Videothoracoscopy in Pleural Empyema Following Methicillin-Resistant Staphylococcus aureus

Our study shows the different therapeutic procedures in 64 patients with pleural effusion due to MRSA pneumonia. The thoracostomy tube associated with pleural washing was decisive in 10 simple effusion patients. Video-assisted thoracic surgery allowed a complete resolution of the disease in 22 complex parapneumonic effusion patients. In 20 of 32 patients with frank pus in the pleural cavity, the videothoracoscopic insufflation of carbon dioxide (CO2) before thoracotomy facilitated the dissection of the lung tissue. In 12 patients, this approach was not applied because of cardiac insufficiency. Videothoracoscopy and decortication after thoracotomy ensured the recovery of functions

Preoperative function evaluation of the major lung resection: muscle-sparing axillary mini-thoracotomy versus video-assisted thoracoscopic surgery

Background: In surgically fit non-small cell lung cancer (NSCLC) patients, pulmonary lobectomy still represents the standard of care. In recent years, the development of minimally invasive video-assisted techniques has reduced perioperative surgical stress, including patients previously thought to be unfit for surgery. Methods: We carried out a review of literature in order to evaluate the role of the preoperative parameters in functionally compromised patients and the effectiveness of video-assisted thoracoscopic surgery (VATS) compared to the “muscle sparing” axillary mini-thoracotomy in major lung resections. Results: Of 99 analyzed papers, we considered the 24 most significant, according to the preoperative functional status evaluation and, especially cardiac and respiratory reserve. Conclusions: In patients with a reduced cardio-respiratory function undergoing pulmonary resection, VATS guarantees results superimposable to mini-thoracotomy and represents a valid alternative to be taken into consideration

Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography in the Management of Solitary Pulmonary Nodule: A Review

Solitary pulmonary nodules are common radiologic findings and their detection has increased due to the introduction and improvement of diagnostics. Since a nodule can be an expression of early lung cancers, a proper classification and management are required because its treatment might lead to decreased morbidity and mortality. In this regard, prominent guidelines are available although they are characterized sometimes by discordant and misleading evidences. Furthermore, the same results of studies in the literature appear conflicting. Aim of this work is to evaluate the role of imaging through an extensive literature review but focusing on (18)F-FDG-PET/CT in order to assess the limits and future perspectives of SPN characterization in early detection of lung cancer

Basic statistics with Microsoft Excel: A review

The scientific world is enriched daily with new knowledge, due to new technologies and continuous discoveries. The mathematical functions explain the statistical concepts particularly those of mean, median and mode along with those of frequency and frequency distribution associated to histograms and graphical representations, determining elaborative processes on the basis of the spreadsheet operations. The aim of the study is to highlight the mathematical basis of statistical models that regulate the operation of spreadsheets in Microsoft Excel

Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of solitary pulmonary nodule: a scoping review

Background: The role of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) in the surgical approach of solitary pulmonary nodule (SPN) is still debated, as the increased metabolic avidity of the lesion was not a sure sign of malignancy. The purpose of this study was to evaluate the effectiveness of18 F-FDG-PET/CT in the characterization of SPN based on the analysis of the most recent data in the literature. Methods: We analyzed systematically the studies in 5 years (from 2016 to 2020), considering sensitivity, specificity and diagnostic accuracy. The reference values have established, beyond which the data have deemed significant. Results:18F-FDG-PET/CT showed sensitivity, specificity and diagnostic accuracy values between 37.8% and 100%, 23.4% and 98.3%, 79.2% and 84.0% respectively. The data collected were very heterogeneous but, analyzing the value curves and the linear curves it was evident that the specificity levels of PET/CT decreased with the increase in the number of patients enrolled in the different experiences. Conclusions:18 F-FDG-PET/CT represents a valid tool in the diagnostic path of SPN but it cannot replace biopsy in the characterization of lesion until a direct correlation between standardized uptake value and the degree of malignancy is demonstrated

Malignant pleural effusion in lung cancer: focus on treatment—through a review of literature

Malignant pleural effusion (MPE) is frequently associated with lung cancer and often the treatment is palliative. However, in some cases, an improvement in survival is possible. We evaluated the therapeutic options of MPE patients in lung cancer through a review of the literature. We have seen how, in addition to palliative treatments, surgery improves survival in selected cases. In patients destined for medical treatment, we noticed that the biomolecular characteristics and receptor structures are fundamental to achieve targeted and personalized therapy. It is now possible an effective treatment for the patients in which palliative cares were the only therapeutic possibility until a few years ago. © Journal of Xiangya Medicine. All rights reserved

Single-port video-assisted thoracoscopic sleeve lobectomy after neoadjuvant immunochemotherapy: a case report

Background: The morbidity and mortality of lung cancer have always ranked first among malignant tumors (MTs). Previous studies have shown that neoadjuvant chemotherapy can improve the 5-year survival rate of patients with non-small cell lung cancer (NSCLC), but the benefit is limited. Studies have proven that neoadjuvant immunotherapy combined with chemotherapy has unique advantages in prolonging patient survival, reducing distant recurrence, and inducing antitumor immunity. However, its impact remains to be more comprehensively investigated. Case description: A 59-year-old male who was admitted to the hospital with a primary complaint of repeated cough and expectoration for 6 months. Preoperative assessment showed right upper lung squamous cell carcinoma with multiple hilar and mediastinal lymph node metastasis, and the clinical stage was cT2aN2M0 stage (IIIA). After three cycles of pembrolizumab + carboplatin + paclitaxel therapy were administered, the reexamination of the tumor was evaluated as partial response (PR), and a sleeve lobectomy of the right upper lung was performed under single-port thoracoscopic surgery. The operation proceeded smoothly without conversion to thoracotomy, and R0 resection was successfully achieved. Postoperative pathological stage was ypT1bN0M0 stage IA, and postoperative pathological remission was evaluated as major pathological response (MPR). After the operation, three cycles of immunotherapy combined with chemotherapy were completed, which was followed by maintenance therapy with pembrolizumab monotherapy for 1 year, and no signs of tumor recurrence and metastasis have been found in follow-up thus far. Conclusions: Through this case, we believe that for locally advanced NSCLC sleeve lobectomy after neoadjuvant therapy may be a safe and feasible treatment option, can avoid pneumonectomy, protect the lung function of patients, and still ensure the R0 resection rate. Moreover, it may does not significantly increase the difficulty of surgical operation or reduce safety. However, further research is needed to confirm our conclusion. And then, neoadjuvant therapy in the perioperative period may induce a series of side effects or adverse reactions, and thus greater attention should be paid to its timely management