PRP was a valid preoperative strategy to improve physical performance in patients with both NSCLC and COPD and this advantage was also maintained after surgery.

Objective: To determine whether RAL affects perioperative outcomes and long-term efficacy in NSCLC patients, compared with traditional VAL. Summary of Background Data: RAL is a promising treatment for NSCLC. However, its efficacy has not been fully evaluated. Methods: A single-center, open-labeled prospective randomized clinical trial was launched in May 2017 to compare the efficacy of RAL and VAL. By May 2020, 320 patients were enrolled. The perioperative results of RAL and VAL were compared. Results: The 320 enrolled patients were randomly assigned to the RAL group (n ¼ 157) and the VAL group (n ¼ 163). Perioperative outcomes were comparable between the 2 groups, including the length of hospital stay (P ¼ 0.76) and the rate of postoperative complications (P ¼ 0.45). No perioperative mortality occurred in either group. The total amount of chest tube drainage {830 mL [interquartile range (IQR), 550-1130 mL] vs 685 mL [IQR, 367.5-1160 mL], P ¼ 0.

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Although controlled studies have demonstrated the benefits of a minimally invasive approach for pulmonary lobectomy over thoracotomy, reports have also documented that significant complications can occur during thoracoscopic lobectomy and sometimes require planned or emergent conversion to open surgery. Several authors have identified and reported causes and implications of intraoperative conversion to thoracotomy using different types of classification. The aim of this single centre retrospective review is to evaluate how the reasons for conversion change with increased experience, dividing patients who were converted to thoracotomy during video-assisted thoracic surgery (VATS) lobectomy, between 2011 and 2017, in two groups: those treated during learning curve (LC group) and those treated after learning curve (ALC group). Our research suggests that the conversion rate, with increased skills, decreases but a variety of reasons for conversion persist. Of these, calcified, benign or malignant hilar adenopathy is the most frequent and represents the leading cause of conversion to open surgery due to complicated vascular dissection or vessel injury. It's strongly recommended, with increased confidence in performing VATS lobectomies, also to develop management strategies and techniques to prevent and control possible intraoperative adverse events.