Annual report of Department of Thoracic Surgery at Shanghai Chest Hospital

Yao, Feng; Wang, Rui; Guo, Xufeng; Gu, Zhenyu; Fan, Liwen; Zho, Wenyong; Ye, Bo; Zhong, Caiyun; Zhao, Heng; Li, Zhigang; Sihoe, Alan D.L.; Hogarth, D. Kyle; Molena, Daniela; Fang, Wentao

doi:10.21037/shc.2017.10.03

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…20 In ultra-high volume centres (UHVC) now emerging in China, the perioperative mortality of thoracic surgery is now less than 0.1%. 21,22 Besides safety, feasibility is also well proven with case series experience. Even in the early years of VATS, increasing complex lung cancer resections have been shown to be achievable with VATS.…”

Section: The Evolution Of Evidence For Vatsmentioning

confidence: 93%

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Video‐assisted thoracoscopic surgery as the gold standard for lung cancer surgery

Sihoe¹

2020

Respirology

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Surgical resection remains the only effective means of cure in the vast majority of patients with early-stage lung cancer. It can be performed via a traditional open approach (particularly thoracotomy) or a minimally invasive approach. VATS is 'keyhole' surgery in the chest, and was first used for lung cancer resection in the early 1990s. Since then, a large volume of evolving clinical evidence has confirmed that VATS lung cancer resection offered proven safety and feasibility, better patient-reported postoperative outcomes, less surgical trauma as quantified by objective outcome measures and equivalent or better survival than open surgery. This has firmly established VATS as the surgical approach of choice for early-stage lung cancer today. Although impressive new non-surgical lung cancer therapies have emerged in recent years, VATS is also being constantly rejuvenated by the development of 'next generation' VATS techniques, the refinement of VATS sublobar resection for selected patients, the utilization of bespoke post-operative recovery programmes for VATS and the synthesis of VATS into multi-modality lung cancer therapy. There is little doubt that VATS will remain as the gold standard for lung cancer surgery for the foreseeable future.

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Section: The Evolution Of Evidence For Vatsmentioning

confidence: 93%

“…In Japan, the 30‐day mortality rate from major lung cancer surgery is nowadays only 0.48% 20 . In ultra‐high volume centres (UHVC) now emerging in China, the perioperative mortality of thoracic surgery is now less than 0.1% 21,22 …”

Section: The Evolution Of Evidence For Vatsmentioning

confidence: 99%

Video‐assisted thoracoscopic surgery as the gold standard for lung cancer surgery

Sihoe¹

2020

Respirology

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“…Median sternotomy has long been the standard approach for surgical resection of thymic malignancies. But thoracoscopic surgery is increasingly used for the treatment of earlystage thymic tumors in recent years (2,3,9,18,19). A variety of studies suggested that it is associated with comparable R0 resection rate and non-inferior survival, in addition to less post-operative complications, less blood loss, shorter length of hospital stay compared to open surgery (2)(3)(4)(5)(6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic thymectomy with partial superior vena cava resection for locally advanced thymomas

Xu¹,

Gu²,

Ji³

et al. 2019

J. Thorac. Dis.

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Background: Video-assisted thoracoscopic surgery (VATS) is now increasingly used for the treatment of early stage thymic malignancies. However, VATS has not been advocated for patients with locally advanced diseases. We reviewed our initial experience in VATS thymectomy with partial superior vena cava (SVC) resection for IASLC/ITMIG stage III thymic tumors. Methods: From August 2017 to October 2018, patients who underwent VATS thymectomy with partial SVC resection were retrospectively reviewed, and peri-operative outcomes and short-term follow-up results were analyzing. Results: Four patients with partial SVC resection via VATS were identified. All of them had pathologically confirmed IASLC/ITMIG stage III thymic tumors invading the SVC. The average of operative time was 228 minutes and mean blood loss was 88 mL. The mean duration of chest tube drainage and post-operative hospital stay were 4.5 and 7.3 days respectively. No major complication was encountered after surgery. No mortality was observed. And no recurrence was detected with the longest follow-up time of 14 months. Conclusions: With careful patient selection and plenty surgical expertise, VATS thymectomy for locally invasive thymic tumors with limited the SVC invasion is challenging yet technically feasible.

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“…The actual 30-day mortality rate from major lung cancer surgery is now only 0.48% in Japan (51). In ultra-high-volume centers (UHVCs) now emerging in China, the peri-operative mortality of thoracic surgery is now less than 0.1% (52,53). Mortality and significant morbidity from lesser wedge resections are almost non-existent amongst normal-risk patients nowadays.…”

Section: "Why Are We Avoiding Surgery For Diagnosis?"mentioning

confidence: 99%

“…Because screening detected lung nodules and GGOs frequently all these criteria for good survival, they are ideal for sublobar resection with curative intent. Indeed, the rate of performing segmentectomy has seen a marked increase in recent years, particularly in East Asia (52,53).…”

Section: "Why Are We Giving Up On the Golden Opportunity For Surgical Treatment?"mentioning

confidence: 99%

Should sublobar resection be offered for screening-detected lung nodules?

Sihoe¹

2021

Transl Lung Cancer Res

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The increasing use of low-dose CT for screening for lung cancer will inevitably identify many small, asymptomatic lung nodules and ground-glass opacities (GGOs). Current guidelines for the management of screening-detected lesions tend to advise a conservative approach based on serial imaging and intervention only if 'suspicious' features emerge. However, more recent developments in thoracic surgery and in the understanding of the screening-detected lesions themselves prompt some pertinent questions over this conservatism. Is CT surveillance sufficiently reliable to exclude malignancy? Is it really necessary to hold back on operative biopsy and resection given modern surgical safety and efficacy? Is the option for early surgical therapy a viable one-especially with the availability of sublobar resection today? Modern data suggests that the risk of inaction for some screening-detected lesions may be higher than expected, whereas the potential harm of surgical intervention may be substantially reduced by sublobar resection and the latest minimally invasive surgical techniques. A more pro-active approach towards offering surgery for screeningdetected lesions should now be considered.

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Annual report of Department of Thoracic Surgery at Shanghai Chest Hospital

Abstract: Alkaloids U 0600Biomimetic Total Syntheses of Cassiarins A (Ia) and B (II). -Due to the high antiplasmodial effects of the title compounds, analogues (Ib)-(Id) are prepared for structure-activity studies.

Cited by 5 publications

References 13 publications

Video‐assisted thoracoscopic surgery as the gold standard for lung cancer surgery

Video‐assisted thoracoscopic surgery as the gold standard for lung cancer surgery

Thoracoscopic thymectomy with partial superior vena cava resection for locally advanced thymomas

Should sublobar resection be offered for screening-detected lung nodules?

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