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Video assisted thoracic surgery (VATS) for recurrent thymoma
No full textBetween 10-30% of patients that undergo a radical operation for thymoma develop a recurrence in a variable range of time. The surgical treatment of thymoma relapses is an established and effective therapeutic approach, particularly for a single intrathoracic recurrence; however, no agreement has been reached on the best surgical approach and the extent of surgical resection, particularly in the most common event of pleural relapses. In the era of minimally invasive approach for most thoracic pathologies, the role of the video assisted thoracic surgery (VATS) approach for thymoma recurrence resection is still unclear and controversial: to date, only few authors have reported in their series a thoracoscopic resection of pleuro-pulmonary relapses, mostly when a single lesion was present. Furthermore, a thoracoscopic approach for mediastinal recurrence has been rarely reported after a previous sternotomy to resect the primary tumor. It is likely that in the future, the role of VATS for thymic recurrence resection will be better defined and extensively studied
Robotic thymectomy
Full text linkThymectomy is the most frequent surgical operation involving the mediastinum, both for the treatment of thymic tumors and for the multidisciplinary management of myasthenia gravis (MG). Different surgical approaches have been described, either traditional open approaches or minimally invasive ones. Robotic thymectomy represents a further step in the evolution of minimally invasive surgery. Available data show that robotic thymectomy may be considered a safe and feasible operation, with encouraging long-term results in myasthenic patients and promising results in patients with early stage thymoma, both in terms of surgical and oncological outcomes. We present the surgical technique of robotic thymectomy that we apply for patients affected by myasthenia gravis and early stage thymoma
Pleural recurrences of thymoma: Role and effectiveness of intrathoracic chemohyperthermia
Full text linkThymoma is a rare tumor of the anterior mediastinum characterized by a relatively indolent behavior. Surgery is the cornerstone in the treatment of this tumor and completeness of resection is the main prognostic facto
Successful Treatment of a Recurrent Wide Tracheoesophageal Fistula With a Bioabsorbable Patch
No full textAcquired nonmalignant tracheoesophageal fistula (TEF) is a rare condition that requires proper treatment. We present the case of a 55-year-old woman with a 4.5-cm recurrent TEF, which had developed after an attempted surgical repair. After closure of the esophageal defect in two layers, a tracheoplasty technique was used to repair the tracheal membranous wall with a synthetic bioabsorbable patch (Gore Bio-A tissue reinforcement) covered with an intercostal muscle flap. The use of Gore Bio-A tissue reinforcement is an innovative and effective method to close a wide tracheal defect while achieving a scaffold for epithelial colonization
Successful Treatment of a Recurrent Wide Tracheoesophageal Fistula With a Bioabsorbable Patch
No full textAcquired nonmalignant tracheoesophageal fistula (TEF) is a rare condition that requires proper treatment. We present the case of a 55-year-old woman with a 4.5-cm recurrent TEF, which had developed after an attempted surgical repair. After closure of the esophageal defect in two layers, a tracheoplasty technique was used to repair the tracheal membranous wall with a synthetic bioabsorbable patch (Gore Bio-A tissue reinforcement) covered with an intercostal muscle flap. The use of Gore Bio-A tissue reinforcement is an innovative and effective method to close a wide tracheal defect while achieving a scaffold for epithelial colonization
Thoracoscopic wedge resection in single-lung patients
Full text linkThe thoracoscopic approach has become a standard procedure in the field of lung resections. However, its advantage in single-lung patients has not yet been well studied. We describe a series of successful thoracoscopic wedge resections in patients presenting with lung cancer after contralateral pneumonectomy
Spontaneous Regression of an Epidermal Growth Factor Receptor-Mutant Left Upper Lobe Adenocarcinoma
No full text: Cancer spontaneous regression is a known manifestation rarely described for thoracic malignancies. We present the case of a patient affected by an EGFR-mutant adenocarcinoma who developed a contralateral aspiration pneumonitis months before surgery and manifested a complete pathological regression without any preoperative oncological treatment. The underlying mechanisms are not clear but immune system activation appears to be a key player, acting as a plausible trigger of a change in host response to cancer cells. Tumor microenvironment appears to be not an "inert spectator", but an "active protagonist" on the course of the disease as well as on its therapeutic targeting
The biological approach for sternal replacement: sternochondral allograft transplantation
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