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2. 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. 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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6. Conversion due to vascular injury during video-assisted thoracic surgery lobectomy: A multicentre retrospective analysis from the Italian video-assisted thoracic surgery group registry

Author

Bertolaccini, Luca, Davoli, Fabio, Pardolesi, Alessandro, Brandolini, Jury, Argnani, Desideria, Bertani, Alessandro, Droghetti, Andrea, Gonfiotti, Alessandro, Divisi, Duilio, Crisci, Roberto, Solli, Piergiorgio, Nosotti, Mario, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, and Guerrera, Francesco

Published
2019
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7. 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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8. Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry.

Author

Maniscalco, Pio, Tamburini, Nicola, Fabbri, Nicolò, Quarantotto, Francesco, Rizzardi, Giovanna, Amore, Dario, Lopez, Camillo, Crisci, Roberto, Spaggiari, Lorenzo, Valpiani, Giorgia, Bertolaccini, Luca, and Cavallesco, Giorgio

Subjects
LOBECTOMY (Lung surgery), LOGISTIC regression analysis, PAIN management, FACTOR analysis, TEMPORAL lobectomy, JUDGMENT (Psychology)
Abstract

Objective. There are limited data for estimating the risk of early discharge following thoracoscopic lobectomy. The objective was to identify the factors associated with a short length of stay and verify the influence of these variables in uncomplicated patients. Methods. We reviewed all lobectomies reported to the Italian VATS Group between January 2014 and January 2020. Patients and perioperative characteristics were divided into two subgroups based on whether or not they met the target duration of stay (≤ or >4 days). The association between preoperative and intraoperative variables and postoperative length of stay (LOS) ≤4 days was assessed using a stepwise multivariable logistic regression analysis to identify factors independently associated with LOS and factors related to LOS in uncomplicated cases. Results. Among 10,240 cases who underwent thoracoscopic lobectomy, 37.6% had a hospital stay ≤4 days. Variables associated with LOS included age, hospital surgical volume, Diffusion Lung CO % (81 [69–94] vs. 85 [73–98]), Forced Expiratory Volume (FEV1) % (92 [79–106] vs. 96 [82–109]), operative time (180 [141–230] vs. 160 [125–195]), uniportal approach (571 [9%] vs. 713 [18.5%]), bioenergy sealer use, and pain control through intercostal block or opioids (p < 0.001). Except for FEV1 and blood loss, all other factors emerged significantly associated with LOS when the analysis was limited to uncomplicated patients. Conclusions. Demographic, clinical, and surgical variables are associated with early discharge after thoracoscopic lobectomy. This study indicates that these characteristics are associated with early discharge. This result can be used in association with clinical judgment to identify appropriate patients for fast-track protocols. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Additional file 1 of Multicenter randomized controlled trial comparing digital and traditional chest drain in a VATS pulmonary lobectomy cohort: interim analysis

Author

Mendogni, Paolo, Tosi, Davide, Marulli, Giuseppe, Comacchio, Giovanni Maria, Pieropan, Sara, Rossi, Veronica, Brascia, Debora, Andriolo, Luigi Gaetano, Imbriglio, Giovanna, Bonitta, Gianluca, Lopez, Camillo, Rea, Federico, and Nosotti, Mario

Subjects
Data_FILES
Abstract

Additional file 1.

Published
2021
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10. 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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11. 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

12. Additional file 1 of Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in Thoracic surgery (PACTS) part 1: preadmission and preoperative care

Author

Piccioni, Federico, Droghetti, Andrea, Bertani, Alessandro, Coccia, Cecilia, Corcione, Antonio, Corsico, Angelo Guido, Crisci, Roberto, Curcio, Carlo, Naja, Carlo Del, Feltracco, Paolo, Fontana, Diego, Gonfiotti, Alessandro, Lopez, Camillo, Massullo, Domenico, Nosotti, Mario, Ragazzi, Riccardo, Rispoli, Marco, Romagnoli, Stefano, Scala, Raffaele, Scudeller, Luigia, Taurchini, Marco, Tognella, Silvia, Umari, Marzia, Valenza, Franco, and Petrini, Flavia

Subjects
InformationSystems_INFORMATIONSTORAGEANDRETRIEVAL, Data_FILES
Abstract

Additional file 1. Search strategy and keywords.

