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  1. Article ; Online: Advances in Lung Transplantation.

    Tosi, Davide / Palleschi, Alessandro

    Cells

    2023  Volume 12, Issue 6

    Abstract: Nowadays, lung transplantation is a clinical reality for the treatment of benign end-stage respiratory diseases [ ... ]. ...

    Abstract Nowadays, lung transplantation is a clinical reality for the treatment of benign end-stage respiratory diseases [...].
    MeSH term(s) Lung Transplantation ; Humans
    Language English
    Publishing date 2023-03-17
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells12060923
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A real-world experience of transition to robotic-assisted thoracic surgery (RATS) for lung resections.

    Palleschi, Alessandro / Mattioni, Giovanni / Mendogni, Paolo / Tosi, Davide

    Frontiers in surgery

    2023  Volume 10, Page(s) 1127627

    Abstract: Objective: We report our experience of transition to robotic-assisted thoracic surgery (RATS) for lung resections with the da Vinci Xi surgical system, exposing short-term results.: Materials and methods: This is a single-center, retrospective ... ...

    Abstract Objective: We report our experience of transition to robotic-assisted thoracic surgery (RATS) for lung resections with the da Vinci Xi surgical system, exposing short-term results.
    Materials and methods: This is a single-center, retrospective analysis of RATS lung resections performed between April 2021 and September 2022 during our new robotic program. The surgical approach evolved over time, starting from a four-arm approach with four incisions. Alternative RATS approaches were subsequently evaluated, such as uniportal and biportal.
    Results: During a 17-month period, 29 lung resections were performed. Of them, 16 were lobectomies, 7 were segmentectomies, and 6 were wedge resections. The most common indication for anatomical lung resection was non-small cell lung cancer. A uniportal approach was used for two simple segmentectomies and a biportal RATS was performed in five lobectomies and two segmentectomies. A mean number of 8.1 lymph nodes and a mean of 2.6 N2 and 1.9 N1 stations were resected during surgery, and no nodal upstaging was observed. Negative resection margins were 100%. There were two (7%) conversions, one to open surgery and one to video-assisted thoracic surgery (VATS). Eight (28%) patients experienced complications with no 30-day mortality.
    Discussion: High-ergonomic and high-quality views were immediately observed. After some procedures, we abandoned uniportal RATS because of the possibility of arm collisions and the necessity of a VATS-skilled surgeon at the operating table.
    Conclusion: RATS for lung resections was safe and effective, and from the surgeon's standpoint, several practical advantages over VATS were observed. Further analysis on outcomes will help better understand the value of this technology.
    Language English
    Publishing date 2023-03-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2023.1127627
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Approaches and outcomes of Robotic-Assisted Thoracic Surgery (RATS) for lung cancer: a narrative review.

    Mattioni, Giovanni / Palleschi, Alessandro / Mendogni, Paolo / Tosi, Davide

    Journal of robotic surgery

    2022  Volume 17, Issue 3, Page(s) 797–809

    Abstract: Robotic-Assisted Thoracic Surgery (RATS) is considered one of the main issues of present thoracic surgery. RATS is a minimally invasive surgical technique allowing enhanced view, accurate and complex movements, and high ergonomics for the surgeon. ... ...

    Abstract Robotic-Assisted Thoracic Surgery (RATS) is considered one of the main issues of present thoracic surgery. RATS is a minimally invasive surgical technique allowing enhanced view, accurate and complex movements, and high ergonomics for the surgeon. Despite these advantages, its application in lung procedures has been limited, mainly by its costs. Since now many different approaches have been proposed and the experience in RATS for lungs ranges from wedge resection to pneumonectomy and is mainly related to lung cancer. The present narrative review explores main approaches and outcomes of RATS lobectomy for lung cancer. A non-systematic review of literature was conducted using the PubMed search engine. An overview of lung robotic surgery is given, and main approaches of robotic lobectomy for lung cancer are exposed. Initial experiences of biportal and uniportal RATS are also described. So far, retrospective analysis reported satisfactory robotic operative outcomes, and comparison with VATS might suggest a more accurate lymphadenectomy. Some Authors might even suggest better perioperative outcomes too. From an oncological standpoint, no definitive prospective study has yet been published but several retrospective analyses report oncological outcomes comparable to those of VATS and open surgery. Literature suggests that RATS for lung procedures is safe and effective and should be considered as a valid additional surgical option.
    MeSH term(s) Humans ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Thoracic Surgery ; Prospective Studies ; Thoracic Surgery, Video-Assisted/methods ; Lung Neoplasms/surgery
    Language English
    Publishing date 2022-12-21
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-022-01512-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Pneumonectomy for Unilateral Proximal Interruption of Pulmonary Artery: A Case Series from the Literature.

