchial mass in the left superior bronchi, and a 68 Ga-DOTATOC positron emission computed tomography suggested a carcinoid tumor. Subsequent pulmonary segmentectomy unveiled a well-circumscribed polypoid lesion diagnosed as a low-grade bronchus SFT through histopathological and immunohistochemical assessments. The patient was asymptomatic after surgical excision and showed no other lesion during the 6-month follow-up. The endobronchial location of SFT is uncommon, with only a few reported cases in the literature, underscoring the necessity of considering various differential diagnoses, including carcinoid, mucoepidermoid carcinoma, endobronchial pleomorphic adenoma, hamartoma, leiomyoma, and metastasis, depending on location and imaging features. This report underscores the importance of careful histological and immunohistochemical evaluation in understanding and appropriately stratifying the risk associated with polypoid lesions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)
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- 2024
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78. Lung Transplantation in Patients with Previous or Unknown Oncological Disease: Evaluation of Short- and Long-Term Outcomes.
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Catelli C, Faccioli E, Silvestrin S, Lorenzoni G, Luzzi L, Bennett D, Schiavon M, Campisi A, Bargagli E, Dell'Amore A, and Rea F
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The accurate selection of the recipient is a crucial aspect in the field of lung transplantation (LTX), especially if patients were previously affected by oncological disease. The aim of this bicentric retrospective study was to evaluate short- and long-term outcomes in patients with previous oncological disease or unknown neoplasia found on native lungs submitted to LTX, compared to a control group. A total of 433 patients were included in the analysis, 31 with malignancies (Group 1) and 402 without neoplastic disease (Group 2). The two groups were compared in terms of short- and long-term outcomes. Patients in Group 1 were older (median age 58 years vs. 50 years, p = 0.039) and mostly affected by idiopathic pulmonary fibrosis (55% vs. 40% p = 0.002). Even though in Group 1 a lower rate of late post-operative complications was found (23% vs. 45%, p = 0.018), the median overall survival (OS) was lower compared to the control group (10 months vs. 29 months, p = 0.015). LTX represents a viable therapeutic option for patients with end-stage lung disease and a history of neoplastic disease. However, every case should be carefully debated in a multidisciplinary setting, considering oncological (histology, stage, and proper disease free-interval) and clinical factors (patient's age and comorbidities). A scrupulous post-transplant follow-up is especially mandatory in those cases.
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- 2024
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79. Perioperative outcomes in redo VATS for pulmonary ipsilateral malignancy: A single center experience.
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Verzeletti V, Busetto A, Cannone G, Bartolotta P, Nicotra S, Schiavon M, Faccioli E, Comacchio GM, Dell'Amore A, and Rea F
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- Humans, Retrospective Studies, Pneumonectomy methods, Reoperation, Thoracic Surgery, Video-Assisted, Lung Neoplasms surgery, Lung Neoplasms pathology
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Background: The role of video-assisted thoracoscopic surgery for oncological major pulmonary resections is now well established; however, the literature within pulmonary re-operations is still limited. The purpose of this study is to evaluate the safety and efficacy of redo thoracoscopic resections for ipsilateral pulmonary malignancy., Methods: Data from patients undergoing video-assisted thoracoscopic surgery at the Unit of Thoracic Surgery of Padua were analyzed, comparing the results between the first and second ipsilateral surgery. The retrospective study included patients who underwent 2 thoracoscopic surgeries for oncological reasons between 2015 and 2022. The variables considered included patients' baseline characteristics, pre, intra, and postoperative data., Results: The study enrolled 51 patients undergoing ipsilateral thoracoscopic re-operation. The statistical analysis showed that surgical time (95min vs 115min; p = 0.009), the presence of intrapleural adhesions at second surgery (30 % vs 76 %; p < 0.001), overall pleural fluid output (200 vs 560 ml; p = 0.003), time with pleural drainage (2 vs 3 days; p = 0.027), air leaks duration time (p = 0.004) and post-operative day of discharge (3 vs 4 days; p = 0.043) were significantly higher in the re-operation group. No statistical differences were observed between the 2 groups respect to R0 resection rate (90.2 % vs 89.1 %; p=>0.9) and complications (5.8 % vs 15.6 %; p = 0.11). The conversion rate to open surgery was 11.8 %., Conclusion: Although some differences emerged between the first and second intervention, they had minimal impact on the clinical course of the patients. Therefore, thoracoscopic surgery has been shown to be safe and effective in re-operations with satisfying perioperative outcomes. To achieve such results, these procedures should be reserved for experienced surgeons., Competing Interests: Declaration of competing interest None., (© 2023 Published by Elsevier Ltd.)
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- 2023
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80. Validated Prognostic Scores to Predict Outcomes in ECLS-Bridged Patients to Lung Transplantation.