Published
2020
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13. Multicenter Randomized Controlled Trial Comparing Digital and Traditional Chest Drain in a VATS&nbsp;Pulmonary Lobectomy Cohort: Interim Analysis

Author

Mendogni, Paolo, primary, Tosi, Davide, additional, Marulli, Giuseppe, additional, Comacchio, Giovanni Maria, additional, Pieropan, Sara, additional, Rossi, Veronica, additional, Brascia, Debora, additional, Andriolo, Luigi Gaetano, additional, Imbriglio, Giovanna, additional, Bonitta, Gianluca, additional, Lopez, Camillo, additional, Rea, Federico, additional, and Nosotti, Mario, additional

Published
2020
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14. Multicenter randomized controlled trial comparing digital and traditional chest drain in a VATS pulmonary lobectomy cohort: interim analysis

Author

Mendogni, Paolo, primary, Tosi, Davide, additional, Marulli, Giuseppe, additional, Comacchio, Giovanni Maria, additional, Pieropan, Sara, additional, Rossi, Veronica, additional, Brascia, Debora, additional, Andriolo, Luigi Gaetano, additional, Imbriglio, Giovanna, additional, Bonitta, Gianluca, additional, Lopez, Camillo, additional, Rea, Federico, additional, and Nosotti, Mario, additional

Published
2020
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15. Safety of lymphadenectomy during video-assisted thoracic surgery lobectomy. Analysis from a national database

Author

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

Subjects
Male, Lung Neoplasms, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Logistic regression, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, 80 and over, Prospective Studies, Lobectomy, Lung cancer, Video-assisted thoracic surgery, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Lymph Node Excision, Lymphatic Metastasis, Mediastinum, Middle Aged, Neoplasm Staging, Pneumonectomy, Thoracic Surgery, Video-Assisted, Treatment Outcome, Prospective cohort study, Non-Small-Cell Lung, Thoracic Surgery, General Medicine, medicine.anatomical_structure, Cardiothoracic surgery, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Video-Assisted, NO, 03 medical and health sciences, medicine, Rank correlation, business.industry, Carcinoma, medicine.disease, Surgery, 030228 respiratory system, Lymphadenectomy, business, Lobectomy, Lung cancer, Video-assisted thoracic surgery
Abstract

OBJECTIVES The Italian VATS Group database was accessed to evaluate whether preoperative and intraoperative factors may affect the safety of lymphadenectomy (LA) during video-assisted thoracic surgery lobectomy. METHODS All video-assisted thoracic surgery lobectomy procedures performed between 1 January 2014 and 30 March 2017 for non-small-cell lung cancer with cN0 or cN1 disease were identified in the database. LA safety was evaluated based on intraoperative (operative time, bleeding and conversion rate) and postoperative (30-day morbidity and mortality, chest drain duration and length of stay) outcomes and was correlated with the number of resected lymph nodes and the rates of nodal upstaging. Continuous variables were presented as mean ± standard deviation and compared using the unpaired t-test; the X2 test was used for categorical variables. Univariable analysis was performed on selected variables. Significant variables (P < 0.30) were entered into a Cox multivariable logistic regression model, using the overall and specific occurrence of complications as dependent variables. The Spearman's rank correlation coefficient was applied as needed. RESULTS A total of 3181 cases (2077 men, 65.3%; mean age of 69 years) met the enrolment criteria. Final pathology was consistent with adenocarcinoma (n = 2262, 67.5%), squamous cell (n = 520, 15.5%), typical (n = 184, 5.5%) and atypical carcinoid (n = 48, 1.4%) and other (n = 335, 10%). The mean number of resected lymph nodes was 13.42 ± 8.24; nodal upstaging occurred in 308 of 3181 (9.68%) cases. Six hundred and fifty-five complications were recorded in 404 (12.7%) patients; in this series, no mortality was observed. Univariable and multivariable analyses did not show any association between the extension of LA and intraoperative or postoperative outcomes. The number of resected lymph nodes and nodal upstagings showed a minimal correlation with intraoperative outcomes and a moderate correlation with postoperative air leak (p = 0.35 and p = 0.48, respectively), arrhythmia (p = 0.29 and p = 0.35, respectively), chest drain duration (p = 0.35 and p = 0.51, respectively) and length of stay (p = 0.35). CONCLUSIONS Based on the VATS Group data, video-assisted thoracic surgery LA proved to be safe and displayed good outcomes even when performed with an extended approach.

