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Simple Summary: Surgery for centrally located lung cancer after previous cancer treatments can be challenging due to the lungs adhering to the chest wall. We investigated whether using the Cavitron Ultrasonic Surgical Aspirator (CUSA) could help. We focused on patients who had thoracoscopic salvage anatomic lung resections after systemic or radiotherapy with and without CUSA. The CUSA group took more time for surgery but had less bleeding. Our analysis found that older age carried more risk for complications, and using CUSA decreased bleeding, whereas radiotherapy increased the risk of bleeding. CUSA seems to prevent harm to blood vessels and airways, which could lead to less bleeding during this specific type of minimally invasive lung cancer surgery. In centrally located lung tumors, salvage pulmonary resections pose challenges due to adhesions between the pulmonary parenchyma, chest wall, and hilum. This study aimed to investigate the surgical outcomes associated with Cavitron Ultrasonic Surgical Aspirator (CUSA) usage in thoracoscopic salvage pulmonary resections. Patients with centrally located advanced-stage lung tumors who underwent salvage anatomic resections following systemic or radiotherapy were included. They were categorized into CUSA and non-CUSA groups, and perioperative parameters and surgical outcomes were analyzed. Results: The study included 7 patients in the CUSA group and 15 in the non-CUSA group. Despite a longer median surgical time in the CUSA group (3.8 h vs. 6.0 h, p = 0.021), there was a significant reduction in blood loss (100 mL vs. 250 mL, p = 0.014). Multivariate analyses revealed that the use of CUSA and radiotherapy had opposing effects on blood loss (β: −296.7, 95% CI: −24.8 to −568.6, p = 0.034 and β: 282.9, 95% CI: 19.7 to 546.3, p = 0.037, respectively). In conclusion, while using CUSA in the salvage anatomic resection of centrally located lung cancer may result in a longer surgical time, it is crucial in minimizing blood loss during the procedure. [ABSTRACT FROM AUTHOR]

Simple Summary: Trismus is a common complication in oral cancer patients that may influence surgical outcomes. This retrospective matched cohort analysis examined the influence of preoperative trismus on survival outcomes in 40 male Taiwanese oral cancer patients undergoing transoral robotic surgery (TORS). Through 1:1 propensity score matching, 20 trismus patients were compared to 20 non-trismus controls. TORS demonstrated comparable short-term surgical outcomes in trismus patients compared to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Analysis of long-term oncological outcomes demonstrated similar 5-year disease-free survival between groups, indicating comparable tumor control. However, trismus patients experienced significantly poorer 5-year overall survival. After adjusting for confounders, trismus independently conferred a 13-fold higher long-term mortality risk. Ultimately, this study highlights preoperative trismus as a harbinger of non-inferior short-term surgical outcomes, but diminished long-term survival in oral cancer patients treated robotically, even among those with equivalent tumor persistence following surgery. Further research should explore mechanisms linking trismus to mortality and approaches to improve outcomes in this population. Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to investigate the associations between trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. We conducted a retrospective propensity score-matched cohort study of 40 Taiwanese male oral cancer patients who underwent TORS between 2016 and 2022. Overall, 20 patients with trismus were matched to 20 patients without trismus. TORS achieved similar operative and short-term clinical outcomes in trismus patients to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Kaplan–Meier and Cox proportional hazard regression analyses were performed to compare overall survival (OS) and disease-free survival (DFS) between the two groups. The overall survival (OS) rate at three years was significantly lower in patients with trismus than those without trismus (27.1% vs. 95.0%, log-rank p = 0.02). However, there was no significant difference in disease-free survival (DFS) rates between the trismus and non-trismus groups (36.6% vs. 62.7%, log-rank p = 0.87). After adjusting for confounders, trismus was independently associated with a 13-fold increased risk of mortality (adjusted HR 12.87, 95% CI 1.55–106.50, p < 0.05). In conclusion, trismus appears to be an independent prognostic factor for reduced long-term OS in Taiwanese male oral cancer patients undergoing TORS, though short-term surgical outcomes were non-inferior in the trismus patients. Further research is warranted to clarify the mechanisms linking trismus and survival in this population. [ABSTRACT FROM AUTHOR]