scholarly journals One Stage Minimally Invasive Thoracoscopic Lung Resection and Transphrenic Adrenalectomy

2020 ◽  
pp. 1-3
Author(s):  
Patrick  Bagan ◽  
Patrick  Bagan ◽  
Bassel Dakhil ◽  
Rym Zaimi ◽  
Mahine Kashi-Dakhil
Keyword(s):  
Postoperative Morbidity ◽  
Single Incision ◽  
Lung Resection ◽  
Small Cell ◽  
Adrenal Metastasis ◽  
Small Cell Lung ◽  
Term Survival ◽  
Vessel Closure ◽  
Solitary Adrenal Metastasis

Surgery may offer a long-term survival benefit to a small proportion of patients with operable non-small cell lung cancer (NSCLC) and solitary adrenal metastasis. Several approaches to lung resection with a separate open or laparoscopic adrenalectomy have been advocated. We present a technique that allows a single incision, single operation through a transdiaphragmatic approach to the ipsilateral adrenal gland following lung resection through a video assisted thoracic surgery (VATS) approach. By using this approach, along with an advanced bipolar device to aid adrenal dissection and clip-less vessel closure, both lobectomy and adrenalectomy can be carried out safely and effectively with minimal perioperative and postoperative morbidity.

Safety and Feasibility of Thoracoscopic Lung Resection for Non-Small-Cell Lung Cancer in Octogenarians

2020 ◽  
pp. 155698452097162
Author(s):  
Xiaoying Lou ◽  
Andrew Sanders ◽  
Kaustubh Wagh ◽  
Jose N. Binongo ◽  
Manu Sancheti ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cox Regression ◽  
Lung Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Preoperative Risk ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis

Objective Octogenarians comprise an increasing proportion of patients presenting with non-small-cell lung cancer (NSCLC). This study examines postoperative morbidity and mortality, and long-term survival in octogenarians undergoing thoracoscopic anatomic lung resection for NSCLC, compared with younger cohorts. Methods We conducted a retrospective review of our institutional Society of Thoracic Surgeons General Thoracic Surgery Database of all patients ≥60 years old undergoing elective lobectomy or segmentectomy for pathologic stage I, II, and IIIA NSCLC between 2009 and 2018. Results were compared between octogenarians ( n = 71) to 2 younger cohorts of 60- to 69-year-olds ( n = 359) and 70- to 79-year-olds ( n = 308). Long-term survival among octogenarians was graphically summarized using the Kaplan–Meier method. Cox regression analysis was used to identify preoperative risk factors for mortality. Results A greater proportion of octogenarians required intensive care unit admission and discharge to extended-care facilities; however, postoperative length of stay was similar between groups. Among postoperative complications, arrhythmia and renal failure were more likely in the older cohort. Compared to the youngest cohort, in-hospital and 30-day mortality were highest among octogenarians. Overall survival among octogenarians at 1, 3, and 5 years was 87.3%, 61.8%, and 50.5%, respectively. On multivariable Cox regression analysis of baseline demographic variables, presence of stroke (hazard ratio [HR] = 28.5, 95% confidence interval [CI]: 6.1 to 132.7, P < 0.001) and coronary artery disease (HR = 2.5, 95% CI: 1.2 to 5.3, P = 0.02) were significant predictors of overall mortality among octogenarians. Conclusions Thoracoscopic resection can be performed with favorable early postoperative outcomes among octogenarians. Long-term survival, although comparable to their healthy peers, is worse than those of younger cohorts. Further study into preoperative risk stratification and alternative therapies among octogenarians is needed.

scholarly journals Long-term survival of adrenal metastasis from non-small cell lung cancer

2012 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Akihiko Iwase ◽  
Emi Onuma ◽  
Osamu Nagashima ◽  
Toshifumi Yae ◽  
Makiko Kunogi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Adrenal Metastasis ◽  
Small Cell Lung ◽  
Term Survival ◽  
Long Term Survival

Impact of Video-Assisted Thoracoscopic Major Lung Resection on Immune Function

2009 ◽  
Vol 17 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Calvin SH Ng ◽  
Innes YP Wan ◽  
Anthony PC Yim
Keyword(s):  
Early Stage ◽  
Small Cell Lung Carcinoma ◽  
Lung Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Term Survival ◽  
Cell Lung Carcinoma ◽  
Long Term Survival ◽  
Video Assisted

Video-assisted thoracoscopic major lung resection for early stage non-small-cell lung carcinoma has been associated with less postoperative pain, better preserved pulmonary function, shorter hospital stay, and enhanced tolerance of adjuvant chemotherapy compared to thoracotomy. Initial concerns regarding safety, oncological clearance, and cost effectiveness were unfounded. Several recent trials have reported improved long-term survival in patients with early stage non-small-cell lung carcinoma undergoing video-assisted thoracoscopic major lung resection, compared to the open technique, although there are inconsistencies. Interestingly, the immune status and autologous tumor killing ability of lung cancer patients have previously been associated with long-term survival. Video-assisted thoracoscopic lung resection results in an attenuated postoperative inflammatory response, but more importantly, it better preserves postoperative immune function. Circulating natural killer and T-cell numbers, T-cell oxidative activity, and levels of immunochemokines such as insulin growth factor binding protein-3 are higher after video-assisted thoracoscopic surgery than after thoracotomy. Recently, interest has developed in the role of the angiogenesis factor, vascular endothelial growth factor, after cancer surgery. Whether differences in immunological and biochemical mediators contribute towards improved long-term survival following video-assisted thoracoscopic major lung resection for cancer remains to be confirmed.

scholarly journals Metastasectomy of Solitary Adrenal Metastasis From Small Cell Lung Cancer

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774090
Author(s):  
Dat Cao Pham ◽  
Ziad Awad ◽  
Bradford S. Hoppe ◽  
Jason Hew ◽  
Ke Ning
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Cranial Irradiation ◽  
Small Cell ◽  
Adrenal Metastasis ◽  
Small Cell Lung ◽  
Term Survival ◽  
Extensive Stage ◽  
Solitary Adrenal Metastasis

Most extensive-stage small cell lung cancers have disseminated disease at diagnosis, and solitary adrenal metastasis from small cell lung cancer is rare. We report the case of a 51-year-old man with extensive-stage small cell lung cancer with solitary right adrenal metastasis (T2N0M1), who was cured with resection of primary tumor, chemotherapy (cisplatin, etoposide), adrenalectomy, consolidative thoracic radiotherapy, and prophylactic cranial irradiation. He remained cancer free, 7.5 years since diagnosis. For small cell lung cancer with solitary adrenal gland metastasis, metastasectomy combined with chemotherapy and radiotherapy can be curative and enable long-term survival. This treatment approach should be further studied, and similar cases should be reported.

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