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Perioperative Management in Thoracic Surgery
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Perioperative Management in Thoracic Surgery

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

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 1083

Special Issue Editor

Dr. Paraskevas Lyberis

E-Mail Website
Guest Editor
Department of Cardiovascular and Thoracic Surgery, ‘Città della Salute e della Scienza di Torino’ Hospital, 10126 Torino, Italy
Interests: thoracic surgery; thoracic oncology; minimally invasive thoracic surgery; pulmonary infections surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Effective perioperative management plays a crucial role in enhancing patient outcomes and minimizing complications in thoracic surgery. This Special Issue is dedicated to exploring the latest advancements and approaches in perioperative care for patients undergoing thoracic surgical procedures. We welcome contributions on a variety of topics, ranging from preoperative assessments and surgical readiness to comprehensive postoperative care, with a special focus on the management of pain. This Special Issue aims to spotlight innovative practices that incorporate state-of-the-art technologies, new pharmacological treatments, and collaborative efforts across multiple disciplines. Our objective is to provide insights into evidence-based techniques and the latest trends that enhance safety, improve operational efficiency, and increase patient satisfaction in the realm of thoracic surgery.

Dr. Paraskevas Lyberis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • thoracic surgery
  • perioperative care
  • preoperative assessment
  • postoperative management
  • pain management
  • surgical outcomes
  • multidisciplinary approach
  • pharmacological innovations
  • patient safety
  • technology in surgery

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Published Papers (2 papers)

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Research

13 pages, 1571 KiB  
Article
Circulating Tumor Cells from Surgical Manipulation Predict Recurrence and Poor Prognosis in Non-Small Cell Lung Cancer
by Akikazu Kawase, Keigo Sekihara, Noriyuki Matsutani, Masafumi Yamaguchi, Yujin Kudo, Makoto Endo, Tetsukan Woo, Yuichi Saito and Noriyoshi Sawabata
J. Clin. Med. 2025, 14(6), 2070; https://doi.org/10.3390/jcm14062070 - 18 Mar 2025
Viewed by 377
Abstract
Background/Objectives: In our previous multicenter prospective controlled study (UMIN000018602), we investigated the impact of surgical manipulation on circulating tumor cells (CTCs) in patients with non-small cell lung cancer (NSCLC). CTCs were detected after surgery in four patients (4/29, 13.8%), although CTCs were not [...] Read more.
Background/Objectives: In our previous multicenter prospective controlled study (UMIN000018602), we investigated the impact of surgical manipulation on circulating tumor cells (CTCs) in patients with non-small cell lung cancer (NSCLC). CTCs were detected after surgery in four patients (4/29, 13.8%), although CTCs were not present before surgery. These four patients had tumor cells leaked into their bloodstream by surgeons’ manipulation. We aimed to clarify long-term outcomes according to the presence of CTCs. Methods: Patients with cT1b-2N0M0 NSCLC scheduled for lobectomy were enrolled, based on the selection criteria of a consolidation-to-ground-glass opacity ratio (over 50%). Peripheral blood samples (≥3 mL) were collected before surgery (for pre-CTCs), during surgery, and immediately after pulmonary vein dissection (for post-CTCs). CTCs were isolated from these samples using ScreenCell®’s size-selective method. Results: From July 2015 to January 2016, 29 patients were enrolled, yielding paired pre- and post-CTC samples for all patients. Thirteen patients were pre-CTC positive, and post-CTCs were detected in 17 patients. Survival analysis revealed a statistically significant difference in recurrence-free survival between patients with and without post-CTCs (p = 0.043), while pre-CTCs status had no significant impact on recurrence (p = 0.226). Patients with post-CTCs had a significantly higher recurrence rate than those without (p = 0.043). Half of patients with post-CTCs but without pre-CTCs had recurrence within 5 years after surgery. Conclusions: Post-CTCs emerged as a significant predictor of recurrence following lobectomy; however, it could be possible for thoracic surgeons to prevent recurrence by improving surgical techniques for NSCLC patients with post-CTCs but without pre-CTCs. Full article
(This article belongs to the Special Issue Perioperative Management in Thoracic Surgery)
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11 pages, 1825 KiB  
Article
Prospective Randomized Comparison of Opioid-Based Versus Non-Opioid-Based Anaesthetic Protocols for Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA)
by Anna Szelka-Urbanczyk, Maja Copik, Hanna Misiolek, Ewa Olewnicka, Maria Mirek and Szymon Białka
J. Clin. Med. 2025, 14(6), 1964; https://doi.org/10.3390/jcm14061964 - 14 Mar 2025
Viewed by 404
Abstract
Background: The evolution of interventional pulmonology has necessitated the refinement of anesthetic techniques to ensure the safety and efficacy of procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), particularly when performed outside the conventional operating room setting. The management of anesthesia in [...] Read more.
Background: The evolution of interventional pulmonology has necessitated the refinement of anesthetic techniques to ensure the safety and efficacy of procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), particularly when performed outside the conventional operating room setting. The management of anesthesia in patients with significant comorbidities, classified as American Society of Anesthesiologists (ASA) class III, presents distinct challenges. In this context, the transtracheal block emerges as a viable alternative to total intravenous anesthesia (TIVA) for these high-risk procedures. Objectives: This study aims to evaluate the comparative safety and efficacy of opioid-based intravenous analgesia versus a regimen combining sedative agents with transtracheal block in the administration of anesthesia for EBUS TBNA in high-risk patients. Design: We conducted a randomized observational study involving 57 elective EBUS-TBNA patients classified as ASA class III. Methods: Participants were allocated into two cohorts: one receiving intravenous opioid analgesia and the other receiving a combination of sedative agents with transtracheal block. Collected data encompassed patient demographics, medical history, incidence of adverse events during anesthesia, indicators of sympathetic nervous system activation, patient satisfaction levels, and the procedural conditions as assessed by the operator. Results: Opioid anesthesia was associated with increased desaturation (95.7% vs. 60.6%; p < 0.05) and higher pain-related sympathetic responses (VAS and SCI at 40–100; p < 0.05). No differences in other adverse events, patient satisfaction, or procedural conditions were noted. Conclusions: In summary, the study indicates that transtracheal block combined with sedatives may be a safer anesthetic alternative to opioid-based regimens for high-risk EBUS-TBNA patients, reducing desaturation and pain-related sympathetic activity without affecting satisfaction or procedural efficacy. Full article
(This article belongs to the Special Issue Perioperative Management in Thoracic Surgery)
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