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Faccioli E, Lorenzoni G, Schneiter D, Dell'Amore A, Hillinger S, Schiavon M, Caviezel C, Gregori D, Rea F, Opitz I, and Inci I
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- Humans, Prognosis, Intensive Care Units, ROC Curve, Retrospective Studies, Extracorporeal Membrane Oxygenation, Lung Transplantation
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Selection of patients who may benefit from extracorporeal life support (ECLS) as a bridge to lung transplant (LTx) is crucial. The aim was to assess if validated prognostic scores could help in selecting patients who may benefit from ECLS-bridging predicting their outcomes. Clinical data of patients successfully ECLS-bridged to LTx from 2009 to 2021 were collected from two European centers. For each patient, we calculated Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score III (SAPS III), Acute Physiology and Chronic Health Evaluation II (APACHE II), before placing ECLS support, and then correlated with outcome. Median values of SOFA, SAPS III, and APACHE II were 5 (IQR 3-9), 57 (IQR 47.5-65), and 21 (IQR 15-26). In-hospital, 30 and 90 days mortality were 21%, 14%, and 22%. SOFA, SAPS III, and APACHE II were analyzed as predictors of in-hospital, 30 and 90 days mortality (SOFA C-Index: 0.67, 0.78, 0.72; SAPS III C-index: 0.48, 0.45, 0.51; APACHE II C-Index: 0.49, 0.45, 0.52). For SOFA, the score with the best performance, a value ≥9 was identified to be the optimal cut-off for the prediction of the outcomes of interest. SOFA may be considered an adequate predictor in these patients, helping clinical decision-making. More specific and simplified scores for this population are necessary., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Faccioli, Lorenzoni, Schneiter, Dell’Amore, Hillinger, Schiavon, Caviezel, Gregori, Rea, Opitz and Inci.)
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- 2023
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81. Extracorporeal life support as a bridge to lung transplantation: a narrative review.
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Faccioli E and Inci I
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Background and Objective: The utilization of extracorporeal life support (ECLS) as a bridge to lung transplantation (LTx) has rapidly expanded over recent years in highly urgent patients even though the reported outcomes in current literature are still divergent. The aim of our narrative review was to provide a comprehensive picture on the peri and post-operative outcomes of patients bridged to LTx with this device from the most updated literature in the field., Methods: The literature about ECLS bridge to LTx was searched on PubMed using a formal strategy. We focused our research on studies published between 2015 and 2022 and in English language. Abstracts, case reports, conference presentations, editorials, expert opinions and review articles were excluded., Key Content and Findings: ECLS has emerged as a valid tool to bridge critically ill patients to LTx. Some issues, like the selection of candidates and the post-operative outcomes, are still matter of debate in the current reported series. We analyzed 14 papers published in the last seven years and with at least 20 patients to provide an updated overview on this topic. We found that, in highly experienced centers, ECLS can be used as a good strategy to allow critically ill patients to remain eligible to LTx with satisfying post-operative outcomes., Conclusions: Specific scores and algorithms should be implemented to improve the selection process of candidates who could benefit more from ECLS as a bridge to LTx. Ambulatory/awake ECLS strategies should be always preferred to enroll patients in active rehabilitation programs awaiting LTx, improving short and long-term outcomes and increasing the success of LTx., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-1163/coif). The series “Extracorporeal Life Support in Thoracic Surgery” was commissioned by the editorial office without any funding or sponsorship. II serves as an unpaid editorial board member of Journal of Thoracic Disease from April 2022 to March 2024 and served as the unpaid Guest Editor of the series. The authors have no other conflicts of interest to declare., (2023 Journal of Thoracic Disease. All rights reserved.)
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- 2023
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82. Microscopical Variables and Tumor Inflammatory Microenvironment Do Not Modify Survival or Recurrence in Stage I-IIA Lung Adenocarcinomas.
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Dell'Amore A, Bonis A, Melan L, Silvestrin S, Cannone G, Shamshoum F, Zampieri A, Pezzuto F, Calabrese F, Nicotra S, Schiavon M, Faccioli E, Mammana M, Comacchio GM, Pasello G, and Rea F
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Microscopical predictors and Tumor Immune Microenvironment (TIME) have been studied less in early-stage NSCLC due to the curative intent of resection and the satisfactory survival rate achievable. Despite this, the emerging literature enforces the role of the immune system and microscopical predictors as prognostic variables in NSCLC and in adenocarcinomas (ADCs) as well. Here, we investigated whether cancer-related microscopical variables and TIME influence survival and recurrence in I-IIA ADCs. We retrospectively collected I-IIA ADCs treated (lobectomy or segmentectomy) at the University Hospital (Padova) between 2016 and 2022. We assigned to pathological variables a cumulative pathological score (PS) resulting as the sum of them. TIME was investigated as tumor-infiltrating lymphocytes (TILs < 11% or ≥11%) and PD-L1 considering its expression (<1% or ≥1%). Then, we compared survival and recurrence according to PS, histology, TILs and PD-L1. A total of 358 I-IIA ADCs met the inclusion criteria. The median PS grew from IA1 to IIA, indicating an increasing microscopical cancer activity. Except for the T-SUVmax, any pathological predictor seemed to be different between PD-L1 < 1% and ≥1%. Histology, PS, TILs and PD-L1 were unable to indicate a survival difference according to the Log-rank test ( p = 0.37, p = 0.25, p = 0.41 and p = 0.23). Even the recurrence was non-significant ( p = 0.90, p = 0.62, p = 0.97, p = 0.74). According to our findings, resection remains the best upfront treatment in I-IIA ADCs. Microscopical cancer activity grows from IA1 to IIA tumors, but it does not affect outcomes. These outcomes are also unmodified by TIME. Probably, microscopical cancer development and immune reaction against cancer are overwhelmed by an adequate R0-N0 resection.
