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1. Predicting a Prolonged Air Leak After Video-Assisted Thoracic Surgery, Is It Really Possible?

Author

Mancuso, M., Pernazza, F., Refai, M., Srella, F., Argnani, D., Marulli, G., De Palma, A., Bortolotti, L., Rizzardi, G., Solli, P.G., Dolci, G.P., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Sollitto, F., Ardò, N., Pariscenti, G.L., Risso, C., Surrente, C., Lopez, C., Droghetti, A., Giovanardi, M., Breda, C., Giudice, Lo F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Nosotti, M., Tosi, D., Negri, G.P., Bandiera, A., Baisi, A., Raveglia, F., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Curcio, C., Amore, D., Rena, O., Nicotra, S., Dell’ Amore, A., Bertani, A., Tancredi, G., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Cardillo, G., Carleo, F., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Crisci, R., Divisi, D., Lausi, P., Guerrera, F., Fontana, D., Beffa, V. Della, Morelli, A., Londero, F., Imperatori, A., Rotolo, N., Terzi, A., Viti, A., Infante, M., Benato, C., Zaraca, Francesco, Pipitone, Marco, Feil, Birgit, Perkmann, Reinhold, Bertolaccini, Luca, Curcio, Carlo, and Crisci, Roberto

Published
2021
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2. Rate and Predictors of Unforeseen PN1/PN2-Disease in Surgically Treated cN0 NSCLC-Patients with Primary Tumor > 3 cm: Nationwide Results from Italian VATS-Group Database

Author

Lococo, Filippo, Nachira, D., Chiappetta, M., Sperduti, I., Congedo, Maria Teresa, Meacci, Elisa, Leoncini, F., Trisolini, Rocco, Crisci, R., Curcio, C., Casiraghi, M., Margaritora, Stefano, Lococo F. (ORCID:0000-0002-9383-5554), Congedo M. T., Meacci E. (ORCID:0000-0001-8424-3816), Trisolini R., Margaritora S. (ORCID:0000-0002-9796-760X), Lococo, Filippo, Nachira, D., Chiappetta, M., Sperduti, I., Congedo, Maria Teresa, Meacci, Elisa, Leoncini, F., Trisolini, Rocco, Crisci, R., Curcio, C., Casiraghi, M., Margaritora, Stefano, Lococo F. (ORCID:0000-0002-9383-5554), Congedo M. T., Meacci E. (ORCID:0000-0001-8424-3816), Trisolini R., and Margaritora S. (ORCID:0000-0002-9796-760X)

Abstract

Background. Since no robust data are available on the real rate of unforeseen N1-N2 disease (uN) and the relative predictive factors in clinical-N0 NSCLC with peripheral tumours > 3 cm, the usefulness of performing a (mini)invasive mediastinal staging in this setting is debated. Herein, we investigated these issues in a nationwide database. Methods. From 01/2014 to 06/2020, 15,784 thoracoscopic major lung resections were prospectively recorded in the “Italian VATS-Group” database. Among them, 1982 clinical-N0 peripheral solid-type NSCLC > 3 cm were identified, and information was retrospectively reviewed. A mean comparison of more than two groups was made by ANOVA (Bonferroni correction for multiple comparisons), while associations between the categorical variables were estimated with a Chi-square test. The multivariate logistic regression model and Kaplan–Meyer method were used to identify the independent predictors of nodal upstaging and survival results, respectively. Results. At pathological staging, 229 patients had N1-involvement (11.6%), and 169 had uN2 disease (8.5%). Independent predictors of uN1 were SUVmax (OR: 1.98; CI 95: 1.44–2.73, p = 0.0001) and tumour-size (OR: 1.52; CI: 1.11–2.10, p = 0.01), while independent predictors of uN2 were age (OR: 0.98; CI 95: 0.96–0.99, p = 0.039), histology (OR: 0.48; CI 95: 0.30–0.78, p = 0.003), SUVmax (OR: 2.07; CI 95: 1.15–3.72, p = 0.015), and the number of resected lymph nodes (OR: 1.03; CI 95: 1.01–1.05, p = 0.002). Conclusions. The unforeseen N1-N2 disease in cN0/NSCLCs > 3 cm undergoing VATS resection is observable in between 12 and 8% of all cases. We have identified predictors that could guide physicians in selecting the best candidate for (mini)invasive mediastinal staging.

