scholarly journals Surgeon Knowledge of the Pulmonary Arterial System and Surgical Plan Confidence Is Improved by Interactive Virtual 3D-CT Models of Lung Cancer Patient Anatomies

2021 ◽  
Vol 8 ◽  
Author(s):  
Kunal Bhakhri ◽  
Eoin R. Hyde ◽  
Sze M. Mak ◽  
Lorenz U. Berger ◽  
Sebastien Ourselin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Video Recording ◽  
Arterial System ◽  
3D Ct ◽  
Anatomical Structures ◽  
Segmental Artery ◽  
Robotic Assisted ◽  
Pulmonary Arterial ◽  
The Impact

Objective: Interactive three-dimensional virtual models of pulmonary structures (3D-CT) may improve the safety and accuracy of robotic-assisted thoracic surgery (RATS). The aim of this study was to evaluate the impact of 3D-CT models as an imaging adjunct on surgical confidence and anatomical assessment for lobectomy planning.Methods: We retrospectively analyzed the response of 10 specialist thoracic surgeons who each reviewed 10 pre-operative images of patients undergoing robotic-assisted lobectomy lung cancer cases from June to November 2018 in our institute, resulting in 100 data points. The number of arteries, veins, and bronchi entering the resected lobes were determined from the operation video recording by the operating surgeon. 3D-CT models were generated for each case and made available for online visualization and manipulation. Thoracic surgeons were invited to participate in the survey which consisted of evaluation of CT (control) and 3D-CT (intervention) models. A questionnaire regarding anatomical structures, surgical approach, and confidence was administered.Results: Ten participants were recruited. 3D-CT models led to a significant (p < 0.003) increase in the surgeons' ability to correctly identifying pulmonary arteries entering the resection lobes in 35% (CT) and 57% (3D-CT) of cases. A significant (p < 1e-13) improvement in anatomy assessment and surgical plan confidence was observed for the 3D-CT arm, with median Likert scale scores of “2–Slightly easy” (CT) and “4–Very easy” (3D-CT).Conclusion: The use of 3D-CT models for thoracic surgery planning increases the surgeon confidence in recognizing anatomical structures, largely by enhanced appreciation of anatomical variations in the segmental pulmonary arterial system. Further studies are needed to investigate if 3D-CT models can be used in providing precise information about segmental artery distribution and therefore surgical planning of sub-lobar resections.

scholarly journals Lobectomy for lung cancer with a displaced left B1 + 2 and an anomalous pulmonary vein: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shinichi Sakamoto ◽  
Hiromitsu Takizawa ◽  
Naoya Kawakita ◽  
Akira Tangoku
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Pulmonary Vein ◽  
Three Dimensional ◽  
Lower Lobe ◽  
Rare Condition ◽  
3D Ct ◽  
Anatomical Structures ◽  
Case Presentation ◽  
Anomalous Pulmonary Vein

Abstract Background A displaced left B1 + 2 accompanied by an anomalous pulmonary vein is a rare condition involving complex structures. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer. Case presentation A 59-year-old male with suspected lung cancer in the left lower lobe was scheduled to undergo surgery. Chest computed tomography revealed a displaced B1 + 2 and hyperlobulation between S1 + 2 and S3, while the interlobar fissure between S1 + 2 and S6 was completely fused. Three-dimensional computed tomography (3D-CT) revealed an anomalous V1 + 2 joining the left inferior pulmonary vein and a branch of the V1 + 2 running between S1 + 2 and S6. We performed left lower lobectomy via video-assisted thoracic surgery, while taking care with the abovementioned anatomical structures. The strategy employed in this operation was to preserve V1 + 2 and confirm the locations of B1 + 2 and B6 when dividing the fissure. Conclusion The aim of the surgical procedure performed in this case was to divide the fissure between S1 + 2 and the inferior lobe to reduce the risk of an unexpected bronchial injury. 3D-CT helps surgeons to understand the stereoscopic positional relationships among anatomical structures.

scholarly journals Erratum to: Ten Years' Experience in Robotic-Assisted Thoracic Surgery for Early Stage Lung Cancer

2019 ◽  
Author(s):  
Monica Casiraghi ◽  
Domenico Galetta ◽  
Alessandro Borri ◽  
Adele Tessitore ◽  
Rosalia Romano ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Early Stage ◽  
Early Stage Lung Cancer ◽  
Robotic Assisted ◽  
Stage Lung Cancer

scholarly journals The impact of certification of general thoracic surgeons on lung cancer mortality: a survey by The Japanese Association for Thoracic Surgery

