Non-Surgical Approaches to the Management of the Intrathoracic Goiter-A Systematic Review.

Background: Intrathoracic goiters (ITGs) are usually managed by surgical excision, However, over recent years, non-surgical strategies are emerging as an alternatives for treating this condition.

Methods: A systematic review of research published since 2017 in the PubMed database was conducted and a total of 39 articles were retrieved, along with methodological issues and future directions in the research on ITGs.

Results: Several non-surgical treatments exist, including radio-iodine ablation (RIA) and mini-invasive approaches, such as transcervical microwave ablation (TcMA), transcervical radiofrequency ablation (TcRfA), or selective embolization of the thyroid arteries (SETA).

Aptamer-Hytac Chimeras for Targeted Degradation of SARS-CoV-2 Spike-1.

The development of novel tools to tackle viral processes has become a central focus in global health, during the COVID-19 pandemic. The spike protein is currently one of the main SARS-CoV-2 targets, owing to its key roles in infectivity and virion formation. In this context, exploring innovative strategies to block the activity of essential factors of SARS-CoV-2, such as spike proteins, will strengthen the capacity to respond to current and future threats.

Corrigendum: Diagnostic and therapeutic management of the thoracic outlet syndrome. Review of the literature and report of an Italian experience.

[This corrects the article DOI: 10.3389/fcvm.2022.

Are Previous Joint Injuries Associated with Muscle Performance in Volleyball Athletes?

 The aim of the present study is to determine whether previous shoulder and knee injuries were associated with isokinetic fatigue index and agonist/antagonist ratio of shoulder internal/external rotators and knee flexors/extensors in male volleyball athletes.  The current study is a cross-sectional investigation of 49 male elite volleyball players competing at a high level in Brazil. Isokinetic fatigue index and agonist/antagonist profiles were assessed during the preseason.

Sarcopenia as a Predictor of Short- and Long-Term Outcomes in Patients Surgically Treated for Malignant Pleural Mesothelioma.

Surgery for malignant pleural mesothelioma (MPM) should be reserved only for patients who have a good performance status. Sarcopenia, a well-known predictor of poor outcomes after surgery, is still underinvestigated in MPM. The aim of this study is to evaluate the role of sarcopenia as a predictor of short-and long-term outcomes in patients surgically treated for MPM.

Tracheal resection and anastomosis for squamous cell carcinoma.

Tracheal malignant tumors are uncommon lesions. The rarity of this condition may generate uncertainties in the diagnosis and treatment. For this reason especially, the surgical treatment should be performed only in centers with a high expertise in tracheal surgery.

Case Report: Surgical Reconstruction of a Massive Thoracic Wall Defect After the Resection of an Undifferentiated Radiation-Induced Sarcoma of the Breast.

A 54-year-old lady was referred to our institute because of a massive thoracic neoplasm arising from the thoracic wall which infiltrated and dislocated the left breast. Twenty years before, the patient had undergone a quadrantectomy with axillary dissection for an infiltrating ductal carcinoma of the left breast, followed by adjuvant radiotherapy and chemotherapy. A true-cut biopsy of the mass showed a low differentiated malignant neoplasm with spindle-shaped cells.

Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: a propensity score matching study from the Italian VATS Group Registry.

Objectives: Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes.

Methods: We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups.

Computed Tomography and Spirometry Can Predict Unresectability in Malignant Pleural Mesothelioma.

Preoperative identification of unresectable pleural mesothelioma could spare unnecessary surgical intervention and accelerate the initiation of medical treatments. The aim of this study is to determine predictors of unresectability, testing our impression that the contraction of the ipsilateral hemithorax is often associated with exploratory thoracotomy. Between 1994 and 2020, 291 patients undergoing intended macroscopic complete resection for mesothelioma after chemotherapy were retrospectively investigated.

Sublingual Sufentanil in Pain Management After Pulmonary Resection: A Randomized Prospective Study.

Background: Successful postoperative pain management after major lung resection surgery is mostly achieved through intravenous administration of analgesic drugs. This study explored the use of sublingual sufentanil cartridges (Zalviso) as a noninvasive alternative to postoperative analgesia.

Methods: From July 2019 to April 2020, patients who underwent major thoracoscopic lung resection surgery were randomly allocated to receive either intravenous pain management, or patient-controlled analgesia by the Zalviso system.

Non-Small-Cell Lung Cancer: Real-World Cost Consequence Analysis.

Purpose: The present work aimed at conducting a real-world data analysis on the management costs and survival analysis comparing data from non-small-cell lung cancer (NSCLC) cases diagnosed in the Veneto region before (2015) and after (2017) the implementation of a regional diagnostic and therapeutic pathway including all new diagnostic and therapeutic strategies.

Method: This study considered 254 incidental cases of NSCLC in 2015 and 228 in 2017 within the territory of the Padua province (Italy), as recorded by the Veneto Cancer Registry. Tobit regression analysis was performed to verify if total and each item costs (2 years after NSCLC diagnosis) are associated with index year, adjusting by year of diagnosis, sex, age, and stage at diagnosis.

Relapse Patterns and Tailored Treatment Strategies for Malignant Pleural Mesothelioma Recurrence after Multimodality Therapy.