Published
2023

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

Author

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

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

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

Published
2021

5. A Delphi Consensus report from the 'Prolonged Air Leak: A Survey' study group on prevention and management of postoperative air leaks after minimally invasive anatomical resections

Author

Zaraca, F., Brunelli, A., Pipitone, M. D., Abdellateef, A., Abu Akar, F., Augustin, F., Batchelor, T., Bertani, A., Crisci, R., D'Amico, T., D'Journo, X. B., Droghetti, A., Fang, W., Gonfiotti, A., Janík, M., Jimenez, M., Kirschbaum, A., Kostic, M., Lazzaro, R., Lucchi, M., Marra, Angelo Alessandro, Murthy, S., Ng, C. S. H., Nachira, Dania, Pardolesi, A., Perkmann, R., Petersen, R. H., Pischik, V., Russo, M. D., Opitz, I., Spaggiari, L., Ugalde, P. A., Vannucci, F., Veronesi, G., Bertolaccini, L., Marra A. (ORCID:0000-0001-8384-5081), Nachira D. (ORCID:0000-0003-2937-9678), Zaraca, F., Brunelli, A., Pipitone, M. D., Abdellateef, A., Abu Akar, F., Augustin, F., Batchelor, T., Bertani, A., Crisci, R., D'Amico, T., D'Journo, X. B., Droghetti, A., Fang, W., Gonfiotti, A., Janík, M., Jimenez, M., Kirschbaum, A., Kostic, M., Lazzaro, R., Lucchi, M., Marra, Angelo Alessandro, Murthy, S., Ng, C. S. H., Nachira, Dania, Pardolesi, A., Perkmann, R., Petersen, R. H., Pischik, V., Russo, M. D., Opitz, I., Spaggiari, L., Ugalde, P. A., Vannucci, F., Veronesi, G., Bertolaccini, L., Marra A. (ORCID:0000-0001-8384-5081), and Nachira D. (ORCID:0000-0003-2937-9678)

Abstract

OBJECTIVES: This study reports the results of an international expert consensus process evaluating the assessment of intraoperative air leaks (IAL) and treatment of postoperative prolonged air leaks (PAL) utilizing a Delphi process, with the aim of helping standardization and improving practice.METHODS: A panel of 45 questions was developed and submitted to an international working group of experts in minimally invasive lung cancer surgery. Modified Delphi methodology was used to review responses, including 3 rounds of voting. The consensus was defined a priori as >50% agreement among the experts. Clinical practice standards were graded as recommended or highly recommended if 50-74% or >75% of the experts reached an agreement, respectively.RESULTS: A total of 32 experts from 18 countries completed the questionnaires in all 3 rounds. Respondents agreed that PAL are defined as >5 days and that current risk models are rarely used. The consensus was reached in 33/45 issues (73.3%). IAL were classified as mild (<100 ml/min; 81%), moderate (100-400 ml/min; 71%) and severe (>400 ml/min; 74%). If mild IAL are detected, 68% do not treat; if moderate, consensus was not; if severe, 90% favoured treatment.CONCLUSIONS: This expert consensus working group reached an agreement on the majority of issues regarding the detection and management of IAL and PAL. In the absence of prospective, randomized evidence supporting most of these clinical decisions, this document may serve as a guideline to reduce practice variation.

