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Latest Advances in Thoracic Surgery
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Latest Advances in Thoracic Surgery

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

Deadline for manuscript submissions: closed (15 March 2024) | Viewed by 4161

Special Issue Editor

Dr. Hideki Ujiie

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan
Interests: cancer biology; lung cancer; surgical oncology; robotic surgery; thoracic surgery; lung diseases; minimally invasive surgery; airway obstruction; pulmonary medicine; respiration disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am pleased to announce this Special Issue entitled “Latest Advances in Thoracic Surgery”.

This Special Issue aims to discuss three primary topics:

  1. Minimally Invasive Techniques: Thoracic surgery has seen significant advancements in minimally invasive procedures. Video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery (RATS) have become more prevalent. These techniques involve smaller incisions, reduced trauma, shorter hospital stays, and faster recovery times for patients compared to traditional open surgery.
  2. Lung Cancer Treatments: Advances in lung cancer treatments have led to improved surgical outcomes. These include the application of targeted therapies and immunotherapies, which have expanded the treatment options for patients with advanced or recurrent lung cancer.
  3. Image-Guided Surgery: Advanced imaging technologies, such as 3D CT scans and intraoperative navigation systems, have allowed surgeons to grain a more precise view of the thoracic structures during surgery. This enables them to perform more accurate and targeted procedures.

It is important to note that the field of medicine, including thoracic surgery, is continuously evolving. New advancements may have emerged since my last update, and I would like to discuss these topics.

Dr. Hideki Ujiie
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

  • lung cancer
  • surgical oncology
  • robotic surgery
  • thoracic surgery
  • lung diseases
  • minimally invasive surgery

Published Papers (4 papers)

