Search

Your search keyword '"Perkmann, Reinhold"' showing total 5 results
Start Over Author "Perkmann, Reinhold" Topic business
5 results on '"Perkmann, Reinhold"'

1. Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: our experience on 1,592 patients

Author

Divisi, Duilio, Barone, Mirko, Bertolaccini, Luca, Rocco, Gaetano, Solli, Piergiorgio, Crisci, Roberto, Italian Vats Group, Ampollini, Luca, Alloisio, Marco, Andreetti, Claudio, Amore, Dario, Baietto, Guido, Bandiera, Alessandro, Benato, Cristiano, Benetti, Diego, Benvenuti, Mauro, Bertani, Alessandro, Bortolotti, Luigi, Bottoni, Edoardo, Camplese, Pierpaolo, Carbognani, Paolo, Cardillo, Giuseppe, Carleo, Francesco, Casadio, Caterina, Cavallesco, Giorgio, Curcio, Carlo, Denegri, Andrea, Di Rienzo, Gaetano, Dolci, Giampiero, Droghetti, Andrea, Gasparri, Roberto, Ghisalberti, Marco, Gonfiotti, Alessandro, Guerrera, Francesco, Imperatori, Andrea, Infante, Maurizio, Lausi, Paolo, Londero, Francesco, Lopez, Camillo, Luzzi, Luca, Maineri, Paola, Maniscalco, Pio, Marulli, Giuseppe, Monteverde, Marco, Morelli, Angelo, Mucilli, Felice, Natali, Pamela, Negri, Giampiero, Nicotra, Samuele, Nosotti, Mario, Perkmann, Reinhold, Poggi, Camilla, Puma, Francesco, Refai, Mayed, Rinaldo, Alessandro, Rizzardi, Giovanna, Rosso, Lorenzo, Rotolo, Nicola, Russo, Emanuele, Sabatini, Armando, Spaggiari, Lorenzo, Stefani, Alessandro, Stella, Franco, Terzi, Alberto, Torre, Massimo, Vinci, Damiano, Viti, Andrea, Voltolini, Luca, Zaraca, Francesco, Divisi, Duilio, Barone, Mirko, Bertolaccini, Luca, Rocco, Gaetano, Solli, Piergiorgio, Crisci, Roberto, Italian VATS, Group, Negri, G, Ampollini, Luca, Alloisio, Marco, Andreetti, Claudio, Amore, Dario, Baietto, Guido, Bandiera, Alessandro, Benato, Cristiano, Benetti, Diego, Benvenuti, Mauro, Bertani, Alessandro, Bortolotti, Luigi, Bottoni, Edoardo, Camplese, Pierpaolo, Carbognani, Paolo, Cardillo, Giuseppe, Carleo, Francesco, Casadio, Caterina, Cavallesco, Giorgio, Curcio, Carlo, Denegri, Andrea, Di Rienzo, Gaetano, Dolci, Giampiero, Droghetti, Andrea, Gasparri, Roberto, Ghisalberti, Marco, Gonfiotti, Alessandro, Guerrera, Francesco, Imperatori, Andrea, Infante, Maurizio, Lausi, Paolo, Londero, Francesco, Lopez, Camillo, Luzzi, Luca, Maineri, Paola, Maniscalco, Pio, Marulli, Giuseppe, Monteverde, Marco, Morelli, Angelo, Mucilli, Felice, Natali, Pamela, Negri, Giampiero, Nicotra, Samuele, Nosotti, Mario, Perkmann, Reinhold, Poggi, Camilla, Puma, Francesco, Refai, Mayed, Rinaldo, Alessandro, Rizzardi, Giovanna, Rosso, Lorenzo, Rotolo, Nicola, Russo, Emanuele, Sabatini, Armando, Spaggiari, Lorenzo, Stefani, Alessandro, Stella, Franco, Terzi, Alberto, Torre, Massimo, Vinci, Damiano, Viti, Andrea, Voltolini, Luca, and Zaraca, Francesco