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- 2023
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83. Radiomics of spinal muscles: toward a radiological biomarker for allograft rejection in lung transplant.
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Giraudo C, Modugno A, Negro G, Dell'Amore A, Cecchin D, Motta R, Balestro E, Boscolo A, Calabrese F, Faccioli E, Navalesi P, Vianello A, Rea F, and Stramare R
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- Humans, Female, Adult, Middle Aged, Retrospective Studies, Biomarkers, Muscles, Allografts, Spine, Lung Transplantation
- Abstract
Purpose: To assess the role of muscle composition and radiomics in predicting allograft rejection in lung transplant., Material and Methods: The last available HRCT before surgery of lung transplant candidates referring to our tertiary center from January 2010 to February 2020 was retrospectively examined. Only scans with B30 kernel reconstructions and 1 mm slice thickness were included. One radiologist segmented the spinal muscles of each patient at the level of the 11th dorsal vertebra by an open-source software. The same software was used to extract Hu values and 72 radiomic features of first and second order. Factor analysis was applied to select highly correlating features and then their prognostic value for allograft rejection was investigated by logistic regression analysis (level of significance p < 0.05). In case of significant results, the diagnostic value of the model was computed by ROC curves., Results: Overall 200 patients had a HRCT prior to the transplant but only 97 matched the inclusion criteria (29 women; mean age 50.4 ± 13 years old). Twenty-one patients showed allograft rejection. The following features were selected by the factor analysis: cluster prominence, Imc2, gray level non-uniformity normalized, median, kurtosis, gray level non-uniformity, and inverse variance. The radiomic-based model including also Hu demonstrated that only the feature Imc2 acts as a predictor of allograft rejection (p = 0.021). The model showed 76.6% accuracy and the Imc2 value of 0.19 demonstrated 81% sensitivity and 64.5% specificity in predicting lung transplant rejection., Conclusion: The radiomic feature Imc2 demonstrated to be a predictor of allograft rejection in lung transplant., (© 2023. The Author(s).)
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- 2023
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84. Vascular/epithelial changes as late sequelae after recovery from SARS-COV-2 infection: an in-vivo comparative study.
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Pezzuto F, Lunardi F, Vedovelli L, Olteanu GE, Fortarezza F, De Pellegrin A, Melan L, Faccioli E, De Franceschi E, Giraudo C, Del Vecchio C, Marinello S, Pasello G, Gregori D, Navalesi P, Rea F, Schiavon M, and Calabrese F
- Subjects
- Humans, SARS-CoV-2, Post-Acute COVID-19 Syndrome, Retrospective Studies, Lung, COVID-19, Lung Neoplasms
- Abstract
Aims: While there is partial evidence of lung lesions in patients suffering from long COVID there are substantial concerns about lung remodelling sequelae after COVID-19 pneumonia. The aim of the present retrospective comparative study was to ascertain morphological features in lung samples from patients undergoing tumour resection several months after SARS-CoV-2 infection., Methods and Results: The severity of several lesions with a major focus on the vascular bed was analysed in 2 tumour-distant lung fragments of 41 cases: 21 SARS-CoV-2 (+) lung tumour (LT) patients and 20 SARS-CoV-2 (-) LT patients. A systematic evaluation of several lesions was carried out by combining their scores into a grade of I-III. Tissue SARS-CoV-2 genomic/subgenomic transcripts were also investigated. Morphological findings were compared with clinical, laboratory and radiological data. SARS-CoV-2 (+) LT patients with previous pneumonia showed more severe parenchymal and vascular lesions than those found in SARS-CoV-2 (+) LT patients without pneumonia and SARS-CoV-2 (-) LT patients, mainly when combined scores were used. SARS-CoV-2 viral transcripts were not detected in any sample. SARS-CoV-2 (+) LT patients with pneumonia showed a significantly higher radiological global injury score. No other associations were found between morphological lesions and clinical data., Conclusions: To our knowledge, this is the first study that, after a granular evaluation of tissue parameters, detected several changes in lungs from patients undergoing tumour resection after SARS-CoV-2 infection. These lesions, in particular vascular remodelling, could have an important impact overall on the future management of these frail patients., (© 2023 The Authors. Histopathology published by John Wiley & Sons Ltd.)
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- 2023
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85. Intrathymic Localization of Melanoma: A Brief Report of Two Cases and a Review of the Literature.
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Cannone G, Verzeletti V, Fortarezza F, Pezzuto F, Polverosi R, Faccioli E, Comacchio GM, Dell'Amore A, Rea F, Schiavon M, and Calabrese F
- Abstract
Intrathymic localizations of melanoma represent a very rare entity, with fewer than ten cases of intrathymic melanoma described in the literature. Herein, we describe two cases of patients who underwent surgical removal of a thymic mass at our thoracic surgery department between 2015 and 2022. The final pathological examination revealed a malignant melanoma in both cases; we therefore carried out a literature review to identify such rare and similar cases. In the first case, the intrathymic localization of melanoma was the first manifestation of the disease, posing a dilemma regarding the metastatic and primitive nature of the neoplasm. The second case described a thymic metastasis from a known previous cutaneous melanoma, for which the patient had successfully been treated six years earlier. After carefully reviewing the literature, we identified only six cases of verified primary intrathymic melanomas and one case of intrathymic metastasis resulting from melanoma previously described. Pathologists should be aware of the occurrence of this rare entity and mindful of the differential diagnoses. Several tools, including immunostaining of melanocytic markers and molecular investigations, are mandatory for final pathological diagnosis.
