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Mitsui H, Fujiwara A, Mokuno M, Minami T. Cardiac Tamponade Caused By Carbon Dioxide Insufflation During Robot-Assisted Thoracic Surgery: A Case Report. A A Pract 2024; 18:e01754. [PMID: 38512718 DOI: 10.1213/xaa.0000000000001754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Various complications can occur during robot-assisted thoracic surgery for mediastinal tumors owing to carbon dioxide (CO2) insufflation. This study reports the case of a 43-year-old woman who underwent robot-assisted surgery for an anterior mediastinal tumor with the subxiphoid approach. Shortly after starting CO2 insufflation, the blood pressure decreased significantly. Subsequent examination of the mediastinum revealed a left-sided pericardial injury. Cardiac tamponade due to entry of CO2 gas into the pericardial cavity was suspected. A deliberate incision was made in the right pericardium, ultimately resolving the cardiac tamponade and substantially improving the patient's blood pressure.
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Affiliation(s)
- Hiroaki Mitsui
- From the Department of Anesthesiology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
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2
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Lan J, Huang Q, Su J, Zhang X, Zhang L. A study on the appropriate dose of rocuronium for intraoperative neuromonitoring in Da Vinci robot thyroid surgery: a randomized, double-blind, controlled trial. Front Endocrinol (Lausanne) 2023; 14:1216546. [PMID: 37745708 PMCID: PMC10517056 DOI: 10.3389/fendo.2023.1216546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background This study was to explore the effect of different doses of rocuronium bromide on neuromonitoring during Da Vinci robot thyroid surgery. Methods This was a prospective, randomized, double-blind, controlled trial that included 189 patients who underwent Da Vinci robot thyroidectomy with intraoperative neuromonitoring(IONM). Patients were randomly divided into three groups and given three different doses of rocuronium (0.3mg/kg, 0.6mg/kg, 0.9mg/kg). Outcome measurements included IONM evoked potential, postoperative Voice Handicap Index-30(VHI-30), intraoperative body movement incidence rate, Cooper score, and hemodynamic changes during anesthesia induction.Results: The difference in IONM evoked potentials at various time points between the three groups was not statistically significant (P>0.05). The difference in Cooper scores and intraoperative body movement incidence rate between 0.6 and 0.9mg/kg groups was statistically significant compared with the 0.3mg/kg group (both P<0.001). There was no statistically significant difference in VHI-30 score and hemodynamic changes during anesthesia induction among the three groups (both P>0.05). Conclusions For patients undergoing Da Vinci robot thyroidectomy, a single dose of rocuronium at 0.6 and 0.9mg/kg during anesthesia induction can provide stable IONM evoked potential. Additionally, compared to 0.3 mg/kg, it can offer better tracheal intubation conditions and lower incidence of body movements during surgery. It is worth noting that the use of higher doses of rocuronium should be adjusted based on the duration of IONM and local practices.
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Affiliation(s)
- Jianning Lan
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qijian Huang
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jiansheng Su
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xuru Zhang
- Department of Anesthesiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Liangcheng Zhang
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
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Scheriau G, Weng R, Lassnigg A, Maleczek M, Zimprich F, Matilla J, Moser B, Bernardi MH. Perioperative management of patients with myasthenia gravis undergoing robotic-assisted thymectomy – a retrospective analysis and clinical evaluation. J Cardiothorac Vasc Anesth 2022; 36:3806-3813. [DOI: 10.1053/j.jvca.2022.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/10/2022] [Accepted: 05/18/2022] [Indexed: 11/11/2022]
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Cavaleri M, Tigano S, Nicoletti R, La Rosa V, Terminella A, Cusumano G, Sanfilippo F, Astuto M. Continuous Erector Spinae Plane Block as Postoperative Analgesic Technique for Robotic-Assisted Thoracic Surgery: A Case Series. J Pain Res 2021; 14:3067-3072. [PMID: 34629899 PMCID: PMC8495611 DOI: 10.2147/jpr.s308027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction The erector spinae plane block (ESPB) is a recently implemented analgesic technique initially reported for thoracic analgesia and subsequently adopted for both intra- and postoperative pain management. Thoracic surgery is among the most painful surgical procedures, even when conducted with minimally invasive approach. Robotic-assisted thoracic surgery (RATS) challenges the traditional analgesic regimens as one of its aims is to decrease the patient’s length of stay (LOS) whilst achieving optimal postoperative pain management. Furthermore, there is lots of growing evidence on the impact of poorly controlled postoperative pain (PP) on the development of chronic post-surgical pain (CPSP). In these case series, we aim to describe our preliminary experience of postoperative pain management with continuous ESPB in the field of RATS. Case Series Presentation In eight consecutive patients undergoing elective RATS procedure, we performed the ESPB after surgery with an initial bolus of local anesthetic followed by catheter insertion for continuous infusion. The infusion of local anesthetic lasted for the first two postoperative days. The effectiveness of the ESPB was evaluated through serial pain assessment with numeric rate scale (NRS) score, both at rest and during movement every 6 hours. Any analgesic rescue drug prescription was reported. We noted that the ESPB strongly reduced the prescription of opioids and of rescue analgesic. In our series, only one patient needed opioids during the first two postoperative days, and no rescue analgesic administration was noted in the remaining cases. Conclusion We report a small but promising experience regarding postoperative pain management with continuous ESPB performed after RATS. We implemented the ESPB before surgery. Larger studies on postoperative pain management with continuous regional blocks in thoracic surgery are warranted.
