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266 results on '"Gonfiotti, Alessandro"'

1. The Overweight Paradox: Impact of Body Mass Index on Patients Undergoing VATS Lobectomy or Segmentectomy

Author

Parini, Sara, Azzolina, Danila, Massera, Fabio, Mastromarino, Maria Giovanna, Papalia, Esther, Baietto, Guido, Curcio, Carlo, Crisci, Roberto, Rena, Ottavio, Alloisio, Marco, Amore, Dario, Ampollini, Luca, Ardò, Nicoletta, Argnani, Desideria, Baisi, Alessandro, Bandiera, Alessandro, Benato, Cristiano, Benvenuti, Mauro Roberto, Bertani, Alessandro, Bortolotti, Luigi, Bottoni, Edoardo, Breda, Cristiano, Camplese, Pierpaolo, Carbognani, Paolo, Cardillo, Giuseppe, Carleo, Francesco, Cavallesco, Giorgio, Cherchi, Roberto, De Palma, Angela, Dell'Amore, Andrea, Della Beffa, Vittorio, Divisi, Duilio, Dolci, Giampiero, Droghetti, Andrea, Ferrari, Paolo, Fontana, Diego, Gasparri, Roberto, Gavezzoli, Diego, Ghisalberti, Marco, Giovanardi, Michele, Gonfiotti, Alessandro, Guerrera, Francesco, Imperatori, Andrea, Infante, Maurizio, Lausi, Paolo, Lo Giudice, Fabio, Londero, Francesco, Lopez, Camillo, Mancuso, Maurizio, Maniscalco, Pio, Margaritora, Stefano, Marulli, Giuseppe, Mazza, Federico, Meacci, Elisa, Melloni, Giulio, Morelli, Angelo, Mucilli, Felice, Natali, Pamela, Negri, Giampiero, Nicotra, Samuele, Nosotti, Mario, Paladini, Piero, Pariscenti, Gianluca, Perkmann, Reinhold, Pernazza, Fausto, Pirondini, Emanuele, Puma, Francesco, Raveglia, Federico, Refai, Majed, Rinaldo, Alessandro, Risso, Carlo, Rizzardi, Giovanna, Rotolo, Nicola, Scarci, Marco, Solli, Piergiorgio, Sollitto, Francesco, Spaggiari, Lorenzo, Stefani, Alessandro, Stella, Franco, Surrente, Corrado, Tancredi, Giorgia, Terzi, Alberto, Torre, Massimo, Tosi, Davide, Vinci, Damiano, Viti, Andrea, Voltolini, Luca, and Zaraca, Francesco

Published
2023
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3. Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature.

Author

Mugnaini, Giovanni, Tombelli, Simone, Burlone, Antonio, Bongiolatti, Stefano, Viggiano, Domenico, Indino, Rossella, Salimbene, Ottavia, Gatteschi, Lavinia, Voltolini, Luca, and Gonfiotti, Alessandro

Subjects
MINIMALLY invasive procedures, LYMPHADENECTOMY, MEDICAL sciences, PROGRESSION-free survival, LUNG surgery
Abstract

Background: Lung cancer is the first cause of cancer-related death. Awake lung resection is a new frontier of the concept of minimally invasive surgery. Our purpose is to demonstrate the feasibility of this technique for lobar and sublobar lung resection in NSCLC patients. Methods: We retrospective reviewed all the medical charts of patients who underwent awake lung resection in our center between March 2018 and March 2024, focusing on patients with NSCLC, and we compared our results with the ones found in literature. Results: Among 45 patients treated with awake lung resections, we selected 15 patients with NSCLC and finally analyzed the results of 12 patients who underwent VATS awake lung resection, 3 lobectomies and 9 wedge resections. The median Charlson comorbidity index (CCI) was 3 and we had 5 patients (41.67%) with a CCI ≥ 4 and a median FEV1 of 56%. We report only 2 conversions to general anesthesia (16.67%) and no conversion to open thoracotomy. We used a nebulizator for the atomization of lidocaine on the lung surface to reduce the cough reflex. Our post-operative results are in line with literature, with a low complication rate (2 patients, 16.67%) and a median length of stay of 5 days. We safely performed a proper lymph node dissection in all 3 lobectomies. Median Overall Survival and Disease-Free Survival were 11 months. Conclusions: Awake lung resections are a feasible way to perform a minimally invasive surgical procedure in NSCLC patients, with low risk of conversion to open surgery. [ABSTRACT FROM AUTHOR]

Published
2025
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4. Heart Disease and Pectus Excavatum: An Underestimated Issue—Single Center Experience and Literature Review.