- Published
- 2023
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86. Lung Transplantation for Pleuroparenchymal Fibroelastosis: A Single-Center Experience with Revision of Literature.
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Faccioli E, Verzeletti V, Giraudo C, Schiavon M, Calabrese F, Loy M, Rea F, and Dell'Amore A
- Abstract
Pleuroparenchymal fibroelastosis (PPFE) is a rare condition characterized by fibrosis involving the pleura and the upper lobes which can be idiopathic or secondary to chemotherapy, transplantations and occupational exposure. For the end-stage form, lung transplantation (LT) is the treatment of choice. The aim of this study was to report our single-center experience for patients subjected to LT for PPFE and comparing it with the already published evidence on this topic. At our center, we have performed 6 bilateral LTs for patients with PPFE (3 males and 3 females) with a median age of 52 years. Median ICU and in-hospital length of stay were 8 and 30 days, respectively. To date, two patients are alive and four are dead, with a median overall survival of 10 months. In addition, after a formal search using the terms "pleuroparenchymal fibroelastosis AND lung transplantation", we collected 14 studies focused on outcomes after LT. LT for PPFE is technically challenging and its post-operative course could also be complicated. Current available data on LT outcomes are extremely poor and mostly limited to case reports. Further studies need to be published to improve knowledge of this disease and to achieve best outcomes for LT.
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- 2023
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87. Macrophages-derived Factor XIII links coagulation to inflammation in COPD.
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Bazzan E, Casara A, Radu CM, Tinè M, Biondini D, Faccioli E, Pezzuto F, Bernardinello N, Conti M, Balestro E, Calabrese F, Simioni P, Rea F, Turato G, Spagnolo P, Cosio MG, and Saetta M
- Subjects
- Humans, Macrophages metabolism, Inflammation metabolism, Fibrin metabolism, Factor XIII metabolism, Factor XIIIa metabolism
- Abstract
Background: The local, extravascular, activation of the coagulation system in response to injury is a key factor mediating the resulting inflammatory response. Coagulation Factor XIIIA (FXIIIA) found in alveolar macrophages (AM) and dendritic cells (DC), by influencing fibrin stability, might be an inflammatory modifier in COPD., Aims: To study the expression of FXIIIA in AM and Langerin+DC (DC-1) and their relation to the inflammatory response and disease progression in COPD., Methods: In 47 surgical lungs, 36 from smokers (22 COPD and 14 no-COPD) and 11 from non-smokers we quantified by immunohistochemistry FXIIIA expression in AM and DC-1 along with numbers of CD8+Tcells and CXCR3 expression in lung parenchyma and airways. Lung function was measured prior to surgery., Results: The percentage of AM expressing FXIII (%FXIII+AM) was higher in COPD than no-COPD and non-smokers. DC-1 expressed FXIIIA and their numbers were higher in COPD than no-COPD and non-smokers. DC-1 positively correlated with %FXIII+AM (r=0.43; p<0.018). CD8+Tcells, which were higher in COPD than in no-COPD, were correlated with DC-1 (p<0.01) and %FXIII+AM. CXCR3+ cells were increased in COPD and correlated with %FXIII+AM (p<0.05). Both %FXIII+AM (r=-0.6; p=0.001) and DC-1 (r=-0.7; p=0.001) correlated inversely with FEV
1 ., Conclusion: FXIIIA, an important link between the extravascular coagulation cascade and inflammatory response, is significantly expressed in alveolar macrophages and dendritic cells of smokers with COPD, suggesting that it could play an important role in the adaptive inflammatory reaction characteristic of the disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bazzan, Casara, Radu, Tinè, Biondini, Faccioli, Pezzuto, Bernardinello, Conti, Balestro, Calabrese, Simioni, Rea, Turato, Spagnolo, Cosio and Saetta.)- Published
- 2023
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88. A multicentric evaluation of pediatric lung transplantation in Italy.
