Effect of Lowest Postoperative Pre-albumin on Outcomes after Robotic-Assisted Pulmonary Lobectomy.

Objective: Lower pre-albumin levels have been associated with increased rates of post-surgical complications, prolonged hospital length of stay (LOS), and death. This study aims to investigate the effect of postoperative pre-albumin levels on perioperative and long-term outcomes following robotic-assisted video thoracoscopic (RAVT) pulmonary lobectomy.

Methods: We retrospectively reviewed 459 consecutive patients who underwent RAVT pulmonary lobectomy by one surgeon for known or suspected lung cancer.

Pretreatment CT and F-FDG PET-based radiomic model predicting pathological complete response and loco-regional control following neoadjuvant chemoradiation in oesophageal cancer.

Introduction: To develop a radiomic-based model to predict pathological complete response (pCR) and outcome following neoadjuvant chemoradiotherapy (NACRT) in oesophageal cancer.

Methods: We analysed 68 patients with oesophageal cancer treated with NACRT followed by esophagectomy, who had staging 18F-fluorodeoxyglucose ( F-FDG) positron emission tomography (PET) and computed tomography (CT) scans performed at our institution. An in-house data-chjmirocterization algorithm was used to extract 3D-radiomic features from the segmented primary disease.

Primary bronchial Ewing sarcoma.

Introduction: Primary bronchial Ewing sarcoma (ES) is a rare endobronchial tumor.

Presentation Of Case: A 65-year-old male presented with six-month history of progressive shortness of breath. Flexible bronchoscopy showed an endobronchial polypoid tumor in the left main stem bronchus about 2 cm from the carina.

Intraoperative Goal-Directed Anesthetic Management of the Patient with Severe Pulmonary Hypertension.

BACKGROUND It is very challenging for anesthesiologists to manage patients with pulmonary hypertension undergoing general anesthesia for elective or emergent surgeries. CASE REPORT We present a patient with severe pulmonary hypertension going through a major robotic thoracic surgery. CONCLUSIONS A goal-directed anesthesia management algorithm based on serial stroke volume (SV) values obtained from FloTrac (Edwards Lifesciences, LLC.

Impact of sarcopenia on outcomes of locally advanced esophageal cancer patients treated with neoadjuvant chemoradiation followed by surgery.

Background: Sarcopenia is an independent predictor of clinical outcomes in multiple gastrointestinal cancers. Total psoas area (TPA), as measured on a single cross-sectional CT image at the L4 vertebral body level, has been correlated with sarcopenia. We sought to evaluate whether TPA was predictive of acute grade ≥3 toxicity, pathologic response, and overall survival in patients with locally advanced esophageal cancer receiving tri-modality therapy.

Effect of small body habitus on peri-operative outcomes after robotic-assisted pulmonary lobectomy: retrospective analysis of 208 consecutive cases.

Background: Patients with smaller body surface area (BSA) have smaller pleural cavities, which limit visualization and instrument mobility during video-assisted thoracoscopic surgery (VATS). We investigated the effects of BSA on outcomes with robotic-assisted VATS lobectomy.

Methods: We analyzed 208 consecutive patients who underwent robotic-assisted lobectomy over 34 months.

Heart failure due to tension hydrothorax after left pneumonectomy.

Tension hydrothorax is a rare complication of pneumonectomy for pleural mesothelioma and an exceptionally rare cause of heart failure. We describe a patient who had undergone extrapleural pneumonectomy, chemotherapy, and radiation for pleural mesothelioma and who developed heart failure symptoms within months of the completion of treatment. Investigation showed a massive left pleural effusion resulting in tension hydrothorax, mediastinal shift, and evidence of right heart failure with constrictive physiology and low cardiac output.

Aortoesophageal fistula secondary to reflux esophagitis.

Aortoenteric fistula is a rare cause of massive upper gastrointestinal bleeding and is in the overwhelming majority of cases due to erosion of a suture line of a prosthetic vascular graft into the bowel. We report the case of a massive fatal gastrointestinal hemorrhage from an aortoenteric fistula secondary to erosion from reflux esophagitis. Proper management requires expedient radiographic and endoscopic evaluation, and even with appropriate management mortality remains extremely high.

Thoracoscopic transillumination in chest wall resection.

Determining the extent of chest wall resection during en bloc lung cancer operations is often difficult secondary to the location of these tumors. We describe a hybrid technique that employs video-thoracoscopy and chest wall transillumination to determine the appropriate margin of resection.