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Papers by alberto salvicchi

European journal of cardio-thoracic surgery, Feb 10, 2024

Video-assisted thoracic surgery, Nov 30, 2023

Journal of Thoracic Disease, Oct 31, 2023

International Journal of Surgery Case Reports

Life

Current guidelines recommend surgery for early-stage non-small cell lung cancer (NSCLC). The stan... more Current guidelines recommend surgery for early-stage non-small cell lung cancer (NSCLC). The standard treatment for patients with cT1N0 NSCLC has been lobectomy with lymph-node dissection, with sublobar resection used only in patients with inadequate cardio-respiratory reserve, with poor performance status, or who are elderly. In 1995, the Lung Cancer Study Group published the results of a randomized, prospective trial demonstrating the superiority of lobectomy compared with sublobar resection. From then on, wedge resection and segmentectomy were reserved exclusively for patients with poor functional reserve who could not tolerate lobectomy. Therefore, the exact role of segmentectomy has been controversial over the past 20 years. Recently, the randomized controlled trial JCOG0802/WJOG4607L demonstrated that segmentectomy was superior to lobectomy in patients with stage IA NSCLC (<2 cm and CTR < 0.5) in terms of both overall-survival and post-operative lung function. Based on t...

Asian Cardiovascular and Thoracic Annals

Background The role of video-assisted thoracoscopic segmentectomy in the treatment of clinical IA... more Background The role of video-assisted thoracoscopic segmentectomy in the treatment of clinical IA non-small-cell lung cancer is not well established. The aim of our retrospective analysis was to evaluate the oncological results of complex and simple video-assisted thoracoscopic segmentectomy. Methods From 2015 to June 2020, data of n = 163 consecutive patients undergoing video-assisted thoracoscopic segmentectomy for solitary pulmonary nodule were analysed. The Kaplan–Meier method, log-rank test and Cox regression were used to estimate, compare survivals and identify risk factors of worse oncological outcomes. Results In this period, n = 123 patients underwent video-assisted thoracoscopic segmentectomy for non-small-cell lung cancer: we performed n = 65 simple and n = 58 complex video-assisted thoracoscopic segmentectomy; n = 99 (80.5%) had a solid appearance on computed tomography scan and n = 78 (63.4%) a moderate-to-high [18F]-2-fluoro-2-deoxy-D-glucose (FDG)-positron emission to...

Interdisciplinary CardioVascular and Thoracic Surgery

OBJECTIVESThe functional impact of thoracoscopic basal segmentectomy in comparison with lower lob... more OBJECTIVESThe functional impact of thoracoscopic basal segmentectomy in comparison with lower lobectomy has not been investigated in-depth and the aim of this study was to clarify this topic.METHODSWe retrospectively analysed a cohort of patients who underwent surgery between 2015 and 2019 for non-small-cell lung cancer, peripherally located lung nodules, far enough from both the apical segment and the lobar hilum to allow an oncologically safe thoracoscopic lower lobectomy or basal segmentectomy. Pulmonary function tests (PFTs) including spirometry and plethysmography were performed 1 month after surgery and forced expiratory volume in 1 s, forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) were collected; the difference, the loss and the recovery rate of pulmonary function were calculated and compared with the Wilcoxon–Mann–Whitney test.RESULTSDuring the study period, n = 45 and n = 16 patients for video-assisted thoracoscopic surgery (VATS) lower lobect...

Translational Lung Cancer Research

Biomedicines

Bronchiolitis obliterans syndrome (BOS) is the most common form of CLAD and is characterized by a... more Bronchiolitis obliterans syndrome (BOS) is the most common form of CLAD and is characterized by airflow limitation and an obstructive spirometric pattern without high-resolution computed tomography (HRCT) evidence of parenchymal opacities. Computed tomography and microCT analysis show abundant small airway obstruction, starting from the fifth generation of airway branching and affecting up to 40–70% of airways. The pathogenesis of BOS remains unclear. It is a multifactorial syndrome that leads to pathological tissue changes and clinical manifestations. Because BOS is associated with the worst long-term survival in LTx patients, many studies are focused on the early identification of BOS. Markers may be useful for diagnosis and for understanding the molecular and immunological mechanisms involved in the onset of BOS. Diagnostic and predictive markers of BOS have also been investigated in various biological materials, such as blood, BAL, lung tissue and extracellular vesicles. The aim...