2016 ◽  
Vol 49 (5) ◽  
pp. e134-e140 ◽  
Author(s):  
Takeshi Nagayasu ◽  
Shuntaro Sato ◽  
Hiroshi Yamamoto ◽  
Naoya Yamasaki ◽  
Tomoshi Tsuchiya ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Cancer Mortality ◽  
Lung Cancer Mortality ◽  
Japanese Association ◽  
The Impact

scholarly journals Implementing an enhanced recovery after thoracic surgery programme in the Netherlands: a qualitative study investigating facilitators and barriers for implementation

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e051513
Author(s):  
Erik M. von Meyenfeldt ◽  
Femke van Nassau ◽  
Carlijn T I de Betue ◽  
L Barberio ◽  
Wilhelmina H Schreurs ◽  
...  
Keyword(s):  
Lung Cancer ◽  
The Netherlands ◽  
Thoracic Surgery ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Implementation Strategies ◽  
Audit And Feedback ◽  
Successful Implementation ◽  
Hospital To Home ◽  
The Impact

ObjectivesThis study aims to elucidate determinants for succesful implementation of the Enhanced Recovery After Thoracic Surgery (ERATS) protocol for perioperative care for surgical lung cancer patients in the Netherlands.SettingLung cancer operations are performed in both academic and regional hospitals, either by cardiothoracic or general thoracic surgeons. Limiting the impact of these operations by optimising and standardising perioperative care with the ERATS protocol is thought to enable reduction in length of stay, complications and costs.ParticipantsA broad spectrum of stakeholders in perioperative care for patients with lung resection participated in this study, ranging from patient representatives, healthcare professionals to an insurance company representative.InterventionsSemistructured interviews (N=14) were conducted with the stakeholders (N=18). The interviews were conducted one on one by telephone and two times, face to face, in small groups. Verbatim transcriptions of these interviews were coded for the purpose of thematic analysis.Outcome measuresDeterminants for successful implementation of the ERATS protocol in the Netherlands.ResultsSeveral determinants correspond with previous publications: having a multidisciplinary team, leadership from a senior clinician and support from an ERAS-coordinator as facilitators; lack of feedback on performance and absence of management support as barriers. Our study underscores the potential detrimental effect of inconsistent communication, the lack of support in the transition from hospital to home and the barrier posed by lack of accessible audit data.ConclusionsBased on a structured problem analysis among a wide selection of stakeholders, this study provides a solid basis for choosing adequate implementation strategies to introduce the ERATS protocol in the Netherlands. Emphasis on consistent and sufficient communication, support in the transition from hospital to home and adequate audit and feedback data, in addition to established implementation strategies for ERAS-type programmes, will enable a tailored approach to implementation of ERATS in the Dutch context.

scholarly journals The Impact of Multidisciplinary Team Meetings on Patient Management in Oncologic Thoracic Surgery: A Single-Center Experience

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 228
Author(s):  
Francesco Petrella ◽  
Davide Radice ◽  
Juliana Guarize ◽  
Gaia Piperno ◽  
Cristiano Rampinelli ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Pulmonary Nodule ◽  
Multidisciplinary Team ◽  
Patient Management ◽  
Solitary Pulmonary Nodule ◽  
Advanced Lung Cancer ◽  
Clinical Settings ◽  
Suspected Recurrence ◽  
The Impact

Background: the aim of this paper is to quantify multidisciplinary team meeting (MDT) impact on the decisional clinical pathway of thoracic cancer patients, assessing the modification rate of the initial out-patient evaluation. Methods: the impact of MDT was classified as follows: confirmation: same conclusions as out-patient hypothesis; modification: change of out-patient hypothesis; implementation: definition of a clear clinical track/conclusion for patients that did not receive any clinical hypothesis; further exams required: the findings that emerged in the MDT meeting require further exams. Results: one thousand consecutive patients evaluated at MDT meetings were enrolled. Clinical settings of patients were: early stage lung cancer (17.4%); locally advanced lung cancer (27.4%); stage IV lung cancer (9.8%); mesothelioma (1%); metastases to the lung from other primary tumors (4%); histologically proven or suspected recurrence from previous lung cancer (15%); solitary pulmonary nodule (19.2%); mediastinal tumors (3.4%); other settings (2.8%). Conclusions: MDT meetings impact patient management in oncologic thoracic surgery by modifying the out-patient clinical hypothesis in 10.6% of cases; the clinical settings with the highest decisional modification rates are “solitary pulmonary nodule” and “proven or suspected recurrence” with modification rates of 14.6% and 13.3%, respectively.

The Impact of Computed Tomographic Screening for Lung Cancer on the Thoracic Surgery Workforce

2014 ◽  
Vol 98 (2) ◽  
pp. 447-452 ◽  
Author(s):  
Janet P. Edwards ◽  
Indraneel Datta ◽  
John Douglas Hunt ◽  
Kevin Stefan ◽  
Chad G. Ball ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Computed Tomographic ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document