Perioperative Outcomes After Combined Esophagectomy and Lung Resection

2022 ◽  
Vol 270 ◽  
pp. 413-420
Author(s):  
Deven C. Patel ◽  
Prasha Bhandari ◽  
Joseph B. Shrager ◽  
Mark F. Berry ◽  
Leah M. Backhus ◽  
...  
Keyword(s):  
Lung Resection ◽  
Perioperative Outcomes

Navigating the Pathway to Robotic Competency in General Thoracic Surgery

2013 ◽  
Vol 8 (3) ◽  
pp. 184-189 ◽  
Author(s):  
Christopher W. Seder ◽  
Stephen D. Cassivi ◽  
Dennis A. Wigle
Keyword(s):  
Robotic Surgery ◽  
Thoracic Surgery ◽  
Skill Acquisition ◽  
Perioperative Complications ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Robot Assisted ◽  
Robotic Skills ◽  
Competency Based

Objective Although robotic technology has addressed many of the limitations of traditional videoscopic surgery, robotic surgery has not gained widespread acceptance in the general thoracic community. We report our initial robotic surgery experience and propose a structured, competency-based pathway for the development of robotic skills. Methods Between December 2008 and February 2012, a total of 79 robot-assisted pulmonary, mediastinal, benign esophageal, or diaphragmatic procedures were performed. Data on patient characteristics and perioperative outcomes were retrospectively collected and analyzed. During the study period, one surgeon and three residents participated in a triphasic, competency-based pathway designed to teach robotic skills. The pathway consisted of individual preclinical learning followed by mentored preclinical exercises and progressive clinical responsibility. Results The robot-assisted procedures performed included lung resection (n = 38), mediastinal mass resection (n = 19), hiatal or para-esophageal hernia repair (n = 12), and Heller myotomy (n = 7), among others (n = 3). There were no perioperative mortalities, with a 20% complication rate and a 3% readmission rate. Conversion to a thoracoscopic or open approach was required in eight pulmonary resections to facilitate dissection (six) or to control hemorrhage (two). Fewer major perioperative complications were observed in the later half of the experience. All residents who participated in the thoracic surgery robotic pathway perform robot-assisted procedures as part of their clinical practice. Conclusions Robot-assisted thoracic surgery can be safely learned when skill acquisition is guided by a structured, competency-based pathway.

Perioperative Outcomes after Lung Resection in Obese Patients

2014 ◽  
Vol 63 (07) ◽  
pp. 544-550 ◽  
Author(s):  
Weston Andrews ◽  
Nonso Osakwe ◽  
Jeffrey Port ◽  
Paul Lee ◽  
Brendon Stiles ◽  
...  
Keyword(s):  
Lung Resection ◽  
Perioperative Outcomes ◽  
Obese Patients

Perioperative outcomes of thoracoscopic lung resection requiring a long operative time

2018 ◽  
Vol 28 (3) ◽  
pp. 380-386
Author(s):  
Shohei Mori ◽  
Yuki Noda ◽  
Yo Tsukamoto ◽  
Takamasa Shibazaki ◽  
Hisatoshi Asano ◽  
...  
Keyword(s):  
Operative Time ◽  
Lung Resection ◽  
Perioperative Outcomes

scholarly journals Conversion from video-assisted thoracic surgery (VATS) to thoracotomy during major lung resection: how does it affect perioperative outcomes?

