Lung resection is associated with significant perioperative morbidity, and a proportion of patients will require intensive care following surgery. We set out to characterise this population, assess their burden of disease and investigate the influence of anaesthetic and surgical techniques on their admission rate. Over a two-year period, 1169 patients underwent surgery, with 30 patients (2.6%) requiring unplanned intensive care. Patients requiring support had a higher mortality (0.2% vs 26.7%, p < 0.001). Logistic regression (following adjustment for Thoracoscore) revealed that an open surgical approach was associated with higher likelihood of admission (p = 0.025, odds ratio = 5.25). There was also a trend towards increased likelihood of admission in patients who received volatile anaesthesia (p = 0.061, odds ratio = 2.08). This topic has been selected for further investigation as part of the 2015 Association of Cardiothoracic Anaesthetists (ACTA) second national collaborative audit, with this study providing pilot data before a multi-centre study.
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http://dx.doi.org/10.1111/anae.13267 | DOI Listing |
Clin Lung Cancer
January 2025
Thoracic Surgery Unit, IRCCS National Cancer Institute Regina Elena, Rome, Italy.
Introduction: To analyze the impact of Kirsten-Rat-Sarcoma Virus (KRAS) mutations on tumor-growth as estimated by tumor-doubling-time (TDT) among solid-dominant clinical-stage I lung adenocarcinoma. Moreover, to evaluate the prognostic role of KRAS mutations, TDT and their combination in completely-resected pathologic-stage I adenocarcinomas.
Methods: In this single-center retrospective analysis, completely resected clinical-stage I adenocarcinomas presenting as solid-dominant nodules (consolidation-to-tumor ratio > 0.
J Clin Med
January 2025
Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy.
Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS.
View Article and Find Full Text PDFJ Clin Med
January 2025
Translational Research Unit, Hospital Universitario Miguel Servet, IIS Aragón, 50009 Zaragoza, Spain.
Lung cancer is the primary cause of cancer-related deaths. Most patients are typically diagnosed at advanced stages. Low-dose computed tomography (LDCT) has been proven to reduce lung cancer mortality, but screening programs using LDCT are associated with a high number of false positives and unnecessary thoracotomies.
View Article and Find Full Text PDFMedicina (Kaunas)
December 2024
Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon 35365, Republic of Korea.
: Video-assisted thoracoscopic surgery (VATS) is associated with less postoperative pain than traditional open thoracotomy. However, trocar and chest tube placement may damage the intercostal nerves, causing significant discomfort. An ultrasound-guided serratus anterior plane block (SAPB) is a promising mode of pain management; this reduces the need for opioids and the associated side-effects.
View Article and Find Full Text PDFCancers (Basel)
January 2025
Division of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.
Tumors located at the tracheal bifurcation constitute a heterogeneous group of neoplasms whose treatment poses significant challenges due to their anatomical location, the requirement for radical resection, the need to restore local anatomy, and the necessity of maintaining adequate oxygenation throughout the entire procedure. Advances in airway reconstruction surgical techniques, anesthesia, and complementary therapies have progressively expanded indications for radical treatment of these neoplasms, resulting in significant improvements in both short- and long-term outcomes in recent years.
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