Published
2018

16. Nodal management and upstaging of disease: Initial results from the Italian VATS Lobectomy Registry

Author

Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Bertani, A, Gonfiotti, A, Nosotti, M, Ferrari, Pa, De Monte, L, Russo, E, Di Paola, G, Solli, P, Droghetti, A, Bertolaccini, L, Crisci, R, Italian VATS, Group, Negri, G, Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, and Guerrera, Francesco

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lymph node (LN), VATS lobectomy, Nodal upstaging, 030204 cardiovascular system & hematology, Resection, NO, 03 medical and health sciences, 0302 clinical medicine, medicine, Quantitative assessment, Lymph node, Surgical approach, Receiver operating characteristic, business.industry, lymph node (LN), nodal upstaging, Surgery, Dissection, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Original Article, Radiology, business
Abstract

Background: VATS lobectomy is an established option for the treatment of early-stage NSCLC. Complete lymph node dissection (CD), systematic sampling (SS) or resecting a specific number of lymph nodes (LNs) and stations are possible intra-operative LN management strategies. Methods: All VATS lobectomies from the “Italian VATS Group” prospective database were retrospectively reviewed. The type of surgical approach (CD or SS), number of LN resected (RN), the positive/resected LN ratio (LNR) and the number and types of positive LN stations were recorded. The rates of nodal upstaging were assessed based on different LN management strategies. Results: CD was the most frequent approach (72.3%). Nodal upstaging rates were 6.03% (N0-to-N1), 5.45% (N0-to-N2), and 0.58% (N1-to-N2). There was no difference in N1 or N2 upstaging rates between CD and SS. The number of resected nodes was correlated with both N1 (OR =1.02; CI, 1.01–1.04; P=0.03) and N2 (OR =1.02; CI, 1.01–1.05; P=0.001) upstaging. Resecting 12 nodes had the best ability to predict upstaging (6 N1 LN or 7 N2 LN). The finding of two positive LN stations best predicted N2 upstaging [area under the curve (AUC) of receiver operating characteristic (ROC) =0.98]. Conclusions: Nodal upstaging (and, indirectly, the effectiveness of intra-operative nodal management) cannot be predicted based on the surgical technique (CD or SS). A quantitative assessment of intra-operative LN management may be a more appropriate and measurable approach to justify the extension of LN resection during VATS lobectomy.

Published
2017

17. Erratum: Nodal management and upstaging of disease: Initial results from the Italian VATS Lobectomy Registry [J Thorac Dis, 9, (2017), (2061-2070)] DOI: 10.21037/jtd.2017.06.12

Author

Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, and Guerrera, Francesco

Subjects
Pulmonary and Respiratory Medicine, NO
Published
2017

18. Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database.

Author

Bongiolatti, Stefano, Gonfiotti, Alessandro, Viggiano, Domenico, Borgianni, Sara, Politi, Leonardo, Crisci, Roberto, Curcio, Carlo, Voltolini, Luca, Italian VATS Group, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, Di Rienzo, Gaetano, Lopez, Camillo, Divisi, Duilio, Morelli, Angelo, Bertani, Alessandro, and Russo, Emanuele

Abstract

Objective: The objective of the study is to analyse the causes and impact of conversion from VATS to thoracotomy identifying any possible pre-operative risk factors and related consequences.Methods: Data from patient who underwent VATS lobectomy (VATS-L) for NSCLC at VATS Group participating centres were retrospectively analysed and divided in two groups: patients treated with VATS-L and patients who suffered from conversion. Predictors of conversion were assessed with univariate and multivariable exact logistic regression. Complications were evaluated as dependent variables of conversion in a Cox multivariable logistic regression model.Results: A total of 4629 patients underwent planned VATS-L for NSCLC and of these, 432 (9.3%) required conversion; the most frequent causes were bleeding (30.4%) and fibro-calcified hilar lymph nodes (23.9%). The independent risk factors at multivariable analysis model were sex male (OR 1.458, p < 0.01), age older than 70 years (OR 1.248, p = 0.036) and the clinically node-positive disease (OR 2.258, p < 0.01). The mortality rate was similar, but the percentage of patients who suffered from any complication (41.7% vs 24.4%, p < 0.01), the complication rate (65% vs 32.2%, p < 0.01), chest tube duration (p < 0.01) and the hospitalisation rate (p < 0.01) were higher for patients converted. Atrial fibrillation (OR 1.471, p = 0.019), prolonged air leak (OR 1.403, p = 0.043), blood transfusions (OR 4.820, p < 0.01), sputum retention (OR 1.80, p = 0.027) and acute kidney failure (OR 2.758, p = 0.03) were significantly associated with conversion at multivariable analysis.Conclusions: Conversion is associated with increased surgical morbidity, blood loss and hospital stay. Sex male, old age and the clinical involvement of lymph nodes were the strongest predictors of conversion. [ABSTRACT FROM AUTHOR]

Published
2019
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24. Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in Thoracic surgery (PACTS) part 1: preadmission and preoperative care.