Subjects
Lung adenocarcinoma, Pulmonary and Respiratory Medicine, medicine.medical_specialty, VATS lobectomy, Standardized uptake value, Malignancy, Ground-glass opacity, NO, 030218 nuclear medicine & medical imaging, Maximum standardized uptake value, 03 medical and health sciences, 0302 clinical medicine, ground glass opacities, Solitary pulmonary nodule (SPN), maximum standardized uptake value, lymph node metastases, lung adenocarcinoma, Lymph node metastase, medicine, Ground glass opacities, Lymph node metastases, Lung cancer, Lymph node, business.industry, Ground glass opacitie, Nodule (medicine), medicine.disease, Primary tumor, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Original Article, Radiology, medicine.symptom, business
Abstract

Background: Multislice computed tomography (MSCT) increased detection of solitary pulmonary nodules (SPNs), changing the management based on radiological and clinical factors. When 18-fluorine fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG-PET/CT) was considered for the evaluation of nodules, the maximum standardized uptake value (SUVmax) more than 2.5 is used frequently as a cut off for malignancy. The purpose of this study is to evaluate SUVmax PET/CT and pulmonary attenuation patterns at MSCT in patients with SPN according to morphological and pathological characteristics of the lesion. Methods: A retrospective study on 1,592 SPN patients was carried out following approval by the Italian Registry of VATS Lobectomies. Results: All patients underwent VATS lobectomy. On histologic examination, 98.1% had primary or second metachronous primary lung cancers. In addition, 10.7% presented occult lymph node metastases (pN1 or pN2) on histological examination. Nodule attenuation on CT was associated with the histology of the lesion (p= 0.030); in particular, pure ground glass opacities (pGGOs) and partially solid nodules were related to adenocarcinomatous histotypes. Conversely, a significant relationship between SUVmax and age, nodule size, pathological node status (pN) was found (P=0.007, P=0.000 and P=0.002 respectively). Conclusions: Nodule attenuation can predict the histology of the lesion whereas SUVmax may relate to the propensity to lymph node metastases.

Published
2017
Full Text
View/download PDF

2. Safety of lymphadenectomy during video-assisted thoracic surgery lobectomy. Analysis from a national database

Author

Gonfiotti, Alessandro, Bertani, Alessandro, Nosotti, Mario, Viggiano, Domenico, Bongiolatti, Stefano, Bertolaccini, Luca, Droghetti, Andrea, Solli, Piergiorgio, Crisci, Roberto, Voltolini, Luca, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, Di Rienzo, Gaetano, Lopez, Camillo, Divisi, Duilio, Morelli, Angelo, Russo, Emanuele, Londero, Francesco, Rosso, Lorenzo, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Giovanardi, Andrea, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Argnani, Desideria, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Ibrahim, Mohsen, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Gonfiotti, Alessandro, Bertani, Alessandro, Nosotti, Mario, Viggiano, Domenico, Bongiolatti, Stefano, Bertolaccini, Luca, Droghetti, Andrea, Solli, Piergiorgio, Crisci, Roberto, Voltolini, Luca, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, Di Rienzo, Gaetano, Lopez, Camillo, Divisi, Duilio, Morelli, Angelo, Russo, Emanuele, Londero, Francesco, Rosso, Lorenzo, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Giovanardi, Andrea, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Argnani, Desideria, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Ibrahim, Mohsen, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, and Guerrera, Francesco

Subjects
Male, Lung Neoplasms, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Logistic regression, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, 80 and over, Prospective Studies, Lobectomy, Lung cancer, Video-assisted thoracic surgery, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Lymph Node Excision, Lymphatic Metastasis, Mediastinum, Middle Aged, Neoplasm Staging, Pneumonectomy, Thoracic Surgery, Video-Assisted, Treatment Outcome, Prospective cohort study, Non-Small-Cell Lung, Thoracic Surgery, General Medicine, medicine.anatomical_structure, Cardiothoracic surgery, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Video-Assisted, NO, 03 medical and health sciences, medicine, Rank correlation, business.industry, Carcinoma, medicine.disease, Surgery, 030228 respiratory system, Lymphadenectomy, business, Lobectomy, Lung cancer, Video-assisted thoracic surgery
Abstract

