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Personalized Cardiothoracic Surgery: Treatment and Management
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Personalized Cardiothoracic Surgery: Treatment and Management

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy in Clinical Medicine".

Deadline for manuscript submissions: 25 January 2027 | Viewed by 2677

Editor

Dr. Dania Nachira

E-Mail Website
Guest Editor
Department of General Thoracic Surgery, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Interests: lung cancer; thoracoscopic (VATS and Uniportal-VATS); cardiothoracic surgery; thymectomy; minimally-invasive surgery; robotic surgery (RATS); esophageal surgery; hyperhidrosis; translational research; rigenerative medicine; innovations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

New technologies and medical developments have been taking traditional cardiothoracic surgery to more minimally invasive approaches and personalized treatments.

This Special Issue aims to collect new evidence on innovations, integrated management, and therapeutic strategies that have been involving thoracic and cardiac surgery in the last few years.

Original research articles and reviews are welcome.

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

  • Updates and new developments in cardiothoracic surgery.
  • Personalized medicine and innovations.
  • Minimally invasive thoracic surgery (VATS and RATS).
  • Mediastinal surgery.
  • Oncological integrated strategies for treatment.
  • New techniques for regional anesthesia in cardiothoracic 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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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 Personalized Medicine is an international peer-reviewed open access monthly 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

  • lung cancer
  • mediastinum
  • VATS
  • RATS
  • cardiothoracic surgery
  • new technologies
  • thoracic anesthesia
  • regional anesthesia

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Published Papers (3 papers)

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Research

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11 pages, 245 KB  
Article
Uniportal-VATS for Early-Stage NSCLC in Octogenarians: A Single-Center, Retrospective Study of Surgical and Short-Term Oncological Outcomes
by Dania Nachira, Alessia Senatore, Giovanni Punzo, Maria Letizia Vita, Maria Teresa Congedo, Khrystyna Kuzmych, Leonardo Petracca-Ciavarella, Filippo Lococo, Elisa Meacci and Stefano Margaritora
J. Pers. Med. 2026, 16(3), 155; https://doi.org/10.3390/jpm16030155 - 7 Mar 2026
Viewed by 896
Abstract
Background/Objectives: This study aimed to assess the safety and efficacy of lung surgery for the treatment of early-stage non-small cell lung cancer (NSCLC) in octogenarians, with a specific focus on the Uniportal-VATS approach, evaluating surgical outcomes and short-term oncological results within a precision [...] Read more.
Background/Objectives: This study aimed to assess the safety and efficacy of lung surgery for the treatment of early-stage non-small cell lung cancer (NSCLC) in octogenarians, with a specific focus on the Uniportal-VATS approach, evaluating surgical outcomes and short-term oncological results within a precision medicine perspective. Methods: This retrospective, single-center study included octogenarian patients who underwent surgical treatment for early-stage NSCLC between January 2018 and March 2024. Among 1329 patients treated during the study period, 136 octogenarians were carefully evaluated by a multidisciplinary board and selected for surgical management. Results: The mean age was 82.41 ± 2.72 years, with a prevalence of men (63.2%). In 107 (78.7%) cases, lung resection was performed using the Uniportal-video-assisted thoracic surgery (U-VATS) approach. Overall, 71 lobectomies (52.2%) and 65 segmentectomies or wedge resections (47.8%) were performed, balancing oncological radicality with comorbidities. Only minor complications occurred, such as atelectasis (2.9%), atrial fibrillation (4.4%), pneumonia (1.5%), or air-leakage (2.2%). Factors significantly associated with postoperative complications included open approach (p = 0.014), lobectomy as the extent of resection (p = 0.008), and chronic obstructive pulmonary disease (COPD) (p = 0.010). On multivariable analysis, lobectomy remained the only independent predictor for postoperative complications (OR: 5.95, 95% CI [1.24–28.62], p = 0.026). In-hospital and 90-day mortality were null. The median length of hospital stay in octogenarians was 6 days and was significantly shorter in the Uniportal-VATS group compared with the open surgery one (p < 0.001). All patients were discharged home independently. One- and three-year overall survival rates were 88% and 71%, respectively. No risk factor was associated with mortality in our series. Conclusions: Lung surgery, particularly the Uniportal-VATS approach, appears to be a safe and effective treatment option for octogenarian patients with early-stage NSCLC, provided that patient selection is carefully based on individual clinical characteristics within a multidisciplinary framework based on individualized risk stratification. When feasible, sublobar resection should be preferred in order to minimize postoperative complications. Full article
(This article belongs to the Special Issue Personalized Cardiothoracic Surgery: Treatment and Management)