Author

Piccioni, Federico, Droghetti, Andrea, Bertani, Alessandro, Coccia, Cecilia, Corcione, Antonio, Corsico, Angelo Guido, Crisci, Roberto, Curcio, Carlo, Del Naja, Carlo, Feltracco, Paolo, Fontana, Diego, Gonfiotti, Alessandro, Lopez, Camillo, Massullo, Domenico, Nosotti, Mario, Ragazzi, Riccardo, Rispoli, Marco, Romagnoli, Stefano, Scala, Raffaele, and Scudeller, Luigia

Subjects
PERIOPERATIVE care, THORACIC surgery, PREOPERATIVE care, THORACOTOMY, POSTOPERATIVE care, VIDEO-assisted thoracic surgery, PATIENT care
Abstract

Introduction: Anesthetic care in patients undergoing thoracic surgery presents specific challenges that necessitate standardized, multidisciplionary, and continuously updated guidelines for perioperative care. Methods: A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, comprising 24 members from 19 Italian centers, was established to develop recommendations for anesthesia practice in patients undergoing thoracic surgery (specifically lung resection for cancer). The project focused on preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and PubMed and Embase literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventative Services Task Force criteria. Results: Recommendations for preoperative care focus on risk assessment, patient preparation (prehabilitation), and the choice of procedure (open thoracotomy vs. video-assisted thoracic surgery). Conclusions: These recommendations should help pulmonologists to improve preoperative management in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve. [ABSTRACT FROM AUTHOR]

Published
2020
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25. Recommendations from the Italian intersociety consensus on Perioperative Anesthesa Care in Thoracic surgery (PACTS) part 2: intraoperative and postoperative care.

Author

Piccioni, Federico, Droghetti, Andrea, Bertani, Alessandro, Coccia, Cecilia, Corcione, Antonio, Corsico, Angelo Guido, Crisci, Roberto, Curcio, Carlo, Del Naja, Carlo, Feltracco, Paolo, Fontana, Diego, Gonfiotti, Alessandro, Lopez, Camillo, Massullo, Domenico, Nosotti, Mario, Ragazzi, Riccardo, Rispoli, Marco, Romagnoli, Stefano, Scala, Raffaele, and Scudeller, Luigia

Subjects
POSTOPERATIVE care, THORACIC surgery, PERIOPERATIVE care, INTRAOPERATIVE care, EARLY ambulation (Rehabilitation), NONINVASIVE ventilation
Abstract

Introduction: Anesthetic care in patients undergoing thoracic surgery presents specific challenges that require a multidisciplinary approach to management. There remains a need for standardized, evidence-based, continuously updated guidelines for perioperative care in these patients. Methods: A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, was established to develop recommendations for anesthesia practice in patients undergoing elective lung resection for lung cancer. The project addressed three key areas: preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventive Services Task Force criteria. Results: Recommendations for intraoperative care focus on airway management, and monitoring of vital signs, hemodynamics, blood gases, neuromuscular blockade, and depth of anesthesia. Recommendations for postoperative care focus on the provision of multimodal analgesia, intensive care unit (ICU) care, and specific measures such as chest drainage, mobilization, noninvasive ventilation, and atrial fibrillation prophylaxis. Conclusions: These recommendations should help clinicians to improve intraoperative and postoperative management, and thereby achieve better postoperative outcomes in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve. [ABSTRACT FROM AUTHOR]

Published
2020
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26. Correction to: Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database.

Author

Bongiolatti, Stefano, Gonfiotti, Alessandro, Viggiano, Domenico, Borgianni, Sara, Politi, Leonardo, Crisci, Roberto, Curcio, Carlo, Voltolini, Luca, Italian VATS Group, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, Di Rienzo, Gaetano, Lopez, Camillo, Divisi, Duilio, Morelli, Angelo, Bertani, Alessandro, and Russo, Emanuele

Abstract

In the "Results" section of the Abstract, the sentence: "The mortality rate was similar, but the percentage of patients who suffered from any complication (41.7% vs 24.4%, p < 0.01), the complication rate (65% vs 32.2%, p < 0.01), chest tube duration (p < 0.01) and the hospitalisation rate (p < 0.01) were higher for patients converted." should read: "The mortality rate was similar, but the percentage of patients who suffered from any complication (41.7% vs 24.4%, p < 0.01), the complication rate (65% vs 32.2%, p < 0.01), chest tube duration (p < 0.01) and length of stay (p < 0.01) were higher for patients converted." [ABSTRACT FROM AUTHOR]

Published
2019
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28. Conversion due to vascular injury during video-assisted thoracic surgery lobectomy: A multicentre retrospective analysis from the Italian video-assisted thoracic surgery group registry

