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Background: With the ongoing prevalence of the emerging variant and global vaccination efforts, the optimal surgical timing for patients with resectable lung cancer in the Omicron-dominant period requires further investigation. Methods: This prospective multicenter study involved patients who underwent radical surgery for lung cancer between January 29, 2023 and March 31, 2023. Patients were categorized into four groups based on the interval between SARS-CoV-2 infection and surgery. The main outcomes evaluated were 30-day mortality and 30-day morbidity. Results: A total of 2081 patients were enrolled in the study, of which 1837 patients (88.3%) had a confirmed SARS-CoV-2 diagnosis before surgery. Notably, no instances of 30-day mortality were observed in any patient. Patients without prior infection had a 30-day morbidity rate of 15.2%, with postoperative pneumonia occurring in 7.0% of cases. In contrast, patients diagnosed with SARS-CoV-2 before surgery had significantly higher rates of 30-day morbidity and postoperative pneumonia when surgery was performed within 4–5 weeks (adjusted odds ratio (aOR) (95% CI):2.18 (1.29–3.71) and 2.39 (1.21–4.79), respectively) or within 6–7 weeks (aOR (95% CI):2.07 (1.36–3.20) and 2.10 (1.20–3.85), respectively). Conversely, surgeries performed ≥ 8 weeks after SARS-CoV-2 diagnosis exhibited similar risks of 30-day morbidity and pneumonia compared to those in the no prior infection group (aOR (95% CI):1.13 (0.77–1.70) and 1.12 (0.67–1.99), respectively). Conclusions: Thoracic surgery for lung cancer conducted 4–7 weeks after SARS-CoV-2 infection is still associated with an increased risk of 30-day morbidity in the Omicron-dominant period. Therefore, surgeons should carefully assess the individual risks and benefits to formulate an optimal surgical strategy for patients with lung cancer with a history of SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Efficient synthesis of H2O2 via photocatalytic oxygen reduction without sacrificial agents is challenging due to inadequate proton supply from water and difficulty in maintaining O−O bond during O2 activation. Herein, we developed a straightforward strategy involving a proton‐rich hydrogel cross‐linked by metal ions [M(n)], which is designed to facilitate the selective production of H2O2 through proton relay and metal ion‐assisted detachment of crucial intermediates. The hydrogel comprises CdS/graphene and alginate cross‐linked by metal ions via O=C−O−M(n) bonds. Efficient O2 reduction and hydrogenation occurred, benefitting from the collaboration between proton‐rich alginate and the photocatalytically active CdS/graphene. Meanwhile, the O=C−O−M(n) bonds enhance the electron density of α‐carbon sites on graphene, crucial for O2 activation and *OOH intermediate detachment, preventing deeper O−O bond cleavage. The role of metal ions in promoting *OOH desorption was demonstrated through Lewis acidity‐dependent activity, with Y(III) having the highest activity, followed by Lu(III), La(III), and Ca(II). [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Neoadjuvant therapy has gained widespread acceptance as the standard modality for locally advanced non-small cell lung cancer. However, the clinical benefit of sleeve lobectomy (SL) or pneumonectomy (PN) following neoadjuvant therapy remains controversial. METHODS The clinical and pathological characteristics of non-small cell lung cancer patients who underwent SL or PN after neoadjuvant therapy at a high-volume single centre between December 2019 and March 2023 were retrospectively collected. The SL group was matched 4:1 with the PN group by propensity score matching. The surgical outcomes were systematically collected and analysed. RESULTS During a 5-year study period, the majority of patients (175 of 215, 81.4%) underwent the SL procedure, while 40 patients (18.6%) underwent PN. Following propensity score matching, the SL group exhibited lower postoperative arrythmia (4.8% vs 26.9%, P  <   0.001), lower 30-day mortality (1.0% vs 7.7%, P  =   0.046) and a shorter length of postoperative hospital stay (6.0 days vs 10.0 days, P  <   0.001), compared with the PN group. In addition, no significant difference was observed between the two groups in terms of disease-free survival or overall survival (P  =   0.977 and P  =   0.913, respectively). CONCLUSIONS SL stands as a safe and feasible option for patients with centrally located non-small-cell lung cancer who have undergone neoadjuvant therapy, in comparison to PN. This finding suggests that SL remains the preferable choice when feasible in the context of the widespread utilization of neoadjuvant therapy. [ABSTRACT FROM AUTHOR]