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Schiavon M, Camagni S, Venuta F, Rosso L, Boffini M, Parisi F, Bertani A, Meloni F, Paladini P, Faccioli E, Colledan M, Diso D, Cattaneo M, Scalini F, Alfieri S, Giunta D, Morosini M, Luzzi L, Lorenzoni G, Dell'Amore A, and Rea F
- Subjects
- Adult, Humans, Child, Male, Female, Adolescent, Infant, Child, Preschool, Retrospective Studies, Tissue Donors, Italy, Treatment Outcome, Lung Transplantation adverse effects, Heart-Lung Transplantation
- Abstract
Background: Pediatric lung transplantation is performed in highly experienced centers due to the peculiar population characteristics. The literature is limited and not representative of individual countries' differences. The purpose of this study was to analyze the Italian experience., Methods: A multicentric retrospective analysis was performed on 110 pediatric patients (<18 years old) who underwent lung transplantation from 1992 to 2019 at 9 Italian centers. Heart-lung transplantations and lung retransplantations were excluded., Results: The population was composed of 44 male and 66 female patients, with a median age of 15 years. The most frequent indication was cystic fibrosis (83%). One quarter of patients were transplanted in an emergency setting. Median donors' Oto score and age were 1 and 15 years, respectively, with 43% of adult donors. In 17% of patients a graft reduction was performed. Postoperatively, the median duration of mechanical ventilation, intensive care unit, and in-hospital stay were 48 hours, 11 and 35 days, respectively. Thirty-day mortality was 6%, and 1-, 5-, and 10-year survival was 72%, 52%, and 33%, respectively. Risk factors for mortality were Oto score and recipients' body mass index., Conclusions: The outcomes of pediatric lung transplantation in Italy are comparable with current literature. Particular attention should be paid to the Oto score and recipient body mass index. Conversely, adult donors and graft reductions can be safely used to expand the donor pool., (Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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89. Precision Surgery in NSCLC.
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Cannone G, Comacchio GM, Pasello G, Faccioli E, Schiavon M, Dell'Amore A, Mammana M, and Rea F
- Abstract
Non-small cell lung cancer (NSCLC) is still one of the leading causes of death worldwide. This is mostly because the majority of lung cancers are discovered in advanced stages. In the era of conventional chemotherapy, the prognosis of advanced NSCLC was grim. Important results have been reported in thoracic oncology since the discovery of new molecular alterations and of the role of the immune system. The advent of new therapies has radically changed the approach to lung cancer for a subset of patients with advanced NSCLC, and the concept of incurable disease is still changing. In this setting, surgery seems to have developed a role of rescue therapy for some patients. In precision surgery, the decision to perform surgical procedures is tailored to the individual patient; taking into consideration not only clinical stage, but also clinical and molecular features. Multimodality treatments incorporating surgery, immune checkpoint inhibitors, or targeted agents are feasible in high volume centers with good results in terms of pathologic response and patient morbidity. Thanks to a better understanding of tumor biology, precision thoracic surgery will facilitate optimal and individualized patient selection and treatment, with the goal of improving the outcomes of patients affected by NSCLC.
- Published
- 2023
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90. Molecular Profiling of Tissue Samples with Chronic Rejection from Patients with Chronic Lung Allograft Dysfunction: A Pilot Study in Cystic Fibrosis Patients.
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Lunardi F, Abbrescia DI, Vedovelli L, Pezzuto F, Fortarezza F, Comacchio GM, Guzzardo V, Ferrigno P, Loy M, Giraudo C, Fraia AS, Faccioli E, Braccioni F, Cozzi E, Gregori D, Verleden GM, Calabrese F, Schena FP, and Rea F
- Subjects
- Humans, Pilot Projects, Quality of Life, Lung surgery, Lung pathology, Allografts, Graft Rejection genetics, Graft Rejection diagnosis, Cystic Fibrosis genetics, Cystic Fibrosis surgery, Cystic Fibrosis pathology
- Abstract
Chronic rejection (CR) is the main culprit for reduced survival and quality of life in patients undergoing lung transplantation (Ltx). High-throughput approaches have been used to unveil the molecular pathways of CR, mainly in the blood and/or in bronchoalveolar lavage. We hypothesized that a distinct molecular signature characterizes the biopsies of recipients with clinically confirmed histological signs of CR. Eighteen cystic fibrosis patients were included in the study and RNA sequencing was performed in 35 scheduled transbronchial biopsies (TBBs): 5 with acute cellular rejection, 9 with CR, and 13 without any sign of post-LTx complication at the time of biopsy; 8 donor lung samples were used as controls. Three networks with 33, 26, and 36 differentially expressed genes (DEGs) were found in TBBs with CR. Among these, seven genes were common to the identified pathways and possibly linked to CR and five of them (LCN2, CCL11, CX3CL1, CXCL12, MUC4) were confirmed by real-time PCR. Immunohistochemistry was significant for LCN2 and MUC4. This study identified a typical gene expression pattern in TBBs with histological signs of CR and the LCN2 gene appeared to play a central role. Thus, it could be crucial in CR pathophysiology.
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- 2023
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91. Multidrug-Resistant and Extended-Spectrum β-Lactamase Gram-Negative Bacteria in Bilateral Lung Transplant Recipients: Incidence, Risk Factors, and In-Hospital Mortality.