Author

Ravasin, Alice, Viggiano, Domenico, Tombelli, Simone, Checchi, Luca, Stefàno, Pierluigi, Voltolini, Luca, and Gonfiotti, Alessandro

Subjects
HEART valve diseases, PECTUS excavatum, MITRAL valve prolapse, CONGENITAL heart disease, MECHANICAL hearts
Abstract

Pectus excavatum (PE) can be associated with either congenital or acquired heart disease. This study highlights the importance of PE surgical repair in cases of severe chest depression on the heart in underlying cardiac diseases exacerbating cardiopulmonary impairment. From January 2023 to March 2024, four male patients underwent PE repair, having heart disease including pericarditis, mitral valve prolapse, ventricular fibrillation arrest and type 1 second-degree atrioventricular block. PE severity was determined by the Haller index (HI). Preoperative assessment included a pulmonary function test, chest computed tomography and cardiac evaluation. The Nuss procedure was performed in three patients, whereas, in one patient, it was performed in combination with a modified Ravitch procedure. The median HI was five. The median time of chest tube removal was 6.5 days. Postoperative complications were prolonged air leak, atrial fibrillation and atelectasis. The median length of hospital stay was 19.5 days, and no 30-day postoperative mortality was recorded. In all patients, surgical repair helped to resolve the underlying cardiological issues, and surgical follow-ups were deemed regular. PE is generally an isolated congenital chest wall abnormality, and, when associated with a heart disease, it can have severe life-threatening hemodynamic consequences due to mechanical compression on the heart for which surgical corrections should be considered. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Perioperative Anti-Fibrotic Treatment Prevents Acute Exacerbation of Idiopathic Pulmonary Fibrosis After Lung Cancer Surgery.

Author

Bongiolatti, Stefano, Salvicchi, Alberto, Rosi, Elisabetta, Bargagli, Elena, Mugnaini, Giovanni, Gonfiotti, Alessandro, Lavorini, Federico, Spagnolo, Paolo, Dell'Amore, Andrea, Rea, Federico, and Voltolini, Luca

Subjects
IDIOPATHIC pulmonary fibrosis, DISEASE exacerbation, LOGISTIC regression analysis, LUNG surgery, PULMONARY fibrosis, SURVIVAL analysis (Biometry)
Abstract

Background: The surgical treatment of concomitant lung cancer in patients with idiopathic pulmonary fibrosis is challenging due to the risk of life-threatening complications such as acute exacerbation development in the perioperative period. Few studies have investigated the role of anti-fibrotic drugs in this setting. The aim of this multicenter retrospective study was to evaluate the incidence of acute exacerbation, according to Collard, after lung resection in patients affected by concomitant idiopathic pulmonary fibrosis and lung cancer who were or were not on antifibrotic treatment. Secondary outcomes included: 30 and 90-day mortality and an estimation of overall and disease-free survival. Material and Methods: The study population consisted of patients affected by idiopathic pulmonary fibrosis who received curative-intent lung surgery in three Italian academic centers between 2015 and 2022. Patients were divided into two groups based on whether they were on perioperative treatment with anti-fibrotic drugs (chronical or prophylactic use) or not. To define predictors of acute exacerbation, univariate and multivariable exact logistic regression analysis were performed. The Kaplan–Meier method with log-rank test was used to estimate survival. Results: During the study period, n = 55 patients underwent lung resection for lung cancer, including 29 patients who were treated with antifibrotic agents. Although the sample size was small and few events were studied, the incidence of acute exacerbation was significantly lower among patient on anti-fibrotic therapy (3.4% vs. 23.1%, p = 0.044); in addition, anti-fibrotic treatment was the strong factor preventing acute exacerbation at the multivariable analysis (OR 0.089, p = 0.038). Post-operative 30- and 90-day mortality rates were not significantly lower in the anti-fibrotic treatment group (0% and 0% vs. 7.7% and 11.5%, p = 0.21 and p = 0.099, respectively). Overall and disease-free survival rates were similar. Conclusions: Considering the limitations of this retrospective study with a small sample size, anti-fibrotic perioperative treatment was associated with reduced incidence of acute exacerbation. Based on these real-world data, this pathway could be proposed as a prophylactic treatment in patients with concomitant idiopathic pulmonary fibrosis and cancer undergoing lung resection. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Post-operative outcomes and quality of life assessment after thoracoscopic lobectomy for Non-small-cell lung cancer in octogenarians: Analysis from a national database