2020 ◽  
Vol 32 (1) ◽  
pp. 55-63
Author(s):  
Joseph Seitlinger ◽  
Anne Olland ◽  
Sophie Guinard ◽  
Gilbert Massard ◽  
Pierre-Emmanuel Falcoz
Keyword(s):  
Risk Factors ◽  
Thoracic Surgery ◽  
Conversion Rate ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
High Risk Population ◽  
Technical Failure ◽  
Perioperative Mortality ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Abstract OBJECTIVES Since video-assisted thoracic surgery (VATS) was first performed in the early 1990s, there have been many developments, and the conversion rate has decreased over the years. This article highlights the specific outcomes of patients undergoing conversion to thoracotomy despite initially scheduled VATS lung resection. METHODS We retrospectively reviewed 501 patients who underwent thoracoscopic anatomic lung resection (i.e. lobectomy, segmentectomy or bilobectomy) between 1 January 2012 and 1 August 2017 at our institution. We explored the risk factors for surgical conversion and adverse events occurring in patients who underwent conversion to thoracotomy. RESULTS A total of 44/501 patients underwent conversion during the procedure (global rate: 8.8%). The main reasons for conversion were (i) anatomical variation, adhesions or unexpected tumour extension (37%), followed by (ii) vascular causes (30%) and (iii) unexpected lymph node invasion (20%). The least common reason for conversion was technical failure (13%). We could not identify any specific risk factors for conversion. The global complication rate was significantly higher in converted patients (40.9%) than in complete VATS patients (16.8%) (P = 0.001). Postoperative atrial fibrillation was a major complication in converted patients (18.2%) [odds ratio (OR) 5.09, 95% confidence interval (CI) 1.80–13.27; P = 0.001]. Perioperative mortality was higher in the conversion group (6.8%) than in the VATS group (0.2%) (OR 33.3, 95% CI 3.4–328; P = 0.003). CONCLUSIONS Through the years, the global conversion rate has dramatically decreased to <10%. Nevertheless, patients who undergo conversion represent a high-risk population in terms of complications (40.9% vs 16.8%) and perioperative mortality (6.8% vs 0.2%).

scholarly journals Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

2020 ◽  
Author(s):  
Yungang Sun ◽  
Feng Shao ◽  
Qiang Zhang ◽  
Zhao Wang
Keyword(s):  
Lung Resection ◽  
Pulmonary Sequestration ◽  
Perioperative Period ◽  
Massive Hemorrhage ◽  
Perioperative Outcomes ◽  
Invasive Technique ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Aberrant Artery ◽  
The Mean

Abstract Background Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration. Methods A total of 24 patients with PS including fifteen males and nine females with the mean age of 40 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Related clinical data were retrieved from hospital records and analyzed. Results All 24 patients had been treated with the UAVTS approach successfully without aberrant artery ruptured or massive hemorrhage, and no patients died during the perioperative period. Overall median surgery time was 102 mins (range, 55-150mins), the mean blood loss was 94 ml (range, 10-300ml), the mean days of chest tube maintained were 4 days (range,1-10days), and the mean postoperative hospitalization days was 6 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, associated with PS, occurring during the average follow-up of 17 months (range, 3-35months). Conclusions Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

scholarly journals Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

2020 ◽  
Author(s):  
Yungang Sun ◽  
Feng Shao ◽  
Qiang Zhang ◽  
Zhao Wang
Keyword(s):  
Lung Resection ◽  
Pulmonary Sequestration ◽  
Perioperative Period ◽  
Massive Hemorrhage ◽  
Perioperative Outcomes ◽  
Invasive Technique ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Aberrant Artery ◽  
The Mean

Abstract Background: Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration. Methods: A total of 24 patients with PS including fifteen males and nine females with the mean age of 40 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Related clinical data were retrieved from hospital records and analyzed. Results: All 24 patients had been treated with the UAVTS approach successfully without aberrant artery ruptured or massive hemorrhage, and no patients died during the perioperative period. Overall median surgery time was 102 mins (range, 55-150mins), the mean blood loss was 94 ml (range, 10-300ml), the mean days of chest tube maintained were 4 days (range,1-10days), and the mean postoperative hospitalization days was 6 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, associated with PS, occurring during the average follow-up of 17 months (range, 3-35months). Conclusions: Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

scholarly journals Robotic Surgery for Non-Small Cell Lung Cancer Treatment in High-Risk Patients

2021 ◽  
Vol 10 (19) ◽  
pp. 4408
Author(s):  
Carmelina Cristina Zirafa ◽  
Gaetano Romano ◽  
Elisa Sicolo ◽  
Claudia Cariello ◽  
Riccardo Morganti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Robotic Surgery ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
Robotic Assisted ◽  
High Risk Patients ◽  
Operative Complications ◽  
Risk Patients ◽  
Post Operative Complications