Published
2022

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

Author

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

Published
2022

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

Author

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

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

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

Published
2019

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

Author

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

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

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

Published
2019

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

Author

Bertolaccini, L., primary, Spaggiari, L., additional, Facciolo, F., additional, Gallina, F., additional, Rea, F., additional, Schiavon, M., additional, Margaritora, S., additional, Congedo, M.T., additional, Lucchi, M., additional, Ceccarelli, I., additional, Alloisio, M., additional, Bottoni, E., additional, Negri, G., additional, Carretta, A., additional, Cardillo, G., additional, Ricciardi, S., additional, Ruffini, E., additional, Costardi, L., additional, Muriana, G., additional, Viggiano, D., additional, Rusca, M., additional, Ventura, L., additional, Marulli, G., additional, De Palma, A., additional, Rosso, L., additional, Mendogni, P., additional, Crisci, R., additional, De Vico, A., additional, Maniscalco, P., additional, Tamburini, N., additional, Puma, F., additional, Ceccarelli, S., additional, Voltolini, L., additional, Bongiolatti, S., additional, Morelli, A., additional, and Londero, F., additional

Published
2021
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12. Does morbid obesity influence perioperative outcomes after video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer? Analysis of the Italian VATS group registry

Author

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

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

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

Published
2021

13. A risk stratification scheme for synchronous oligometastatic non-small cell lung cancer developed by a multicentre analysis

Author

Spaggiari, L., Bertolaccini, L., Facciolo, F., Gallina, F. T., Rea, F., Schiavon, M., Margaritora, S., Congedo, M. T., Lucchi, M., Ceccarelli, I., Alloisio, M., Bottoni, E., Negri, G., Carretta, A., Cardillo, G., Ricciardi, S., Ruffini, E., Costardi, L., Muriana, G., Viggiano, D., Rusca, M., Ventura, L., Marulli, G., De Palma, A., Rosso, L., Mendogni, P., Crisci, R., De Vico, A., Maniscalco, P., Tamburini, N., Puma, F., Ceccarelli, S., Voltolini, L., Bongiolatti, S., Morelli, A., Londero, F., Margaritora S. (ORCID:0000-0002-9796-760X), Congedo M. T., Bottoni E., Ventura L., Ceccarelli S., Spaggiari, L., Bertolaccini, L., Facciolo, F., Gallina, F. T., Rea, F., Schiavon, M., Margaritora, S., Congedo, M. T., Lucchi, M., Ceccarelli, I., Alloisio, M., Bottoni, E., Negri, G., Carretta, A., Cardillo, G., Ricciardi, S., Ruffini, E., Costardi, L., Muriana, G., Viggiano, D., Rusca, M., Ventura, L., Marulli, G., De Palma, A., Rosso, L., Mendogni, P., Crisci, R., De Vico, A., Maniscalco, P., Tamburini, N., Puma, F., Ceccarelli, S., Voltolini, L., Bongiolatti, S., Morelli, A., Londero, F., Margaritora S. (ORCID:0000-0002-9796-760X), Congedo M. T., Bottoni E., Ventura L., and Ceccarelli S.

Abstract

Backgrounds: Oligometastatic Non-Small Cell Lung Cancer (NSCLC) patients represent a category without a standard therapeutic approach. However, in selected oligometastatic NSCLC, radical surgery seems to offer a good prognosis. This retrospective study aimed to analyse the long-term outcomes of synchronous oligometastatic patients treated with curative intent and identify the factors associated with better results and the proposal of a risk stratification system for classifying the synchronous oligometastatic NSCLC. Methods: The medical records of patients from 18 centres with pathologically diagnosed synchronous oligometastatic NSCLC were retrospectively reviewed. The inclusion criteria were synchronous oligometastatic NSCLC, radical surgical treatment of the primary tumour with or without neoadjuvant/adjuvant therapy and radical treatment of all metastatic sites. The Kaplan – Meier method estimated survivals. A stratified backward stepwise Cox regression model was assessed for multivariable survival analyses. Results: 281 patients were included. The most common site of metastasis was the brain, in 50.89 % patients. Median overall survival was 40 months (95 % CI: 29–53). Age ≤65 years (HR = 1.02, 95 % CI: 1.00–1.05; p = 0.019), single metastasis (HR = 0.71, 95 % CI: 0.45–1.13; p = 0.15) and presence of contralateral lung metastases (HR = 0.30, 95 % CI: 0.15 – 0.62; p = 0.001) were associated with a good prognosis. The presence of pathological N2 metastases negatively affected survival (HR = 2.00, 95 % CI: 1.21–3.32; p = 0.0065). These prognostic factors were used to build a simple risk classification scheme. Conclusions: Treatment of selected synchronous oligometastatic NSCLC with curative purpose could be conducted safely and at acceptable 5-year survival levels, especially in younger patients with pN0 disease.

