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Stares M, Lewis G, Vallet M, Killean A, Tramonti G, Patrizio A, Mackean M, Harrow S, Barrie C, MacLennan K, Campbell S, Evans T, Tufail A, Hall P, Phillips I. Real-World Impact of SABR on Stage I Non-Small-Cell Lung Cancer Outcomes at a Scottish Cancer Centre. Cancers (Basel) 2023; 15:cancers15051431. [PMID: 36900224 PMCID: PMC10000454 DOI: 10.3390/cancers15051431] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Stereotactic ablative body radiotherapy (SABR) offers patients with stage I non-small-cell lung cancer (NSCLC) a safe, effective radical therapy option. The impact of introducing SABR at a Scottish regional cancer centre was studied. METHODS The Edinburgh Cancer Centre Lung Cancer Database was assessed. Treatment patterns and outcomes were compared across treatment groups (no radical therapy (NRT), conventional radical radiotherapy (CRRT), SABR and surgery) and across three time periods reflecting the availability of SABR (A, January 2012/2013 (pre-SABR); B, 2014/2016 (introduction of SABR); C, 2017/2019, (SABR established)). RESULTS 1143 patients with stage I NSCLC were identified. Treatment was NRT in 361 (32%), CRRT in 182 (16%), SABR in 132 (12%) and surgery in 468 (41%) patients. Age, performance status, and comorbidities correlated with treatment choice. The median survival increased from 32.5 months in time period A to 38.8 months in period B to 48.8 months in time period C. The greatest improvement in survival was seen in patients treated with surgery between time periods A and C (HR 0.69 (95% CI 0.56-0.86), p < 0.001). The proportion of patients receiving a radical therapy rose between time periods A and C in younger (age ≤ 65, 65-74 and 75-84 years), fitter (PS 0 and 1), and less comorbid patients (CCI 0 and 1-2), but fell in other patient groups. CONCLUSIONS The introduction and establishment of SABR for stage I NSCLC has improved survival outcomes in Southeast Scotland. Increasing SABR utilisation appears to have enhanced the selection of surgical patients and increased the proportion of patients receiving a radical therapy.
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Affiliation(s)
- Mark Stares
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
- Correspondence: ; Tel.: +44-1315371000
| | - Georgina Lewis
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Maheva Vallet
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Angus Killean
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Giovanni Tramonti
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Ailsa Patrizio
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Melanie Mackean
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Stephen Harrow
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Colin Barrie
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Kirsty MacLennan
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Sorcha Campbell
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Tamasin Evans
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Aisha Tufail
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Edinburgh Cancer Informatics Programme
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Peter Hall
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
| | - Iain Phillips
- Edinburgh Cancer Centre, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK
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Lewis G, Phillips I, Evans T, Campbell S, Maclennan K, Tufail A, Fullerton R, Mactier K, Finn D, Patrizio A, MacKean M. Treatment outcomes for stage I lung cancer in south-east Scotland. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Swan A, Boh Z, Patrizio A, Phillips I, Evans T, MacLennan K, Tufail A, Barrie C, MacKean M. Real world prospective data on tyrosine kinase inhibitors in the treatment of epidermal growth factor receptor mutation positive non-small cell lung cancer at the Edinburgh Cancer Centre. Lung Cancer 2021. [DOI: 10.1016/s0169-5002(21)00278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Killean A, Phillips I, Collinson C, Patrizio A, Evans T, Little F, Campbell S, Tufail A, Barrie C, Mackean M. Comparing methods of evaluating sarcopenia in stage III/IV lung cancer. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Collinson C, Killean A, Tufail A, Evans T, Mackean M, Maclennan K, Little F, Barrie C, Campbell S, Patrizio A, Phillips I. Detecting early weight loss in patients with advanced lung cancer. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30216-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fallahi P, Foddis R, Elia G, Ragusa F, Patrizio A, Benvenga S, Cristaudo A, Antonelli A, Ferrari SM. CXCL8 and CXCL11 chemokine secretion in dermal fibroblasts is differentially modulated by vanadium pentoxide. Mol Med Rep 2018; 18:1798-1803. [PMID: 29901202 DOI: 10.3892/mmr.2018.9121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/16/2018] [Indexed: 11/06/2022] Open
Abstract
An increase in skin rashes or atopic dermatitis has been observed in individuals working with vanadium. However, to the best of our knowledge no in vivo or in vitro studies have evaluated the effect of exposure to vanadium in dermal fibroblasts. Cells viability and proliferation were assessed by WST‑1 assay, cells were treated with increasing concentrations of V2O5 (1, 10 and 100 nM). CXCL8 and CXCL11 concentrations were measured in the supernatants using an ELISA assay. V2O5 was not observed as having a significant effect on dermal fibroblast's viability and proliferation. However, it was revealed that V2O5 was able to induce the secretion of CXCL8 and CXCL11 chemokines into dermal fibroblasts. V2O5 synergistically increased the effect of interferon (IFN)γ on CXCL11 secretion. In addition, V2O5 synergistically increased the effect of the tumor necrosis factor α on CXCL8 secretion and abolished the inhibitory effect of IFNγ. V2O5 induction of CXCL8 and CXCL11 chemokines may lead to the appearance and perpetuation of an inflammatory reaction into the dermal tissue. Further studies are required to evaluate dermal integrity and manifestations in subjects occupationally exposed, or living in polluted areas.