Objective To explore the impact of preoperative biliary drainage methods on perioperative complications. Methods Clinical data of 448 patients of malignant distal biliary obstruction with jaundice who underwent pancreaticoduodenectomy and received preoperative biliary drainage were collected from January 2012 to December 2019. Among them, 238 patients received percutaneous transhepatic cholangial drainage(PTCD) as PTCD group and 210 patients received endoscopic retrograde cholangiopancreatography (ERCP) as ERCP group, including 101 cases with endoscopic biliary sten-ting (EBS) as EBS group and 109 cases with endoscopic nasobiliary drainage. The intervention unsuccess rate and perio-perative complications of different biliary drainage methods were analyzed. Results Intervention unsuccess rate of ERCP was higher than that of PTCD (P=0.034). Postoperative pancreatic fistula rate and reoperation rate were higher in ERCP group than those in PTCD group, respectively (P=0.005 and P=0.025). In analysis of subgroup, overall postoperative complication rate in EBS group was higher than that in PTCD group (P=0.014), and pancreatic fistula rate and reoperation rate in EBS group were higher than those in PTCD group (P

Background: While an association between postoperative acute kidney injury (AKI) and adverse events exists, the incidence and impact of postoperative AKI after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma remain unclear. This study aimed to diagnose AKI and investigate the risk factors for and prognostic value of postoperative AKI. Methods: Clinical characteristics of patients who underwent pancreaticoduodenectomy between 2013 and 2020 at a high‐volume centre were collected retrospectively. The Kidney Disease Improving Global Outcomes criteria were used to diagnose AKI. A 1:2 propensity score matching (PSM) was used to minimise bias between the AKI and non‐AKI groups. Short‐term surgical and long‐term survival outcomes were compared between groups. Multivariate logistic regression analysis assessed the independent risk factors for AKI development, major complications, and 30‐day mortality. Results: Postoperative AKI occurred in 10.7% of 1312 patients. Total bilirubin level > 250 μmol/L (odds ratio [OR]: 3.24; p < 0.001), estimated glomerular filtration rate < 60 ml/min/1.73 m2 (OR: 2.30; p = 0.048), and intraoperative estimated blood loss >1000 ml (OR: 2.96; p = 0.001) were independent risk factors for postoperative AKI. After PSM, higher incidences of major complications (p < 0.001) and 30‐day mortality (p < 0.001) were observed in the AKI group than in the non‐AKI group. There was no difference in long‐term overall survival outcomes between both groups (p = 0.535). AKI was an independent predictor of major complications (OR: 3.06; p < 0.001) and 30‐day mortality (OR: 2.87; p = 0.034). Conclusions: Postoperative AKI is common after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma and has a predictive effect on major complications and 30‐day mortality. Therefore, prevention and proper management of postoperative AKI are required in clinical practice. [ABSTRACT FROM AUTHOR]

The article "Reply to Wei-Zhen Tang et al." published in the European Journal of Cardio-Thoracic Surgery compares the surgical outcomes of sleeve lobectomy (SL) and pneumonectomy (PN) following neoadjuvant therapy. Out of 175 patients, 29.1% underwent complex SL procedures, with varying complexities such as carinoplasty, vascular reconstruction, extended SL, and chest wall resection. The study found that complex SL procedures had longer operating times compared to PN, but similar 30-day morbidity, mortality rates, disease-free survival, and overall survival. The decision to perform complex SL after neoadjuvant therapy depends on factors like tumor location, surgeon experience, and patient condition. [Extracted from the article]