To date, there have been no established therapies for recurrent malignant pleural mesothelioma (MPM) after multimodality treatment. Aims of this retrospective study are to analyze the recurrence pattern, its treatment and to identify the predictors of best oncological outcomes for relapsed MPM, comparing extrapleural pneumonectomy (EPP) vs. pleurectomy/decortication (PD).

Video-assisted thoracoscopic lobectomy after neoadjuvant chemotherapy for non-small cell lung cancer: a multicenter propensity-matched study.

Background: The role of video-assisted thoracoscopic surgery for the treatment of non-small-cell lung cancer after neoadjuvant chemotherapy remains controversial. The aim of this study is to demonstrate the reliability of video-assisted lobectomy compared to the open approach by evaluating perioperative and long-term outcomes.

Methods: In this retrospective, multicentric study from January 2010 to December 2018, we included all patients with non-small-cell lung cancer who underwent lobectomy through the video-assisted or open approach after neoadjuvant chemotherapy.

Lobectomy With Artery Reconstruction and Pneumonectomy for Non-Small Cell Lung Cancer: A Propensity Score Weighting Study.

Background: The treatment of non-small cell lung cancer is based, when suitable, on surgical resection. Pneumonectomy has been considered the standard surgical procedure for locally advanced lung cancers but it is associated with high mortality and morbidity rates. Reconstruction of the pulmonary artery, associated with parenchyma-sparing techniques, is meant to be an alternative to pneumonectomy.

Multidisciplinary oncoplastic approach to chest wall reconstruction following wide resections. Report of three cases.

An advanced cancer or an infection process localized on chest wall often require large full thickness resection to obtain free margins and site sterilization. Superior skills and expertise can be provided by a multidisciplinary surgical team, overcoming technical difficulties otherwise insurmountable for a single specialist. Only a multidisciplinary approach, providing both skeletal reconstruction and soft tissue coverage, allows to restore chest wall functions and stable coverage of lung and viscera.

Video-assisted left lower lobectomy with intrapericardial pulmonary vein isolation.

The thoracoscopic approach to lobectomy is now the gold standard in cases of pulmonary malignancies because it is associated with a significant reduction in both  postoperative hospital stay and pain. Even in cases of complex resection, as in the case reported here, the procedure can be performed safely after careful pre-operative planning.  This video tutorial describes our technique for the intrapericardial isolation of the left inferior pulmonary vein in a patient affected by a left lower lobe metastasis from a colonic carcinoma.

VATS right basal segmentectomy for NSCLC in a patient with systemic sclerosis.

In recent decades, the thoracoscopic approach has been accepted as the gold standard to treat early stage non-small-cell lung cancer because it reduces postoperative pain and results in a shorter hospital stay. More recently, several techniques for performing sublobar resection have been reported that achieve a radical resection while sparing as much parenchyma as possible.  This video tutorial illustrates our technique for resecting the basal segments of the right lower lobe in a patient presenting with an adenocarcinoma in the right lower lobe.

Post-operative hypercoagulable whole blood profiles in patients undergoing open thoracotomy vs video-assisted thoracoscopic surgery.

Background: Patients undergoing video-assisted thoracoscopic surgery (VATS) have a lower risk of thrombosis compared to those undergoing open thoracotomy (OT) which may be due to several post-operative factors such as early mobilisation, shorter hospital stays, lower transfusion rates and lower risk of infections. Whether the higher thrombotic risk after OT is also linked to a peri-operative hypercoagulable state is a matter of debate. We therefore conducted a case-control study to compare peri-operative coagulation profiles in patients with primary lung cancer undergoing VATS vs OT.

Bronchus intermedius sleeve resection through a VATS approach.

In recent years, parenchymal sparing techniques for tumor resection have been developed in order to reduce the amount of lung parenchyma that must be removed in cases of centrally located tumors. These techniques maintain oncological radicality while reducing postoperative complications. At the same time, video-assisted thoracoscopic surgery (VATS) has been shown to offer comparable surgical and oncological outcomes to thoracotomy, even in complex cases that require tracheal and bronchial reconstructions.

Thrombotic risk following video-assisted thoracoscopic surgery versus open thoracotomy: a systematic review and meta-analysis.

Objectives: There is no consensus on the risk of thrombotic events following video-assisted thoracoscopic surgery (VATS) versus open thoracotomy (OT), despite multiple studies. In fact, the estimates for the overall thrombotic risk for VATS versus OT are inconclusive. In this systematic review and meta-analysis, we endeavoured to ascertain the best estimate of thrombotic risk in VATS versus OT.

Repair of Adult Benign Tracheoesophageal Fistulae With Absorbable Patches: Single-Center Experience.

Background: This group previously reported on the repair of a wide tracheoesophageal fistula with a bioabsorbable patch. The current study describes a consecutive series of patients operated on using the same technique.

Methods: Data of patients undergoing surgical closure of tracheoesophageal fistula at a single center from 2011 to 2018 were extracted and analyzed.

Postpneumonectomy bronchopleural fistula: analysis of risk factors and the role of bronchial stump coverage.

Purpose: Bronchopleural fistula (BPF) is a potentially fatal complication of pneumonectomy. We analyze its occurrence rate, risk factors, and the methods used for its prevention.

Methods: We reviewed the medical records of patients who underwent pneumonectomy at our Institution between January, 1990 and March, 2016.