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Affiliation(s)
- P Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - R Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - G Elia
- Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - F Ragusa
- Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - A Patrizio
- Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - S Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, I‑98125 Messina, Italy
| | - A Cristaudo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - A Antonelli
- Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - S M Ferrari
- Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, I‑56126 Pisa, Italy
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Fallahi P, Foddis R, Elia G, Ragusa F, Patrizio A, Guglielmi G, Frenzilli G, Benvenga S, Cristaudo A, Antonelli A, Ferrari SM. Induction of Th1 chemokine secretion in dermal fibroblasts by vanadium pentoxide. Mol Med Rep 2018. [PMID: 29532885 DOI: 10.3892/mmr.2018.8712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vanadium is a soft, silvery‑grey metal with a number of different oxidation states. The most common commercial form of vanadium is vanadium pentoxide (V2O5). All vanadium compounds are considered toxic. An increase in skin rashes has been observed in certain vanadium workers, including the development of atopic dermatitis. However, to the best of our knowledge, no prior in vivo or in vitro studies have evaluated the effect of vanadium exposure in human dermal fibroblasts. The present study evaluated the effect of V2O5 on proliferation and chemokine secretion in dermal fibroblasts. The results revealed that V2O5 had no significant effect on the viability or proliferation of fibroblasts, however it was able to induce the secretion of T‑helper (Th)1 chemokines from dermal fibroblasts, synergistically increasing the effect of important Th1 cytokines, including interferon‑γ and tumor necrosis factor‑α. Through these processes, V2O5 may lead to the induction and perpetuation of an inflammatory reaction in dermal tissue. The induction and perpetuation of inflammation in the dermis and the variety of involved candidate genes may be at the base of V2O5‑induced effects following occupational and environmental exposures. Further studies are necessary to evaluate dermal integrity and manifestations in subjects who are occupationally exposed, or living in polluted areas.
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Affiliation(s)
- P Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - R Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - G Elia
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - F Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - A Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - G Guglielmi
- U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero‑Universitaria Pisana, I‑56124 Pisa, Italy
| | - G Frenzilli
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - S Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, I‑98125 Messina, Italy
| | - A Cristaudo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I‑56126 Pisa, Italy
| | - A Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
| | - S M Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, I‑56126 Pisa, Italy
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Fallahi P, Foddis R, Elia G, Ragusa F, Patrizio A, Benvenga S, Cristaudo A, Antonelli A, Ferrari SM. Vanadium pentoxide induces the secretion of CXCL9 and CXCL10 chemokines in thyroid cells. Oncol Rep 2018. [PMID: 29517108 DOI: 10.3892/or.2018.6307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vanadium is a grey metal, existing in different states of oxidation, whose most common form in commercial products is vanadium pentoxide (V2O5). All vanadium compounds have been considered toxic. A carcinogenic role of vanadium on the thyroid has recently been proposed. However no in vivo or in vitro studies have evaluated thyroid disruption in humans and/or animals after exposure to vanadium. In the present study we evaluate the effect of V2O5 on proliferation, and chemokine secretion in normal thyrocytes. Our study demonstrated that V2O5 has no effect on thyroid follicular cell viability or proliferation, but it is able to induce the secretion of T-helper (Th)1 chemokines into the thyroid, synergistically increasing the effect of important Th1 cytokines such as interferon (IFN)γ and tumor necrosis factor (TNF)α. Through this process, V2O5 promotes the induction and perpetuation of an inflammatory reaction in the thyroid. Further studies are necessary to evaluate thyroid function, and nodules, in subjects occupationally exposed, or living in polluted areas.
