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Thoracic Surgery: Current Practice and Future Directions
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Thoracic Surgery: Current Practice and Future Directions

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

Deadline for manuscript submissions: 24 November 2024 | Viewed by 1535

Special Issue Editor

Dr. Dania Nachira

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Guest Editor
Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Interests: lung; lung cancer; lung diseases; thoracic diseases; malignant pleural effusion; mesothelioma; mediastinal diseases; thoracic surgery; bronchoscopy

Special Issue Information

Dear Colleagues,

In the last few years, thoracic surgery has been experiencing a tremendous development in terms of new technologies, and innovations in minimally invasive approaches and in integrated strategies for oncological treatments.

This Special Issue aims to collect new evidence on the safety, efficacy and reproducibility of minimally invasive techniques, such as Uniportal-VATS and RATS, in lung, mediastinal and esophageal diseases. It also aims to delve deeper into the results of new oncological integrated strategies for treatment, such as the role of immunotherapy in the neoadjuvant protocols of therapy.

This Special Issue will also look into innovative management in thoracic anesthesiology and loco-regional blocks for pain management during minimally invasive approaches.

Original research articles and reviews are welcome.

Research areas may include (but are not limited to) the following:

  • Current evidence on NSCLC pathogenesis, modern strategies for integrated treatment and future perspectives;
  • Novel endoscopic diagnostic and therapeutic techniques in thoracic surgery;
  • Minimally invasive thoracic surgery (VATS and RATS);
  • New anesthesiology and pain management strategies in thoracic surgery.

I look forward to receiving your contributions.

Dr. Dania Nachira
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • NSCLC
  • mediastinum
  • thymoma
  • esophageal disease
  • immunotherapy
  • new technologies
  • minimally invasive surgery
  • VATS
  • RATS

Published Papers (2 papers)

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Research

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13 pages, 3863 KiB  
Article
Are the Efficacy and Safety of Chest Tubes in Uniportal Video-Assisted Thoracic Surgery Related to the Level of Intercostal Space Insertion or to the Drain Type? A Prospective Multicenter Study
by Dania Nachira, Pietro Bertoglio, Mahmoud Ismail, Antonio Giulio Napolitano, Giuseppe Calabrese, Khrystyna Kuzmych, Maria Teresa Congedo, Carolina Sassorossi, Elisa Meacci, Leonardo Petracca Ciavarella, Marco Chiappetta, Filippo Lococo, Piergiorgio Solli and Stefano Margaritora
J. Clin. Med. 2024, 13(2), 430; https://doi.org/10.3390/jcm13020430 - 12 Jan 2024
Cited by 1 | Viewed by 816
Abstract
Objectives: The aim of this study is to evaluate if the efficacy and safety of chest tube placement are influenced by the level of intercostal space insertion (uniportal VATS vs. biportal VATS) or by the type of drain employed (standard vs. smart coaxial [...] Read more.
Objectives: The aim of this study is to evaluate if the efficacy and safety of chest tube placement are influenced by the level of intercostal space insertion (uniportal VATS vs. biportal VATS) or by the type of drain employed (standard vs. smart coaxial drain). Methods: Data on patients who underwent either uniportal or biportal VATS upper lobectomies with lymphadenectomy were prospectively collected in three European centers. The uniportal VATS group with a 28 Fr standard chest tube (U-VATS standard) was compared with the uniportal VATS group with a 28 Fr smart drain (U-VATS smart), and U-VATS smart was also compared with biportal VATS with a 28 Fr smart drain inserted in the VIII intercostal space (Bi-VATS smart). Results: When comparing the U-VATS standard group with the U-VATS smart, a higher fluid output was recorded in the U-VATS smart (p: 0.004) in the III post-operative day (p.o.) and overall (p: 0.027), with a lower 90-day re-admission in the U-VATS smart (p: 0.04). The Bi-VATS smart group compared to U-VATS smart showed a higher fluid output in the I p.o. (p < 0.001), with no difference in total fluid amount or hospitalization. The Bi-VATS smart recorded a lower incidence (p < 0.001) of residual pleural space or effusion (p: 0.004) at chest X-rays prior to drain removal but a higher level of pain and chronic intercostal neuralgia (p: 0.03). Conclusions: Chest tube insertion through the same incision space in uniportal VATS seems to be safe and effective. Smart drains can improve the fluid output in uniportal VATS, as if the drainage were inserted in a lower space (i.e., biportal VATS), but with less discomfort. Full article
(This article belongs to the Special Issue Thoracic Surgery: Current Practice and Future Directions)
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Review

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11 pages, 238 KiB  
Review
Is RATS Superior to VATS in Thoracic Autonomic Nervous System Surgery?
by Federico Raveglia, Angelo Guttadauro, Ugo Cioffi, Maria Chiara Sibilia and Francesco Petrella
J. Clin. Med. 2024, 13(11), 3193; https://doi.org/10.3390/jcm13113193 - 29 May 2024
Viewed by 290
Abstract
Technological development in the field of robotics has meant that, in recent years, more and more thoracic surgery departments have adopted this type of approach at the expense of VATS, and today robotic surgery boasts numerous applications in malignant and benign thoracic pathology. [...] Read more.
Technological development in the field of robotics has meant that, in recent years, more and more thoracic surgery departments have adopted this type of approach at the expense of VATS, and today robotic surgery boasts numerous applications in malignant and benign thoracic pathology. Because autonomic nervous system surgery is a high-precision surgery, it is conceivable that the application of RATS could lead to improved outcomes and reduced side effects, but its feasibility has not yet been thoroughly studied. This review identified three main areas of application: (1) standard thoracic sympathectomy, (2) selective procedures, and (3) nerve reconstruction. Regarding standard sympathectomy and its usual areas of application, such as the management of hyperhidrosis and some cardiac and vascular conditions, the use of RATS is almost anecdotal. Instead, its impact can be decisive if we consider selective techniques such as ramicotomy, optimizing selective surgery of the communicating gray branches, which appears to reduce the incidence of compensatory sweating only when performed with the utmost care. Regarding sympathetic nerve reconstruction, there are several studies, although not conclusive, that point to it as a possible solution to reverse surgical nerve interruption. In conclusion, the characteristics of RATS might make it preferable to other techniques and, particularly, VATS, but to date, the data in the literature are too weak to draw any evidence. Full article
(This article belongs to the Special Issue Thoracic Surgery: Current Practice and Future Directions)
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