Author

Alloisio, Marco, Amore, Dario, Ampollini, Luca, Andreetti, Claudio, Argnani, Desideria, Baietto, Guido, Bandiera, Alessandro, Benato, Cristiano, Benvenuti, Mauro Roberto, Bertani, Alessandro, Bertolaccini, Luca, Bortolotti, Luigi, Bottoni, Edoardo, Breda, Cristiano, Camplese, Pierpaolo, Carbognani, Paolo, Cardillo, Giuseppe, Casadio, Caterina, Cavallesco, Giorgio, Cherchi, Roberto, Crisci, Roberto, Curcio, Carlo, Dell’Amore, Andrea, Della Beffa, Vittorio, Dolci, Giampiero, Droghetti, Andrea, Ferrari, Paolo A., Fontana, Diego, Gargiulo, Gaetano, Gasparri, Roberto, Gavezzoli, Diego, Ghisalberti, Marco, Giovanardi, Michele, Gonfiotti, Alessandro, Guerrera, Francesco, Imperatori, Andrea, Infante, Maurizio, Iurilli, Luciano, Lausi, Paolo, Lo Giudice, Fabio, Londero, Francesco, Luzzi, Luca, Lopez, Camillo, Mancuso, Maurizio, Maniscalco, Pio, Margaritora, Stefano, Meacci, Elisa, Melloni, Giulio, Morelli, Angelo, Mucilli, Felice, Natali, Pamela, Negri, Giampiero, Nicotra, Samuele, Nosotti, Mario, Pariscenti, Gianluca, Perkmann, Reinhold, Pernazza, Fausto, Pirondini, Emanuele, Poggi, Camilla, Puma, Francesco, Refai, Majed, Rinaldo, Alessandro, Rizzardi, Giovanna, Rosso, Lorenzo, Rotolo, Nicola, Russo, Emanuele, Sabbatini, Armando, Scarci, Marco, Spaggiari, Lorenzo, Stefani, Alessandro, Solli, Piergiorgio, Surrente, Corrado, Terzi, Alberto, Torre, Massimo, Vinci, Damiano, Viti, Andrea, Voltolini, Luca, Zaccagna, Gino, Zaraca, Francesco, Bongiolatti, Stefano, and Borgianni, Sara

Published
2021
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12. Primary Chest Wall Ewing Sarcoma: Treatment and Long-Term Results.

Author

Salimbene, Ottavia, Viggiano, Domenico, Muratori, Francesco, Lo Piccolo, Roberto, Facchini, Flavio, Tamburini, Angela, Campanacci, Domenico Andrea, Voltolini, Luca, and Gonfiotti, Alessandro

Subjects
EWING'S sarcoma, CANCER treatment, OVERALL survival, SURGICAL complications, MEDICAL records
Abstract

Objective: The aim of the study is to evaluate early and long-term results of chest wall primary Ewing's sarcoma patients treated in the time period February 2000–February 2023 by a multidisciplinary approach. Methods: We retrospectively reviewed the medical records of patients who underwent chest wall resection for a primary tumor. Treatment approach, extent of resection, 30-day mortality, overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) were analyzed. Results: Overall, n = 15 consecutive patients were treated for chest wall primary Ewing's sarcoma. A median of n = 3 ribs was resected with a median of n = 2 ribs adjacent to the lesion. Resections were extended to the adjacent structures in n = 5 patients (33.3%). In all cases, we performed a prosthetic reconstruction, associated with muscle flap (n = 10, 66.6%) or with rigid titanium bars and muscle flap (n = 6, 40%). A radical resection was accomplished in n = 13 patients (84.6%). The median surgical time was 310 ± 120 min; median hospitalization was 7.8 ± 1.9 days. Post-operative mortality was zero. We recorded n = 4 (30.7%) post-operative complication. The median follow-up (FU) was 26 months. Moreover, 5-year overall and event-free survival were 52% and 48%, respectively. Conclusions: This case series confirms the benefit of the multidisciplinary approach for Ewing sarcomas in early and long-term results. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Stereotactic Ablative Radiotherapy as an Alternative to Lobectomy in Patients With Medically Operable Stage I NSCLC: A Retrospective, Multicenter Analysis

Author

Scotti, Vieri, Bruni, Alessio, Francolini, Giulio, Perna, Marco, Vasilyeva, Polina, Loi, Mauro, Simontacchi, Gabriele, Viggiano, Domenico, Lanfranchi, Biancaluisa, Gonfiotti, Alessandro, Topulli, Juljana, Olmetto, Emanuela, Maragna, Virginia, Ferrari, Katia, Bonti, Viola, Comin, Camilla, Balduzzi, Sara, D’Amico, Roberto, Lohr, Frank, Voltolini, Luca, and Livi, Lorenzo

Published
2019
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16. Endobronchial Ultrasound/Transbronchial Needle Aspiration-Biopsy for Systematic Mediastinal lymph Node Staging of Non-Small Cell Lung Cancer in Patients Eligible for Surgery: A Prospective Multicenter Study