OBJECTIVES The Italian VATS Group database was accessed to evaluate whether preoperative and intraoperative factors may affect the safety of lymphadenectomy (LA) during video-assisted thoracic surgery lobectomy. METHODS All video-assisted thoracic surgery lobectomy procedures performed between 1 January 2014 and 30 March 2017 for non-small-cell lung cancer with cN0 or cN1 disease were identified in the database. LA safety was evaluated based on intraoperative (operative time, bleeding and conversion rate) and postoperative (30-day morbidity and mortality, chest drain duration and length of stay) outcomes and was correlated with the number of resected lymph nodes and the rates of nodal upstaging. Continuous variables were presented as mean ± standard deviation and compared using the unpaired t-test; the X2 test was used for categorical variables. Univariable analysis was performed on selected variables. Significant variables (P < 0.30) were entered into a Cox multivariable logistic regression model, using the overall and specific occurrence of complications as dependent variables. The Spearman's rank correlation coefficient was applied as needed. RESULTS A total of 3181 cases (2077 men, 65.3%; mean age of 69 years) met the enrolment criteria. Final pathology was consistent with adenocarcinoma (n = 2262, 67.5%), squamous cell (n = 520, 15.5%), typical (n = 184, 5.5%) and atypical carcinoid (n = 48, 1.4%) and other (n = 335, 10%). The mean number of resected lymph nodes was 13.42 ± 8.24; nodal upstaging occurred in 308 of 3181 (9.68%) cases. Six hundred and fifty-five complications were recorded in 404 (12.7%) patients; in this series, no mortality was observed. Univariable and multivariable analyses did not show any association between the extension of LA and intraoperative or postoperative outcomes. The number of resected lymph nodes and nodal upstagings showed a minimal correlation with intraoperative outcomes and a moderate correlation with postoperative air leak (p = 0.35 and p = 0.48, respectively), arrhythmia (p = 0.29 and p = 0.35, respectively), chest drain duration (p = 0.35 and p = 0.51, respectively) and length of stay (p = 0.35). CONCLUSIONS Based on the VATS Group data, video-assisted thoracic surgery LA proved to be safe and displayed good outcomes even when performed with an extended approach.

Published
2018

3. Nodal management and upstaging of disease: Initial results from the Italian VATS Lobectomy Registry

Author

Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Bertani, A, Gonfiotti, A, Nosotti, M, Ferrari, Pa, De Monte, L, Russo, E, Di Paola, G, Solli, P, Droghetti, A, Bertolaccini, L, Crisci, R, Italian VATS, Group, Negri, G, Bertani, Alessandro, Gonfiotti, Alessandro, Nosotti, Mario, Ferrari, Paolo Albino, De Monte, Lavinia, Russo, Emanuele, Di Paola, Gioacchino, Solli, Piero, Droghetti, Andrea, Bertolaccini, Luca, Crisci, Roberto, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, and Guerrera, Francesco

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lymph node (LN), VATS lobectomy, Nodal upstaging, 030204 cardiovascular system & hematology, Resection, NO, 03 medical and health sciences, 0302 clinical medicine, medicine, Quantitative assessment, Lymph node, Surgical approach, Receiver operating characteristic, business.industry, lymph node (LN), nodal upstaging, Surgery, Dissection, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Original Article, Radiology, business
Abstract

Background: VATS lobectomy is an established option for the treatment of early-stage NSCLC. Complete lymph node dissection (CD), systematic sampling (SS) or resecting a specific number of lymph nodes (LNs) and stations are possible intra-operative LN management strategies. Methods: All VATS lobectomies from the “Italian VATS Group” prospective database were retrospectively reviewed. The type of surgical approach (CD or SS), number of LN resected (RN), the positive/resected LN ratio (LNR) and the number and types of positive LN stations were recorded. The rates of nodal upstaging were assessed based on different LN management strategies. Results: CD was the most frequent approach (72.3%). Nodal upstaging rates were 6.03% (N0-to-N1), 5.45% (N0-to-N2), and 0.58% (N1-to-N2). There was no difference in N1 or N2 upstaging rates between CD and SS. The number of resected nodes was correlated with both N1 (OR =1.02; CI, 1.01–1.04; P=0.03) and N2 (OR =1.02; CI, 1.01–1.05; P=0.001) upstaging. Resecting 12 nodes had the best ability to predict upstaging (6 N1 LN or 7 N2 LN). The finding of two positive LN stations best predicted N2 upstaging [area under the curve (AUC) of receiver operating characteristic (ROC) =0.98]. Conclusions: Nodal upstaging (and, indirectly, the effectiveness of intra-operative nodal management) cannot be predicted based on the surgical technique (CD or SS). A quantitative assessment of intra-operative LN management may be a more appropriate and measurable approach to justify the extension of LN resection during VATS lobectomy.