Journal of Clinical Medicine

The chest wall can be involved in both primary and secondary tumors, and even today, their manage... more The chest wall can be involved in both primary and secondary tumors, and even today, their management and treatment continue to be a challenge for surgeons. Primary chest-wall tumors are relatively rare and include a large group of neoplasms that can arise from not only bone or cartilage of the chest wall but also from associated subcutaneous tissue from muscle and blood vessels. Secondary tumors refer to a direct invasion of the chest wall by neoplasms located elsewhere in the body, mainly metastases from breast cancer and lung cancer. En-bloc surgical excision of the lesion should ensure adequate negative margins to avoid local recurrence, and a full thickness surgical resection is often required, and it can result in important chest-wall defects such as skeletal instability or impaired breathing dynamics. The reconstruction of large defects of the chest wall can be complex and often requires the use of prosthetic and biologic mesh materials. This article aims to review the litera...

The International Journal of Medical Robotics and Computer Assisted Surgery

Flail Chest (FC) is a most life-threatening complication of chest blunt trauma and it is defined ... more Flail Chest (FC) is a most life-threatening complication of chest blunt trauma and it is defined as the fracture of three or more consecutive ribs, resulting in a paradoxical movement of a segment of the thoracic wall during spontaneous breathing. A 46 year-old patient had clinical presentation of post-traumatic, with a Computed Tomography (CT) scan showing multiple fractures of chondralsternal cartilage and sternal fractures. In a few hours the patient’s respiratory functionality and hemodynamic worsened so the patient underwent early Surgical Stabilization of Rib Fractures (SSRF). In this case we preferred to use the STRATOS system, placing rib clips with a connecting bar from the third rib to the fifth rib, with a positive outcome. Surgical stabilization of anterior FC is a safe procedure and reduces mortality, morbidity, duration of mechanical ventilation, Hospital Length of Stay (HLOS) and Intensive Care Unit Length of Stay (ICU-LOS). In polytraumatized patients, early stabiliz...

Computers & Operations Research, 2021

Objective: The objectives of our retrospective analysis were to estimate the oncological long-ter... more Objective: The objectives of our retrospective analysis were to estimate the oncological long-term results of patients with ypN2 and to evaluate the impact of lymph node ratio (LNR) on overall (OS) and disease-free survival (DFS). Methods: We analysed all consecutive patients (n=85) undergoing neoadjuvant chemotherapy (NAC) and surgery for pre-operative pathologically proven stage IIIA-B (N2) NSCLC from 2014 to 2020. Median LNR (0.29 or 29%) was selected as threshold for grouping. Survival was estimated using the Kaplan-Meier method. Cox regression was used to test the association between OS, DFS and covariates. Results: Post-operative mortality was 3.5%. The median follow-up was 21 months (range 6-69 months). The 5-year OS and DFS of the cohort were 41% and 20%. Patients with LNR>0.29 (n=13; 15.3%) showed a trend toward worse survival than patients with LNR0 (n=44; 51.8%) with a 5-year OS of 56% VS 14% (p=0.077), confirmed as a trend at the multivariable analysis (HR 2.28; p=0.0...

Current Challenges in Thoracic Surgery, 2021

Indian Journal of Surgery, 2021

Clear cell carcinoma is a variant of thymic epithelial malignant tumors that is rarely associated... more Clear cell carcinoma is a variant of thymic epithelial malignant tumors that is rarely associated with paraneoplastic syndrome, like myasthenia gravis, or thymoma. Thymic carcinoma (TC) is often asymptomatic and unresectable or metastatic at presentation, so the prognosis is poor also due to the lack of standardized multimodality treatments. We report a successful case of a robot-assisted radical thymectomy in a 63-year-old man affected by stage V myasthenia gravis who presented generalized weakness and respiratory failure, treated by mechanical ventilation and tracheostomy. The post-operative course was uneventful. The final pathological examination showed the presence of two distinct lesions: a type B3 Masaoka-Koga stage I thymoma and a clear cell carcinoma completely encapsulated. The patient is alive without recurrence and partial remission of the myasthenia after radical thymectomy.

Journal of Xiangya Medicine, 2020