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Affiliation(s)
- Marco Cavaleri
- Department of General Surgery and Medical-Surgical Specialties, Section of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy
| | - Stefano Tigano
- Department of General Surgery and Medical-Surgical Specialties, Section of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy.,School of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy
| | - Roberta Nicoletti
- Department of General Surgery and Medical-Surgical Specialties, Section of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy.,School of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy
| | - Valeria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, Section of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy.,School of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy
| | - Alberto Terminella
- Thoracic Surgery Unit, Department of General Surgery and Medical-Surgical Specialties, University Hospital "G. Rodolico" - San Marco Hospital, Catania, 95121, Italy
| | - Giacomo Cusumano
- Thoracic Surgery Unit, Department of General Surgery and Medical-Surgical Specialties, University Hospital "G. Rodolico" - San Marco Hospital, Catania, 95121, Italy
| | - Filippo Sanfilippo
- Department of General Surgery and Medical-Surgical Specialties, Section of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy
| | - Marinella Astuto
- Department of General Surgery and Medical-Surgical Specialties, Section of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy.,School of Anaesthesia and Intensive Care, University Hospital "G. Rodolico", University of Catania, Catania, 95123, Italy
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McKendrick M, Yang S, McLeod GA. The use of artificial intelligence and robotics in regional anaesthesia. Anaesthesia 2021; 76 Suppl 1:171-181. [PMID: 33426667 DOI: 10.1111/anae.15274] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022]
Abstract
The current fourth industrial revolution is a distinct technological era characterised by the blurring of physics, computing and biology. The driver of change is data, powered by artificial intelligence. The UK National Health Service Topol Report embraced this digital revolution and emphasised the importance of artificial intelligence to the health service. Application of artificial intelligence within regional anaesthesia, however, remains limited. An example of the use of a convoluted neural network applied to visual detection of nerves on ultrasound images is described. New technologies that may impact on regional anaesthesia include robotics and artificial sensing. Robotics in anaesthesia falls into three categories. The first, used commonly, is pharmaceutical, typified by target-controlled anaesthesia using electroencephalography within a feedback loop. Other types include mechanical robots that provide precision and dexterity better than humans, and cognitive robots that act as decision support systems. It is likely that the latter technology will expand considerably over the next decades and provide an autopilot for anaesthesia. Technical robotics will focus on the development of accurate sensors for training that incorporate visual and motion metrics. These will be incorporated into augmented reality and visual reality environments that will provide training at home or the office on life-like simulators. Real-time feedback will be offered that stimulates and rewards performance. In discussing the scope, applications, limitations and barriers to adoption of these technologies, we aimed to stimulate discussion towards a framework for the optimal application of current and emerging technologies in regional anaesthesia.