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Boscolo A, Sella N, Pettenuzzo T, De Cassai A, Crociani S, Schiavolin C, Simoni C, Geraldini F, Lorenzoni G, Faccioli E, Fortarezza F, Lunardi F, Giraudo C, Dell'Amore A, Cattelan A, Calabrese F, Gregori D, Rea F, and Navalesi P
- Subjects
- Adult, Humans, Female, Middle Aged, Male, Hospital Mortality, Retrospective Studies, Gram-Negative Bacteria, Anti-Bacterial Agents therapeutic use, Risk Factors, Drug Resistance, Multiple, Bacterial, beta-Lactamases pharmacology, Lung Transplantation
- Abstract
Background: In recent decades, the incidence of multidrug-resistant (MDR) and extended-spectrum β-lactamase (ESBL) gram-negative (GN) bacteria has increased progressively among lung transplantation (LT) recipients. A prompt diagnosis, prevention, and management of these pathogens remain the cornerstone for successful organ transplantation., Research Question: What are the incidence of MDR and ESBL GN bacteria within the first 30 days after LT and related risk of in-hospital mortality? What are the potential clinical predictors of isolation of MDR and ESBL GN bacteria?, Study Design and Methods: All consecutive LT recipients admitted to the ICU of the University Hospital of Padua (February 2016-December 2021) were screened retrospectively. Only adult patients undergoing the first bilateral LT and not requiring invasive mechanical ventilation, extracorporeal membrane oxygenation, or both before surgery were included. MDR and ESBL GN bacteria were identified using in vitro susceptibility tests and were isolated from the respiratory tract, blood, urine, rectal swab, or surgical wound or drainage according to a routine protocol., Results: One hundred fifty-three LT recipients were screened, and 132 were considered for analysis. Median age was 52 years (interquartile range, 41-60 years) and 46 patients (35%) were women. MDR and ESBL GN bacteria were identified in 45 patients (34%), and 60% of patients demonstrated clinically relevant infection. Pseudomonas aeruginosa (n = 22 [49%]) and Klebsiella pneumoniae (n = 17 [38%]) were frequently isolated after LT from the respiratory tract (n = 21 [47%]) and multiple sites (n = 18 [40%]). Previous recipient-related colonization (hazard ratio [HR], 2.48 [95% CI, 1.04-5.90]; P = .04) and empirical exposure to broad-spectrum antibiotics (HR, 6.94 [95% CI, 2.93-16.46]; P < .01) were independent predictors of isolation of MDR and ESBL GN bacteria. In-hospital mortality of the MDR and ESBL group was 27% (HR, 6.38 [95% CI, 1.98-20.63]; P < .01)., Interpretation: The incidence of MDR and ESBL GN bacteria after LT was 34%, and in-hospital mortality was six times greater. Previous recipient-related colonization and empirical exposure to broad-spectrum antibiotics were clinical predictors of isolation of MDR and ESBL GN bacteria., (Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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92. Autologous Blood Pleurodesis: What Is the Optimal Time Interval and Amount of Blood?
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Campisi A, Dell'Amore A, Zhang Y, Gu Z, Ciarrocchi AP, Faccioli E, Bertolaccini L, Rea F, Stella F, and Fang W
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- Humans, Retrospective Studies, Treatment Outcome, Pneumonectomy adverse effects, Postoperative Complications etiology, Pleurodesis adverse effects, Pneumothorax etiology
- Abstract
Background: Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized., Methods: We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed., Results: After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1-13) after ABPP were also statistically different ( p < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis., Conclusion: In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped., Competing Interests: None declared., (Thieme. All rights reserved.)
- Published
- 2022
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93. Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review of the Most Updated Literature.
- Author
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Faccioli E, Verzeletti V, Perazzolo Marra M, Boscolo A, Schiavon M, Navalesi P, Rea F, and Dell'Amore A
- Abstract
Pulmonary endarterectomy (PEA) is the treatment of choice in case of chronic thromboembolic pulmonary hypertension (CTEPH). PEA is performed by an increasing number of surgeons; however, the reported outcomes are limited to a few registries or to individual centers' experiences. This systematic review focuses on pre-operative evaluation, intra-operative procedure and post-operative results in patients submitted to PEA for CTEPH. The literature included was searched using a formal strategy, combining the terms "pulmonary endarterectomy" AND "chronic pulmonary hypertension" and focusing on studies published in the last 5 years (2017-2022) to give a comprehensive overview on the most updated literature. The selection of the adequate surgical candidate is a crucial point, and the decision should always be performed by expert multidisciplinary teams composed of surgeons, pulmonologists and radiologists. In all the included studies, the surgical procedure was performed through a median sternotomy with intermittent deep hypothermic circulatory arrest under cardiopulmonary bypass. In case of residual pulmonary hypertension, alternative combined treatments should be considered (balloon angioplasty and/or medical therapy until lung transplantation in highly selected cases). Short- and long-term outcomes, although not homogenous across the different studies, are acceptable in highly experienced CTEPH centers.
- Published
- 2022
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94. Evaluation of Tissue Ischemia/Reperfusion Injury in Lung Recipients Supported by Intraoperative Extracorporeal Membrane Oxygenation: A Single-Center Pilot Study.