Review

Jump to: Research

20 pages, 634 KB  
Review
Three-Dimensional Bronchovascular Modelling in Sublobar Pulmonary Resection: A Tool for Personalised Thoracic Surgery
by Victor A. Shahen and Cheng-Hon Yap
J. Pers. Med. 2026, 16(6), 335; https://doi.org/10.3390/jpm16060335 - 22 Jun 2026
Viewed by 281
Abstract
Sublobar pulmonary resection has become an increasingly adopted approach for early-stage non-small cell lung cancer, driven by evidence that anatomical segmentectomy can achieve oncological outcomes comparable to lobectomy in selected patients. Safe execution of sublobar resection depends on accurate preoperative identification of segmental [...] Read more.
Sublobar pulmonary resection has become an increasingly adopted approach for early-stage non-small cell lung cancer, driven by evidence that anatomical segmentectomy can achieve oncological outcomes comparable to lobectomy in selected patients. Safe execution of sublobar resection depends on accurate preoperative identification of segmental bronchovascular anatomy, which demonstrates substantial variability. Conventional two-dimensional (2D) computed tomography (CT) imposes significant limitations on anatomical interpretation, particularly at the segmental and subsegmental level. Three-dimensional (3D) bronchovascular modelling provides patient-specific representations of segmental anatomy and relationships that address these limitations. This narrative review examines the current and emerging roles of 3D modelling in personalised thoracic surgery. It discusses the anatomical basis for its application, the limitations of conventional imaging, and the contribution of 3D modelling to preoperative planning and intraoperative decision making. It also considers broader applications, current limitations, and future directions, with emphasis on how patient-specific 3D modelling can support more tailored operative strategies and more individualised surgical care. Full article
(This article belongs to the Special Issue Personalized Cardiothoracic Surgery: Treatment and Management)
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16 pages, 1378 KB  
Review
Anesthetic Management of Eosinophilic Granulomatosis with Polyangiitis: A Narrative Review with an Illustrative Case in Cardiac Surgery
by Debora Emanuela Torre and Carmelo Pirri
J. Pers. Med. 2026, 16(5), 241; https://doi.org/10.3390/jpm16050241 - 30 Apr 2026
Viewed by 767
Abstract
Background: Eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg–Strauss syndrome, is a rare necrotizing vasculitis characterized by asthma, eosinophilia, and systemic granulomatosis vasculitis. Perioperative risk is primarily driven by airway hyperreactivity, potential cardiac disease, chronic immunosuppressive therapy, and reported alterations in plasma cholinesterase [...] Read more.
Background: Eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg–Strauss syndrome, is a rare necrotizing vasculitis characterized by asthma, eosinophilia, and systemic granulomatosis vasculitis. Perioperative risk is primarily driven by airway hyperreactivity, potential cardiac disease, chronic immunosuppressive therapy, and reported alterations in plasma cholinesterase activity. Evidence specifically addressing anesthetic management remains scarce and largely limited to case-based reports. Methods: A focused narrative review was conducted by searching MEDLINE (via PubMed), Scopus, and Embase from inception to January 2026 for publications reporting perioperative anesthetic management in patients with EGPA/Churg–Strauss syndrome. Case reports and case-based descriptions providing explicit anesthetic details were qualitatively synthesized. Results: Available evidence consists predominantly of isolated case reports across heterogeneous surgical settings, including ENT, abdominal, orthopedic, ambulatory, pediatric, and rare cardiac procedures. Recurring perioperative principles include optimization of bronchial disease and continuation of inhaled therapy; minimization of airway stimulation and avoidance of histamine-releasing drugs; selection of induction agents preserving hemodynamic stability in the presence of myocardial involvement; preference for non-depolarizing neuromuscular blockade with quantitative monitoring (and consideration for sugammadex when appropriate); individualized corticosteroid management and multimodal, opioid-sparing analgesia, often supported by regional techniques. Conclusions: In the absence of dedicated perioperative guidelines, anesthetic care for EGPA should be individualized based on clinical phenotype and organ involvement. A structured approach targeting airway protection, cardiovascular stability, safe neuromuscular management, and opioid-sparing analgesia may represent a pragmatic risk-mitigation framework. These considerations are illustrated by an institutional experience in mitral valve surgery. Full article
(This article belongs to the Special Issue Personalized Cardiothoracic Surgery: Treatment and Management)
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