Robotic-assisted pulmonary resection has greatly increased over the last few years, yet data on the application of robotic surgery in high-risk patients are still lacking. The objective of this study is to evaluate the perioperative outcomes in ASA III-IV patients who underwent robotic-assisted lung resection for NSCLC. Between January 2010 and December 2017, we retrospectively collected the data of 148 high-risk patients who underwent lung resection for NSCLC via a robotic approach at our institution. For this study, the prediction of operative risk was based on the ASA-PS score, considering patients in ASA III and IV classes as high-risk patients: of the 148 high-risk patients identified, 146 patients were classified as ASA III (44.8%) and two as ASA IV (0.2%). Possible prognostic factors were also analysed. The average hospital stay was 6 days (8–30). Post-operative complications were observed in 87 (58.8%) patients. Patients with moderate/severe COPD developed in 33 (80.5%) cases post-operative complications, while elderly patients in 25 (55%) cases, with a greater incidence of high-grade complications. No difference was observed when comparing the data of obese and non-obese patients. Robotic surgery appears to be associated with satisfying post-operative results in ASA III-IV patients. Both marginal respiratory function and advanced age represent negative prognostic factors. Due to its safety and efficacy, robotic surgery can be considered the treatment of choice in high-risk patients.

scholarly journals Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

2019 ◽  
Author(s):  
Yungang Sun ◽  
Feng Shao ◽  
Qiang Zhang ◽  
Zhao Wang
Keyword(s):  
Lung Resection ◽  
Pulmonary Sequestration ◽  
Perioperative Period ◽  
Massive Hemorrhage ◽  
Perioperative Outcomes ◽  
Invasive Technique ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Aberrant Artery ◽  
The Mean

Abstract Background Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration.Methods A total of 24 patients with PS including fifteen males and nine females with the mean age of 40.54±14.49 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Referring clinical data were retrieved from hospital records and analyzed.Results All 24 patients had been treated with the UAVTS approach successfully with no aberrant artery ruptured and no massive hemorrhage occurred, and no patients died during the perioperative period. Overall median surgery time was 102.21 ±28.00 mins (range, 55-150mins), the mean blood loss was 94.17±78.90 ml (range, 10-300ml), the mean days of chest tube maintained were 4.21±2.21 days (range,1-10days), and the mean postoperative hospitalization days was 5.79 ±2.35 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, occurring during the average follow-up of 17.42 ±2.00 months (range, 3-35months).Conclusions Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

scholarly journals Lung Cancer Surgery after Treatment with Anti-PD1/PD-L1 Immunotherapy for Non-Small-Cell Lung Cancer: A Case—Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4915
Author(s):  
Kinan El Husseini ◽  
Nicolas Piton ◽  
Marielle De Marchi ◽  
Antoine Grégoire ◽  
Roman Vion ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lung Resection ◽  
Operating Time ◽  
Small Cell ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Preoperative Treatment ◽  
Small Cell Lung

Background: Immune checkpoint inhibitors (ICIs) are the standard of care for non-resectable non-small-cell lung cancer and are under investigation for resectable disease. Some authors have reported difficulties during lung surgery following ICI treatment. This retrospective study investigated the perioperative outcomes of lung resection in patients with preoperative ICI. Methods: Patients with major lung resection after receiving ICIs were included as cases and were compared to patients who received preoperative chemotherapy without ICI. Surgical, clinical, and imaging data were collected. Results: A total of 25 patients were included in the ICI group, and 34 were included in the control group. The ICI patients received five (2–18) infusions of ICI (80% with pembrolizumab). Indications for surgery varied widely across groups (p < 0.01). Major pathological response was achieved in 44% of ICI patients and 23.5% of the control group (p = 0.049). Surgery reports showed a higher rate of tissue fibrosis/inflammation in the ICI group (p < 0.01), mostly in centrally located tumours (7/13, 53.8% vs. 3/11, 27.3% of distal tumours, p = 0.24), with no difference in operating time (p = 0.81) nor more conversions (p = 0.46) or perioperative complications (p = 0.94). There was no 90-day mortality. Disease-free survival was higher in the ICI group (HR = 0.30 (0.13–0.71), p = 0.02). Conclusions: This study further supports the safety and feasibility of lung resection in patients following preoperative treatment with ICI.

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