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Multicenter phase II trial of accelerated cisplatin and high-dose epirubicin followed by surgery or radiotherapy in patients with stage IIIa non-small-cell lung cancer with mediastinal lymph node involvement (N2-disease).

To assess the therapeutic activity of accelerated cisplatin and high-dose epirubicin with erythropoietin and G-CSF support as induction therapy for patients with stage IIIa-N2 non-small-cell lung cancer (NSCLC). Patients with stage IIIa-N2 NSCLC were enrolled in a phase II trial. They received cisplatin 60 mg m(-2) and epirubicin 135 mg m(-2) every 2 weeks for three courses combined with erythropoietin and G-CSF. Depending on results of clinical response to induction therapy and restaging, patients were treated with surgery or radiotherapy. In total, 61 patients entered from March 2001 to Apri

Surgery for bronchioloalveolar carcinoma and "very early" adenocarcinoma: an evolving standard of care?

Lobectomy and mediastinal lymph node dissection is the standard surgical management of early stage non-small cell lung cancer (NSCLC) because more limited resections have been associated with a higher risk of local recurrence. Nevertheless, recent lung cancer screening studies have led to the detection of an increasing number of "very early" NSCLC (defined as less than 2 cm in size) and of good-prognosis histologic subtypes, bronchioloalveolar carcinoma (BAC), and adenocarcinoma (AC), mixed subtypes that are potentially appropriate for sublobar resection. The precise indications for sublobar r

[Pulmonary mucormycosis in a multiple-trauma patient].

Mucormycosis are opportunist infections occurring usually among predisposed patients. We report a case of an 18-year-old male with a severe thoracic trauma who developed an Absidia infection on his contused pulmonary parenchyma, without presenting the usual risk factors (diabetes mellitus, immunodeficiency). The early diagnosis using bronchoscopy has probably improved the outcome by allowing a faster treatment. After 18-months, the infectious process resolved thanks to a combination of a medical treatment composed of high-dose amphotericin B lipid formulation, itraconazole and a complementary

A prospective feasibility study of bronchial thermoplasty in the human airway.

BACKGROUND: Bronchial thermoplasty is a novel procedure being developed as a potential treatment for asthma. Experience with animal studies has enabled development of appropriate reliable equipment, definition of therapeutic parameters, and descriptions of tissue effects of treatment. STUDY OBJECTIVES: This study was undertaken to assess the feasibility and general safety of the application of bronchial thermoplasty in the human airway, and to determine if the reduction in airway smooth muscle seen in animal studies could be replicated. DESIGN: A prospective study. SETTING: Academic thoraci

Omentum is highly effective in the management of complex cardiothoracic surgical problems.

OBJECTIVES: Vascularized, pedicled tissue flaps are often used for cardiothoracic surgical problems complicated by factors that adversely affect healing, such as previous irradiation, established infection, or steroid use. We reviewed our experience with use of the omentum in these situations to provide a yardstick against which results with other vascularized flaps (specifically muscle flaps) could be compared. METHODS: A retrospective review was undertaken of 85 consecutive patients in whom omentum was used in the chest. In 47 patients (group I), use of omentum was prophylactic to aid in th

[Usefulness of video-assisted thoracoscopy for the diagnosis of solitary pulmonary nodules].

OBJECTIVES: Various approaches are used for the diagnosis and treatment of solitary pulmonary nodules (SPN) of unknown origin. New imaging techniques and nuclear medicine have provided more information about SPN, but surgical removal is still the most sensitive and specific way to obtain a correct analysis of the lesion. With video-assisted thoracic surgery (VATS), a histological diagnosis can be obtained without resorting to thoracotomy. In the present study we describe our experience with the diagnosis and treatment of SPN using VATS. MATERIAL AND METHODS: From July 1992 through April 2001,

Pulmonary lobectomy for lung cancer: a prospective study to compare patients with forced expiratory volume in 1 s more or less than 80% of predicted.

