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Anile M, Ferrante F, Zacchini B, Pernazza A, Bassi M, Vannucci J, Venuta F. Not all that glitters is gold. J Thorac Dis 2024; 16:2681-2683. [PMID: 38738223 PMCID: PMC11087643 DOI: 10.21037/jtd-24-38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/08/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Francesco Ferrante
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Beatrice Zacchini
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Angelina Pernazza
- Department of Radiology, Oncology and Pathology, University of Rome Sapienza, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Perugia, Perugia, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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Bassi M, Vaz Sousa R, Zacchini B, Centofanti A, Ferrante F, Poggi C, Carillo C, Pecoraro Y, Amore D, Diso D, Anile M, De Giacomo T, Venuta F, Vannucci J. Lung Cancer Surgery in Octogenarians: Implications and Advantages of Artificial Intelligence in the Preoperative Assessment. Healthcare (Basel) 2024; 12:803. [PMID: 38610225 PMCID: PMC11011722 DOI: 10.3390/healthcare12070803] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/07/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
The general world population is aging and patients are often diagnosed with early-stage lung cancer at an advanced age. Several studies have shown that age is not itself a contraindication for lung cancer surgery, and therefore, more and more octogenarians with early-stage lung cancer are undergoing surgery with curative intent. However, octogenarians present some peculiarities that make surgical treatment more challenging, so an accurate preoperative selection is mandatory. In recent years, new artificial intelligence techniques have spread worldwide in the diagnosis, treatment, and therapy of lung cancer, with increasing clinical applications. However, there is still no evidence coming out from trials specifically designed to assess the potential of artificial intelligence in the preoperative evaluation of octogenarian patients. The aim of this narrative review is to investigate, through the analysis of the available international literature, the advantages and implications that these tools may have in the preoperative assessment of this particular category of frail patients. In fact, these tools could represent an important support in the decision-making process, especially in octogenarian patients in whom the diagnostic and therapeutic options are often questionable. However, these technologies are still developing, and a strict human-led process is mandatory.
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Affiliation(s)
- Massimiliano Bassi
- Division of Thoracic Surgery, Department of General Surgery and Surgical Specialties “Paride Stefanini”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy
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Cauti FM, Rossi P, Bianchi S, Magnocavallo M, Capone S, Della Rocca DG, Polselli M, Bruno K, Tozzi P, Rossi C, Vannucci J, Pugliese F, Quaglione R, Venuta F, Anile M. Modified sympathicotomy in patients with refractory ventricular tachycardia and structural heart disease: a single-center experience. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01706-6. [PMID: 38040851 DOI: 10.1007/s10840-023-01706-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Modified cardiac sympathetic denervation (CSD) with stellate ganglion (SG) sparing is a novel technique for cardiac neuromodulation in patients with refractory ventricular tachycardia (VT). OBJECTIVES Our aim is to describe the mid- to long-term clinical outcome of the modified CSD with SG sparing in a series of patients with structural heart disease (SHD) and refractory VT. METHODS All consecutive patients with SHD and refractory VT undergoing modified CSD were enrolled. Baseline clinical characteristics and periprocedural data were collected for all patients. The primary outcome was any recurrence of sustained VT. RESULTS We enrolled 15 patients (age: 69.2 ± 7.9 years; male 100%) undergoing modified CSD. Left ventricular ejection fraction was 37 ± 11% and all patients had an implantable cardiac defibrillator (ICD); the underlying cardiomyopathy was non-ischemic in 73.3% of them. At least one previous ablation had been attempted in 66.6% of cases. The 73.3% of patients underwent bilateral CSD and the mean effective surgical time was 10.8 ± 2.4 min per side; no major periprocedural complication occurred. After a median follow-up time of 15 months (IQR: 8.5-24.5 months), the primary outcome occurred in 47.6% of cases. All patients experienced a reduction of ICD shocks after CSD (3.1 ICD shocks/patient before vs. 0.3 ICD shocks/patient after CSD; p-value: 0.001). Bilateral CSD and a VT cycle length < 340 ms were associated with better outcomes. CONCLUSIONS A modified CSD approach with stellate ganglion sparing appears to be safe, fast, and effective in the treatment of patients with SHD and refractory VTs.
