Francesco Borrata

Preliminary experience with video-assisted thoracic surgery lobectomy for lung malignancies: general considerations moving toward standard practice

As part of the Second Catania Symposium on Thoracic Oncology, as we started the experience with video-assisted thoracic surgery (VATS) lobectomy for lung malignancies, we reviewed our data and argued some comments in a more general discussion. Operated patients with non-small-cell lung cancer were divided in two groups and compared: VATS (collected in a prospective database) and open (historical group). Out of 74 patients, 31 in group A and 44 in group B. The majority of patients in group A were stage I-II. Mean operative time was shorter in group A. Postoperative hospital stay was shorter in group A. There was no mortality. VATS is effective and safe to perform pulmonary lobectomy in our unit, and it represents our preferred approach for early-stage lung cancer.

Extended uniportal bilateral sympathectomy

Hyperhidrosis affect 3% of the population and, despite benign nature of the disease, the individuals seek medical advice in order to improve their quality of life which can be severely compromised. The interruption of the sympathetic chain (sympathectomy) and of the nerve of Kuntz established its role as the definitive treatment of primary hyperhidrosis. In this manuscript, we present our extended uniportal technique with the aid of the video. Uniportal approach expresses all its benefit when applied for this procedure because there is no specimen to be retrieved and all the surgery is accomplished through a 1-2 cm port access.

Single incision extended video assisted transcervical thymectomy

In the last 30 years the introduction of VATS in the surgical practice made possible to perform a wide range of thoracic operations including thymectomy. We describe our single incision video-assisted transcervical thymectomy (VATT) for non-thymomatous myasthenia gravis and/or small (<2 cm) intrathymic thymoma in 13 patients. The mean operation time was of 164 minutes (range, 45–275 minutes). The length of hospitalization was 3 days (range, 2–5 days). Decrease of symptoms was obtained in the entire group after a mean follow up of 79 months (range, 8–150 months), and two patients had a complete stable remission. In conclusion, single incision extended transcervical thymectomy (TT) is a safe and successful procedure which allows a complete excision of the anterior mediastinal fat.

An unexpected difficult intubation in a patient with myasthenia gravis undergoing video-assisted transcervical thymectomy

Although there are different methods to evaluate predictive parameters of difficult intubation in apparently normal patients, sometimes this event is unpredictable.We herein report a clinical case of difficult intubation during anaesthesia for video-assisted thymectomy in non-thymomatous myasthenia gravis.