OBJECTIVE: To compare post-operative course, lung function and survival of lung cancer patients with a forced expiratory volume in 1 s (FEV1) more or less than 80% of predicted submitted to lobectomy. METHODS: The data of patients undergoing lobectomy for non small cell carcinoma at the Thoracic Surgery Unit of the Ospedale Maggiore Policlinico of Milan, Italy, were prospectively collected. Inclusion criteria were a radical resectable tumor with size less than 2.5 cm, negative mediastinal nodes, capability to complete pulmonary function tests, Exclusion criteria were FEV1 <40% of predicted, p

Video-assisted thoracic surgical non-rib spreading simultaneously stapled lobectomy: a more patient-friendly oncologic resection.

OBJECTIVE: To evaluate the outcomes from a new surgical technique for lobectomy. PATIENTS: Two hundred fifty consecutive patients with an average age of 67.3 years underwent simultaneously stapled lobectomy. METHODS: Video-assisted thoracic surgical non-rib spreading lobectomy (VNSSL) is a new technique that has been evolving for approximately 6.5 years. During 1990, we began using video-assisted thoracic surgery (VATS) for simple, benign diseases. Throughout 1991, VATS was applied to malignant problems, ie, mediastinal masses, staging of lymph nodes, malignant effusions, and coin lesions. A

Follow-up in lung cancer: how often and for what purpose?

OBJECTIVES: The present study evaluates the cost-effectiveness of two follow-up routines: a strict follow-up with frequent visits, imaging, and laboratory examinations was compared to a follow-up with infrequent visits that were scheduled mainly on the basis of the patient's symptoms. METHODS: A retrospective evaluation was undertaken of 130 patients who underwent a complete resection of non-small cell lung cancer (NSCLC). All patients had complete follow-up for at least 2 years after their operation. The patients were separated into two groups: strict (n = 67), with a routine follow-up polic

Pulmonary hydatidosis: surgical treatment and follow-up of 240 cases.

OBJECTIVE: We review a series of 240 patients treated surgically for pulmonary hydatid cyst in our center between 1966 and 1988, assessing the results with our surgical technique, which involves a novel needle aspiration device designed by Professor D. Figuera, and postoperative treatment protocol. PATIENTS AND METHODS: The majority (60.4%) of the patients were from areas endemic for hydatid disease. The mean age of the patients at the time of the surgical procedure was 31.5 +/- 7.2 years (range: 4-70 years). A trocar-suction device was used for the needle aspiration of 276 (92%) of the 300 c

Bronchogenic cysts of the lung.

BACKGROUND: The clinical presentation of lung bronchogenic cysts (BC) is variable, from respiratory distress at birth to late appearance of symptoms. METHODS: This study of BC was based on a retrospective review of 41 cases: 21 infants and children and 20 adults, aged 1 day to 68 years. The diagnosis was antenatal in 4 cases. Three infants required mechanical ventilation, and 2 had their cyst drained before resection. Twenty infants and children and 17 adults underwent operations. RESULTS: Compression was the most important complication in infants and children. Cough, infection, and hemoptys

[Thoracic peridural anesthesia for intra- and postoperative analgesia in lung resections. A comparison of stress reactions and postoperative lung function].

47 patients who were scheduled for lung resection were assigned to two groups. 23 patients had a neurolept analgesia and postoperatively parenteral analgetics. 24 patients received a combination of thoracic peridural anaesthesia and nitrous oxide-oxygen anaesthesia for surgery. The peridural analgesia was continued for 2-3 days for postoperative pain control. Heart rate and mean arterial pressure were recorded. Before, during and after surgery blood was drawn for determination of plasma glucose and cortisol. Postoperatively vital capacity and FEV1 were measured and blood gas analyses were perf

Survival with optimal medical management in a cohort of severe necrotizing bacterial lung infections.

BACKGROUND: Necrotizing pneumonia and lung gangrene represent a continuum of severe lung infection. Traditionally, severe cases have been referred for surgical debridement. However, this has been linked to high mortality. Some groups have published encouraging results using a conservative medical approach. Unfortunately, lack of a standardized definition of necrotizing pneumonia has precluded meaningful comparison between medical and surgical approach in severe cases. Our objective was to describe the outcome of a cohort of severe necrotizing pneumonia treated with optimal medical management.