- Author
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Calabrese F, Pezzuto F, Fortarezza F, Lunardi F, Faccioli E, Lorenzoni G, Boscolo A, Sella N, Gregori D, Schiavon M, Navalesi P, Dell'Amore A, and Rea F
- Subjects
- Humans, Pilot Projects, Retrospective Studies, Lung, Ischemia, Extracorporeal Membrane Oxygenation methods, Reperfusion Injury
- Abstract
Intraoperative veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) as intraoperative hemodynamic support during lung transplantation is becoming a standard practice due to promising clinical results. Nevertheless, studies on tissue/molecular pathways investigating ischemia/reperfusion injury are still lacking. Patients receiving a bilateral lung transplantation between January 2012 and December 2018 at the University Hospital of Padova were included in this retrospective single-center observational study. The present study aimed to investigate ischemia/reperfusion injury in 51 tissue specimens obtained from 13 recipients supported by intraoperative VA-ECMO and 38 who were not. Several tissue analyses, including apoptosis evaluation and inducible nitric oxide synthase expression, were performed on the biopsies at the time of transplantation. Lung samples from the ECMO group (both pre- and post-reperfusion) were comparable, or for some parameters better, than samples from the non-ECMO group. Leukocyte margination was significantly lower in the ECMO group than in the non-ECMO group. Primary graft dysfunction, mainly at 24 and 48 h, was correlated with the tissue injury score of the post-reperfusion biopsy. The interquartile ranges for all morphological parameters showed high grade variability between pre- and post-reperfusion in the non-ECMO group. These preliminary data support the use of intraoperative ECMO based on lower lung tissue ischemia/reperfusion injury. Larger case series are mandatory to confirm our findings.
- Published
- 2022
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95. Lung transplantation in patients with a history of anatomical native lung resection.
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Iskender I, Pecoraro Y, Moreno Casado P, Kubisa B, Schiavon M, Faccioli E, Ehrsam J, Damarco F, Nosotti M, Inci I, Venuta F, Van Raemdonck D, and Ceulemans LJ
- Subjects
- Male, Humans, Adult, Pneumonectomy adverse effects, Retrospective Studies, Lung surgery, Fibrosis, Lung Transplantation adverse effects, Bronchiectasis surgery, Bronchiectasis etiology
- Abstract
Objectives: History of anatomical lung resection complicates lung transplantation (LTx). Our aim was to identify indications, intraoperative approach and outcome in these challenging cases in a retrospective multicentre cohort analysis., Methods: Members of the ESTS Lung Transplantation Working Group were invited to submit data on patients undergoing LTx after a previous anatomical native lung resection between January 2005 and July 2020. The primary end point was overall survival (Kaplan-Meier estimation)., Results: Out of 2690 patients at 7 European centres, 26 (1%) patients (14 males; median age 33 years) underwent LTx after a previous anatomical lung resection. The median time from previous lung resection to LTx was 12 years. The most common indications for lung resection were infections (n = 17), emphysema (n = 5), lung tumour (n = 2) and others (n = 2). Bronchiectasis (cystic fibrosis or non-cystic fibrosis related) was the main indication for LTx (n = 21), followed by COPD (n = 5). Two patients with a previous pneumonectomy underwent contralateral single LTx and 1 patient with a previous lobectomy had ipsilateral single LTx. The remaining 23 patients underwent bilateral LTx. Clamshell incision was performed in 12 (46%) patients. Moreover, LTx was possible without extracorporeal life support in 13 (50%) patients. 90-Day mortality was 8% (n = 2) and the median survival was 8.7 years., Conclusions: The history of anatomical lung resection is rare in LTx candidates. The majority of patients are young and diagnosed with bronchiectasis. Although the numbers were limited, survival after LTx in patients with previous anatomical lung resection, including pneumonectomy, is comparable to reported conventional LTx for bronchiectasis., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
- Published
- 2022
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96. Spontaneous Regression of an Epidermal Growth Factor Receptor-mutant Left Upper Lobe Adenocarcinoma.
- Author
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Schiavon M, Lloret Madrid A, Pezzuto F, Giraudo C, Comacchio GM, Faccioli E, Dell'Amore A, Calabrese F, and Rea F
- Subjects
- ErbB Receptors genetics, Humans, Lung pathology, Tumor Microenvironment, Adenocarcinoma pathology, Lung Neoplasms pathology
- Abstract
Spontaneous regression of cancer is a known manifestation rarely described for thoracic malignancies. We present the case of a patient affected by an epidermal growth factor receptor-mutant adenocarcinoma who developed a contralateral aspiration pneumonitis months before surgery and manifested a complete pathologic regression without any preoperative oncologic treatment. The underlying mechanisms are not clear, but immune system activation appears to be a key player, acting as a plausible trigger of a change in host response to cancer cells. The tumor microenvironment does not appear to be an "inert spectator" but rather an "active protagonist" on the course of the disease and its therapeutic targeting., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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97. Sarcopenia as a Predictor of Short- and Long-Term Outcomes in Patients Surgically Treated for Malignant Pleural Mesothelioma.
- Author
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Faccioli E, Terzi S, Giraudo C, Zuin A, Modugno A, Labella F, Zambello G, Lorenzoni G, Schiavon M, Gregori D, Pasello G, Calabrese F, Dell'Amore A, and Rea F
- Abstract
Surgery for malignant pleural mesothelioma (MPM) should be reserved only for patients who have a good performance status. Sarcopenia, a well-known predictor of poor outcomes after surgery, is still underinvestigated in MPM. The aim of this study is to evaluate the role of sarcopenia as a predictor of short-and long-term outcomes in patients surgically treated for MPM. In our analysis, we included patients treated with a cytoreductive intent in a multimodality setting, with both pre- and post-operative CT scans without contrast available. We excluded those in whom a complete macroscopic resection was not achieved. Overall, 86 patients were enrolled. Sarcopenia was assessed by measuring the mean muscular density of the bilateral paravertebral muscles (T12 level) on pre-and post-operative CTs; a threshold value of 30 Hounsfield Units (HU) was identified. Sarcopenia was found pre-operatively in 57 (66%) patients and post-operatively in 61 (74%). Post-operative sarcopenic patients had a lower 3-year overall survival (OS) than those who were non-sarcopenic (34.9% vs. 57.6% p = 0.03). Pre-operative sarcopenia was significantly associated with a higher frequency of post-operative complications (65% vs. 41%, p = 0.04). The evaluation of sarcopenia, through a non-invasive method, would help to better select patients submitted to surgery for MPM in a multimodality setting.