    Mattioni, Giovanni / Nosotti, Mario / Rosso, Lorenzo / Palleschi, Alessandro / Tosi, Davide / Mendogni, Paolo

    Life (Basel, Switzerland)

    2023  Volume 13, Issue 12

    Abstract: Background: Unilateral proximal interruption of the pulmonary artery (UPIPA) is a rare congenital disease, and its optimal management remains undefined in the existing literature. The occasional necessity for pneumonectomy is still supported by limited ... ...

    Abstract Background: Unilateral proximal interruption of the pulmonary artery (UPIPA) is a rare congenital disease, and its optimal management remains undefined in the existing literature. The occasional necessity for pneumonectomy is still supported by limited evidence.
    Methods: A systematic review of the literature was conducted using the PubMed search engine, focusing on UPIPA cases that received pneumonectomy. Thirty-one pertinent articles were selected and included in the analysis. A case reported from our institution was included in the analysis.
    Results: We found 25 adults and seven children affected by UPIPA who received an indication for pneumonectomy, plus an additional case that was reported by our institution. Among adult patients, the predominant indication was hemoptysis (57%), followed by suspected or confirmed lung cancer (23%). Approximately 46% of surgical procedures were classified as urgent or emergent. Postoperative complications were observed in 36% of cases, with no recorded mortality. In pediatric cases, pneumonectomy was primarily a life-saving intervention, performed urgently or emergently in 75% of instances. A possible late complication in pediatric patients involves a mediastinal shift leading to respiratory distress, which may be mitigated using an inflatable prosthesis.
    Conclusions: Pneumonectomy achieves complete resolution of UPIPA symptoms. In the adult population, its primary indication is hemoptysis, with procedures conducted in both elective and urgent/emergent settings. Despite a mortality rate of zero, a notable proportion of patients may experience postoperative complications. In pediatric cases, the clinical presentation varies more extensively, and pneumonectomy is typically reserved for life-threatening situations, emphasizing the need for careful patient selection.
    Language English
    Publishing date 2023-12-12
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13122328
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Donation after circulatory death: possible strategies for in-situ organ preservation.

    Zanierato, Marinella / Dondossola, Daniele / Palleschi, Alessandro / Zanella, Alberto

    Minerva anestesiologica

    2020  Volume 86, Issue 9, Page(s) 984–991

    Abstract: Donation after circulatory death (DCD) is an accepted strategy to expand the potential donor pool. The complexity of organ procurement from DCD donors requires the development of new strategies for organ preservation. Standard DCD organ recovery involves ...

    Abstract Donation after circulatory death (DCD) is an accepted strategy to expand the potential donor pool. The complexity of organ procurement from DCD donors requires the development of new strategies for organ preservation. Standard DCD organ recovery involves a super rapid technique, with cold thoracic and abdominal perfusion. However, the conventional methods of preservation based on static and hypothermic storage may not be the most appropriate for DCD grafts, especially in the presence of long warm ischemia times. New strategies designed to improve the preservation of in-situ DCD grafts include the use of normothermic regional perfusion (NRP) for abdominal organs and concomitant cold lung flushing. The use of in-situ NRP is a significant advance in abdominal organ retrieval and it has the potential to increase organ recovery rates due to its applicability in both controlled and uncontrolled DCD donors. We describe an innovative preservation strategy based on the combination of donor NRP for abdominal organ preservation and a normothermic open-lung approach with protective mechanical ventilation for lung preservation.
    MeSH term(s) Death ; Extracorporeal Circulation ; Humans ; Organ Preservation ; Perfusion ; Tissue Donors ; Tissue and Organ Procurement
    Language English
    Publishing date 2020-04-06
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 123584-9
    ISSN 1827-1596 ; 0026-4717 ; 0375-9393
    ISSN (online) 1827-1596
    ISSN 0026-4717 ; 0375-9393
    DOI 10.23736/S0375-9393.20.14262-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Outcomes of extended surgical resections for locally advanced thymic malignancies: a narrative review.

    Tosi, Davide / Damarco, Francesco / Franzi, Sara / Mohamed, Shehab / Palleschi, Alessandro / Mendogni, Paolo

    Gland surgery

    2022  Volume 11, Issue 3, Page(s) 611–621

    Abstract: Background and objective: Thymic malignancies represent the most common anterior mediastinal neoplasms, as well as rare and challenging tumors. Surgery is the cornerstone in the treatment of thymic malignancies, although a multidisciplinary approach is ... ...

