Last minute cancellation of elective lung cancer surgery is associated with poorer survival.

Objectives: Our objective was to assess the incidence and reason of last-minute cancellations before surgery for lung cancer and their association with outcomes.

Methods: Retrospective analysis on all consecutive patients booked for elective lung cancer surgery from January 2017 through December 2022 in a single centre.Last minute cancellation: a cancellation occurring within the last 24 hours from the planned operation.

Oncologic outcomes after minimally invasive segmentectomy or lobectomy in patients with hypermetabolic clinical stage IA1-2 non-small cell lung cancer.

Objective: To evaluate the oncologic outcome of patients with hypermetabolic tumors resected by segmentectomy or lobectomy.

Methods: This was a retrospective analysis of all consecutive patients with peripheral clinical stage IA1-2 non-small cell lung cancer (January 2017-June 2023) who underwent resection by segmentectomy or lobectomy in a single center. A hypermetabolic tumor was defined as a tumor with a positron emission tomography (PET) maximum standardized uptake value >2.

Self-reported dyspnoea and shortness of breathing deterioration in long-term survivors after segmentectomy or lobectomy for early-stage lung cancer.

Objectives: The aim of this study was to assess the self-reported current dyspnoea and perioperative changes of dyspnoea in long-term survivors after minimally invasive segmentectomy or lobectomy for early-stage lung cancer.

Methods: Cross-sectional telephonic survey of patients alive and disease-free as of March 2023, with pathologic stage IA1-2, non-small-cell lung cancer, assessed 1-5 years after minimally invasive segmentectomy or lobectomy (performed from January 2018 to January 2022). Current dyspnoea level: Baseline Dyspnoea Index score <10.

Minimally invasive segmentectomy and lobectomy for peripheral stage IA1-2 non-small-cell lung cancer: a case-matched cohort study from a UK Centre.

Objectives: The objective of this study is to compare in a real-world series the short- and long-term results of segmentectomy and lobectomy for peripheral clinical stage IA non-small-cell lung cancer (NSCLC).

Methods: Single-centre cohort study including a series of consecutive patients undergoing minimally invasive segmentectomy or lobectomy for peripheral (outer third of the lung) clinical stage IA NSCLC (January 2017-August 2022). Propensity score case matching analysis generated 2 matched groups of patients undergoing segmentectomy or lobectomy.

Impact of lung cancer screening on surgical stage distribution and surgical practice: a regional analysis of patients operated in and out of a screening program.

Objectives: The aim of this study was to assess variations in surgical stage distribution in 2 centres within the same UK region. One centre was covered by an active screening program started in November 2018 and the other was not covered by screening.

Methods: Retrospective analysis of 1895 patients undergoing lung resections (2018-2022) in 2 centres.

Increased minute ventilation-to-carbon dioxide slope during cardiopulmonary exercise test is associated with poor postoperative outcome following lung cancer resection.

Objectives: Ventilatory efficiency [minute ventilation-to-carbon dioxide output slope (VE/VCO2 slope)] can be measured at sub-maximal workload during cardiopulmonary exercise test. The aim of this study is to assess the association between VE/VCO2 slope and outcome after lung cancer resections.

Methods: Retrospective, single-centre analysis on all patients undergoing lung resection for cancer (April 2014-August 2022) and with a preoperative cardiopulmonary exercise test.

Prolonged air leak after segmentectomy: incidence and risk factors.

Background: We designed this study to investigate the rate and risk factors of prolonged air leak (PAL) in patients undergoing pulmonary segmentectomy in our unit.

Methods: We performed a retrospective cohort study on 191 patients undergoing pulmonary segmentectomy (January 2017-August 2021). A PAL was defined as an air leak >5 days.

Video-Assisted-Thoracoscopic-Surgery Pleural Decorticator for Emergency Empyema Surgery.

Background/need: Pleural empyemas carry a high morbidity and mortality. Some can be managed with medical treatment but most require some form of surgery with the goals to remove the infected material from the pleural space and to help re-expand the collapsed lung. Keyhole surgery by Video Assisted Thoracoscopy Surgery (VATS) is rapidly becoming a common approach to deal with early stage empyemas to avoid larger, more painful thoracotomies that hinder recovery.

Impact of the type of initial intervention on the outcomes of lung volume reduction for emphysema: a propensity matched study.

Background: The type of initial intervention i.e., endobronchial valve (EBV) implantation or lung volume reduction surgery (LVRS) to be offered as initial intervention remains vague in the treatment of emphysema-chronic obstructive pulmonary disease (COPD) patients.

A risk model to predict an unplanned admission to the intensive care unit following lung resection.

Objectives: The goal of this study was to develop a risk-adjusting model to stratify the risk of an unplanned admission to the intensive care unit (following lung resection).

Methods: We performed a retrospective analysis of 3123 patients undergoing anatomical lung resections (2014-2019) in 2 centres. A risk score was developed by testing several variables for a possible association with a subsequent ICU admission using stepwise logistic regression analyses, validated by the bootstrap resampling technique.

Poor preoperative quality of life predicts prolonged hospital stay after VATS lobectomy for lung cancer.

Objectives: The aim of this study was to assess whether quality of life (QoL) scales are associated with postoperative length of stay (LoS) following video-assisted thoracoscopic surgery (VATS) lobectomy for lung cancer.

