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Introduction: Self‐expanding Y‐metal stents (SEMS) are best suited lesions with involvement of the carina and proximal main bronchi; however, Y‐stents can be difficult to place. These difficulties guided us to develop a modification of the classic technique that addresses some of the challenges during positioning. We present the Y reverse technique for Y stent insertion using a combination of rigid and flexible bronchoscopy. Materials and Methods: This retrospective study included 15 consecutive patients, suffering from tracheal‐carina‐lower main bronchi complex, hospitalized at the Thoracic Surgery Unit of the Vanvitelli University of Naples between October 2021 and October 2023. Inclusion criteria: patients in which the length of the stenosis of the right bronchi was greater than that of the left bronchi, advanced oncological conditions, severe respiratory failure; exclusion criteria: Karnofsky scale with <40 points. All patients were admitted to the hospital and treated with Y‐stent insertion using the modified technique Y reverse. Results: The comparison between the group undergoing the Y reverse technique with the group undergoing the traditional positioning of the Y prosthesis has shown an improvement in respiratory function; prolongation of the mean survival time; improvement in SpO2 in spontaneous breathing; reduction mean time procedure. p < 0.05 was considered as statistically significant. Conclusion: Y Reverse is a safe and effective procedure that provides rapid symptom relief in individuals who have critical central airway obstruction near the distal portion of the trachea, carina, and main right and left bronchi. [ABSTRACT FROM AUTHOR]

Background: Nowadays, Thoracic Surgery is technologically advanced; therefore, it also focuses its attention on nursing care. The aim of the study is to evaluate the effect of the assessment of a dedicated team of nurses (DTN) in all onco-hematological patients undergoing VATS lobectomy for lung cancer on the outcome of the patient, preventing pressure injuries, reducing perioperative stress, duration of operations, complications, and hospital stay times. Methods: We performed a single-center observational retrospective study, including 31 DTN and 760 onco-hematological patients who underwent thoracic surgery between 30 October 2018 and 30 June 2023 at "Vanvitelli" University of Naples. Results: DTN ensures good nursing care before, during, and after surgery. Operative time was reduced by approximately 20 min, decreasing hospital infections in the DNT period and reducing intraoperative complications such as bleeding and hospital costs (p < 0.05). Conclusions: Thoracic surgery nurses require more specialized training to adapt to the development of sophisticated. [ABSTRACT FROM AUTHOR]

A 73‐year‐old woman was admitted to our hospital with severe respiratory distress due to postpneumonectomy neoplastic central airway obstruction. An emergency recanalization with rigid bronchoscopy (RB) was planned. Controlled and jet ventilation are routinely used to assure ventilation during RB, but the risk of inadequate oxygenation and removal of carbon dioxide was prohibitively high in this case due to the presence of a single lung. The use of venovenous extracorporeal membrane oxygenation was decided by multidisciplinary team to support ventilation during RB. Complete airway recanalization was successfully achieved without any complications. The patient was discharged 2 days later. Pathology revealed metastatic adenocarcinoma, and the patient was reviewed for oncologic treatment. [ABSTRACT FROM AUTHOR]

Myocardial revascularization in patients presenting with an anterior mediastinal mass poses considerable challenges. In this report, we outline two cases involving patients with anterior mediastinal masses who underwent surgical resection alongside concurrent myocardial revascularization. One patient underwent coronary artery bypass graft surgery, while the other was treated by percutaneous coronary intervention with drug‐eluting stent placement. Both patients fully recovered from the relative procedures and were discharged within two weeks post‐surgery, ultimately diagnosed with thymoma. The concomitant intervention offered the advantage of promptly addressing both conditions, and it was performed safely through a collaborative multidisciplinary effort. [ABSTRACT FROM AUTHOR]

Introduction: Central airway tumors involving the trachea and main‐stem bronchi are a common cause of airway obstruction and a significant cause of mortality among the patients of thoracic diseases with respiratory failure. Debulking in rigid bronchoscopy is quick, safe, and effective. It can be complex and hard in patients with severe bronchial or tracheal obstruction and/or with intraluminal bleeding tumors because of inadequate distal airway control. We have used laser tube as a new technique of ventilation for severe central airway obstruction. Materials and Methods: Forty‐six patients with severe airway obstruction undergoing rigid bronchoscopy from September 2020 to June 2022 at the Thoracic Surgery Department of the University L. Vanvitelli of Naples underwent placement of laser tube. Results: In all patients who underwent rigid bronchoscopy with the use of the laser tube, a reduction of obstruction of more than 50% was obtained and in all patients no hypoxia (saturation < 88%), nor hypercapnia, nor significant bleeding were reported. Discussion: The results of this study suggest that rigid bronchoscopic debulking with the use of laser tube is a safe and effective technique in the management of central airway obstruction. Conclusions: The use of the laser tube allows the monitoring of gas exchange, which controls hypoxemia. Thanks to the double cuff put distally to the tracheal obstruction or in the contralateral bronchus to the obstructed one, the laser tube prevents the flooding of blood from debulking below the stenosis. Rigid bronchoscopy with laser tube will expand its use in the future. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Lung cancer is a pathology with an important incidence. It is a multifactorial disease characterized by epigenetic and nutritional factors. Indeed, there is a strong association between adipose tissue and the pulmonary system, and low‐grade inflammation of obese and/or overweight subjects have a pivotal role in lung cancer establishment.In this study, we analyzed body composition through bioelectrical impedance analysis (BIA) and biochemical parameters such as glycemic and lipidic profile, inflammation profile and adiponectin serum levels in 30 patients (19 male; 11 women) undergoing video‐assisted thoracoscopic surgery (VATS) lobectomy for lung cancer from September 2021 to May 2022 at the Thoracic Unit of Luigi Vanvitelli University of Naples. A control group were also recruited (15 male; 15 female) consisting of age and sex matched volunteered subjects at the Thoracic Unit of Luigi Vanvitelli University of Naples. The control group and lung cancer patients were monitored for anthropometric and biochemical parameters before VATS lobectomy. Furthermore, the lung cancer patients were also monitored after 6 months of surgery.Body composition is modified after surgery and also albumin and C‐reactive protein (CRP) serum levels. In the overweight patients in our study, adiponectin levels were found to be reduced compared with the control group and increased in the same patients after VATS lobectomy.Tumor removal as well as weight loss could affect adiponectin levels, and thus also a reduction in inflammation. In addition, weight loss could also be due to a psychological condition given by the intervention and not to malnutrition related to therapy. [ABSTRACT FROM AUTHOR]

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Thoracoscopic right upper lobectomy is a demanding procedure especially in case of hilar adhesions. Herein, we reported a simple technique as the simultaneous ligation of hilar structures to facilitate thoracoscopic right upper lobectomy. After resections of fissures and of hilar lymph nodes, the following structures were sequentially isolated and simultaneously resected in their natural position: V2+A2 vessels; right upper bronchus; and V1+V3+A1+A3 vessels. This technique was successfully applied in 9 patients. The mean hospitalization was 5.2±3.3 days. No intraoperative and major postoperative complications were observed. All patients were alive without recurrence (median follow: 34 months)., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)