Published
2021

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

Author

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

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

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

Published
2020

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

Author

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

Subjects
NO
Published
2020

16. Hospital organization and thoracic oncological patient management during the coronavirus disease-2019 outbreak: A brief report from a nationwide survey of the Italian Society of Thoracic Surgery

Author

Viggiano, D., Lococo, Filippo, Dell'Amore, A., Crisci, R., Torre, M., Rea, F., Muriana, G., Lococo F. (ORCID:0000-0002-9383-5554), Viggiano, D., Lococo, Filippo, Dell'Amore, A., Crisci, R., Torre, M., Rea, F., Muriana, G., and Lococo F. (ORCID:0000-0002-9383-5554)

Abstract

The current coronavirus disease 2019 (COVID-19) pandemic has made us aware of the weaknesses and often the inadequacies of our current technologies and practices and has presented us with a huge challenge: to reorganize the way we work and sometimes even think, in order to ensure the safety of our patients. The Italian Society of Thoracic Surgery has launched various initiatives in response to the COVID-19 pandemic, aimed at facilitating the exchange of information, strategies and personal experiences between institutions. This article presents the results of a survey amongst all Italian thoracic surgery units accredited to SICT, with the aim of providing a glimpse of the current working conditions in these units, and an understanding of the impact of COVID-19 on their daily activities and patient care.

Published
2020

17. Predicting a Prolonged Air Leak After Video-Assisted Thoracic Surgery, Is It Really Possible?

Author

Zaraca, Francesco, primary, Pipitone, Marco, additional, Feil, Birgit, additional, Perkmann, Reinhold, additional, Bertolaccini, Luca, additional, Curcio, Carlo, additional, Crisci, Roberto, additional, Mancuso, M., additional, Pernazza, F., additional, Refai, M., additional, Srella, F., additional, Argnani, D., additional, Marulli, G., additional, De Palma, A., additional, Bortolotti, L., additional, Rizzardi, G., additional, Solli, P.G., additional, Dolci, G.P., additional, Perkmann, R., additional, Zaraca, F., additional, Benvenuti, M., additional, Gavezzoli, D., additional, Cherchi, R., additional, Ferrari, P., additional, Mucilli, F., additional, Camplese, P., additional, Melloni, G., additional, Mazza, F., additional, Cavallesco, G., additional, Maniscalco, P., additional, Voltolini, L., additional, Gonfiotti, A., additional, Sollitto, F., additional, Ardò, N., additional, Pariscenti, G.L., additional, Risso, C., additional, Surrente, C., additional, Lopez, C., additional, Droghetti, A., additional, Giovanardi, M., additional, Breda, C., additional, Giudice, Lo F., additional, Alloisio, M., additional, Bottoni, E., additional, Spaggiari, L., additional, Gasparri, R., additional, Torre, M., additional, Rinaldo, A., additional, Nosotti, M., additional, Tosi, D., additional, Negri, G.P., additional, Bandiera, A., additional, Baisi, A., additional, Raveglia, F., additional, Stefani, A., additional, Natali, P., additional, Scarci, M., additional, Pirondini, E., additional, Curcio, C., additional, Amore, D., additional, Rena, O., additional, Nicotra, S., additional, Dell’ Amore, A., additional, Bertani, A., additional, Tancredi, G., additional, Ampollini, L., additional, Carbognani, P., additional, Puma, F., additional, Vinci, D., additional, Cardillo, G., additional, Carleo, F., additional, Margaritora, S., additional, Meacci, E., additional, Luzzi, L., additional, Ghisalberti, M., additional, Crisci, R., additional, Divisi, D., additional, Lausi, P., additional, Guerrera, F., additional, Fontana, D., additional, Beffa, V. Della, additional, Morelli, A., additional, Londero, F., additional, Imperatori, A., additional, Rotolo, N., additional, Terzi, A., additional, Viti, A., additional, Infante, M., additional, and Benato, C., additional