Author

Divisi, Duilio, primary, Di Leonardo, Gabriella, additional, Venturino, Massimiliano, additional, Scarnecchia, Elisa, additional, Gonfiotti, Alessandro, additional, Viggiano, Domenico, additional, Lucchi, Marco, additional, Mastromarino, Maria Giovanna, additional, Bertani, Alessandro, additional, and Crisci, Roberto, additional

Published
2023
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26. 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, Francesco, Brunelli, Alessandro, Pipitone, Marco Damiano, Abdellateef, Amr, Abu Akar, Firas, Augustin, Florian, Batchelor, Tim, Bertani, Alessandro, Crisci, Roberto, D'Amico, Thomas, D'Journo, Xavier Benoit, Droghetti, Andrea, Fang, Wentao, Gonfiotti, Alessandro, Janík, Miroslav, Jiménez, Marcelo, Kirschbaum, Andreas, Kostic, Marko, Lazzaro, Richard, Lucchi, Marco, Marra, Alessandro, Murthy, Sudish, Ng, Calvin S H, Nachira, Dania, Pardolesi, Alessandro, Perkmann, Reinhold, Petersen, René Horsleben, Pischik, Vadim, Russo, Michele Dario, Opitz, Isabelle, et al, and University of Zurich

Subjects
10255 Clinic for Thoracic Surgery, 2740 Pulmonary and Respiratory Medicine, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, 2746 Surgery
Published
2022
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34. 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, Francesco, Brunelli, Alessandro, Pipitone, Marco Damiano, Abdellateef, Amr, Abu Akar, Firas, Augustin, Florian, Batchelor, Tim, Bertani, Alessandro, Crisci, Roberto, D'amico, Thomas, D'journo, Xavier Benoit, Droghetti, Andrea, Fang, Wentao, Gonfiotti, Alessandro, Janík, Miroslav, Jimenez, Marcelo, Kirschbaum, Andreas, Kostic, Marko, Lazzaro, Richard, Lucchi, Marco, Marra, Alessandro, Murthy, Sudish, Ng, Calvin S.H., Nachira, Dania, Pardolesi, Alessandro, Perkmann, Reinhold, Petersen, Rene Horsleben, Pischik, Vadim, Russo, Michele Dario, Opitz, Isabelle, Spaggiari, Lorenzo, Ugalde, Paula A., Vannucci, Fernando, Veronesi, Giulia, Bertolaccini, Luca, Zaraca, Francesco, Brunelli, Alessandro, Pipitone, Marco Damiano, Abdellateef, Amr, Abu Akar, Firas, Augustin, Florian, Batchelor, Tim, Bertani, Alessandro, Crisci, Roberto, D'amico, Thomas, D'journo, Xavier Benoit, Droghetti, Andrea, Fang, Wentao, Gonfiotti, Alessandro, Janík, Miroslav, Jimenez, Marcelo, Kirschbaum, Andreas, Kostic, Marko, Lazzaro, Richard, Lucchi, Marco, Marra, Alessandro, Murthy, Sudish, Ng, Calvin S.H., Nachira, Dania, Pardolesi, Alessandro, Perkmann, Reinhold, Petersen, Rene Horsleben, Pischik, Vadim, Russo, Michele Dario, Opitz, Isabelle, Spaggiari, Lorenzo, Ugalde, Paula A., Vannucci, Fernando, Veronesi, Giulia, and Bertolaccini, Luca

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

37. 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, Francesco, primary, Brunelli, Alessandro, additional, Pipitone, Marco Damiano, additional, Abdellateef, Amr, additional, Abu Akar, Firas, additional, Augustin, Florian, additional, Batchelor, Tim, additional, Bertani, Alessandro, additional, Crisci, Roberto, additional, D’Amico, Thomas, additional, D'Journo, Xavier Benoit, additional, Droghetti, Andrea, additional, Fang, Wentao, additional, Gonfiotti, Alessandro, additional, Janík, Miroslav, additional, Jiménez, Marcelo, additional, Kirschbaum, Andreas, additional, Kostic, Marko, additional, Lazzaro, Richard, additional, Lucchi, Marco, additional, Marra, Alessandro, additional, Murthy, Sudish, additional, Ng, Calvin S H, additional, Nachira, Dania, additional, Pardolesi, Alessandro, additional, Perkmann, Reinhold, additional, Petersen, René Horsleben, additional, Pischik, Vadim, additional, Russo, Michele Dario, additional, Opitz, Isabelle, additional, Spaggiari, Lorenzo, additional, Ugalde, Paula A, additional, Vannucci, Fernando, additional, Veronesi, Giulia, additional, and Bertolaccini, Luca, additional

Published
2022
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38. The Overweight Paradox: Impact of Body Mass Index on Patients Undergoing VATS Lobectomy or Segmentectomy

