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A combined approach by VATS and VAMLA improves radicality of minimally invasive mediastinal lymphadenectomy without increase in operation time, morbidity, and drainage time.

Glomus tumors are neoplasms arising from modified smooth muscle cells surrounding arteriovenous anastomosis in the dermis and subcutaneous tissues, which are contributing to blood flow regulation and temperature control on the skin surface. Glomus cells are sparse or absent in visceral organs, making extracutaneous presentation of glomus tumors an extremely rare finding. We briefly report histological considerations on glomus tumors of the trachea and sum the multidisciplinary aspects of their staged endoscopic and surgical management using the example of a rare case presentation.

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This retrospective analysis of 15 dogs with postcontrast ring enhancing brain lesions, each detected by a single Computed Tomography [CT] examination, searched for any association between their CT appearance and the pathologic diagnosis. In a subgroup of these dogs [n = 7] necropsied within 2 days of the last CT scan, we evaluated whether there was any anatomic correlation between the ring zone and the histopathologic features of the lesions. Our study consisted of eight dogs with primary brain tumors [3 meningiomas, 3 astrocytomas, 1 mixed glioma, 1 oligodendroglioma], 4 with metastatic brain tumors [2 fibrosarcomas, 1 mammary carcinoma, 1 melanoma] and 3 with non‐neoplastic brain lesions [2 intraparenchymal hemorrhages, 1 pyogranulomatous meningoencephalitis]. The overall size and shape of the contrast enhancing CT lesions, as well as the thickness, surface texture and degree of enhancement of the ring were subjectively evaluated. No association was found between the CT lesion characteristics and the pathologic diagnosis. In the sub‐group of dogs euthanatized within 2 days of the CT examination, distinct histologic features which anatomically correlated with the zone of ring enhancement were found in 3 of 7 lesions. The findings of this study are consistent with those of ring‐enhancing lesions in people, and indicates that CT ring enhancement is a non‐specific phenomenon which can occur in a variety of neoplastic and non‐neoplastic lesions in the dog.

This paper describes a prospective, observational, single-centre study of 20 consecutive patients with clinical stage I lung carcinoma undergoing anatomical sublobar resections using complete video-assisted thoracoscopic surgery (cVATS). Thirteen male and seven female patients with a median age of 68 (range 57-84) years and a median of four (range 0-9) relevant comorbid conditions presented with five right-sided and 15 left-sided tumours, with a median diameter of 2.3 (range 1.0-5.2) cm. Thirteen segmentectomies, three bisegmentectomies and four trisegmentectomies with lymphadenectomy of the N1 stations and the mediastinum were performed, with a median duration of 212 (range 91-397) min, a conversion rate to open surgery of 20% and conversion to lobectomy of 10%. In five patients, we noted 10 postoperative adverse events but no transfusions, no readmissions and zero mortality. Median drainage time was six days, with a median hospital stay of 8.5 days. According to the pTNM classification, 10, three, one, and six patients were staged as Ia, Ib, IIb and IIIa, respectively. The distance between the tumour and the parenchymal stapling line exceeded the tumour diameter in 56%, 0% and 0% of T1a, T1b and T2 tumours, respectively. To conclude, cVATS anatomical sublobar resections are technically feasible. We observed a favourable postoperative course in 20 multimorbid or aged patients. In patients fit for lobectomy, the tumour diameter should not exceed 2 cm.

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