Methods: This is a single-centre retrospective analysis on 250 consecutive patients submitted to VATS lobectomies (233) or segmentectomies (17) over a period of 3 years. QoL was assessed in all patients by the self-administration of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 questionnaire.

Urinothorax following percutaneous image-guided renal cryoablation.

A 69-year-old lady with 2 renal cell carcinomas, one sited at the upper pole of her solitary right kidney, underwent percutaneous image-guided cryoablation and developed urinothorax as a complication. This was diagnosed from pleural fluid analysis and radiology imaging with computed tomography (CT). Management included image-guided chest drain and retrograde ureteric stent insertion to divert the urine from entering the pleural cavity.

Eurolung risk score is associated with long-term survival after curative resection for lung cancer.

Objective: The study objective was to verify whether the Eurolung score was associated with long-term prognosis after lung cancer resection.

Methods: A total of 1359 consecutive patients undergoing anatomic lung resection (1136 lobectomies, 103 pneumonectomies, 120 segmentectomies) (2014-2018) were analyzed. The parsimonious aggregate Eurolung2 score was calculated for each patient.

Ninety-day hospital costs associated with prolonged air leak following lung resection.

Objectives: Our goal was to assess the postoperative 90-day hospital costs of patients with prolonged air leak (PAL) including costs incurred after discharge from the initial index hospitalization.

Methods: We performed a retrospective analysis of 982 patients undergoing lobectomy (898) or segmentectomy (78) (April 2014-August 2018). A total of 167 operations were open, 780 were video-assisted thoracoscopic surgery and 28 were robotic.

A risk model to predict 2-year survival after video-assisted thoracoscopic surgery lobectomy for non-small-cell lung cancer.

Objectives: We sought to identify the risk factors associated with mortality post-video-assisted thoracoscopic surgery (VATS) lobectomy over a 2-year period.

Methods: Analysis was performed using a sample from an institutionally maintained database. All lobectomies for non-small-cell lung cancer from April 2014 to March 2018 started with VATS approach and with a complete follow-up were included (n = 732).

The Impact of a Newly Established Multidisciplinary Team on the Interventional Treatment of Patients With Emphysema.

Background: The emphysema interventional treatment involves mainly lung volume reduction surgery (LVRS) and endobronchial valve (EBV) implantation. Few institutes discuss these cases at a dedicated emphysema multidisciplinary team (MDT) meeting.

Objectives: To investigate the impact of a newly established dedicated emphysema MDT meeting on the interventional treatment of such patients.

Ninety-day hospital costs for anatomic lung resections†.

Objectives: The study aimed to assess the total cost (TC) and relative cost (RC) of 90-day postoperative care at the hospital after anatomic lung resection.

Methods: Six hundred and forty lung resections (April 2014-September 2016) were performed at a single centre (547 lobectomies, 55 pneumonectomies and 38 segmentectomies). TC was calculated up to 90 days from the date of surgery and included the postoperative cost of the index hospitalization and the costs of hospital or emergency department readmissions, clinic appointments, medications and radiology post-discharge up to 90 days from the operation.

Use of Bioglue™ to seal a difficult to treat air leak in a complicated empyema patient.

Surgical sealants have been used in thoracic surgery in an effort to reduce air leak duration, intercostal drain duration, length of stay and complications. They are instilled over a defect usually treated with other means. We herein present the technique of controlling a difficult to treat defect by directly instilling Bioglue™ alone into a crater, caused during empyema Video-assisted thoracic surgery in a 50-year-old patient with a trapped lung.

Do pleural adhesions influence the outcome of patients undergoing major lung resection?

Objectives: Our goal was to investigate whether pleural adhesions identified during an operation can induce adverse events. We investigated the outcome of major lung resection in patients with pleural adhesions encountered on entry into the pleural cavity.

Methods: We conducted a retrospective analysis of 144 patients undergoing major lung resection over a period of 9 months.

Is preoperative hypercapnia a justified exclusion criterion for lung volume reduction surgery?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether potential surgical candidates for lung volume reduction surgery (LVRS), who have preoperative hypercapnia, should be excluded on this basis. Using the reported search, 45 papers were found, of which 14 represented the best evidence to answer the clinical question.

Stratifying tumour subtypes based on copy number alteration profiles using next-generation sequence data.

Motivation: The role of personalized medicine and target treatment in the clinical management of cancer patients has become increasingly important in recent years. This has made the task of precise histological substratification of cancers crucial. Increasingly, genomic data are being seen as a valuable classifier.

Impact of a thoracic nurse-led chest drain clinic on patient satisfaction.

Nurse-led clinics are an increasingly used resource in managing postoperative patients and meeting their clinical needs. Since 2007, St James' University Hospital has run a ward-based nurse-led clinic; providing follow-up and management of patients after thoracic surgery. We aimed to assess patient satisfaction with the clinic's ability to manage their postoperative needs.

Ward-based, nurse-led, outpatient chest tube management: analysis of impact, cost-effectiveness and patient safety.

Objectives: Prolonged drainage and air leaks are recognized complications of elective and acute thoracic surgery and carry significant burden on inpatient stay and outpatient resources. Since 2007, we have run a ward-based, nurse-led clinic for patients discharged with a chest drain in situ. The aim of this study is to assess its cost-effectiveness and safety.