Author

Parini, Sara, primary, Azzolina, Danila, additional, Massera, Fabio, additional, Mastromarino, Maria Giovanna, additional, Papalia, Esther, additional, Baietto, Guido, additional, Curcio, Carlo, additional, Crisci, Roberto, additional, Rena, Ottavio, additional, Alloisio, Marco, additional, Amore, Dario, additional, Ampollini, Luca, additional, Ardò, Nicoletta, additional, Argnani, Desideria, additional, Baisi, Alessandro, additional, Bandiera, Alessandro, additional, Benato, Cristiano, additional, Benvenuti, Mauro Roberto, additional, Bertani, Alessandro, additional, Bortolotti, Luigi, additional, Bottoni, Edoardo, additional, Breda, Cristiano, additional, Camplese, Pierpaolo, additional, Carbognani, Paolo, additional, Cardillo, Giuseppe, additional, Carleo, Francesco, additional, Cavallesco, Giorgio, additional, Cherchi, Roberto, additional, De Palma, Angela, additional, Dell'Amore, Andrea, additional, Della Beffa, Vittorio, additional, Divisi, Duilio, additional, Dolci, Giampiero, additional, Droghetti, Andrea, additional, Ferrari, Paolo, additional, Fontana, Diego, additional, Gasparri, Roberto, additional, Gavezzoli, Diego, additional, Ghisalberti, Marco, additional, Giovanardi, Michele, additional, Gonfiotti, Alessandro, additional, Guerrera, Francesco, additional, Imperatori, Andrea, additional, Infante, Maurizio, additional, Lausi, Paolo, additional, Lo Giudice, Fabio, additional, Londero, Francesco, additional, Lopez, Camillo, additional, Mancuso, Maurizio, additional, Maniscalco, Pio, additional, Margaritora, Stefano, additional, Marulli, Giuseppe, additional, Mazza, Federico, additional, Meacci, Elisa, additional, Melloni, Giulio, additional, Morelli, Angelo, additional, Mucilli, Felice, additional, Natali, Pamela, additional, Negri, Giampiero, additional, Nicotra, Samuele, additional, Nosotti, Mario, additional, Paladini, Piero, additional, Pariscenti, Gianluca, additional, Perkmann, Reinhold, additional, Pernazza, Fausto, additional, Pirondini, Emanuele, additional, Puma, Francesco, additional, Raveglia, Federico, additional, Refai, Majed, additional, Rinaldo, Alessandro, additional, Risso, Carlo, additional, Rizzardi, Giovanna, additional, Rotolo, Nicola, additional, Scarci, Marco, additional, Solli, Piergiorgio, additional, Sollitto, Francesco, additional, Spaggiari, Lorenzo, additional, Stefani, Alessandro, additional, Stella, Franco, additional, Surrente, Corrado, additional, Tancredi, Giorgia, additional, Terzi, Alberto, additional, Torre, Massimo, additional, Tosi, Davide, additional, Vinci, Damiano, additional, Viti, Andrea, additional, Voltolini, Luca, additional, and Zaraca, Francesco, additional

Published
2022
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39. Post-operative and early oncological results of simple and complex full thoracoscopic segmentectomies for non-small-cell lung cancer.

Author

Bongiolatti, Stefano, Salvicchi, Alberto, Indino, Rossella, Vokrri, Eduart, Gonfiotti, Alessandro, Borgianni, Sara, Viggiano, Domenico, and Voltolini, Luca

Abstract

Background: The role of video-assisted thoracoscopic segmentectomy in the treatment of clinical IA non-small-cell lung cancer is not well established. The aim of our retrospective analysis was to evaluate the oncological results of complex and simple video-assisted thoracoscopic segmentectomy. Methods: From 2015 to June 2020, data of n = 163 consecutive patients undergoing video-assisted thoracoscopic segmentectomy for solitary pulmonary nodule were analysed. The Kaplan–Meier method, log-rank test and Cox regression were used to estimate, compare survivals and identify risk factors of worse oncological outcomes. Results: In this period, n = 123 patients underwent video-assisted thoracoscopic segmentectomy for non-small-cell lung cancer: we performed n = 65 simple and n = 58 complex video-assisted thoracoscopic segmentectomy; n = 99 (80.5%) had a solid appearance on computed tomography scan and n = 78 (63.4%) a moderate-to-high [18F]-2-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomographic computed tomography scan avidity. Mortality was 0%, and complications occurred in n = 14 (21.5%) and 9 (15.5%) patients. The median follow-up was 24 (range: 6−60) months and the 5-year overall survival was 96% without difference between video-assisted thoracoscopic segmentectomies (p = 0.16). Local recurrence developed in n = 2 (3.1%) and n = 3 (5.2%) patients; regional in n = 2 (3.1%) and 1 (1.8%) and distant in 8 (12.3%) and 2 (3.4%), without difference between video-assisted thoracoscopic segmentectomies (p = 0.51). The overall 5-year disease-free survival rate was 78%. Pathological upstaging was observed in n = 13 patients (nodal in n = 6, tumour in n = 7) and it was the only significant factor for worse disease-free survival at the multivariable analysis (hazard ratio: 2.43, 95% CI: 1.04−8.68, p = 0.049), value confirmed also in the group of intended video-assisted thoracoscopic segmentectomy (p = 0.047). Conclusions: Pathological upstaging after simple or complex video-assisted thoracoscopic segmentectomy is a risk factor for recurrence and then video-assisted thoracoscopic segmentectomy should be considered an appropriate therapeutic option for selected stage IA non-small-cell lung cancer patients. [ABSTRACT FROM AUTHOR]