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Affiliation(s)
- Filippo Maria Cauti
- Arrhythmology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Cardiology Unit, Dipartimento Cuore e Grossi Vasi, Policlinico Umberto I, Sapienza University, Rome, Italy.
| | - Pietro Rossi
- Arrhythmology Unit, Fatebenefratelli Isola - Gemelli Isola, Rome, Italy
| | - Stefano Bianchi
- Arrhythmology Unit, Fatebenefratelli Isola - Gemelli Isola, Rome, Italy
| | | | - Silvia Capone
- Arrhythmology Unit, Fatebenefratelli Isola - Gemelli Isola, Rome, Italy
| | - Domenico Giovanni Della Rocca
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard - Heart, Brussels, Belgium
| | - Marco Polselli
- Arrhythmology Unit, Fatebenefratelli Isola - Gemelli Isola, Rome, Italy
| | - Katia Bruno
- Department of Anesthesiology, Sapienza University, Rome, Italy
| | | | - Chiara Rossi
- Presidio Ospedaliero Santo Spirito in Sassia, Rome, Italy
| | - Jacopo Vannucci
- Division of Thoracic Surgery and Lung Transplant, Sapienza University, Rome, Italy
| | | | - Raffaele Quaglione
- Cardiology Unit, Dipartimento Cuore e Grossi Vasi, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery and Lung Transplant, Sapienza University, Rome, Italy
| | - Marco Anile
- Division of Thoracic Surgery and Lung Transplant, Sapienza University, Rome, Italy
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Mottola E, Adotti F, Pernazza A, Della Rocca C, D'Amati G, Nardis P, Vannucci J, Bassi M, Venuta F, Anile M. Xanthoma of rib: a case report and review of the literature. J Cardiothorac Surg 2023; 18:205. [PMID: 37400894 PMCID: PMC10318816 DOI: 10.1186/s13019-023-02315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/28/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Xanthomas are well-circumscribed benign proliferative lesions seen mainly in soft tissues. Usually, they are found in hyperlipidemia and familial hyperlipoproteinemia. Histologically, are characterized by macrophage-like mononuclear cells, multinucleated giant cells and abundant foam cells. The bone involvement, however, is notoriously rare and rib localization is extremely rare. CASE PRESENTATION A 55-year-old man performed a chest X-ray and a subsequent chest Computed Tomography scan showing a rib lesion that was surgically removed and a diagnosis of rib xanthoma was made. The patient presented an unknown condition of hyperlipidemia. CONCLUSION Rib xanthoma can be discovered accidentally and can be helpful in identifying an unrecognized condition of hyperlipidemia.