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Affiliation(s)
- M McKendrick
- Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, UK.,Optomize Ltd, Glasgow, UK
| | - S Yang
- James Watt School of Engineering, University of Glasgow, Glasgow, UK
| | - G A McLeod
- Department of Anaesthesia, Ninewells Hospital, Dundee, UK.,University of Dundee, UK
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Lacroix V, Kahn D, Matte P, Pieters T, Noirhomme P, Poncelet A, Steyaert A. Robotic-Assisted Lobectomy Favors Early Lung Recovery versus Limited Thoracotomy. Thorac Cardiovasc Surg 2020; 69:557-563. [PMID: 33045756 DOI: 10.1055/s-0040-1715598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Postoperative pulmonary recovery after lobectomy has showed early benefits for the video-assisted thoracoscopic surgery and sparing open techniques over nonsparing techniques. Robotic-assisted procedures offer benefits in term of clinical outcomes, but their advantages on pulmonary recovery and quality of life have not yet been distinctly prospectively studied. METHODS Eighty-six patients undergoing lobectomy over a period of 29 months were prospectively studied for their pulmonary function recovery and pain score level during the in-hospital stay and at 1, 2, and 6 months. Quality of life was evaluated at 2 and 6 months. Forty-five patients were operated by posterolateral limited thoracotomy and 41 patients by robotic approach. The postoperative analgesia protocol differed for the two groups, being lighter for the robotic group. RESULTS The pulmonary tests were not significantly different during the in-hospital stay. At 1 month, the forced expiratory volume in 1 second, forced vital capacity, vital capacity, and maximal expiratory pressure were significantly better for the robotic group (p = 0.05, 0.04, 0.05, and 0.02, respectively). There was no significant difference left at 2 and 6 months. Pain intensity was equivalent during the in-hospital stay but was significantly lower for the robotic group at 1 month (p = 0.02). At 2 and 6 months, pain and quality of life were comparable. CONCLUSION Robotic technique can offer similar pulmonary and pain recovery during the in-hospital stay with a lighter analgesia protocol. It clearly favors the early term recovery compared with the open limited technique. The objective and subjective functional recovery becomes equivalent at 2 and 6 months.
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Affiliation(s)
- Valérie Lacroix
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - David Kahn
- Department of Anesthesiology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Pascal Matte
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Thierry Pieters
- Department of Pulmonary Medicine, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Philippe Noirhomme
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Alain Poncelet
- Department of Cardiovascular and Thoracic Surgery, IREC, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Arnaud Steyaert
- Department of Anesthesiology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.,Institute of Neuroscience, Université Catholique de Louvain, Bruxelles, Belgium
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Eichhorn M, Haag J, Grünewald C, Reimer P, Winter H. [Robot-assisted Mediastinal Mass Resection]. Zentralbl Chir 2020; 146:111-118. [PMID: 32767302 DOI: 10.1055/a-1192-7205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In recent years, robot-assisted thoracic surgery is gaining more and widespread interest in Europe. Due to the narrow space and the complexity of anatomical structures, conventional minimally invasive mediastinal surgery may be challenging for the thoracic surgeon. Robot-assisted mediastinal surgery opens up new possibilities for minimally invasive surgery, as it permits greater dexterity, a three-dimensional view, and tremor adjustment, which allows the surgeon to perform complex procedures in small thoracic spaces. As robotic platforms continue to evolve, more complex mediastinal thoracic surgical interventions will be facilitated, translating to improved outcomes for patients. This article provides an overview of the current status of robot-assisted mediastinal surgery and summarises general aspects of the indication, set-up and steps of robot-assisted thoracoscopic surgery in mediastinal mass resections.
