Thoracic Surgery: Recent Developments and Future Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 25 May 2025 | Viewed by 308

Special Issue Editors


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Guest Editor
Department of Thoracic Surgery, AOU delle Marche, 60126 Ancona, Italy
Interests: minimally invasive thoracic surgery; ERAS; VATS; sublobar resetions; postoperative risk assessment

E-Mail Website
Guest Editor
Thoracic Surgery Unit, Ospedale del Mare Napoli, University of Perugia, Naples, Italy
Interests: minimally invasive thoracic surgery; ERAS; VATS; sublobar resetions; postoperative risk assessment

Special Issue Information

Dear Colleagues,

As already broadly reported, the role of minimally invasive thoracic surgery (VATS/RATS) has emerged, showing a great contribution in the early postoperative period after pulmonary resection for cancer.

Moreover, perioperative patient management based on personalized nodule localization, tailored surgical procedures (e.g., sublobar resections, sleeve resections, etc.) and more patient-centred standardized pathways of care (e.g., ERAS) are of primary importance to enhance perioperative course disputing the traditional standards of care. In this context, the new target therapies play a crucial rule in managing lung neoplasms before or after the surgical phase.

This Special Issue will highlight the recent developments and future challenges in the management of patients with lung cancer, analyzing how these modalities are substantially revolutioning patient care and improving outcomes in the battle against this disease.

The new advances in this field and the value of recent scientific achievements in assessing the current therapeutic horizon for lung cancer patients will also be covered in this Special Issue.

Dr. Marco Andolfi
Dr. Lucio Cagini
Guest Editors

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Keywords

  • VATS
  • RATS
  • ERAS
  • sublobar resection
  • minimally invasive thoracic surgery
  • target therapy
  • nodule localization

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Published Papers (1 paper)

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Research

13 pages, 1709 KiB  
Article
Unlocking the Potential of Computed Tomography-Guided Tracers in Pinpointing Lung Lesions during Surgery: A Collaborative Multi-Institutional Journey
by Rossella Potenza, Marco Andolfi, Andrea Dell’Amore, Marialuisa Lugaresi, Gabriella Roca, Leonardo Valentini, Chiara Catelli, Francesco Buia, Giampiero Dolci, Chiara Floridi, Riccardo Moretti, Claudia Colafigli, Majed Refai, Federico Rea, Francesco Puma and Niccolò Daddi
J. Clin. Med. 2024, 13(20), 6041; https://doi.org/10.3390/jcm13206041 - 10 Oct 2024
Abstract
Background: Multiple techniques exist for the preoperative localization of small, deeply located solid or subsolid pulmonary nodules to guide limited thoracoscopic resection. This study aims to conduct a multi-institutional comparison of three different tomography-guided tracers’ methods. Methods: A retrospective multicenter cross-sectional study was [...] Read more.
Background: Multiple techniques exist for the preoperative localization of small, deeply located solid or subsolid pulmonary nodules to guide limited thoracoscopic resection. This study aims to conduct a multi-institutional comparison of three different tomography-guided tracers’ methods. Methods: A retrospective multicenter cross-sectional study was conducted. All patients suitable for CT-guided tracers with microcoil (GROUP1, n = 58), hook wire (GROUP2, n = 86), or bioabsorbable hydrogel plug (GROUP3, n = 33) were scheduled for video-assisted thoracoscopic wedge resection. Outcome variables: successful nodule localization, safety, and the feasibility of the tracers’ placement. A χ2 test or Fisher’s test for expected numbers less than five and a Kruskal–Wallis test were used to analyze the categorical and continuous variables, respectively. For the power calculations, we used G*Power version 3.1.9.6. Results: One hundred seventy-seven patients underwent the localization and resection of 177 nodules detected with three different CT-guided tracers. A significant difference was recorded for cancer history (p = 0.030), respiratory function, Charlson comorbidity index (p = 0.018), lesion type (p < 0.0001), distance from pleura surface (p < 0.0001), and time between preoperative CT-guided tracers and surgical procedures (p < 0.0001). Four post-procedural complications were recorded and in GROUP2, four cases of tracer dislocations occurred. Finally, hook wire group was associated with the shortest surgical time (93 min, p = 0.001). Conclusions: All methods were feasible and efficient, resulting in a 100% success rate for the microcoils and the bioabsorbable hydrogel plugs and a 94.2% success rate for the hook wires. Our results highlight the need to choose a technique that is less stressful for the patient and helps the surgeon by extending the approach to deep nodules and resecting over the course of several days from deployment. Full article
(This article belongs to the Special Issue Thoracic Surgery: Recent Developments and Future Challenges)
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