1
|
Bertoglio P, Querzoli G, Kestenholz P, Scarci M, La Porta M, Solli P, Minervini F. Surgery for Solitary Fibrous Tumors of the Pleura: A Review of the Available Evidence. Cancers (Basel) 2023; 15:4166. [PMID: 37627194 PMCID: PMC10453165 DOI: 10.3390/cancers15164166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/12/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
Solitary fibrous tumors of the pleura (pSFT) are a relatively rare neoplasms that can arise from either visceral or parietal pleura and may have different aggressive biological behaviors. Surgery is well known to be the cornerstone of the treatment for pSFT. We reviewed the existing literature, focusing on the role of surgery in the management and treatment of pSFT. All English-written literature has been reviewed, focusing on those reporting on the perioperative management and postoperative outcomes. Surgery for pSFT is feasible and safe in all experiences reported in the literature, but surgical approaches and techniques may vary according to the tumor dimensions, localization, and surgeons' skills. Long-term outcomes are good, with a 10-year overall survival rate of more than 70% in most of the reported experiences; on the other hand, recurrence may happen in up to 17% of cases, which occurs mainly in the first two years after surgery, but case reports suggest the need for a longer follow-up to assess the risk of late recurrence. Malignant histology and dimensions are the most recognized risk factors for recurrence. Recurrence might be operated on in select patients. Surgery is the treatment of choice in pSFT, but a radical resection and a careful postoperative follow-up should be carried out.
Collapse
Affiliation(s)
- Pietro Bertoglio
- Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40100 Bologna, Italy; (M.L.P.); (P.S.)
- Alma Mater Studiorum, University of Bologna, 40064 Bologna, Italy
| | - Giulia Querzoli
- Pathology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40100 Bologna, Italy;
| | - Peter Kestenholz
- Division of Thoracic Surgery, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland; (P.K.); (F.M.)
| | - Marco Scarci
- Department of Thoracic Surgery, Imperial College Healthcare NHS Trust, London W2 1NY, UK;
| | - Marilina La Porta
- Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40100 Bologna, Italy; (M.L.P.); (P.S.)
| | - Piergiorgio Solli
- Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40100 Bologna, Italy; (M.L.P.); (P.S.)
| | - Fabrizio Minervini
- Division of Thoracic Surgery, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland; (P.K.); (F.M.)
| |
Collapse
|
2
|
Nakanishi A, Haruki T, Nakamura H. Cowboy technique for solitary fibrous tumor of the pleura via single-port video-assisted thoracoscopic surgery. Asian J Endosc Surg 2022; 15:472-473. [PMID: 34528399 DOI: 10.1111/ases.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/24/2021] [Accepted: 09/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Atsuyuki Nakanishi
- Department of Surgery, Division of General Thoracic Surgery, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Tomohiro Haruki
- Department of Surgery, Division of General Thoracic Surgery, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Hiroshige Nakamura
- Department of Surgery, Division of General Thoracic Surgery, Faculty of Medicine, Tottori University, Tottori, Japan
| |
Collapse
|
3
|
Li S, Cui F, Liu J, Xu X, Shao W, Yin W, Chen H, He J. Nonintubated uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Chin J Cancer Res 2015; 27:197-202. [PMID: 25937782 DOI: 10.3978/j.issn.1000-9604.2015.03.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/01/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The objective of the current study was to evaluate the feasibility and safety of nonintubated uniportal video-assisted thoracoscopic surgery (VATS) for the management of primary spontaneous pneumothorax (PSP). METHODS From November 2011 to June 2013, 32 consecutive patients with PSP were treated by nonintubated uniportal thoracoscopic bullectomy using epidural anaesthesia and sedation without endotracheal intubation. An incision 2 cm in length was made at the 6(th) intercostal space in the median axillary line. The pleural space was entered by blunt dissection for placement of a soft incision protector. Instruments were then inserted through the incision protector to perform thoracoscopic bullectomy. Data were collected within a minimum follow-up period of 10 months. RESULTS The average time of surgery was 49.0 min (range, 33-65 min). No complications were recorded. The postoperative feeding time was 6 h. The mean postoperative chest tube drainage and hospital stay were 19.3 h and 41.6 h, respectively. The postoperative pain was mild for 30 patients (93.75%) and moderate for two patients (6.25%). No recurrences of pneumothorax were observed at follow-up. CONCLUSIONS The initial results indicated that nonintubated uniportal video-assisted thoracoscopic operations are not only technically feasible, but may also be a safe and less invasive alternative for select patients in the management of PSP. This is the first report to include the use of a nonintubated uniportal technique in VATS for such a large number of PSP cases. Further work and development of instruments are needed to define the applications and advantages of this technique.
Collapse
Affiliation(s)
- Shuben Li
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Fei Cui
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Jun Liu
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xin Xu
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Wenlong Shao
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Weiqiang Yin
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Hanzhang Chen
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Jianxing He
- 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| |
Collapse
|
4
|
Ibrahim M, Menna C, Andreetti C, D'Andrilli A, Ciccone AM, Maurizi G, Cassiano F, Rendina EA. Flexible videoscope for thoracoscopic lobectomy: evolution of uniportal technique. Surg Endosc 2014; 29:2056-9. [PMID: 25294544 DOI: 10.1007/s00464-014-3865-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/02/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Over the years reducing the number of ports during Video-assisted thoracic surgery (VATS) has allowed to accomplish pulmonary lobectomy with a single incision. Endoscopic view and instruments maneuvers issues could be improved by using flexible endoscope. We report our experience of fifteen uniportal VATS (UVATS) using a flexible thoracoscope. METHODS A single incision of about 4-5 cm long was performed at the 5th intercostal space along the anterior axillary line. No additional skin incisions were made. A flexible videoscope and multiple VATS instruments were simultaneously inserted into the uniport. Pulmonary lobectomy with systematic mediastinal lymph node dissection was performed. Verbal pain scores were registered using the visual analog scale from 0 to 10 at the first post-operative day. RESULTS No post-operative complications or hospital mortality were recorded. Mean operative time was 112.6 min (range 70-200) and mean postoperative hospital stay 3.2 days (range 2-6). Mean pain score was 0.5 (range 0-2). CONCLUSIONS Single-incision VATS lobectomy using a flexible thoracoscope is a feasible and safe approach.
Collapse
Affiliation(s)
- Mohsen Ibrahim
- Division of Thoracic Surgery, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome "Sapienza", Via di Grottarossa 1035, 00189, Rome, Italy,
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Solitary fibrous tumours of the pleura: report of two cases and literature review. Ir J Med Sci 2013; 182:729-33. [PMID: 23609596 DOI: 10.1007/s11845-013-0952-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/10/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Solitary fibrous tumours of the pleura (SFTPs) are rare pleural mesenchymal neoplasms with distinct clinicopathological and immunohistochemical features, accounting for less than 5 % of all neoplasms involving the pleura. METHODS We present two cases of SFTP with a review of the current literature. RESULTS Clinical presentation varies according to size and intrathoracic localisation. The molecular pathology of SFTPs is largely unknown. Complete surgical resection is recommended with long-term clinic and radiographic follow-up due to its malignant potential. CONCLUSIONS This is a summary of available literature outlining current clinical practice in the diagnosis, management, and treatment of SFTPs in Ireland.
Collapse
|