Should all patients receive extended thromboprophylaxis after resection of primary lung cancer?

Objective: The optimal duration of thromboprophylaxis in patients undergoing resection of primary lung cancer is not known. We investigated the incidence of pulmonary emboli and venous thromboembolism in patients undergoing early-stage lung cancer resection and the impact of change from short duration to extended thromboprophylaxis.

Methods: We reviewed the outcomes of consecutive patients who underwent resection of early-stage primary lung cancer following a change in protocol from inpatient-only to extended thromboprophylaxis to 28 days.

Optimal resection rate for lung cancer in the UK: how high should we go?

Background: The optimal resection rate for institutions managing early-stage primary lung cancer is not known. Whether the prognosis of patients who do not proceed to operation is determined by their comorbidities for which they were deemed at prohibitively high-operative risk, or disease progression, is uncertain. We investigated the outcomes of patients with early-stage lung cancer who were considered for surgical management.

Mitochondrial Inhibitor Atovaquone Increases Tumor Oxygenation and Inhibits Hypoxic Gene Expression in Patients with Non-Small Cell Lung Cancer.

Purpose: Tumor hypoxia fuels an aggressive tumor phenotype and confers resistance to anticancer treatments. We conducted a clinical trial to determine whether the antimalarial drug atovaquone, a known mitochondrial inhibitor, reduces hypoxia in non-small cell lung cancer (NSCLC).

Patients And Methods: Patients with NSCLC scheduled for surgery were recruited sequentially into two cohorts: cohort 1 received oral atovaquone at the standard clinical dose of 750 mg twice daily, while cohort 2 did not.

Imaging of congenital chest wall deformities.

To identify the anatomy and pathology of chest wall malformations presenting for consideration for corrective surgery or as a possible chest wall "mass", and to review the common corrective surgical procedures. Congenital chest wall deformities are caused by anomalies of chest wall growth, leading to sternal depression or protrusion, or are related to failure of normal spine or rib development. Cross-sectional imaging allows appreciation not only of the involved structures but also assessment of the degree of displacement or deformity of adjacent but otherwise normal structures and differentiation between anatomical deformity and neoplasia.

Changes in pulmonary function tests predict radiological response to chemotherapy in malignant pleural mesothelioma.

Objectives: Response to chemotherapy in malignant pleural mesothelioma (MPM) is usually evaluated by radiological criteria, but no common agreement exists on their validity, yet. The cytoreductive effect of chemotherapy on pleural thickening may make the lung more expansible, reducing the restrictive ventilatory impairment. The aim of this study was to evaluate the changes in pulmonary function following chemotherapy in patients with MPM and to correlate these findings with radiological changes.

Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis.

Objective: Thymectomy is a well-defined therapeutic option for patients with myasthenia gravis; however, controversies still exist about the surgical approach, indication, and timing for surgery. We reviewed our experience reporting surgical and neurologic results after robotic thymectomy in patients with myasthenia gravis.

Methods: Between 2002 and 2010, 100 patients (74 female and 26 male; median age, 37 years) underwent left-sided robotic thymectomy using the da Vinci robotic system (Intuitive Surgical, Inc, Sunnyvale, Calif).

Robot-aided thoracoscopic thymectomy for early-stage thymoma: a multicenter European study.

Objective: Minimally invasive thymectomy for stage I to stage II thymoma has been suggested in recent years and considered technically feasible. However, because of the lack of data on long-term results, controversies still exist on surgical access indication. We sought to evaluate the results after robot-assisted thoracoscopic thymectomy in early-stage thymoma.

A prospective randomized trial comparing stapler and laser techniques for interlobar fissure completion during pulmonary lobectomy.

Alveolar air leaks, often resulting from lung tissue traumatization during dissection of fissures, still remain a challenging problem in lung surgery. Several tools and techniques have been used to reduce air leakage, but none was judged ideal. This prospective, randomized trial was designed to evaluate the feasibility, safety, and effectiveness of completion of fissures during pulmonary lobectomy by using a laser system.

Single-institution experience on robot-assisted thoracoscopic operations for mediastinal diseases.

Objective: : After the introduction of video-assisted thoracoscopic surgery 20 years ago, the minimally invasive techniques in thoracic surgery have found a growing application. The recent introduction of robotic technology has increased the potentiality of thoracoscopic technique leading to an expansion of indications and applications, particularly for the management of mediastinal diseases. We reviewed our experience in robot-assisted thoracoscopic resection of benign and malignant mediastinal diseases.

Prosthetic azygo-atrial bypass for palliation of superior vena cava syndrome.

We report a case of locally advanced excavated non-small cell lung cancer with superior vena cava (SVC) syndrome that underwent four cycles of induction chemotherapy. Due to early treatment failure and the impossibility applying radical radiotherapy, a decision was made to perform surgery. The patient underwent right intrapericardial pneumonectomy with en-bloc resection of the SVC, azygos vein and mediastinal lymph nodes.

Multidisciplinary approach for advanced stage thymic tumors: long-term outcome.

Background: In advanced stage thymic tumors complete surgical resection is not always achievable. Although surgery remains the cornerstone of therapy, there is growing evidence that multimodality treatment increases resectability and reduces the incidence of local and systemic relapses.

Methods: Between 1980 and 2008, 75 patients with stages III (n = 51), IVA (n = 18) and IVB (n = 6) thymic tumors were treated.

Pneumonectomy for lung cancer over the age of 75 years: is it worthwhile?

The objective of the study was to evaluate the outcome in elderly patients (>75 years) submitted to pneumonectomy for lung cancer. Records of 40 elderly patients, who underwent pneumonectomy at our Institution from 1990 to 2008, were retrospectively reviewed. This group was compared with 289 younger patients submitted to pneumonectomy in the same period.