    Abstract Background and objective: Thymic malignancies represent the most common anterior mediastinal neoplasms, as well as rare and challenging tumors. Surgery is the cornerstone in the treatment of thymic malignancies, although a multidisciplinary approach is mandatory, for both, locally advanced or metastatic disease. In our narrative review, we explored the recent literature to investigate clinical and radiological assessment, multimodality approach and outcomes of locally advanced thymic tumors. More than one-third of patients affected by an anterior mediastinal mass are asymptomatic at diagnosis. In case of locally advanced thymoma, symptoms are related to compression or invasion of adjacent structures, such as the superior vena cava (SVC), innominate veins and pericardium. Paraneoplastic syndromes, such as myasthenia gravis (MG), are related to release of antibodies, hormones and cytokines.
    Methods: Diagnostic methods must be chosen accurately to avoid unnecessary surgical resections, to define the best strategy of care, and to plan the surgical strategy. Therefore, each case must be evaluated in a multidisciplinary context, where surgery plays an essential role.
    Key content and findings: In this narrative review, we describe indications and surgical techniques for the treatment of locally advanced thymoma; focusing on oncological outcomes after different approaches.
    Conclusions: In conclusion, aggressive surgery is always indicated, when possible, and when a complete resection can be planned, yet, the multidisciplinary approach is mandatory, in case of both locally or metastatic advanced disease.
    Language English
    Publishing date 2022-03-31
    Publishing country China (Republic : 1949- )
    Document type Journal Article ; Review
    ZDB-ID 3016969-0
    ISSN 2227-8575 ; 2227-684X
    ISSN (online) 2227-8575
    ISSN 2227-684X
    DOI 10.21037/gs-21-642
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  7. Article: Telemonitoring: An opportunity in cystic fibrosis lung transplant recipients.

    Corinna Morlacchi, Letizia / Privitera, Emilia / Rossetti, Valeria / Santambrogio, Martina / Bellofiore, Angela / Rosso, Lorenzo / Palleschi, Alessandro / Nosotti, Mario / Blasi, Francesco

    Heliyon

    2023  Volume 9, Issue 10, Page(s) e19931

    Abstract: Introduction: Telemedicine has been successfully employed in a wide range of conditions, such as such as chronic lung disease and COVID-19. This study evaluate the role of telemonitoring for the early diagnosis of acute lung allograft dysfunction in ... ...

    Abstract Introduction: Telemedicine has been successfully employed in a wide range of conditions, such as such as chronic lung disease and COVID-19. This study evaluate the role of telemonitoring for the early diagnosis of acute lung allograft dysfunction in cystic fibrosis adults who underwent lung transplant (LuTx). Quality of life and functional level achieved during a 12 months follow up were assessed.
    Methods: Patients were randomized into two groups; control group received traditional hospital-based follow-up, whereas patients in the intervention group received, on top of standard care, a telemonitoring device, with a pulse oximeter and a spirometer integrated. Telemonitoring data were digitally transmitted to our centre.
    Results: Sixteen patients were enrolled in each group. No statistically significant difference was found between the two groups in terms of incidence of allograft dysfunction, time from onset of symptoms to diagnosis and time of occurrence from LuTx. Moreover, both groups achieved similar quality of life and functional level. With reference to the telemonitoring group: 1) hospital reported data were consistent with those being remotely registered; 2) adherence to telemonitoring decreased during the follow up; 3) the majority of patients reported a high degree of satisfaction.
    Conclusion: The COVID19 pandemic highlighted the necessity to investigate alternative practices to treat chronically ill individuals. Telemonitoring is a valuable tool to improve quality care to LuTx recipients.
    Language English
    Publishing date 2023-09-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2023.e19931
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Pulmonary Lobectomy for Early-Stage Lung Cancer with Uniportal versus Three-Portal Video-Assisted Thoracic Surgery: Results from a Single-Centre Randomized Clinical Trial.

    Tosi, Davide / Mazzucco, Alessandra / Musso, Valeria / Bonitta, Gianluca / Rosso, Lorenzo / Mendogni, Paolo / Righi, Ilaria / Carrinola, Rosaria / Damarco, Francesco / Palleschi, Alessandro

    Journal of clinical medicine

    2023  Volume 12, Issue 22

    Abstract: Video-assisted thoracic surgery (VATS) is a consolidated approach; however, there is no consensus on the number of ports leading to less postoperative pain. We compared early postoperative pain after uniportal and three-portal VATS lobectomy for early- ... ...