Author

Luca Bertolaccini, Fabio Davoli, Alessandro Pardolesi, Jury Brandolini, Desideria Argnani, Alessandro Bertani, Andrea Droghetti, Alessandro Gonfiotti, Duilio Divisi, Roberto Crisci, Piergiorgio Solli, Mario Nosotti, Carlo Curcio, Dario Amore, Giuseppe Marulli, Samuele Nicotra, Andrea De Negri, Paola Maineri, Gaetano di Rienzo, Camillo Lopez, Angelo Morelli, Francesco Londero, Lorenzo Spaggiari, Roberto Gasparri, Guido Baietto, Caterina Casadio, Maurizio Infante, Cristiano Benato, Marco Alloisio, Edoardo Bottoni, Giuseppe Cardillo, Francesco Carleo, Franco Stella, Giampiero Dolci, Francesco Puma, Damiano Vinci, Giorgio Cavallesco, Pio Maniscalco, Luca Ampollini, Paolo Carbognani, Alberto Terzi, Andrea Viti, Giampiero Negri, Alessandro Bandiera, Reinhold Perkmann, Francesco Zaraca, Claudio Andretti, Camilla Poggi, Felice Mucilli, Pierpaolo Camplese, Luca Luzzi, Marco Ghisalberti, Andrea Imperatori, Nicola Rotolo, Luigi Bortolotti, Giovanna Rizzardi, Massimo Torre, Alessandro Rinaldo, Armando Sabbatini, Majed Refai, Mauro Roberto Benvenuti, Diego Benetti, Alessandro Stefani, Pamela Natali, Paolo Lausi, Francesco Guerrera, Bertolaccini, Luca, Davoli, Fabio, Pardolesi, Alessandro, Brandolini, Jury, Argnani, Desideria, Bertani, Alessandro, Droghetti, Andrea, Gonfiotti, Alessandro, Divisi, Duilio, Crisci, Roberto, Solli, Piergiorgio, Nosotti, Mario, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Bertolaccini L., Davoli F., Pardolesi A., Brandolini J., Argnani D., Bertani A., Droghetti A., Gonfiotti A., Divisi D., Crisci R., Solli P., Nosotti M., Curcio C., Amore D., Marulli G., Nicotra S., De Negri A., Maineri P., 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., Andretti 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., and Guerrera F.

Subjects
Registrie, Male, Complications, Lung Neoplasms, medicine.medical_treatment, Iatrogenic Disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Risk Factors, Thoracotomy, Registries, Pneumonectomy, Video-assisted thoracic surgery lobectomy, Univariate analysis, Thoracic Surgery, Video-Assisted, Thoracic Surgery, General Medicine, Treatment Outcome, Oncology, Italy, Cardiothoracic surgery, Female, Lung cancer, Human, medicine.medical_specialty, Complications, Conversion, Lung cancer, Lymph nodes dissection, Vascular injury, Video-assisted thoracic surgery lobectomy, VATS lobectomy, Video-Assisted, Vascular injury, NO, 03 medical and health sciences, medicine, Conversion, Lymph nodes dissection, Aged, Humans, Retrospective Studies, Vascular System Injuries, business.industry, Risk Factor, nutritional and metabolic diseases, Retrospective cohort study, medicine.disease, Surgery, Lung Neoplasm, 030228 respiratory system, business, Complication
Abstract

Objectives Vascular injuries are among the most severe causes of unplanned conversion during VATS lobectomies. The study aimed to analyse the incidence of vascular injuries and their risk factors during VATS lobectomy. Methods The Italian VATS lobectomy Registry was used to collect data from 66 Thoracic Surgery Units. From 2013 to October 2016 (out of more than 3,700 patients enrolled) only information from Units with an enrollment >100 VATS lobectomies were retrospectively analysed. Logistic regression analysis was performed on selected variables of the univariate analysis. Results Ten institutions contributed a total of 1,679 patients. Vascular injuries leading to conversion occurred in 44 (2.6%) patients. Years of experiences were inversely related to the risk of vascular injuries. Univariate analysis showed age, gender, surgical activity, Charlson Index Score and number of resected lymph nodes like significantly associated variables. Multivariate analysis revealed that number of resected lymph nodes, VATS experience ratio (number of VATS lobectomies/total lobectomies performed in the same year at same centre), and surgical activity of the centre were significantly associated with the risk of conversion. Unplanned thoracotomy was correlated with postoperative morbidity. Conclusion Vascular injuries in VATS lobectomies represented a rare complication which could directly affect the postoperative outcomes. The predictive factors for conversion were multifactorial and depended on characteristics of centres and surgeons’ seniority. Minimally invasive VATS lobectomy approaches did not influence the risk of vascular damages.

Published
2019

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