Published
2023
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42. Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: our experience on 1,592 patients

Author

Divisi, Duilio, Barone, Mirko, Bertolaccini, Luca, Rocco, Gaetano, Solli, Piergiorgio, Crisci, Roberto, Italian Vats Group, Ampollini, Luca, Alloisio, Marco, Andreetti, Claudio, Amore, Dario, Baietto, Guido, Bandiera, Alessandro, Benato, Cristiano, Benetti, Diego, Benvenuti, Mauro, Bertani, Alessandro, Bortolotti, Luigi, Bottoni, Edoardo, Camplese, Pierpaolo, Carbognani, Paolo, Cardillo, Giuseppe, Carleo, Francesco, Casadio, Caterina, Cavallesco, Giorgio, Curcio, Carlo, Denegri, Andrea, Di Rienzo, Gaetano, Dolci, Giampiero, Droghetti, Andrea, Gasparri, Roberto, Ghisalberti, Marco, Gonfiotti, Alessandro, Guerrera, Francesco, Imperatori, Andrea, Infante, Maurizio, Lausi, Paolo, Londero, Francesco, Lopez, Camillo, Luzzi, Luca, Maineri, Paola, Maniscalco, Pio, Marulli, Giuseppe, Monteverde, Marco, Morelli, Angelo, Mucilli, Felice, Natali, Pamela, Negri, Giampiero, Nicotra, Samuele, Nosotti, Mario, Perkmann, Reinhold, Poggi, Camilla, Puma, Francesco, Refai, Mayed, Rinaldo, Alessandro, Rizzardi, Giovanna, Rosso, Lorenzo, Rotolo, Nicola, Russo, Emanuele, Sabatini, Armando, Spaggiari, Lorenzo, Stefani, Alessandro, Stella, Franco, Terzi, Alberto, Torre, Massimo, Vinci, Damiano, Viti, Andrea, Voltolini, Luca, Zaraca, Francesco, Divisi, Duilio, Barone, Mirko, Bertolaccini, Luca, Rocco, Gaetano, Solli, Piergiorgio, Crisci, Roberto, Italian VATS, Group, Negri, G, Ampollini, Luca, Alloisio, Marco, Andreetti, Claudio, Amore, Dario, Baietto, Guido, Bandiera, Alessandro, Benato, Cristiano, Benetti, Diego, Benvenuti, Mauro, Bertani, Alessandro, Bortolotti, Luigi, Bottoni, Edoardo, Camplese, Pierpaolo, Carbognani, Paolo, Cardillo, Giuseppe, Carleo, Francesco, Casadio, Caterina, Cavallesco, Giorgio, Curcio, Carlo, Denegri, Andrea, Di Rienzo, Gaetano, Dolci, Giampiero, Droghetti, Andrea, Gasparri, Roberto, Ghisalberti, Marco, Gonfiotti, Alessandro, Guerrera, Francesco, Imperatori, Andrea, Infante, Maurizio, Lausi, Paolo, Londero, Francesco, Lopez, Camillo, Luzzi, Luca, Maineri, Paola, Maniscalco, Pio, Marulli, Giuseppe, Monteverde, Marco, Morelli, Angelo, Mucilli, Felice, Natali, Pamela, Negri, Giampiero, Nicotra, Samuele, Nosotti, Mario, Perkmann, Reinhold, Poggi, Camilla, Puma, Francesco, Refai, Mayed, Rinaldo, Alessandro, Rizzardi, Giovanna, Rosso, Lorenzo, Rotolo, Nicola, Russo, Emanuele, Sabatini, Armando, Spaggiari, Lorenzo, Stefani, Alessandro, Stella, Franco, Terzi, Alberto, Torre, Massimo, Vinci, Damiano, Viti, Andrea, Voltolini, Luca, and Zaraca, Francesco