Published
2021
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18. National adoption of video-assisted thoracoscopic surgery (VATS) lobectomy: The Italian VATS register evaluation

Author

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

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

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

Published
2018

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

Author

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

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

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

Published
2019

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

Author

Infante, Mv, Benato, C, Silva, R, Rocco, G, Bertani, A, Bertolaccini, L, Gonfiotti, A, Giovannetti, R, Bonadiman, C, Lonardoni, A, Canneto, B, Falezza, G, Gandini, P, Curcio, C, Crisci, R, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benvenuti, Mr, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Dell'Amore, A, Della Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Lo Giudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, Stefano, Meacci, Elisa, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F, Margaritora, S (ORCID:0000-0002-9796-760X), Meacci, E (ORCID:0000-0001-8424-3816), Infante, Mv, Benato, C, Silva, R, Rocco, G, Bertani, A, Bertolaccini, L, Gonfiotti, A, Giovannetti, R, Bonadiman, C, Lonardoni, A, Canneto, B, Falezza, G, Gandini, P, Curcio, C, Crisci, R, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benvenuti, Mr, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Dell'Amore, A, Della Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Lo Giudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, Stefano, Meacci, Elisa, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F, Margaritora, S (ORCID:0000-0002-9796-760X), and Meacci, E (ORCID:0000-0001-8424-3816)

Abstract

OBJECTIVES: Inherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons' ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry.METHODS: The registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications.RESULTS: Four thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3-6). Grade 1 and 2 and Grade 3-5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (<100 cases, P < 0.001), but there was no significant difference between intermediate- and high-volume centres under this aspect. Low-volume centres were significantly more likely to convert due to issues with difficult local anatomy, but not significantly so for bleeding. Conversion, lower case-volume, comorbidity burden, male gender, adhesions, blood loss, operative time, sealants and epidural analgesia were significantly associated with increased postoperative morbidity.CONCLUSIONS: VATS lobectomy is a safe procedure even in medically compromised patients. An improved classification system for conversions is proposed and prevention strategies are suggested to reduce conversion rates and possibly complications in less-experienced centres.

Published
2019

21. Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery

Author

Gao, S., Barello, Serena, Chen, L., Chen, C., Che, G., Cai, K., Crisci, R., D'Andrilli, A., Droghetti, A., Fu, X., Ferrari, P. A., Fernando, H. C., Ge, D., Graffigna, Guendalina, Huang, Y., Hu, J., Jiao, W., Jiang, G., Li, X., Li, H., Li, S., Liu, L., Ma, H., Ma, D., Martinez, G., Maurizi, G., Phan, K., Qiao, K., Refai, M., Rendina, E. A., Shao, G., Shen, J., Tian, H., Voltolini, L., Vannucci, J., Vanni, C., Wu, Q., Xu, S., Yu, F., Zhao, S., Zhang, P., Zhang, L., Zhi, X., Zhu, C., Ng, C., Sihoe, A. D. L., Ho, A. M. H., Barello S. (ORCID:0000-0002-8514-2563), Graffigna G. (ORCID:0000-0003-4378-7467), Gao, S., Barello, Serena, Chen, L., Chen, C., Che, G., Cai, K., Crisci, R., D'Andrilli, A., Droghetti, A., Fu, X., Ferrari, P. A., Fernando, H. C., Ge, D., Graffigna, Guendalina, Huang, Y., Hu, J., Jiao, W., Jiang, G., Li, X., Li, H., Li, S., Liu, L., Ma, H., Ma, D., Martinez, G., Maurizi, G., Phan, K., Qiao, K., Refai, M., Rendina, E. A., Shao, G., Shen, J., Tian, H., Voltolini, L., Vannucci, J., Vanni, C., Wu, Q., Xu, S., Yu, F., Zhao, S., Zhang, P., Zhang, L., Zhi, X., Zhu, C., Ng, C., Sihoe, A. D. L., Ho, A. M. H., Barello S. (ORCID:0000-0002-8514-2563), and Graffigna G. (ORCID:0000-0003-4378-7467)