Published
2017

4. Early and midterm outcomes following open surgical conversion after failed endovascular aneurysm repair from the 'Italian North-easT RegIstry of surgical Conversion AfTer Evar' (INTRICATE)

Author

Stefano Bonvini, Reinhold Perkmann, Tommaso Miccoli, Sandro Lepidi, Riccardo Bozza, Filippo Gorgatti, Francesco Squizzato, Andrea Xodo, Gian Franco Veraldi, Luca Mezzetto, D. Cognolato, Mario D'Oria, Antonio Maria Jannello, Valentina Wasserman, Paolo Frigatti, Marco Pipitone, Luca Garriboli, Maila Trillini, Federico Zani, Alessandra Ferrari, Michele Antonello, D. Milite, Franco Grego, Davide Mastrorilli, Federico Furlan, Xodo, Andrea, D'Oria, Mario, Squizzato, Francesco, Antonello, Michele, Grego, Franco, Bonvini, Stefano, Milite, Domenico, Frigatti, Paolo, Cognolato, Diego, Veraldi, Gian Franco, Perkmann, Reinhold, Garriboli, Luca, Jannello, Antonio Maria, and Lepidi, Sandro

Subjects
Male, medicine.medical_specialty, Endoleak, medicine.medical_treatment, Failure, 030204 cardiovascular system & hematology, Risk Assessment, Endovascular aneurysm repair, 03 medical and health sciences, Graft infection, Open surgery conversion, 0302 clinical medicine, Risk Factors, Abdominal aortic aneurysm, Reinterventions, medicine, Humans, Hospital Mortality, Registries, 030212 general & internal medicine, Aortic rupture, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Endovascular Procedures, Area under the curve, Retrospective cohort study, Odds ratio, Perioperative, medicine.disease, Conversion to Open Surgery, Confidence interval, Surgery, Survival Rate, Treatment Outcome, Italy, Female, Stents, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal, Follow-Up Studies
Abstract

Objective To report the early and mid-term outcomes following open surgical conversion (OSC) after failed endovascular aortic repair (EVAR) using data from a multicentric registry. Methods A retrospective study was carried out on consecutive patients undergoing OSC after failed EVAR at eight tertiary vascular units from the same geographic area in the North-East of Italy, from April 2005 to November 2019. Study endpoints included early and follow-up outcomes. Results A total of 144 consecutive patients were included in the study. Endoleaks were the most common indication for OSC (50.7%), with endograft infection (24.6%) and occlusion (21.9%) being the second most prevalent causes. The overall rate of 30-day all-cause mortality was 13.9% (n = 20); 32 patients (22.2%) experienced at least one major complication. Mean length of stay was 13 ± 12.7 days. On multivariate logistic regression, age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01-1-19; P = .02), renal clamping time (OR, 1.07; 95% CI, 1.02-1.13; P = .01), and suprarenal/celiac clamping (OR, 6.66; 95% CI, 1.81-27.1; P = .005) were identified as independent predictors of perioperative major complications. Age was the only factor associated with perioperative mortality at 30 days. Renal clamping time >25 minutes had sensitivity of 65% and specificity of 70% in predicting the occurring of major adverse events (area under the curve, 0.72; 95% CI, 0.61-0.82). At 5 years, estimated survival was significantly lower for patients treated due to aortic rupture/dissection (28%; 95% CI, 13%-61%), compared with patients in whom the indication for treatment was endoleak (54%; 95% CI, 40%-73%), infection (53%; 95% CI, 30%-94%), or thrombosis (82%; 95% CI, 62%-100%; P = .0019). Five-year survival rates were significantly lower in patients who received emergent treatment (28%; 95% CI, 14%-55%) as compared with those who were treated in an urgent (67%; 95% CI, 48%-93%) or elective setting (57%; 95% CI, 43%-76%; P = .00026). Subjects who received suprarenal/celiac (54%; 95% CI, 36%-82%) or suprarenal (46%; 95% CI, 34%-62%) aortic cross-clamping had lower survival rates at 5 years than those whose aortic-cross clamp site was infrarenal (76%; 95% CI, 59%-97%; P = .041). Using multivariate Cox proportional hazard, older age and emergency setting were independently associated with higher risk for overall 5-year mortality. Conclusions OSC after failed EVAR was associated with relatively high rates of early morbidity and mortality, particularly for emergency setting surgery. Endoleaks with secondary sac expansion were the main indication for OSC, and suprarenal aortic cross-clamping was frequently required. Endograft infection and emergent treatment remained associated with poorer short- and long-term survival.