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Research

11 pages, 3130 KiB  
Article
A System for Mixed-Reality Holographic Overlays of Real-Time Rendered 3D-Reconstructed Imaging Using a Video Pass-through Head-Mounted Display—A Pathway to Future Navigation in Chest Wall Surgery
by Jan Arensmeyer, Benedetta Bedetti, Philipp Schnorr, Jens Buermann, Donatas Zalepugas, Joachim Schmidt and Philipp Feodorovici
J. Clin. Med. 2024, 13(7), 2080; https://doi.org/10.3390/jcm13072080 - 3 Apr 2024
Viewed by 854
Abstract
Background: Three-dimensional reconstructions of state-of-the-art high-resolution imaging are progressively being used more for preprocedural assessment in thoracic surgery. It is a promising tool that aims to improve patient-specific treatment planning, for example, for minimally invasive or robotic-assisted lung resections. Increasingly available mixed-reality hardware [...] Read more.
Background: Three-dimensional reconstructions of state-of-the-art high-resolution imaging are progressively being used more for preprocedural assessment in thoracic surgery. It is a promising tool that aims to improve patient-specific treatment planning, for example, for minimally invasive or robotic-assisted lung resections. Increasingly available mixed-reality hardware based on video pass-through technology enables the projection of image data as a hologram onto the patient. We describe the novel method of real-time 3D surgical planning in a mixed-reality setting by presenting three representative cases utilizing volume rendering. Materials: A mixed-reality system was set up using a high-performance workstation running a video pass-through-based head-mounted display. Image data from computer tomography were imported and volume-rendered in real-time to be customized through live editing. The image-based hologram was projected onto the patient, highlighting the regions of interest. Results: Three oncological cases were selected to explore the potentials of the mixed-reality system. Two of them presented large tumor masses in the thoracic cavity, while a third case presented an unclear lesion of the chest wall. We aligned real-time rendered 3D holographic image data onto the patient allowing us to investigate the relationship between anatomical structures and their respective body position. Conclusions: The exploration of holographic overlay has proven to be promising in improving preprocedural surgical planning, particularly for complex oncological tasks in the thoracic surgical field. Further studies on outcome-related surgical planning and navigation should therefore be conducted. Ongoing technological progress of extended reality hardware and intelligent software features will most likely enhance applicability and the range of use in surgical fields within the near future. Full article
(This article belongs to the Special Issue Latest Advances in Thoracic Surgery)
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11 pages, 1832 KiB  
Article
Suitable Patient Selection and Optimal Timing of Treatment for Persistent Air Leak after Lung Resection
by Yoshikane Yamauchi, Hiroyuki Adachi, Nobumasa Takahashi, Takao Morohoshi, Taketsugu Yamamoto, Makoto Endo, Tsuyoshi Ueno, Tekkan Woo, Yuichi Saito and Noriyoshi Sawabata
J. Clin. Med. 2024, 13(4), 1166; https://doi.org/10.3390/jcm13041166 - 19 Feb 2024
Viewed by 757
Abstract
Objectives: The choice of therapeutic intervention for postoperative air leak varies between institutions. We aimed to identify the optimal timing and patient criteria for therapeutic intervention in cases of postoperative air leaks after lung resection. Methods: This study utilized data from a prospective [...] Read more.
Objectives: The choice of therapeutic intervention for postoperative air leak varies between institutions. We aimed to identify the optimal timing and patient criteria for therapeutic intervention in cases of postoperative air leaks after lung resection. Methods: This study utilized data from a prospective multicenter observational study conducted in 2019. Among the 2187 cases in the database, 420 cases with air leaks on postoperative day 1 were identified. The intervention group underwent therapeutic interventions, such as pleurodesis or surgery, while the observation group was monitored without intervention. A comparison between the intervention group and the observation group were analyzed using the cumulative distribution and hazard functions. Results: Forty-six patients (11.0%) were included in the intervention group. The multivariate analysis revealed that low body mass index (p = 0.019), partial resection (p = 0.010), intraoperative use of fibrin glue (p = 0.008), severe air leak on postoperative day 1 (p < 0.001), and high forced expiratory volume in 1 s (p = 0.021) were significant predictors of the requirement for intervention. The proportion of patients with persistent air leak in the observation group was 20% on postoperative day 5 and 94% on postoperative day 7. The hazard of air leak cessation peaked from postoperative day 3 to postoperative day 7. Conclusions: This research contributes valuable insights into predicting therapeutic interventions for postoperative air leaks and identifies scenarios where spontaneous cessation is probable. A validation through prospective studies is warranted to affirm these findings. Full article
(This article belongs to the Special Issue Latest Advances in Thoracic Surgery)
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10 pages, 1485 KiB  
Article
Developing a Virtual Reality Simulation System for Preoperative Planning of Robotic-Assisted Thoracic Surgery
by Hideki Ujiie, Ryohei Chiba, Aogu Yamaguchi, Shunsuke Nomura, Haruhiko Shiiya, Aki Fujiwara-Kuroda, Kichizo Kaga, Chad Eitel, Tod R. Clapp and Tatsuya Kato
J. Clin. Med. 2024, 13(2), 611; https://doi.org/10.3390/jcm13020611 - 21 Jan 2024
Cited by 1 | Viewed by 1329
Abstract
Background. Robotic-assisted thoracic surgery (RATS) is now standard for lung cancer treatment, offering advantages over traditional methods. However, RATS’s minimally invasive approach poses challenges like limited visibility and tactile feedback, affecting surgeons’ navigation through com-plex anatomy. To enhance preoperative familiarization with patient-specific [...] Read more.
Background. Robotic-assisted thoracic surgery (RATS) is now standard for lung cancer treatment, offering advantages over traditional methods. However, RATS’s minimally invasive approach poses challenges like limited visibility and tactile feedback, affecting surgeons’ navigation through com-plex anatomy. To enhance preoperative familiarization with patient-specific anatomy, we devel-oped a virtual reality (VR) surgical navigation system. Using head-mounted displays (HMDs), this system provides a comprehensive, interactive view of the patient’s anatomy pre-surgery, aiming to improve preoperative simulation and intraoperative navigation. Methods. We integrated 3D data from preoperative CT scans into Perspectus VR Education software, displayed via HMDs for in-teractive 3D reconstruction of pulmonary structures. This detailed visualization aids in tailored preoperative resection simulations. During RATS, surgeons access these 3D images through Tile-ProTM multi-display for real-time guidance. Results. The VR system enabled precise visualization of pulmonary structures and lesion relations, enhancing surgical safety and accuracy. The HMDs offered true 3D interaction with patient data, facilitating surgical planning. Conclusions. VR sim-ulation with HMDs, akin to a robotic 3D viewer, offers a novel approach to developing robotic surgical skills. Integrated with routine imaging, it improves preoperative planning, safety, and accuracy of anatomical resections. This technology particularly aids in lesion identification in RATS, optimizing surgical outcomes. Full article
(This article belongs to the Special Issue Latest Advances in Thoracic Surgery)
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15 pages, 1302 KiB  
Article
The Efficacy of Continuous Serratus Anterior and Erector Spinae Plane Blocks vs Intercostal Nerve Block in Uniportal-Vats Surgery: A Propensity-Matched Prospective Trial
by Dania Nachira, Giovanni Punzo, Giuseppe Calabrese, Flaminio Sessa, Maria Teresa Congedo, Giovanna Beccia, Paola Aceto, Khrystyna Kuzmych, Chiara Cambise, Carolina Sassorossi, Adriana Nocera, Alessia Senatore, Maria Letizia Vita, Elisa Meacci, Liliana Sollazzi and Stefano Margaritora
J. Clin. Med. 2024, 13(2), 606; https://doi.org/10.3390/jcm13020606 - 21 Jan 2024
Viewed by 876
Abstract
Background: To evaluate the analgesic efficacy of continuous erector spinae plane block(c-ESPB) and serratus anterior plane block(c-SAPB) versus the intercostal nerve block (ICNB) in Uniportal-VATS in terms of pain control, drug consumption, and complications. Methods: Ninety-three consecutive patients, undergone one of the three [...] Read more.
Background: To evaluate the analgesic efficacy of continuous erector spinae plane block(c-ESPB) and serratus anterior plane block(c-SAPB) versus the intercostal nerve block (ICNB) in Uniportal-VATS in terms of pain control, drug consumption, and complications. Methods: Ninety-three consecutive patients, undergone one of the three peripheral nerve blocks after Uniportal-VATS, were prospectively enrolled. A 1:1 propensity score matching was used to minimize bias. Results: C-ESPB and c-SAPB groups had no difference in morphine request upon awakening compared to ICNB. A higher VAS-score was recorded in c-ESPB compared to ICNB in the first 12 h after surgery. A significantly lower consumption of paracetamol in II postoperative day (p.o.d.) and tramadol in I and II p.o.d. was recorded in the c-ESPB group compared to the ICNB group. A higher dynamic VAS score was recorded at 24 h and 48 h in the ICNB group compared to the c-SAPB. No difference was found in safety, VAS-score and drug consumption between c-ESPB and c-SAPB at any given time, except for a higher tramadol request in c-SAPB in II p.o.d. Conclusions: C-ESPB and c-SAPB appear to have the same safety and analgesic efficacy when compared between them and to ICNB in Uniportal-VATS approach. C-ESPB showed a delayed onset of analgesic effect and a lower postoperative drug consumption compared to ICNB. Full article
(This article belongs to the Special Issue Latest Advances in Thoracic Surgery)
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