Clinical Outcome and Risk Factors for Thoracic Surgery

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

Deadline for manuscript submissions: 24 January 2025 | Viewed by 1190

Special Issue Editors


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Guest Editor
Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health—DSCTV, University of Padova, 35122 Padova, Italy
Interests: heart transplantation; lung transplantation; heart and lung transplantation; pulmonary artery hypertension; pulmonary thromboendarterectomy; ECMO; cardiac assistance devices; tracheal surgery; robotic surgery; minimally invasive cardiothoracic surgery
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Guest Editor
Thoracic Surgery Department, University and Hospital Trust, Borgo Trento, P.le A. Stefani, 1, 37126 Verona, Italy
Interests: minimally invasive surgery; robotic surgery; immunotherapy; lung cancer; ERAS; postoperative in thoracic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Journal of Clinical Medicine (JCM) is now introducing a Special Issue series that will update our clinical and scientific community on the recent advances in pulmonary medicine. Thoracic surgery has undergone notable changes in recent years. First, the advent of minimally invasive thoracoscopic and robotic surgery techniques revolutionized our surgical practice and had a great impact on both perioperative and long-term results. At the same time, minimal invasiveness has become not only surgical but also the pre-operative and post-operative treatment of patients has changed. Just think of the worldwide implementation of ERAS protocols. We have then entered the era of screening programs for lung cancer, which is bringing excellent results and allows us to send more and more patients to the surgical table with initial lesions and therefore with excellent treatment prospects. In addition to surgery, oncology is also changing; targeted therapies and immunotherapy are revolutionizing the treatment of lung cancer and also our clinical and surgical practice.

To obtain the maximum effect in minimally invasive surgery and to operate on patients undergoing neoadjuvant therapies, especially immunotherapy, correct stratification of surgical risk is essential for us as surgeons. This last aspect today requires a careful multidisciplinary evaluation aimed at evaluating all the respiratory, cardiological, anesthesiologic, internal, rehabilitation, and nutritional aspects that we know significantly influence the post-operative course of our patients.

Finally, the careful evaluation of the long-term results will help us to correctly understand the role of minimally invasive surgery, such as anatomical sublobar pulmonary resections, robotic surgery, hybrid surgery techniques, and thoracic surgery, in immunotreated or subjected patients to targeted therapies and how to obtain the maximum effect in terms of survival by combining surgery with these therapies.

To answer these important questions and promote future research, we sincerely welcome your submissions to this Special Issue of the JCM.

Prof. Dr. Andrea Dell’Amore
Dr. Alessio Campisi
Guest Editors

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Keywords

  • thoracic surgery
  • ERAS
  • lung diseases
  • lung cancer
  • pulmonary rehabilitation
  • pharmacological treatments and clinical trials
  • immunotherapy
  • minimally invasive surgery
  • postoperative complication
  • pulmonary function
  • preoperative evaluation

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Published Papers (1 paper)

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Research

10 pages, 471 KiB  
Article
Thoracic Ultrasound as an Alternative to Chest X-ray in Thoracic Surgery Patients: A Single-Center Experience
by Luigi Lione, Alberto Busetto, Vincenzo Verzeletti, Giorgio Cannone, Alessandro Bonis, Alessandro Berni, Daniele Gasparini, Marco Mammana, Alessandro Rebusso, Samuele Nicotra, Dario Gregori, Andrea Dell’Amore and Federico Rea
J. Clin. Med. 2024, 13(13), 3663; https://doi.org/10.3390/jcm13133663 - 23 Jun 2024
Viewed by 987
Abstract
Background/Objectives: Chest X-ray (CXR) is currently the most used investigation for clinical follow-up after major noncardiac thoracic surgery. This study explores the use of lung ultrasound (LUS) as an alternative to CXR in the postoperative management of patients who undergo major thoracic [...] Read more.
Background/Objectives: Chest X-ray (CXR) is currently the most used investigation for clinical follow-up after major noncardiac thoracic surgery. This study explores the use of lung ultrasound (LUS) as an alternative to CXR in the postoperative management of patients who undergo major thoracic procedures. Methods: The patients in our cohort were monitored with both a CXR and a lung ultrasonography after surgery and the day after chest drain removal. The LUS was performed by a member of the medical staff of our unit who was blinded to both the images and the radiologist’s report of the CXR. Findings were compared between the two methods. Results: In the immediate postoperative evaluation, 280 patients were compared, finding general agreement between the two procedures at 84% (kappa statistic, 0.603). The LUS showed a sensibility of 84.1%, a specificity of 84.3%, a positive predictive value (PPV) of 60.9%, and a negative predictive value (NPV) of 94.8%. We evaluated 219 out of 280 patients in the postdrainage-removal setting due to technical issues. Concordance between the methods in the postdrainage-removal setting was 89% (kappa statistic, 0.761) with the LUS demonstrating an 82.2% sensibility, a 93.2% specificity, a PPV of 85.7%, and an NPV of 91.3%. Conclusions: The results of this study showed a substantial agreement between LUS and CXR, suggesting that the LUS could reduce the number of X rays in certain conditions. The high NPV allows for the exclusion of PNX and pleural effusion without the need to expose patients to radiation. Discrepancies were noted in cases of mild pneumothorax or modest pleural effusion, without altering the clinical approach. Full article
(This article belongs to the Special Issue Clinical Outcome and Risk Factors for Thoracic Surgery)
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