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Thoracic Surgery: Updates and New Trends

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

Deadline for manuscript submissions: 31 January 2026 | Viewed by 713

Special Issue Editor


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Guest Editor
1. Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
2. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
Interests: minimally invasive surgery; robotic surgery; lung cancer; mediastinal tumors; pleural tumors
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Special Issue Information

Dear Colleagues,

Thoracic surgery has significantly advanced in recent years, marked by the integration of cutting-edge technologies and innovative surgical techniques into both diagnosis and treatments. Minimally invasive procedures, such as robot-assisted thoracic surgery (RATS) and the Ion bronchoscopy procedure have become increasingly prevalent, allowing clinicians to identify and characterize very small nodules and then, in combination with robotic surgical systems, to achieve enhanced surgical precision and dexterity, leading to reduced postoperative pain, shorter hospital stays, and quicker recoveries. In addition, artificial intelligence (AI) and machine learning are proving to be transformative in thoracic surgery. These technologies facilitate surgical planning, intraoperative navigation, and postoperative outcome prediction. For instance, AI-driven video analysis assists in surgical phase recognition, enabling real-time decision support and skill assessment. Additionally, virtual reality (VR) is used for preoperative planning, allowing surgeons to simulate procedures and optimize strategies before entering the operating room.

Furthermore, the development of hybrid operating rooms has facilitated the combination of surgical and interventional procedures, enhancing the treatment of complex thoracic conditions.

Overall, the convergence of technological innovation and surgical expertise is propelling thoracic surgery into a new era, characterized by enhanced patient outcomes, increased procedural efficiency, and expanded therapeutic possibilities.

Dr. Monica Casiraghi
Guest Editor

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Keywords

  • minimally invasive surgery
  • new technology
  • diagnosis
  • bronchoscopy
  • robotic system
  • artificial intelligence

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Published Papers (1 paper)

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Research

12 pages, 614 KB  
Article
10-Year Long-Term Outcomes of Robotic-Assisted Segmentectomy for Early-Stage Non-Small-Cell Lung Cancer
by Monica Casiraghi, Riccardo Orlandi, Antonio Mazzella, Lara Girelli, Giovanni Caffarena, Matteo Chiari, Luca Bertolaccini, Giorgio Lo Iacono, Cristina Diotti, Claudia Bardoni, Patrick Maisonneuve and Lorenzo Spaggiari
J. Clin. Med. 2025, 14(16), 5608; https://doi.org/10.3390/jcm14165608 - 8 Aug 2025
Viewed by 582
Abstract
Objectives: Robotic-assisted segmentectomy (RAS) has proven to be safe and feasible for early-stage lung cancer; nonetheless, its oncologic efficacy and long-term outcomes are still debated. We aimed to explore whether RAS could be an alternative to robotic-assisted lobectomy (RAL) in early-stage NSCLC, focusing [...] Read more.
Objectives: Robotic-assisted segmentectomy (RAS) has proven to be safe and feasible for early-stage lung cancer; nonetheless, its oncologic efficacy and long-term outcomes are still debated. We aimed to explore whether RAS could be an alternative to robotic-assisted lobectomy (RAL) in early-stage NSCLC, focusing on long-term outcomes such as 10-year cancer-specific survival (CSS), cumulative rate of relapse (RR), and local recurrence (LR). Methods: Patients undergoing RAS for early-stage NSCLC (clinical stage I) were analyzed from August 2007 to August 2023. A 1:3 propensity score-matched analysis was performed among patients undergoing RAL, based on demographic characteristics and pathological stage. Primary endpoints were CSS, RR, and LR. Results: A total of 40 patients undergoing RAS were retrospectively enrolled. After matching 120 patients undergoing RAL, no significant differences were found in postoperative complications, median operative time, or length of hospital stay. Patients undergoing RAS had comparable 10-year CSS (p = 0.90) and RR (p = 0.99) to those undergoing RAL, whereas 10-year of cumulative incidence of local recurrence (LR) was 11.0% (95% CI: 3.4–23.7%) for RAS patients and 2.8% (95% CI: 0.5–8.9%) for RAL patients (p = 0.08). Additionally, RAL provided a significantly higher number of N1 and N2 lymph node retrievals (p < 0.0001 and 0.06, respectively), as well as a higher number of N2 stations (p = 0.0001). Conclusions: Based on our experiences, even though RAS can ensure excellent long-term outcomes in selected cases of early-stage NSCLC, comparable to RAL, the local recurrence rate was higher in the RAS group. Full article
(This article belongs to the Special Issue Thoracic Surgery: Updates and New Trends)
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