Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature
Abstract Background Lung cancer is the first cause of cancer-related death. Awake lung resection is a new frontier of the concept of minimally invasive surgery. Our purpose is to demonstrate the feasibility of this technique for lobar and sublobar lung resection in NSCLC patients. Methods We retrosp...
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03313-6 |
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| author | Giovanni Mugnaini Simone Tombelli Antonio Burlone Stefano Bongiolatti Domenico Viggiano Rossella Indino Ottavia Salimbene Lavinia Gatteschi Luca Voltolini Alessandro Gonfiotti |
| author_facet | Giovanni Mugnaini Simone Tombelli Antonio Burlone Stefano Bongiolatti Domenico Viggiano Rossella Indino Ottavia Salimbene Lavinia Gatteschi Luca Voltolini Alessandro Gonfiotti |
| author_sort | Giovanni Mugnaini |
| collection | DOAJ |
| description | Abstract Background Lung cancer is the first cause of cancer-related death. Awake lung resection is a new frontier of the concept of minimally invasive surgery. Our purpose is to demonstrate the feasibility of this technique for lobar and sublobar lung resection in NSCLC patients. Methods We retrospective reviewed all the medical charts of patients who underwent awake lung resection in our center between March 2018 and March 2024, focusing on patients with NSCLC, and we compared our results with the ones found in literature. Results Among 45 patients treated with awake lung resections, we selected 15 patients with NSCLC and finally analyzed the results of 12 patients who underwent VATS awake lung resection, 3 lobectomies and 9 wedge resections. The median Charlson comorbidity index (CCI) was 3 and we had 5 patients (41.67%) with a CCI ≥ 4 and a median FEV1 of 56%. We report only 2 conversions to general anesthesia (16.67%) and no conversion to open thoracotomy. We used a nebulizator for the atomization of lidocaine on the lung surface to reduce the cough reflex. Our post-operative results are in line with literature, with a low complication rate (2 patients, 16.67%) and a median length of stay of 5 days. We safely performed a proper lymph node dissection in all 3 lobectomies. Median Overall Survival and Disease-Free Survival were 11 months. Conclusions Awake lung resections are a feasible way to perform a minimally invasive surgical procedure in NSCLC patients, with low risk of conversion to open surgery. |
| format | Article |
| id | doaj-art-dd4c7303e47a40aa94f1bc62f83428d7 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-dd4c7303e47a40aa94f1bc62f83428d72025-01-19T12:38:17ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-0120111210.1186/s13019-024-03313-6Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literatureGiovanni Mugnaini0Simone Tombelli1Antonio Burlone2Stefano Bongiolatti3Domenico Viggiano4Rossella Indino5Ottavia Salimbene6Lavinia Gatteschi7Luca Voltolini8Alessandro Gonfiotti9Thoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalThoracic Surgery Unit, Careggi University HospitalAbstract Background Lung cancer is the first cause of cancer-related death. Awake lung resection is a new frontier of the concept of minimally invasive surgery. Our purpose is to demonstrate the feasibility of this technique for lobar and sublobar lung resection in NSCLC patients. Methods We retrospective reviewed all the medical charts of patients who underwent awake lung resection in our center between March 2018 and March 2024, focusing on patients with NSCLC, and we compared our results with the ones found in literature. Results Among 45 patients treated with awake lung resections, we selected 15 patients with NSCLC and finally analyzed the results of 12 patients who underwent VATS awake lung resection, 3 lobectomies and 9 wedge resections. The median Charlson comorbidity index (CCI) was 3 and we had 5 patients (41.67%) with a CCI ≥ 4 and a median FEV1 of 56%. We report only 2 conversions to general anesthesia (16.67%) and no conversion to open thoracotomy. We used a nebulizator for the atomization of lidocaine on the lung surface to reduce the cough reflex. Our post-operative results are in line with literature, with a low complication rate (2 patients, 16.67%) and a median length of stay of 5 days. We safely performed a proper lymph node dissection in all 3 lobectomies. Median Overall Survival and Disease-Free Survival were 11 months. Conclusions Awake lung resections are a feasible way to perform a minimally invasive surgical procedure in NSCLC patients, with low risk of conversion to open surgery.https://doi.org/10.1186/s13019-024-03313-6Awake lung resectionsMinimally invasive lung surgeryVATS lung resectionsNSCLC surgery, uniportal VATS surgerySpontaneous breathing patients |
| spellingShingle | Giovanni Mugnaini Simone Tombelli Antonio Burlone Stefano Bongiolatti Domenico Viggiano Rossella Indino Ottavia Salimbene Lavinia Gatteschi Luca Voltolini Alessandro Gonfiotti Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature Journal of Cardiothoracic Surgery Awake lung resections Minimally invasive lung surgery VATS lung resections NSCLC surgery, uniportal VATS surgery Spontaneous breathing patients |
| title | Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature |
| title_full | Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature |
| title_fullStr | Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature |
| title_full_unstemmed | Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature |
| title_short | Awake thoracic surgery for lung cancer treatment: where we are and future perspectives—our experience and review of literature |
| title_sort | awake thoracic surgery for lung cancer treatment where we are and future perspectives our experience and review of literature |
| topic | Awake lung resections Minimally invasive lung surgery VATS lung resections NSCLC surgery, uniportal VATS surgery Spontaneous breathing patients |
| url | https://doi.org/10.1186/s13019-024-03313-6 |
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