Published
2022
Full Text
View/download PDF

5. Conversion due to vascular injury during video-assisted thoracic surgery lobectomy: A multicentre retrospective analysis from the Italian video-assisted thoracic surgery group registry

Author

Luca Bertolaccini, Fabio Davoli, Alessandro Pardolesi, Jury Brandolini, Desideria Argnani, Alessandro Bertani, Andrea Droghetti, Alessandro Gonfiotti, Duilio Divisi, Roberto Crisci, Piergiorgio Solli, Mario Nosotti, Carlo Curcio, Dario Amore, Giuseppe Marulli, Samuele Nicotra, Andrea De Negri, Paola Maineri, Gaetano di Rienzo, Camillo Lopez, Angelo Morelli, Francesco Londero, Lorenzo Spaggiari, Roberto Gasparri, Guido Baietto, Caterina Casadio, Maurizio Infante, Cristiano Benato, Marco Alloisio, Edoardo Bottoni, Giuseppe Cardillo, Francesco Carleo, Franco Stella, Giampiero Dolci, Francesco Puma, Damiano Vinci, Giorgio Cavallesco, Pio Maniscalco, Luca Ampollini, Paolo Carbognani, Alberto Terzi, Andrea Viti, Giampiero Negri, Alessandro Bandiera, Reinhold Perkmann, Francesco Zaraca, Claudio Andretti, Camilla Poggi, Felice Mucilli, Pierpaolo Camplese, Luca Luzzi, Marco Ghisalberti, Andrea Imperatori, Nicola Rotolo, Luigi Bortolotti, Giovanna Rizzardi, Massimo Torre, Alessandro Rinaldo, Armando Sabbatini, Majed Refai, Mauro Roberto Benvenuti, Diego Benetti, Alessandro Stefani, Pamela Natali, Paolo Lausi, Francesco Guerrera, Bertolaccini, Luca, Davoli, Fabio, Pardolesi, Alessandro, Brandolini, Jury, Argnani, Desideria, Bertani, Alessandro, Droghetti, Andrea, Gonfiotti, Alessandro, Divisi, Duilio, Crisci, Roberto, Solli, Piergiorgio, Nosotti, Mario, Curcio, Carlo, Amore, Dario, Marulli, Giuseppe, Nicotra, Samuele, De Negri, Andrea, Maineri, Paola, di Rienzo, Gaetano, Lopez, Camillo, Morelli, Angelo, Londero, Francesco, Spaggiari, Lorenzo, Gasparri, Roberto, Baietto, Guido, Casadio, Caterina, Infante, Maurizio, Benato, Cristiano, Alloisio, Marco, Bottoni, Edoardo, Cardillo, Giuseppe, Carleo, Francesco, Stella, Franco, Dolci, Giampiero, Puma, Francesco, Vinci, Damiano, Cavallesco, Giorgio, Maniscalco, Pio, Ampollini, Luca, Carbognani, Paolo, Terzi, Alberto, Viti, Andrea, Negri, Giampiero, Bandiera, Alessandro, Perkmann, Reinhold, Zaraca, Francesco, Andretti, Claudio, Poggi, Camilla, Mucilli, Felice, Camplese, Pierpaolo, Luzzi, Luca, Ghisalberti, Marco, Imperatori, Andrea, Rotolo, Nicola, Bortolotti, Luigi, Rizzardi, Giovanna, Torre, Massimo, Rinaldo, Alessandro, Sabbatini, Armando, Refai, Majed, Benvenuti, Mauro Roberto, Benetti, Diego, Stefani, Alessandro, Natali, Pamela, Lausi, Paolo, Guerrera, Francesco, Bertolaccini L., Davoli F., Pardolesi A., Brandolini J., Argnani D., Bertani A., Droghetti A., Gonfiotti A., Divisi D., Crisci R., Solli P., Nosotti M., Curcio C., Amore D., Marulli G., Nicotra S., De Negri A., Maineri P., di Rienzo G., Lopez C., Morelli A., Londero F., Spaggiari L., Gasparri R., Baietto G., Casadio C., Infante M., Benato C., Alloisio M., Bottoni E., Cardillo G., Carleo F., Stella F., Dolci G., Puma F., Vinci D., Cavallesco G., Maniscalco P., Ampollini L., Carbognani P., Terzi A., Viti A., Negri G., Bandiera A., Perkmann R., Zaraca F., Andretti C., Poggi C., Mucilli F., Camplese P., Luzzi L., Ghisalberti M., Imperatori A., Rotolo N., Bortolotti L., Rizzardi G., Torre M., Rinaldo A., Sabbatini A., Refai M., Benvenuti M.R., Benetti D., Stefani A., Natali P., Lausi P., and Guerrera F.