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Affiliation(s)
- Emilia Mottola
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Flavia Adotti
- Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy
| | - Angelina Pernazza
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy
| | - Carlo Della Rocca
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy
| | - Giulia D'Amati
- Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy
| | - Piergiorgio Nardis
- Interventional Radiology Section of Department of Radiological, Oncological, and Anatomopathological, Sciences of Policlinico Umberto I of Rome, Sapienza University of Rome, Rome, Italy
| | - Jacopo Vannucci
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| | - Massimiliano Bassi
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Anile
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
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Marro M, Leiva-Juárez MM, D'Ovidio F, Chan J, Van Raemdonck D, Ceulemans LJ, Moreno P, Kindelan AA, Krueger T, Koutsokera A, Ehrsam JP, Inci I, Yazicioglu A, Yekeler E, Boffini M, Brioude G, Thomas PA, Pizanis N, Aigner C, Schiavon M, Rea F, Anile M, Venuta F, Keshavjee S. Lung Transplantation for Primary Ciliary Dyskinesia and Kartagener Syndrome: A Multicenter Study. Transpl Int 2023; 36:10819. [PMID: 36865666 PMCID: PMC9970992 DOI: 10.3389/ti.2023.10819] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Abstract
Primary ciliary dyskinesia, with or without situs abnormalities, is a rare lung disease that can lead to an irreversible lung damage that may progress to respiratory failure. Lung transplant can be considered in end-stage disease. This study describes the outcomes of the largest lung transplant population for PCD and for PCD with situs abnormalities, also identified as Kartagener's syndrome. Retrospectively collected data of 36 patients who underwent lung transplantation for PCD from 1995 to 2020 with or without SA as part of the European Society of Thoracic Surgeons Lung Transplantation Working Group on rare diseases. Primary outcomes of interest included survival and freedom from chronic lung allograft dysfunction. Secondary outcomes included primary graft dysfunction within 72 h and the rate of rejection ≥A2 within the first year. Among PCD recipients with and without SA, the mean overall and CLAD-free survival were 5.9 and 5.2 years with no significant differences between groups in terms of time to CLAD (HR: 0.92, 95% CI: 0.27-3.14, p = 0.894) or mortality (HR: 0.45, 95% CI: 0.14-1.43, p = 0.178). Postoperative rates of PGD were comparable between groups; rejection grades ≥A2 on first biopsy or within the first year was more common in patients with SA. This study provides a valuable insight on international practices of lung transplantation in patients with PCD. Lung transplantation is an acceptable treatment option in this population.
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Affiliation(s)
- Matteo Marro
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Miguel M Leiva-Juárez
- Division of Thoracic Surgery, Columbia University Medical Center, New York, NY, United States
| | - Frank D'Ovidio
- Division of Thoracic Surgery, Columbia University Medical Center, New York, NY, United States
| | - Justin Chan
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | - Paula Moreno
- Thoracic Surgery and Lung Transplantation Unit, University Hospital Reina Sofia, Cordoba, Spain
| | | | - Thorsten Krueger
- Division of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Angela Koutsokera
- Division of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Jonas Peter Ehrsam
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Ilhan Inci
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Alkin Yazicioglu
- Department of Thoracic Surgery, University of Health Sciences, Ankara, Türkiye
| | - Erdal Yekeler
- Department of Thoracic Surgery, University of Health Sciences, Ankara, Türkiye
| | - Massimo Boffini
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Geoffrey Brioude
- Division of Thoracic Surgery, University of Marseilles, Marseille, France
| | | | - Nikolaus Pizanis
- Department of Thoracic Surgery, University Hospital Essen, Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery, University Hospital Essen, Essen, Germany
| | - Marco Schiavon
- Department of Cardio-Thoracic Surgery, Padua University Hospital, Padua, Italy
| | - Federico Rea
- Department of Cardio-Thoracic Surgery, Padua University Hospital, Padua, Italy
| | - Marco Anile
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Shaf Keshavjee
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada
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Cauti FM, Capone S, Rossi P, Polselli M, Venuta F, Vannucci J, Bruno K, Pugliese F, Tozzi P, Bianchi S, Anile M. Cardiac sympathetic denervation for untreatable ventricular tachycardia in structural heart disease. Strengths and pitfalls of evolving surgical techniques. J Interv Card Electrophysiol 2022:10.1007/s10840-022-01404-9. [PMID: 36282370 DOI: 10.1007/s10840-022-01404-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/19/2022] [Indexed: 10/31/2022]
Abstract
Cardiac sympathetic denervation (CSD) is a valuable option in the setting of refractory ventricular arrhythmias in patient with structural heart disease. Since the procedure was introduced for non structural heart disease patients the techniques evolved and were modified to be adopted in several settings. In this state-of-the-art article we revised different techniques, their rationale, strengths, and pitfalls.