Abstract

not available

Published
2019

25. Current Practices in the Management of Pulmonary Ground-Glass Opacities: A Survey of SICT Members

Author

Lococo, Filippo, Cusumano, G., De Filippis, A. F., Curcuru, G., Quercia, R., Marulli, G., Monaco, G., Granone, Pierluigi, Muriana, G., Rea, F., Crisci, Serena, Di Rienzo, G., Cardillo, G., Lococo, A., Amore, D., Divisi, D., Dolci, G., Guggino, G., Larocca, V., Loizzi, D., Luzzi, L., Monaco, F., Porziella, Venanzio, Rena, O., Lococo F. (ORCID:0000-0002-9383-5554), Granone P. (ORCID:0000-0002-8826-3045), Crisci R., Porziella V. (ORCID:0000-0001-6000-3172), Lococo, Filippo, Cusumano, G., De Filippis, A. F., Curcuru, G., Quercia, R., Marulli, G., Monaco, G., Granone, Pierluigi, Muriana, G., Rea, F., Crisci, Serena, Di Rienzo, G., Cardillo, G., Lococo, A., Amore, D., Divisi, D., Dolci, G., Guggino, G., Larocca, V., Loizzi, D., Luzzi, L., Monaco, F., Porziella, Venanzio, Rena, O., Lococo F. (ORCID:0000-0002-9383-5554), Granone P. (ORCID:0000-0002-8826-3045), Crisci R., and Porziella V. (ORCID:0000-0001-6000-3172)

Abstract

Background: Several gray areas and controversies exist concerning the management of pulmonary ground-glass opacities (GGOs), and there is a lack of consensus among clinicians on this topic. One of the main aims of the Italian Society of Thoracic Surgery is to promote education and research, so we decided to perform a survey on this topic to estimate current trends in practice in a large sample of thoracic surgeons. Methods: A total of 160 thoracic surgeons responded, namely, completed our questionnaire (response rate, 53%; 160 of 302). The survey was composed of 36 questions divided into six subsections: (1) demographic characteristics of the respondents; (2) terminology and taxonomy; (3) radiologic and radiometabolic evaluation; (4) diagnostic approach and indications for surgery; (5) surgical management; and (6) radiologic surveillance. Results: We observed some divergence of opinion regarding the definition of mixed GGOs, the role of 18F fluorodeoxyglucose positron emission tomography and computed tomography scans, indications for nonsurgical biopsy, intraoperative techniques for localizing GGOs, indications for surgery, extension of lung resection and lymph node dissection according to the radiologic scenario, use of intraoperative frozen section analysis, and radiologic surveillance of pure GGOs. Conclusions: This topic warrants more investigation in the future. An upcoming consensus conference of Italian Society of Thoracic Surgery experts (also open to experts in other specialties) could provide updated indications for GGO management based on the literature, expert opinions, and the results of the present survey.

Published
2018

30. Controllo del dolore post-­‐toracotomia

Author

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

Published
2013

40. [Current role of open window thoracostomy]

Author

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

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

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

Published
2000

41. 256 * EARLY DETECTION OF LUNG CANCER IN AN ASYMPTOMATIC HIGH-RISK POPULATION BY LOW-DOSE COMPUTED TOMOGRAPHY SCAN AND MOLECULAR MARKERS: VALIDATION OF A PERSONALIZED RISK MODEL TO OPTIMIZE THE SCANNING INTERVAL

Author

Cardillo, G., primary, Veronesi, G., additional, Maisonneuve, P., additional, Bellomi, M., additional, Bertolotti, R., additional, Margaritora, S., additional, Lococo, A., additional, Crisci, R., additional, Bertani, A., additional, Ialongo, P., additional, Di Fiore, P. P., additional, Spaggiari, L., additional, and Bianchi, F., additional

Published
2013
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