Intercostal Catheters Reduce Long-Term Pain and Postoperative Opioid Consumption after VATS.

: Pain after video-assisted thoracoscopic surgery (VATS) leads to impaired postoperative recovery, possible side effects of opioid usage, and higher rates of chronic post-surgery pain (CPSP). Nevertheless, guidelines on perioperative pain management for VATS patients are lacking. The aim of this study was to analyze the effectiveness of intercostal catheters in combination with a single shot intraoperative intercostal nerve block (SSINB) in comparison to SSINB alone with respect to opioid consumption and CPSP.

Analysis of Pain Management after Anatomic VATS Resection in Austrian Thoracic Surgery Units.

Background: Postoperative pain influences rehabilitation, postoperative complications and quality of life. Despite its impact, there are no uniform treatment guidelines. Different centers seem to use various strategies.

Sarcopenia and Mediastinal Adipose Tissue as a Prognostic Marker for Short- and Long-Term Outcomes after Primary Surgical Treatment for Lung Cancer.

Surgical resection remains the gold standard of treatment for early-stage lung cancer. Several risk models exist to predict postoperative morbidity and mortality. Psoas muscle sarcopenia has already successfully been used for morbidity prediction in lung transplantation and is not yet included in the available risk scores for pulmonary resections.

Risk factors, complications and costs of prolonged air leak after video-assisted thoracoscopic surgery for primary lung cancer.

Background: Prolonged air leak (PAL) represents a common complication after lung resection. This study aims to analyze the risk factors for the development of a PAL, its impact on the postoperative outcome and to estimate additional treatment costs.

Methods: A single center database was queried for all patients scheduled for video-assisted thoracoscopic surgery for primary lung cancer.

External validation of risk prediction scores in patients undergoing anatomic video-assisted thoracoscopic resection.

Background: EuroLung Risk scores were established to predict postoperative morbidity and mortality in patients undergoing anatomic lung resections. We aimed to perform an external validation of the EuroLung scores, which were calculated from data of the European Society of Thoracic Surgeons database, in our video-assisted thoracoscopic surgery cohort.

Methods: All available EuroLung scores were calculated for 718 patients scheduled for anatomic video-assisted thoracoscopic surgery resections between 2009 and 2019.

Delay to surgical treatment in lung cancer patients and its impact on survival in a video-assisted thoracoscopic lobectomy cohort.

Patient pathways from first suspicious imaging until final surgical treatment vary and in some instances cause considerable delay. This study aims to investigate the impact of this delay on survival of lung cancer patients. The institutional database was queried to identify patients with primary lung cancer who were treated with primary surgery.

Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption.

Background: Postoperative pain after video-assisted thoracoscopic surgery (VATS) affects patients' recovery, postoperative complications, and length of stay (LOS). Despite its relevance, there are no guidelines on optimal perioperative pain management. This study aims to analyse the effects of an additional intercostal catheter (ICC) in comparison to a single shot intraoperative intercostal nerve block (SSINB).

Nerve at risk: anatomical variations of the left recurrent laryngeal nerve and implications for thoracic surgeons.

Objectives: Recurrent laryngeal nerve (RLN) injury during thoracic surgery may result in life-threatening postoperative complications including recurrent aspiration and pneumonia. Anatomical details of the intrathoracic course are scarce. However, only an in-depth understanding of the anatomy will help reduce nerve injury.

Right-Sided Approach for Segmental Resection of the Left Main Bronchus-Technical Considerations.

Carcinoids of the left main bronchus are rare tumors of the bronchial system and patients often present with dyspnea, asthma-like symptoms, and pneumonia. Gold standard for therapy of carcinoids is surgical resection, but the surgical approach for segmental resection and anastomosis of the left main bronchus is a matter of discussion. With a left-sided approach the access to the bronchus is blocked by the aortic arch and the pulmonary vein.

VATS Partial Pleurectomy Versus VATS Pleural Abrasion: Significant Reduction in Pneumothorax Recurrence Rates After Pleurectomy.

Introduction: Surgical treatment of primary spontaneous pneumothorax (PSP) usually consists of bullectomy and any form of pleurodesis to reduce risk of disease recurrence. Whether pleurectomy is superior to pleural abrasion is still a matter of debate with recurrence rates especially high when performed with a video-assisted thoracoscopic (VATS) approach. Aim of this study was to compare the efficacy of the two methods in prevention of recurrence of pneumothorax in a minimally invasive setting.

Intraoperative complications during VATS lobectomies from conversion to minimally-invasive "trouble-shooting".

The aim of this study was to explore intraoperative complications during video-assisted thoracoscopic surgery (VATS) lobectomy. Vascular and bronchial injuries, after a robust learning curve, can be sometimes successfully managed by VATS. During a VATS lobectomy, it is necessary: to be prepared in potentially dangerous situations; to think about strategies to handle intraoperative complications and to share these strategies with your own staff.

Prediction of delayed graft function and long-term graft survival by serum and urinary neutrophil gelatinase-associated lipocalin during the early postoperative phase after kidney transplantation.

Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as an early marker protein for kidney dysfunction in various clinical settings. In this prospective study we evaluated serial changes of serum and urinary NGAL within the first 7 days after kidney transplantation in 170 consecutive recipients. The main focus of this study was to assess the performance of serum and urinary NGAL in the prediction of delayed graft function (DGF) and two-year graft and patient survival.

Causes, predictors and consequences of conversion from VATS to open lung lobectomy.

Background: To analyze causes, predictors and consequences of conversions from intended VATS lobectomy to open surgery.

Methods: This is a retrospective analysis of a prospectively maintained database.

Results: From 2009 until December 2012, 232 patients were scheduled for anatomical VATS resection.

Up-regulation of neutrophil gelatinase-associated lipocalin in colorectal cancer predicts poor patient survival.

Background: Lipocalin-2 (Lcn-2) is expressed in human neutrophils and epithelial cells, particularly in the presence of inflammation or cancer. It was shown to be highly expressed in various human cancers. Increased protein levels were associated with decreased survival of patients with breast or gastric cancer.

Robotic-assisted minimally invasive vs. thoracoscopic lung lobectomy: comparison of perioperative results in a learning curve setting.

Purpose: Minimally invasive lung lobectomy was introduced in the late 1990s. Since that time, various different approaches have been described. At our institution, two different minimally invasive approaches, a robotic and a conventional thoracoscopic one, were performed for pulmonary lobectomies.

Lipocalin-2 as mediator of chemokine expression and granulocyte infiltration during ischemia and reperfusion.

Lipocalin-2 (Lcn2) expression contributes to ischemia and reperfusion injury (IRI) by enhancing pro-inflammatory responses. The aim of this work was to elucidate the regulation of Lcn2 during hypoxia and its effects on the expression of key chemokines and adhesion molecules. Lcn2 wt and Lcn2(-/-) mice were used in a heterotopic heart transplantation model.

Combined pancreas-kidney transplantation for patients with end-stage nephropathy caused by type-2 diabetes mellitus.

Background: Simultaneous pancreas-kidney (SPK) transplantation is widely accepted as an optimal therapeutic option for patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease, but the indication for patients with type 2 diabetes mellitus (T2DM) is still controversially discussed.

Methods: Twenty-one T2DM recipients of a first combined pancreas-kidney graft performed at our center during a 9-year period were retrospectively analyzed with regard to demographic characteristics; cardiovascular risk factors; surgical, immunological, and infectious complications; and patient and graft survivals and compared with T1DM recipients (n=195) and 32 T2DM patients who received a kidney transplant alone (KTA) during the same period.

Results: Patient survival at 1 and 5 years was 96.