Subjects
Registrie, Male, Complications, Lung Neoplasms, medicine.medical_treatment, Iatrogenic Disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Risk Factors, Thoracotomy, Registries, Pneumonectomy, Video-assisted thoracic surgery lobectomy, Univariate analysis, Thoracic Surgery, Video-Assisted, Thoracic Surgery, General Medicine, Treatment Outcome, Oncology, Italy, Cardiothoracic surgery, Female, Lung cancer, Human, medicine.medical_specialty, Complications, Conversion, Lung cancer, Lymph nodes dissection, Vascular injury, Video-assisted thoracic surgery lobectomy, VATS lobectomy, Video-Assisted, Vascular injury, NO, 03 medical and health sciences, medicine, Conversion, Lymph nodes dissection, Aged, Humans, Retrospective Studies, Vascular System Injuries, business.industry, Risk Factor, nutritional and metabolic diseases, Retrospective cohort study, medicine.disease, Surgery, Lung Neoplasm, 030228 respiratory system, business, Complication
Abstract

Objectives Vascular injuries are among the most severe causes of unplanned conversion during VATS lobectomies. The study aimed to analyse the incidence of vascular injuries and their risk factors during VATS lobectomy. Methods The Italian VATS lobectomy Registry was used to collect data from 66 Thoracic Surgery Units. From 2013 to October 2016 (out of more than 3,700 patients enrolled) only information from Units with an enrollment >100 VATS lobectomies were retrospectively analysed. Logistic regression analysis was performed on selected variables of the univariate analysis. Results Ten institutions contributed a total of 1,679 patients. Vascular injuries leading to conversion occurred in 44 (2.6%) patients. Years of experiences were inversely related to the risk of vascular injuries. Univariate analysis showed age, gender, surgical activity, Charlson Index Score and number of resected lymph nodes like significantly associated variables. Multivariate analysis revealed that number of resected lymph nodes, VATS experience ratio (number of VATS lobectomies/total lobectomies performed in the same year at same centre), and surgical activity of the centre were significantly associated with the risk of conversion. Unplanned thoracotomy was correlated with postoperative morbidity. Conclusion Vascular injuries in VATS lobectomies represented a rare complication which could directly affect the postoperative outcomes. The predictive factors for conversion were multifactorial and depended on characteristics of centres and surgeons’ seniority. Minimally invasive VATS lobectomy approaches did not influence the risk of vascular damages.

Published
2019

Catalog

Books, media, physical & digital resources
See catalog results