    Abstract Video-assisted thoracic surgery (VATS) is a consolidated approach; however, there is no consensus on the number of ports leading to less postoperative pain. We compared early postoperative pain after uniportal and three-portal VATS lobectomy for early-stage NSCLC. In this randomized clinical trial, patients undergoing VATS lobectomy were randomly assigned to receive uniportal (U-VATS Group) or three-portal (T-VATS Group) VATS. The inclusion criteria were age ≤ 80 years and ASA < 4. The exclusion criteria were clinical T3, previous thoracic surgery, induction therapy, chest radiotherapy, connective tissue or vascular diseases, major organ failure, and analgesics or corticosteroids use. The postoperative analgesia protocol was based on NRS. Pain was measured as analgesic consumption; the secondary endpoints were intra- and postoperative complications, conversion rate, surgical time, dissected lymph nodes, hospital stay, and respiratory function. Out of 302 eligible patients, 120 were included; demographics were distributed homogeneously. The mean cumulative morphine consumption (CMC) in the U-VATS Group after 7 days was lower than in the T-VATS Group (77.4 mg vs. 90.1 mg,
    Language English
    Publishing date 2023-11-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12227167
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  9. Article: Management of Pleural Effusion Secondary to Malignant Mesothelioma.

    Musso, Valeria / Diotti, Cristina / Palleschi, Alessandro / Tosi, Davide / Aiolfi, Alberto / Mendogni, Paolo

    Journal of clinical medicine

    2021  Volume 10, Issue 18

    Abstract: Malignant pleural mesothelioma (MPM) is a highly aggressive pleural tumour which has been epidemiologically linked to occupational exposure to asbestos. MPM is often associated with pleural effusion, which is a common cause of morbidity and whose ... ...

    Abstract Malignant pleural mesothelioma (MPM) is a highly aggressive pleural tumour which has been epidemiologically linked to occupational exposure to asbestos. MPM is often associated with pleural effusion, which is a common cause of morbidity and whose management remains a clinical challenge. In this review, we analysed the literature regarding the diagnosis and therapeutic options of pleural effusion secondary to mesothelioma. Our aim was to provide a comprehensive view on this subject, and a new algorithm was proposed as a practical aid to clinicians dealing with patients suffering from pleural effusion.
    Language English
    Publishing date 2021-09-19
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm10184247
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Computational fluid dynamics of the airways after left-upper pulmonary lobectomy: A case study.

    Tullio, Marta / Aliboni, Lorenzo / Pennati, Francesca / Carrinola, Rosaria / Palleschi, Alessandro / Aliverti, Andrea

    International journal for numerical methods in biomedical engineering

    2021  Volume 37, Issue 7, Page(s) e3462

    Abstract: Pulmonary lobectomy is the gold standard intervention for lung cancer removal and consists of the complete resection of the affected lung lobe, which, coupled with the re-adaptation of the remaining thoracic structures, decreases the postoperative ... ...

    Abstract Pulmonary lobectomy is the gold standard intervention for lung cancer removal and consists of the complete resection of the affected lung lobe, which, coupled with the re-adaptation of the remaining thoracic structures, decreases the postoperative pulmonary function of the patient. Current clinical practice, based on spirometry and cardiopulmonary exercise tests, does not consider local changes, providing an average at-the-mouth estimation of residual functionality. Computational Fluid Dynamics (CFD) has proved a valuable solution to obtain quantitative and local information about airways airflow dynamics. A CFD investigation was performed on the airway tree of a left-upper pulmonary lobectomy patient, to quantify the effects of the postoperative alterations. The patient-specific bronchial models were reconstructed from pre- and postoperative CT scans. A parametric laryngeal model was merged to the geometries to account for physiological-like inlet conditions. Numerical simulations were performed in Fluent. The postoperative configuration revealed fluid dynamic variations in terms of global velocity (+23%), wall pressure (+48%), and wall shear stress (+39%). Local flow disturbances emerged at the resection site: a high-velocity peak of 4.92 m/s was found at the left-lower lobe entrance, with a local increase of pressure at the suture zone (18 Pa). The magnitude of pressure and secondary flows increased in the trachea and flow dynamics variations were observed also in the contralateral lung, causing altered lobar ventilation. The results confirmed that CFD is a patient-specific approach for a quantitative evaluation of fluid dynamics parameters and local ventilation providing additional information with respect to current clinical approaches.
    MeSH term(s) Bronchi ; Computer Simulation ; Humans ; Hydrodynamics ; Lung/diagnostic imaging ; Lung/surgery ; Trachea
    Language English
    Publishing date 2021-06-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2540968-2
    ISSN 2040-7947 ; 2040-7939
    ISSN (online) 2040-7947
    ISSN 2040-7939
    DOI 10.1002/cnm.3462
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