Subjects
Lung adenocarcinoma, Pulmonary and Respiratory Medicine, medicine.medical_specialty, VATS lobectomy, Standardized uptake value, Malignancy, Ground-glass opacity, NO, 030218 nuclear medicine & medical imaging, Maximum standardized uptake value, 03 medical and health sciences, 0302 clinical medicine, ground glass opacities, Solitary pulmonary nodule (SPN), maximum standardized uptake value, lymph node metastases, lung adenocarcinoma, Lymph node metastase, medicine, Ground glass opacities, Lymph node metastases, Lung cancer, Lymph node, business.industry, Ground glass opacitie, Nodule (medicine), medicine.disease, Primary tumor, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Original Article, Radiology, medicine.symptom, business
Abstract

Background: Multislice computed tomography (MSCT) increased detection of solitary pulmonary nodules (SPNs), changing the management based on radiological and clinical factors. When 18-fluorine fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG-PET/CT) was considered for the evaluation of nodules, the maximum standardized uptake value (SUVmax) more than 2.5 is used frequently as a cut off for malignancy. The purpose of this study is to evaluate SUVmax PET/CT and pulmonary attenuation patterns at MSCT in patients with SPN according to morphological and pathological characteristics of the lesion. Methods: A retrospective study on 1,592 SPN patients was carried out following approval by the Italian Registry of VATS Lobectomies. Results: All patients underwent VATS lobectomy. On histologic examination, 98.1% had primary or second metachronous primary lung cancers. In addition, 10.7% presented occult lymph node metastases (pN1 or pN2) on histological examination. Nodule attenuation on CT was associated with the histology of the lesion (p= 0.030); in particular, pure ground glass opacities (pGGOs) and partially solid nodules were related to adenocarcinomatous histotypes. Conversely, a significant relationship between SUVmax and age, nodule size, pathological node status (pN) was found (P=0.007, P=0.000 and P=0.002 respectively). Conclusions: Nodule attenuation can predict the histology of the lesion whereas SUVmax may relate to the propensity to lymph node metastases.

Published
2017
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43. Post-operative outcomes and quality of life assessment after thoracoscopic lobectomy for Non-small-cell lung cancer in octogenarians: Analysis from a national database

Author

Bongiolatti, Stefano, primary, Gonfiotti, Alessandro, additional, Borgianni, Sara, additional, Crisci, Roberto, additional, Curcio, Carlo, additional, Voltolini, Luca, additional, Alloisio, Marco, additional, Amore, Dario, additional, Ampollini, Luca, additional, Andreetti, Claudio, additional, Argnani, Desideria, additional, Baietto, Guido, additional, Bandiera, Alessandro, additional, Benato, Cristiano, additional, Benvenuti, Mauro Roberto, additional, Bertani, Alessandro, additional, Bertolaccini, Luca, additional, Bortolotti, Luigi, additional, Bottoni, Edoardo, additional, Breda, Cristiano, additional, Camplese, Pierpaolo, additional, Carbognani, Paolo, additional, Cardillo, Giuseppe, additional, Casadio, Caterina, additional, Cavallesco, Giorgio, additional, Cherchi, Roberto, additional, Dell’Amore, Andrea, additional, Della Beffa, Vittorio, additional, Dolci, Giampiero, additional, Droghetti, Andrea, additional, Ferrari, Paolo A., additional, Fontana, Diego, additional, Gargiulo, Gaetano, additional, Gasparri, Roberto, additional, Gavezzoli, Diego, additional, Ghisalberti, Marco, additional, Giovanardi, Michele, additional, Guerrera, Francesco, additional, Imperatori, Andrea, additional, Infante, Maurizio, additional, Iurilli, Luciano, additional, Lausi, Paolo, additional, Lo Giudice, Fabio, additional, Londero, Francesco, additional, Luzzi, Luca, additional, Lopez, Camillo, additional, Mancuso, Maurizio, additional, Maniscalco, Pio, additional, Margaritora, Stefano, additional, Meacci, Elisa, additional, Melloni, Giulio, additional, Morelli, Angelo, additional, Mucilli, Felice, additional, Natali, Pamela, additional, Negri, Giampiero, additional, Nicotra, Samuele, additional, Nosotti, Mario, additional, Pariscenti, Gianluca, additional, Perkmann, Reinhold, additional, Pernazza, Fausto, additional, Pirondini, Emanuele, additional, Poggi, Camilla, additional, Puma, Francesco, additional, Refai, Majed, additional, Rinaldo, Alessandro, additional, Rizzardi, Giovanna, additional, Rosso, Lorenzo, additional, Rotolo, Nicola, additional, Russo, Emanuele, additional, Sabbatini, Armando, additional, Scarci, Marco, additional, Spaggiari, Lorenzo, additional, Stefani, Alessandro, additional, Solli, Piergiorgio, additional, Surrente, Corrado, additional, Terzi, Alberto, additional, Torre, Massimo, additional, Vinci, Damiano, additional, Viti, Andrea, additional, Zaccagna, Gino, additional, and Zaraca, Francesco, additional