- Published
- 2022
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98. Autologous Blood Patch Pleurodesis: A Large Retrospective Multicenter Cohort Study.
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Campisi A, Dell'Amore A, Gabryel P, Ciarrocchi AP, Sielewicz M, Zhang Y, Gu Z, Faccioli E, Stella F, Rea F, Fang W, and Piwkowski C
- Subjects
- Cohort Studies, Humans, Length of Stay, Pneumonectomy, Postoperative Complications epidemiology, Retrospective Studies, Chest Tubes, Pleurodesis methods
- Abstract
Background: Prolonged air leaks (PAL) complicate 10% to 15% of lung resections, delaying chest tube removal and prolonging length of hospital stay. No consensus exists for managing this common complication, despite favorable results for autologous blood patch pleurodesis (ABPP) in the literature. The aim of this study was to evaluate the effectiveness and safety of ABPP., Methods: We retrospectively reviewed medical records of 510 patients with PAL after lobectomy in four centers between January 2010 and December 2019. They were divided into two groups: group A consisted of patients who received ABPP for PAL of more than 5 days; and group B was patients for whom no ABPP or other procedure was performed for PAL unless strictly necessary. Propensity score matched analysis was performed, and 109 patients were included in each group. Time to cessation of air leak and chest tube removal, length of hospital stay, reoperation, and complications rate were examined., Results: After the propensity score matching, ABPP significantly reduced the number of days before chest tube removal (8.12 vs 9.30, P = .004), and length of hospital stay (10 vs 11 days, P = .045) with fewer perioperative complications (6 vs 17, P = .015). Furthermore, ABPP was related to lower incidence of any additional invasive procedures (0 vs 9, P = .002) and reoperation (0 vs 4, P = .044). No patient in the ABPP group had long-term complications related to pleurodesis., Conclusions: Autologous blood patch pleurodesis is safe and effective in reducing length of hospital stay and leads to earlier chest tube removal without increasing complications., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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99. Lobar size reduction in lung transplantation: A propensity score study.
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Schiavon M, Mendogni P, Faccioli E, Lorenzoni G, Mazzucco A, Nosotti M, and Rea F
- Subjects
- Humans, Lung surgery, Propensity Score, Retrospective Studies, Treatment Outcome, Lung Transplantation methods, Primary Graft Dysfunction etiology
- Abstract
Objective: For small-sized recipients of lung transplantation, the time span for organ reception from standard donors is generally longer than for normal-sized patients. Despite its underuse, lobar reduction may be a concrete option for these patients. This study aims to assess early and long-term outcomes associated with lobar reduction in lung transplantation., Methods: A retrospective study was performed on 608 consecutive lung transplantations at 2 centers between January 2005 and August 2019 (559 standard lung transplantations [standard transplantation] and 49 with lobar reduction [lung transplantation group]). A propensity-score weighting approach was used to account for potential confounding related to patients' nonrandom allocation to the 2 intervention groups. The effects of the intervention on postoperative outcomes were assessed with a weighted regression approach., Results: The propensity score was estimated on 571 patients (522 in standard transplantation group and 49 in lung transplantation group). In terms of early outcomes, the lung transplantation group showed a higher percentage of severe primary graft dysfunction at 0 hours and reported longer intensive care unit stay than the standard transplantation group. No other differences in terms of morbidity, mortality, mechanical ventilation time, hospital stay, and anastomotic complications were observed. Although the lung transplantation group showed worse long-term pulmonary function, the 2 populations had comparable survival outcomes., Conclusions: The use of lobar reduction showed early and long-term results comparable to those after standard lung transplantation. Although a higher rate of early severe primary graft dysfunction and slightly reduced respiratory function were detected in the lobar group, these did not affect patients' morbidity and survival., (Copyright © 2021 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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100. Tracheal resection and anastomosis for squamous cell carcinoma.
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Faccioli E, Comacchio G, Mammana M, Zambello G, Zuin A, and Rea F
- Subjects
- Anastomosis, Surgical, Humans, Trachea surgery, Bronchial Neoplasms, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell surgery, Tracheal Neoplasms diagnosis, Tracheal Neoplasms pathology, Tracheal Neoplasms surgery
- Abstract
Tracheal malignant tumors are uncommon lesions. The rarity of this condition may generate uncertainties in the diagnosis and treatment. For this reason especially, the surgical treatment should be performed only in centers with a high expertise in tracheal surgery. If the involved tracheal tract is less than 4-5 cm and the tumor is localized, the treatment of choice is based on a segmental tracheal resection with an end-to-end anastomosis. In this video tutorial, we describe how we perform tracheal resection with an end-to-end anastomosis in a patient with a squamous cell carcinoma., (© The Author 2022. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
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