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Affiliation(s)
- Filippo Maria Cauti
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebenefratelli Isola Tiberina, Via Ponte Quattro Capi 39, 00186, Rome, Italy.
| | - Silvia Capone
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebenefratelli Isola Tiberina, Via Ponte Quattro Capi 39, 00186, Rome, Italy
- Cardiology Unit, Dipartimento Cuore E Grossi Vasi, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Pietro Rossi
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebenefratelli Isola Tiberina, Via Ponte Quattro Capi 39, 00186, Rome, Italy
| | - Marco Polselli
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebenefratelli Isola Tiberina, Via Ponte Quattro Capi 39, 00186, Rome, Italy
| | - Federico Venuta
- Thoracic Unit, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Jacopo Vannucci
- Thoracic Unit, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Katia Bruno
- Department of Anesthesiology, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Francesco Pugliese
- Department of Anesthesiology, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Pierfrancesco Tozzi
- Department of Anesthesiology, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Stefano Bianchi
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebenefratelli Isola Tiberina, Via Ponte Quattro Capi 39, 00186, Rome, Italy
| | - Marco Anile
- Thoracic Unit, Policlinico Umberto I, Sapienza University, Rome, Italy
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Anile M, Vannucci J, Ferrante F, Bruno K, De Paolo D, Bassi M, Pugliese F, Venuta F. Non-Intubated Thoracic Surgery: Standpoints and Perspectives. Front Surg 2022; 9:937633. [PMID: 36034396 PMCID: PMC9407015 DOI: 10.3389/fsurg.2022.937633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Non-intubated video-assisted thoracic surgery (NI-VATS) combines the advantages of a non-intubated surgery with the benefits of a minimally invasive approach. First, NI-VATS is performed in the case of fragile patients when general anesthesia and/or orotracheal intubation can be foreseen as inconvenient. However, NI-VATS indications have been increasingly extended to different patient conditions, considering the increasingly assessed safety and feasibility of the procedure. Currently, the NI-VATS approach is used worldwide for different thoracic surgery procedures, including the management of malignant pleural effusion, surgical treatment of empyema, anatomical and non-anatomical lung resection, and other indications. In fact, this approach has shown to be less impactful than VATS under general anesthesia, allowing for shortened hospitalization and faster recovery after surgery. Besides, NI-VATS is associated with fewer pulmonary complications, less respiratory distress, and a mild systemic inflammatory reaction. For these reasons, this approach should be considered not only in patients with poor cardiac or respiratory function (general functional reserve), but also in other eligible conditions. We explored the anesthetic and surgical aspects of such an approach, including the management of analgesia, cough reflex, depth of sedation, and intraoperative technical issues to put this approach in perspective.
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Affiliation(s)
- Marco Anile
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Francesco Ferrante
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Katia Bruno
- Department of Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Dalila De Paolo
- Department of Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Francesco Pugliese
- Department of Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
- Correspondence: Federico Venuta
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Bassi M, Mottola E, Mantovani S, Amore D, Pagini A, Diso D, Vannucci J, Poggi C, De Giacomo T, Rendina EA, Venuta F, Anile M. Coaxial Drainage versus Standard Chest Tube after Pulmonary Lobectomy: A Randomized Controlled Study. Curr Oncol 2022; 29:4455-4463. [PMID: 35877214 PMCID: PMC9317584 DOI: 10.3390/curroncol29070354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Chest tubes are routinely inserted after thoracic surgery procedures in different sizes and numbers. The aim of this study is to assess the efficacy of Smart Drain Coaxial drainage compared with two standard chest tubes in patients undergoing thoracotomy for pulmonary lobectomy. Ninety-eight patients (57 males and 41 females, mean age 68.3 ± 7.4 years) with lung cancer undergoing open pulmonary lobectomy were randomized in two groups: 50 received one upper 28-Fr and one lower 32-Fr standard chest tube (ST group) and 48 received one 28-Fr Smart Drain Coaxial tube (SDC group). Hospitalization, quantity of fluid output, air leaks, radiograph findings, pain control and costs were assessed. SDC group showed shorter hospitalization (7.3 vs. 6.1 days, p = 0.02), lower pain in postoperative day-1 (p = 0.02) and a lower use of analgesic drugs (p = 0.04). Pleural effusion drainage was lower in SDC group in the first postoperative day (median 400.0 ± 200.0 mL vs. 450.0 ± 193.8 mL, p = 0.04) and as a mean of first three PODs (median 325.0 ± 137.5 mL vs. 362.5 ± 96.7 mL, p = 0.01). No difference in terms of fluid retention, residual pleural space, subcutaneous emphysema and complications after chest tubes removal was found. In conclusion, Smart Drain Coaxial chest tube seems a feasible option after thoracotomy for pulmonary lobectomy. The SDC group showed a shorter hospitalization and decreased analgesic drugs use and, thus, a reduction of costs.