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Affiliation(s)
- Martin Eichhorn
- Chirurgische Abteilung, Thoraxklinik, Universitätsklinikum Heidelberg, Deutschland, Translational Lung Research Center (TLRCH) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL)
| | - Johannes Haag
- Chirurgische Abteilung, Thoraxklinik, Universitätsklinikum Heidelberg, Deutschland, Translational Lung Research Center (TLRCH) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL)
| | - Christiane Grünewald
- Chirurgische Abteilung, Thoraxklinik, Universitätsklinikum Heidelberg, Deutschland, Translational Lung Research Center (TLRCH) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL)
| | - Peter Reimer
- Chirurgische Abteilung, Thoraxklinik, Universitätsklinikum Heidelberg, Deutschland, Translational Lung Research Center (TLRCH) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL)
| | - Hauke Winter
- Chirurgische Abteilung, Thoraxklinik, Universitätsklinikum Heidelberg, Deutschland, Translational Lung Research Center (TLRCH) Heidelberg, Deutsches Zentrum für Lungenforschung (DZL)
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Anesthetic considerations and goals in robotic pediatric surgery: a narrative review. J Anesth 2020; 34:286-293. [PMID: 31980927 DOI: 10.1007/s00540-020-02738-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/13/2020] [Indexed: 12/28/2022]
Abstract
The morphosis from open surgeries to minimally invasive procedures is in greater part owing to the development of robotics. There has been a hiking popularity of robotic assistance for surgeries in recent years. Though a minimally invasive approach for surgery, it poses major challenges for an anesthesiologist that compound further for pediatric patients. The need of the hour for an anesthesiologist is to have a scrupulous knowledge and understanding of the associated anatomical and physiological considerations in case of pediatric patients. Major anesthetic concerns include restricted patient access, physiologic changes of pneumoperitoneum and different operative positions, risk of hypothermia, efficient fluid and peri-operative pain management. Timely anticipation, cautious observation for peri-operative complications and quick intervention to manage the same are warranted to provide high-quality anesthetic care. This simply implies that as robotic surgery plans to stretch up-to zenith, anesthesiologists shall strive to ace their part in robotic pediatric anesthesia as well. With an efficient and dynamic teamwork, robotic-assisted surgeries hold the potential to turn wonders for the future of surgery.
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Gao S, Barello S, Chen L, Chen C, Che G, Cai K, Crisci R, D'Andrilli A, Droghetti A, Fu X, Ferrari PA, Fernando HC, Ge D, Graffigna G, Huang Y, Hu J, Jiao W, Jiang G, Li X, Li H, Li S, Liu L, Ma H, Ma D, Martinez G, Maurizi G, Phan K, Qiao K, Refai M, Rendina EA, Shao G, Shen J, Tian H, Voltolini L, Vannucci J, Vanni C, Wu Q, Xu S, Yu F, Zhao S, Zhang P, Zhang L, Zhi X, Zhu C, Ng C, Sihoe ADL, Ho AMH. Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery. Transl Lung Cancer Res 2019; 8:1174-1187. [PMID: 32010595 DOI: 10.21037/tlcr.2019.12.25] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Shugeng Gao
- Department of Thoracic Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Serena Barello
- Department of Psychology, EngageMinds Hub Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Liang Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 211166, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350122, China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610065, China
| | - Kaican Cai
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Roberto Crisci
- Division of Thoracic Surgery, University of L'Aquila, Mazzini Hospital, Teramo, Italy
| | - Antonio D'Andrilli
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea Droghetti
- Division of Thoracic Surgery, Carlo Poma Hospital, Mantova, Italy
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Paolo Albino Ferrari
- Division of Thoracic Surgery, A. Businco Cancer Center, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Hiran C Fernando
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Di Ge
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Guendalina Graffigna
- Department of Psychology, EngageMinds Hub Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Yunchao Huang
- Department of Thoracic Surgery, Cancer Research Institute of Yunnan Province, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming 650106, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China
| | - Wenjie Jiao
- Division of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100032, China
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610065, China
| | - Haitao Ma
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Soochow 215006, China
| | - Dongchun Ma
- Department of Cardiothoracic Surgery, Anhui Chest Hospital, Hefei 230022, China
| | - Guillermo Martinez
- Department of Anesthesia and Intensive Care, Papworth Hospital, Cambridge, UK
| | - Giulio Maurizi
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Kevin Phan
- Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia
| | - Kun Qiao
- Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen 518034, China
| | - Majed Refai
- Division of Thoracic Surgery, AOU Ospedali Riuniti, Ancona, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Guoguang Shao
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - Jianfei Shen
- Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Wenzhou 325035, China
| | - Hui Tian
- Department of Thoracic Surgery, The Qilu Hospital of Shandong University, Jinan 250012, China
| | - Luca Voltolini
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Camilla Vanni
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Qingchen Wu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
| | - Shidong Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Fenglei Yu
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Song Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Peng Zhang
- Department of Cardiothoracic Surgery, Tianjing General Hospital of Tianjing Medical University, Tianjing 300052, China
| | - Lanjun Zhang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Chengchu Zhu
- Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Wenzhou 325035, China
| | - Calvin Ng
- Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | | | - Anthony M H Ho
- Department of Anesthesiology and Perioperative Medicine, Queen's University Kingston, Ontario, Canada
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