Current Challenges and Future Directions in Lung Resections in Thoracic Surgery

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

Deadline for manuscript submissions: 15 September 2025 | Viewed by 283

Special Issue Editors


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Guest Editor
The Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
Interests: thoracic surgery; lung volume reduction – endobronchial valves – lung volume reduction surgery – hybrid procedures; robotic surgery (RATS); implementation of high-risk MDTs in thoracic surgery; mediastinal surgery

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Guest Editor
University General Hospital of Heraklion, 715 00 Heraklion, Greece
Interests: VATS; thoracic surgery; endobronchial stents; lung cancer

Special Issue Information

Dear Colleagues,

The evolution in the practice of thoracic surgery has been astonishing during the last decade. Many new technologies and modalities have been rolled out to everyday practice, constituting surgical treatment possible in more patients and in pathologies that previously were not amendable to treatment. Some examples include the utilization of robotic platforms in minimally invasive approaches, the evolution of lung volume reduction interventions in the form of surgery, valves, or hybrid procedures, the increasing performance of sublobar anatomical lung resections in lung resections, the implementation of screening services for lung cancer, the utilization of artificial intelligence in the research and clinical practice of thoracic surgeons, the application of 3D reconstructions and marking of lesions in lung resections, the implementation of targeted therapy as multimodal treatment in lung cancer, and many others.

In this Special Issue, we welcome authors to submit manuscripts that provide a comprehensive connection between present challenges and future directions in thoracic surgery with the implementation of the abovementioned evolutionary new developments within the specialty.

Dr. Vasileios K. Kouritas
Dr. Emmanuel Michael Kefaloyannis
Guest Editors

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Keywords

  • robotic-assisted thoracic surgery (RATS)
  • robotic
  • sublobar
  • 3D
  • emphysema
  • endobronchial valves
  • lung volume reduction surgery (LVRS)
  • high-risk
  • AI
  • research
  • lung
  • screening
  • lung cancer

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Published Papers (1 paper)

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Research

9 pages, 222 KiB  
Article
Next-Day Discharge Is Feasible in Robotic-Assisted Thoracic Surgery Anatomical Lung Resections Irrespective of Patient Characteristics
by Ra’fat Tawalbeh, William Ansley, Obada Alqudah, Ahmad Asqalan, Hammad Hassan, Bartolmiej Szafron, Cristina Viola, Jakub Kadlec, Waldemar Bartosik and Vasileios Kouritas
J. Clin. Med. 2025, 14(9), 3198; https://doi.org/10.3390/jcm14093198 - 5 May 2025
Viewed by 189
Abstract
Background: Next-day discharge post-robotic-assisted thoracic surgery (RATS) anatomical lung resections are shown to be achieved in young and fit patients. This study aims to compare next-day discharge RATS anatomical lung resection patients matched with patients who stayed longer. Methods: A retrospective analysis of [...] Read more.
Background: Next-day discharge post-robotic-assisted thoracic surgery (RATS) anatomical lung resections are shown to be achieved in young and fit patients. This study aims to compare next-day discharge RATS anatomical lung resection patients matched with patients who stayed longer. Methods: A retrospective analysis of patients who underwent RATS anatomical lung resection by a single surgeon was conducted. Based on the variables found to be different, two propensity-matched groups were created: a next-day discharge group and a group of patients with longer stays. Results: This study included 202 patients, 49 (24.3%) of whom were discharged the next day. The mean age was 68.3 ± 9.8 years, and 114 (56.4%) patients were females. Based on the variables found different, two matched groups with 46 patients for age, gender, performance score, American Society of Anesthesiologists score, number of co-morbidities and Forced Expiratory Volume in 1 sec were created. Re-admissions, complications, and death rates were similar, but next-day discharge patients had more sublobar resections (65.2% vs. 37%, p = 0.029), shorter procedures (132 vs. 179 min, p = 0.048), and morning theater slots (71.7% vs. 32.6, p = 0.018). These were shown to be independent predictors of next-day discharge. Major air leak issues also kept patients in the hospital longer (23.9% vs. 6.5%, p = 0.024). Conclusions: Next-day discharge following RATS anatomical lung resection appeared to have no increased risk of re-admissions or complications, irrespective of fitness, age, or other patient characteristics. Patients receiving short-duration surgery and morning sublobar resections without major air leak issues have higher chances of achieving next-day discharge. Full article
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