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Affiliation(s)
- Massimiliano Bassi
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
- Correspondence: ; Tel./Fax: +39-06-49970220
| | - Emilia Mottola
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Sara Mantovani
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Davide Amore
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Andreina Pagini
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Daniele Diso
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Jacopo Vannucci
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Camilla Poggi
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Tiziano De Giacomo
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Erino Angelo Rendina
- Thoracic Surgery Unit, Sant’Andrea Hospital, Università La Sapienza, 00189 Rome, Italy;
| | - Federico Venuta
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
| | - Marco Anile
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant “PARIDE STEFANINI”, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy; (E.M.); (S.M.); (D.A.); (A.P.); (D.D.); (J.V.); (C.P.); (T.D.G.); (F.V.); (M.A.)
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Mantovani S, Pernazza A, Bassi M, Amore D, Vannucci J, Poggi C, Diso D, d’Amati G, Della Rocca C, Rendina EA, Venuta F, Anile M. Prognostic impact of spread through air spaces in lung adenocarcinoma. Interact Cardiovasc Thorac Surg 2022; 34:1011-1015. [PMID: 34662397 PMCID: PMC10634402 DOI: 10.1093/icvts/ivab289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 09/01/2021] [Accepted: 09/09/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Spread through air spaces (STAS) is a pattern of invasion present in some adenocarcinomas (ADC). The goal of this study was to assess the impact of STAS in patients treated with different types of surgical resections and on the clinical outcome in patients with ADC of different diameters and with different degrees of nodal involvement. METHODS A total of 109 patients were reviewed. Complete surgical resection with systematic nodal dissection was achieved in all patients. The median follow-up was 65 months (3-90 months). RESULTS STAS was observed in 70 cases (64.2%); 13 patients (18.5%) had lymph node involvement (N1 and N2). Overall survival and progression-free survival were higher in patients without STAS (P = 0.042; P = 0.027). The presence of STAS in tumours ≤2 cm was a predictor of worse progression-free survival following sublobar resection compared to major resections (P = 0.011). Sublobar resection of N0 STAS-positive tumours was associated with worse long-term survival compared to a major resection (P = 0.04). Statistical analyses showed that age >70 years and recurrence were independent variables for survival; smoking pack-years >20, sublobar resection and nodal involvement were independent variables for recurrence; and smoking pack-years >20 were independent variables for a history of cancer and pleural invasion for local recurrence. CONCLUSIONS STAS seems to play a role in long-term survival, particularly for patients with N0 and tumours smaller than 2 cm. Further studies are necessary to validate this hypothesis.
