Prognostic factors for long-term survival following complete resection by lobectomy in stage I non-small cell lung cancer.

Background: The aim of this study was to evaluate predictors for long-term overall survival (OS) in patients with stage I non-small cell lung cancer (NSCLC).

Methods: All patients undergoing complete resection by lobectomy for stage I NSCLC between October 2012 and December 2015 at a single center were included. Univariable and multivariable Cox regression analyses were performed to identify prognostic factors.

A simple size-tailored algorithm for the removal of chest drain following minimally invasive lobectomy: a prospective randomized study.

Background: The pleural space can resorb 0.11-0.36 ml/kg of body weight/hour (h) per hemithorax.

New method in treatment of post-operative air leakage with fresh frozen plasma.

Background: No consensus regarding the best post-operative treatment option for air leak has been established. In this study, we evaluate the use of intra-pleural fresh frozen plasma (FFP) as a promising treatment method.

Methods: Treatment for a sustained air leak (3 days) was warranted in approximately 12% of the lung surgeries at our institution.

Cumulative Sum Analysis of the Learning Curve for Uniportal Video-Assisted Thoracoscopic Lobectomy and Lymphadenectomy.

The study was performed to analyze the learning curve of performing uniportal video-assisted thoracoscopic surgery (uVATS) for lobectomy and lymphadenectomy, and to evaluate the possible disadvantages in outcomes during the course of learning. This is a prospective study of 52 consecutive patients undergoing uVATS lobectomy by a single surgeon from January 2016 to December 2017. Operation time (OPT) and the number of harvested lymph nodes (LNs) were evaluated by means of cumulative sum control chart by assessing efficiency (refinement in procedure to reach decreasing OPT and increasing number of harvested LNs) and mastery (absence of outliers).

Aspirin for patients undergoing major lung resections: hazardous or harmless?†.

Objectives: Acetylsalicylic acid (ASA, aspirin) is a medication widely used for primary and secondary prevention of cardiovascular diseases, which are the leading cause of morbidity and mortality worldwide. Whether aspirin should be continued or paused in the perioperative period remains controversial, especially in thoracic surgical settings.

Methods: A single-centred retrospective study comprised 486 patients.

Surgery for lung tumors in the elderly: A retrospective cohort study on the influence of advanced age (over 80 years) on the development of complications by using a multivariate risk model.

Background: The prevalence of lung cancer and other tumors is increasing among the elderly people. The purpose of this study was to examine the influence of advanced age (80 + years) on the immediate perioperative outcome as well as to define potential risk factors that may lead to increasing morbidity and mortality after lung resections.

Methods: A retrospective cohort analysis of the data from an electronic database of 208 elderly patients (165 patients ≥70 years, 45 patients ≥80 years) undergoing pulmonary anatomical resection for lung tumors during January 2013-December 2016 was conducted.

Uniportal video-assisted thoracoscopic resection of anterior segment of the left upper lobe.

Anatomical segment resections are often technically more demanding than lobectomies. Anterior segment of the left upper lobe (S3) is usually removed within the standard resection of the upper three segments.    Our patient in this case was a 56-year-old with a known oropharyngeal carcinoma, otherwise amenable to curative treatment, who was admitted to our clinic with  a 1-cm nodule in the anterior segment of the left upper lobe.

Uniportal video-assisted thoracoscopic surgery for anatomical fissureless anterior segment resection (S3) of the right upper lobe followed by lymph node dissection.

Uniportal video-assisted thoracoscopic (UVATS) resections seem to offer real benefits over conventional surgery in terms of postoperative pain and better cosmetic results.  The procedure described in this tutorial, an anterior segment resection of the right upper lobe, is rarely performed, and fissureless resection of this segment by means of UVATS has, at time of writing, never been described in the literature.  Our patient was a 79-year-old female, admitted to our clinic for treatment of a solitary metachronous metastatic tumor of a colon carcinoma, located in the anterior segment of the right upper lobe.

Posterior uniportal video-assisted thoracoscopic surgery for anatomical lung resections.

Background: The acceptance of uniportal video-assisted thoracoscopic surgery (uVATS) for anatomical lung resections has been growing in recent years. This study presents the first case-series in the literature with posterior uVATS (puVATS) technique for specific anatomical lung resections.

Methods: The first 20 consecutive patients who underwent an anatomical lung resection by a single surgeon, by means of puVATS technique were evaluated in terms of pre-, peri- and post-operative results.

[Initial Experience with Uniportal Video-Assisted Thoracoscopic Surgery for Anatomical Lung Resections: A Propensity Score Study and an Observational Assessment of the Learning Curve].

Introduction: Uniportal video-assisted thoracoscopic surgery (UVATS) for anatomical lung resections has gained popularity of late. This study aimed to elucidate the impediments to implementing the uniportal access method into the daily routine of VATS lung resections. To this end, we reviewed our initial experience and evaluated our progress.

Fissure-last video-assisted thoracoscopic lobectomy for 'non-upper' lobes.

Background: Surgical approach into the fissural parenchyma may be an important and modifiable factor for the prevention of air leak after anatomical lung resections. Fissureless fissure-last technique has been described as useful technique to reduce air leak, yet in video-assisted thoracoscopic surgery (VATS) data are limited and mostly on the upper lobes. The purpose of this study is to evaluate the safety and feasibility of fissureless fissure-last VATS 'non-upper' lobectomies and the impact of it on the immediate outcome, especially relating to air leak.

Posterior uniportal video-assisted thoracoscopic surgery for resection of the apical segment of the right lower lobe followed by completion lobectomy.

Uniportal thoracoscopic resections offer less pain and better cosmetic results. They are usually performed through an antero-lateral incision. Posterior uniportal approach has not been described yet.

Fissureless fissure-last video-assisted thoracoscopic lobectomy for all lung lobes: a better alternative to decrease the incidence of prolonged air leak?

Objectives: Prolonged air leak (PAL) after major lung resections is a common postoperative complication that leads to extended length of hospital stay (LOS) and increased hospital costs. Dissection of the lung tissue through the fissure may increase the incidence of PAL especially in the patients with incomplete fissures. The objective of this study was to evaluate the impact of the fissureless fissure-last technique in VATS lobectomy on immediate outcome, especially relating to air leak and LOS.

Postoperative chest tube management: snapshot of German diversity.

Objectives: The management of chest tubes is one of the most critical aspects in patient care in thoracic surgery, and no consensus exists regarding the ideal chest tube management strategy.

Methods: Chest tube management protocols and their effects on chest tube therapy were compared at four German specialist thoracic surgery units. Altogether, 79 patients were stratified for underlying disease and type of surgery.

Combined videothoracoscopic and videomediastinoscopic approach improves radicality of minimally invasive mediastinal lymphadenectomy for early stage lung carcinoma.

Objectives: To assess the feasibility and radicality of a combined thoracoscopic and mediastinoscopic approach to mediastinal lymphadenectomy compared to thoracoscopy only for minimally invasive management of early stage lung carcinoma.

Methods: Prospective observational study of patients undergoing anatomical thoracoscopic lung resection for lung carcinoma in our department in 2007. Mediastinal lymphadenectomy was performed either thoracoscopically (VATS group) or by a combination of video-assisted mediastinoscopic lymphadenectomy (VAMLA) and thoracoscopy (VAMLA+VATS group).