Published
2021
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44. Impact of Persistent N2 Disease and Lymph Node Ratio on Oncological Outcomes after Multimodal Treatment in Pre-Operative Histologically Proven N2 Disease Non-Small-Cell Lung Cancer

Author

Salvicchi, Alberto, primary, Bongiolatti, Stefano, additional, Mazzoni, Francesca, additional, Gonfiotti, Alessandro, additional, Salvicchi, Alberto, additional, Viggiano, Domenico, additional, Ferrari, Katia, additional, Scotti, Vieri, additional, and Voltolini, Luca, additional

Published
2021
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45. 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, Francesco, Brunelli, Alessandro, Pipitone, Marco Damiano, Abdellateef, Amr, Akar, Firas Abu, Augustin, Florian, Batchelor, Tim, Bertani, Alessandro, Crisci, Roberto, D'Amico, Thomas, D'Journo, Xavier Benoit, Droghetti, Andrea, Fang, Wentao, Gonfiotti, Alessandro, Janík, Miroslav, Jiménez, Marcelo, Kirschbaum, Andreas, Kostic, Marko, Lazzaro, Richard, and Lucchi, Marco

Subjects
POSTOPERATIVE care, CLINICAL decision support systems, CONSENSUS (Social sciences), LUNG surgery, CANCER invasiveness
Abstract

Open in new tab Download slide 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. [ABSTRACT FROM AUTHOR]

Published
2022
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46. Post-operative outcomes and quality of life assessment after thoracoscopic lobectomy for Non-small-cell lung cancer in octogenarians: Analysis from a national database

Author

Bongiolatti, Stefano, Gonfiotti, Alessandro, Borgianni, Sara, Crisci, Roberto, Curcio, Carlo, Voltolini, Luca, Margaritora, Stefano, Italian VATS, Group, Margaritora, Stefano (ORCID:0000-0002-9796-760X), Bongiolatti, Stefano, Gonfiotti, Alessandro, Borgianni, Sara, Crisci, Roberto, Curcio, Carlo, Voltolini, Luca, Margaritora, Stefano, Italian VATS, Group, and Margaritora, Stefano (ORCID:0000-0002-9796-760X)

Abstract

Background: Thoracoscopic lobectomy (VATS-L) for non-small-cell lung cancer (NSCLC) is a well-established option for early stage NSCLC, but the evidences are limited for octogenarians. Objective: The objectives of this multi-institutional study were to evaluate the post-operative outcomes of VATS-L in octogenarians and to estimate the post-operative quality of life (QoL) using a validated questionnaire (EuroQoL5D). Methods: Data from patients underwent VATS-L between 2014 and 2019 were analysed and divided into two groups: Group A (younger patients) and Group B (octogenarians). To define predictors for complications, univariate and multivariable logistic regression analysis were performed. Results: 7023 patients underwent VATS-L and 329 (4.6%) were octogenarians. 30-day and 90-day post-operative mortality were similar (0.95% vs 0.91%, p = 0.84 and 1.3% vs 1.2%, p = 0.58), whereas the percentage of patients who suffered from any complication (25.5% vs 31.9%, p = 0.012) and the complication rate (31.6% vs 45.2%, p= 0.01) were higher for octogenarians. At discharge, the values of EuroQoL5D were worse in group B, but after one month these levels became similar. Age 80 years had a significant influence on morbidity on both univariate and multivariable analyses (p = 0.025). Conclusions: VATS-L for NSCLC can be performed in selected octogenarians without increased risk of postoperative death, acceptable not-life-threatening complications and a moderate impact on QoL.

Published
2021

50. The role of postoperative radiotherapy for thymomas: a multicentric retrospective evaluation from three Italian centers and review of the literature

Author

Bruni, Alessio, primary, Stefani, Alessandro, additional, Perna, Marco, additional, Borghetti, Paolo, additional, Giaj Levra, Niccolò, additional, D’Angelo, Elisa, additional, D’Onofrio, Alessandra, additional, Rubino, Laura, additional, Frassinelli, Luca, additional, Salvestrini, Viola, additional, Mariotti, Matteo, additional, Alongi, Filippo, additional, Gonfiotti, Alessandro, additional, Livi, Lorenzo, additional, and Scotti, Vieri, additional

Published
2020
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