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Affiliation(s)
- Sara Mantovani
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Angelina Pernazza
- Department of Medical-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Davide Amore
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Giulia d’Amati
- Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy
| | - Carlo Della Rocca
- Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy
| | | | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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10
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Andreetti C, Ibrahim M, Gagliardi A, Poggi C, Maurizi G, Armillotta D, Peritone V, Teodonio L, Rendina EA, Venuta F, Anile M, Natale G, Santini M, Fiorelli A. Adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers as prognostic factors of early-stage large-cell neuroendocrine carcinoma. Thorac Cancer 2022; 13:900-912. [PMID: 35170859 PMCID: PMC8977171 DOI: 10.1111/1759-7714.14287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 01/25/2023] Open
Abstract
Background We investigated whether adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers affected survival of patients with the early stage of large‐cell neuroendocrine cancer. Methods This was a retrospective multicenter study including consecutive patients undergoing resection of node negative large‐cell neuroendocrine carcinoma. Five‐year survival and disease‐free survival rate were evaluated by the Kaplan–Meier method and the log‐rank test in relation to adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers (synaptophysin, chromogranin A, and neuron‐specific enolase). Results Our study population included 117 patients; 47 (40%) of these received adjuvant chemotherapy. Patients treated with adjuvant chemotherapy had better survival (74% vs. 45%, p = 0.002) and disease‐free survival (79% vs. 40%, p = 0.001) in all cases except patients with tumor <20 mm (79.5% vs. 57.4%, p = 0.43). Lobectomy compared to sublobar resection was associated with better survival (67% vs. 0.1%, p < 0.0001) and disease‐free survival (65% vs. 0.1%, p < 0.0001) also in patients with tumor <20 mm (79% vs. 28%, p = 0.001). Patients with triple‐positive neuroendocrine markers had better survival (79% vs. 35%, p = 0.0001) and disease‐free survival (69% vs. 42%, p = 0.0008). Regression analysis showed that tumor size <20 mm, lobectomy, adjuvant chemotherapy, and triple‐positive immunistochemical neuroendocrine markers were significant favorable prognostic factors for survival outcomes. Conclusions Lobectomy seems to be the management of choice in patients with large‐cell neuroendocrine cancer <20 mm while adjuvant chemotherapy should be administered only in patients with tumor >20 mm.
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Affiliation(s)
- Claudio Andreetti
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Mohsen Ibrahim
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Antonio Gagliardi
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Camilla Poggi
- Thoracic Surgery Unit, Policlinico Hospital, University of Rome La Sapienza, Rome, Italy
| | - Giulio Maurizi
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Domenico Armillotta
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Valentina Peritone
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Leonardo Teodonio
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Erino Angelo Rendina
- Thoracic Surgery Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Federico Venuta
- Thoracic Surgery Unit, Policlinico Hospital, University of Rome La Sapienza, Rome, Italy
| | - Marco Anile
- Thoracic Surgery Unit, Policlinico Hospital, University of Rome La Sapienza, Rome, Italy
| | - Giovanni Natale
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Santini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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11
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Cauti FM, Rossi P, Anile M. Increasing Evidence of Limited Cardiac Sympathetic Denervation for Refractory VT. Ann Thorac Surg 2022; 114:2405-2406. [PMID: 35149046 DOI: 10.1016/j.athoracsur.2022.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Filippo Maria Cauti
- Arrhythmia Unit, S. Giovanni Calibita Hospital, Via Ponte Quattro Capi 39, 00186 Rome-Italy.
| | - Pietro Rossi
- Arrhythmia Unit, S. Giovanni Calibita Hospital, Isola Tiberina, Rome, Italy
| | - Marco Anile
- Thoracic Unit, Policlinico Umberto I, Sapienza University, Rome, Italy
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12
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Napolioni V, Bianconi F, Potenza R, Carpi FM, Ludovini V, Picciolini M, Tofanetti FR, Bufalari A, Pallotti S, Poggi C, Anile M, Daddi N, Venuta F, Puma F, Vannucci J. Genome-wide expression of the residual lung reacting to experimental Pneumonectomy. BMC Genomics 2021; 22:881. [PMID: 34872491 PMCID: PMC8650537 DOI: 10.1186/s12864-021-08171-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/12/2021] [Indexed: 11/21/2022] Open
Abstract