Совпадение в полном тексте источника
… In surgical series, consisting mainly of lobectomies and pneumonectomies, the mortality rates varied mostly between 8.5% and 40% ( 4 , 7 - 11 , 13 , 16 , 21 , 22 , 24 , 25 ). … In the lung, debridement may include lobectomy or pneumonectomy. However, we argue that there is no clear scientific basis that supports the application of this principle to the lung. …

Robotic-assisted versus video-assisted thoracoscopic anatomical pulmonary resection in elderly patients with lung cancer: A propensity score-matched comparison of short-term outcomes.

OBJECTIVE: Lung cancer is a major health issue, particularly among the elderly. This study aimed to compare the short-term outcomes of robot-assisted thoracoscopic surgery (RATS) versus video-assisted thoracoscopic surgery (VATS) for anatomical pulmonary resection in elderly patients with lung cancer. METHODS: A retrospective analysis was performed on patients aged ≥65 years who underwent RATS or VATS. Propensity score matching (PSM) was applied to balance baseline characteristics. Demographic, clinical, and perioperative variables were compared. RESULTS: A total of 594 patients who underwen

Robotic vs thoracoscopic vs open lobectomy and segmentectomy for lung cancer: a multicenter cohort study in the ATS of Milan.

The study aimed at comparing the effectiveness of open thoracotomy (OT), video-assisted thoracoscopic surgery (VATS), and robot-assisted thoracic surgery (RATS) for anatomical lung resection in early-stage non-small cell lung cancer. We conducted a multicenter cohort study across eight hospitals in the Milan health authority, including patients undergoing lobectomy or segmentectomy in 2016-2021 (retrospective) and 2023-2025 (prospective). Inverse probability weighting was used to estimate average treatment effects. Primary outcomes were postoperative complications, 30-day readmission, and conv

Lymph Node Metastasis and Recurrence Patterns in Clinical Stage IA Lower-Lobe Non-Small Cell Lung Cancer: Toward an Optimal Surgical Strategy for Superior Segment (S6) Tumors.

PURPOSE: The superior segment (S6) may differ from the basal segments (BSs) in lymphatic spread, affecting surgical strategy and mediastinal lymph node dissection (LND). We aimed to define lymphatic spread patterns and to guide surgical strategy in S6 non-small cell lung cancer (NSCLC). METHODS: We reviewed 375 patients with cT1a-cT1c N0 lower-lobe NSCLC (S6, 168; BS, 207) who underwent segmentectomy or lobectomy (2012-2024). We analyzed nodal metastasis and recurrence by station. RESULTS: Segmentectomy was more frequent in S6 than in BS. pN1 and pN2 incidence was 8.3% and 2.4% in S6 and 4.3

Understanding exacerbation risk in BLVR: A logistic regression approach to complication prediction.

BackgroundChronic obstructive pulmonary disease (COPD) with emphysema is associated with persistent airflow limitation and frequent exacerbations. Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) improves lung function and quality of life but carries a risk of postprocedural complications, including acute exacerbations and pneumonia. Predictors of these adverse events remain incompletely defined.PurposeTo identify clinical and inflammatory factors associated with postprocedural exacerbations in patients undergoing BLVR with EBVs, aiming to support individualized risk

Biological surgical stress after minimally invasive lung resection for non-small cell lung cancer: comparing robotic and thoracoscopic surgical platforms.

In resectable non-small cell lung cancer (NSCLC), a minimally invasive surgical approach is considered standard. Robotic-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) are two such approaches that have demonstrated comparable clinical outcomes on conventional postoperative endpoints. Potential differences in perioperative biological surgical stress remain incompletely characterized. Acute-phase inflammatory biomarkers may provide objective insight beyond conventional postoperative endpoints. We performed a single-center retrospective cohort study of patients w