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Affiliation(s)
- P Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
| | - R Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I-56126 Pisa, Italy
| | - G Elia
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
| | - F Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
| | - A Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
| | - S Benvenga
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Messina, I-98125 Messina, Italy
| | - A Cristaudo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, I-56126 Pisa, Italy
| | - A Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
| | - S M Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, I-56126 Pisa, Italy
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Price A, Campbell S, Erridge S, Ironside J, Little F, Evans T, Mackean M, Patrizio A. P2.02-008 How Do We Really Treat Patients with Stage III Non-Small Cell Lung Cancer (NSCLC)? J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mackean M, Allen A, Price A, Ironside J, Erridge S, Campbell S, Patrizio A, Fergusson R. 180 Why do some patients with small cell lung cancer (SCLC) not get chemotherapy? Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70181-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Orfei P, Almenräder N, Patrizio A, Bigetti E, Pinto G. [Laryngeal mask perforation: complication of jugular vein cannulation in a newborn]. Anaesthesist 2002; 51:467-9. [PMID: 12391533 DOI: 10.1007/s00101-002-0327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This case report describes the perforation of a laryngeal mask during central venous cannulation of the internal jugular vein in a 2000 g, formerly preterm infant. The procedure was undertaken with the patient under general anaesthesia with a laryngeal mask and spontaneous breathing. As a result of the infant's clinical status, multiple needle insertions were required to obtain venous access. The needle was inadvertently advanced to the retropharynx and perforated the air-filled part of the laryngeal mask. Ventilation parameters remained stable. The laryngeal mask causes anatomical alterations of cervical structures in the newborn and therefore its use for the airway management during jugular vein cannulation appears to be limited.
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Affiliation(s)
- P Orfei
- Institut für Anästhesiologie und Reanimation, Universitätsklinikum Umberto, Rom, Italien.
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Orfei P, Bigetti E, Patrizio A, Pinto G. [The use of alfentanil for short duration surgery in pediatric anesthesia]. Minerva Anestesiol 2000; 66:123-9. [PMID: 10817001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND In the present paper, the effectiveness of the alfentanyl-propofol combination versus fentanyl-propofol association in pediatric anesthesia during short surgical procedures was investigated. METHODS EXPERIMENTAL DESIGN randomized study. SETTING This study was carried out at the Surgical-Division of the Pediatric Clinic of the University "La Sapienza", Rome. PATIENT 100 children (age 4.95 +/- 0.26 yr, body weight 21.13 +/- 0.86 kg) undergone to short anesthesia (50 +/- 0.01 min), were examined. PATIENTs were divided randomly into two groups, A and B, each composed of 50 children. PATIENTs in group A received an alfentanyl bolus dose of 50 micrograms.kg-1 and a continuous infusion of 0.50 microgram.kg-1.min-1, whereas patients in group B received a fentanyl bolus dose of 5 micrograms.kg-1 and a continuous infusion of 0.16 microgram.kg-1.min-1. In all patients, propofol was given in the same dose (bolus dose 1 mg.kg-1; continuous infusion 0.1 mg.kg-1.min-1) in association with opioid analgesic. MEASUREMENTS non-invasive arterial pressure, EKG, heart rate, rectal temperature, oxygen saturation, capnography; during the postoperative course, we evaluated the motor activity response, the degree of weakfulness and consciousness. RESULTS No significant differences between two groups in the systolic, diastolic and mean arterial pressure were pointed out whereas a decrease in heart rate in the group B and a better and more rapid restoration of breathing in group A was observed. Children of group A, after awakening, were more quiet and answered more readily to simple orders (64%). In group B 50% of children showed psychomotor unrest and 10% of them cried. The group that received alfentanyl answered more readily than group B (42% versus 26%). CONCLUSIONS The present study shows that alfentanyl allows a better control of the surgical analgesia and it assures a good analgesic cover for all short surgical procedures without risk of early respiratory depression in postoperative period. Furthermore alfentanyl assures an early postoperative recovery due to the minimal pool, minimal undesired effects, and a cardiocirculatory stability.
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Affiliation(s)
- P Orfei
- Istituto di Anestesiologia e Rianimazione, Università degli Studi di Roma La Sapienza, Roma.
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Orfei P, Frandina G, Patrizio A, Bigetti E, Nicolucci S, Romualdi R, Galassi A, Pinto G. [Use of the laryngeal mask for airway control in difficult intubations in children]. Minerva Anestesiol 1999; 65:561-9. [PMID: 10479844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
LMA was introduced in clinical practice by Arthur Brain in 1983 as a valuable substitute of tracheal tube in adult who underwent general anaesthesia; since then its applications have been extensively studied. LMA is a relatively new non-invasive ventilatory device which has allowed a radical change in the management of modern general anaesthesia. In this study, the application of LMA is assessed during induction and maintenance of general anaesthesia in children affected by severe facial deformities that could render the placement of the tracheal tube difficult. Three patients were affected by complex malformative syndromes involving the maxillo-facial skeleton and one patient presented a massive teratoma, originating from the orbit. In all these cases, LMA provided a patient airway and a satisfactory ventilation during both induction and the repeated attempts of inserting the tracheal tube; in one case, since the orotracheal intubation failed, LMA has proved to be as effective as the tracheal tube during the maintenance of general anaesthesia. Therefore, LMA is recommended as an essential ventilatory device in the hands of paediatric anaesthesiologists.
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Affiliation(s)
- P Orfei
- Istituto di Anestesiologia e Rianimazione, Università degli Studi La Sapienza, Roma
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