Background Acute or chronic irreversible respiratory failure may occur in patients undergoing pneumonectomy. Aim of this study was to determine transcriptome expression changes after experimental pneumonectomy in swine model. Experimental left pneumonectomy was performed in five pigs under general anaesthesia. Both the resected and the remaining lung, after 60 post-operative completely uneventful days, underwent genome-wide bulk RNA-Sequencing (RNA-Seq). Results Histological analysis showed dilation of air spaces and rupture of interalveolar septa. In addition, mild inflammation, no fibrosis, radial stretch of the bronchus, strong enlargement of airspaces and thinning of the blood supply were observed. Bioinformatic analyses of bulk RNA-Seq data identified 553 Differentially Expressed Genes (DEGs) at adjusted P-value below 0.001, between pre- and post-pneumonectomy. The top 10 up-regulated DEGs were Edn1, Areg, Havcr2, Gadd45g, Depp1, Cldn4, Atf3, Myc, Gadd45b, Socs3; the top 10 down-regulated DEGs were Obscn, Cdkn2b, ENSSSCG00000015738, Prrt2, Amer1, Flrt3, Efnb2, Tox3, Znf793, Znf365. Leveraging digital cytometry tools, no difference in cellular abundance was found between the two experimental groups, while the analysis of cell type-specific gene expression patterns highlighted a striking predominance of macrophage-specific genes among the DEGs. DAVID-based gene ontology analysis showed a significant enrichment of “Extrinsic apoptotic signaling pathway” (FDR q = 7.60 × 10− 3) and “Response to insulin” (FDR q = 7.60 × 10− 3) genes, along with an enrichment of genes involved as “Negative regulators of DDX58/IFIH1 signaling” (FDR q = 7.50 × 10− 4) found by querying the REACTOME pathway database. Gene network analyses indicated a general dysregulation of gene inter-connections. Conclusion This translational genomics study highlighted the existence both of individual genes, mostly dysregulated in certain cellular populations (e.g., macrophages), and gene-networks involved in pulmonary reaction after left pneumonectomy. Their involvement in lung homeostasis is largely supported by previous studies, carried out both in humans and in other animal models (under homeostatic or disease-related conditions), that adopted candidate-gene approaches. Overall, the present findings represent a preliminary assessment for future, more focused, studies on compensatory lung adaptation, pulmonary regeneration and functional reload. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-021-08171-3.
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Affiliation(s)
- Valerio Napolioni
- Genomic and Molecular Epidemiology (GAME) Lab., School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | | | - Rossella Potenza
- Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy.,Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Vienna Ludovini
- Department of Medical Oncology, S. Maria Della Misericordia Hospital, Perugia, Italy
| | | | - Francesca R Tofanetti
- Department of Medical Oncology, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Antonello Bufalari
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Stefano Pallotti
- Genetics and Animal Breeding Group, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
| | - Niccolò Daddi
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
| | - Francesco Puma
- Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy.
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13
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Mantovani S, Vannucci J, Bassi M, Mottola E, Venuta F, Anile M. Left uniportal VATS for lung decortication after chemical pleurodesis under spontaneous breathing in patient with lymphangiomyomatosis. Multimed Man Cardiothorac Surg 2021; 2021. [PMID: 34767702 DOI: 10.1510/mmcts.2021.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 11/06/2022]
Abstract
Pneumothorax can be the first symptom of lymphangioleiomyomatosis. Patients with lymphangioleiomyomatosis have a higher risk of recurrence of pneumothorax. Chemical pleurodesis is a viable option to treat the recurrence, but in rare cases, it is not the solution. We present the case of a patient with lymphangioleiomyomatosis undergoing a talc poudrage via video-assisted thoracoscopic surgery for pneumothorax that failed to reexpand the lung. We proposed to the patient a surgical approach to debride the lung parenchyma with the patient under deep sedation with spontaneous breathing. The patient was discharged on the 5th postoperative day. The chest computed tomography scan showed complete lung reexpansion. We advocate that video-assisted thoracoscopic surgery in patients who are awake is a feasible surgical option that permits the restoration of physiological lung expansion in selected patients who underwent chemical pleurodesis and minimizes the risk of one-lung ventilation.
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Affiliation(s)
- Sara Mantovani
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Emilia Mottola
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | | | - Marco Anile
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
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14
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Iaiza A, Tito C, Ianniello Z, Ganci F, Laquintana V, Gallo E, Sacconi A, Masciarelli S, De Angelis L, Aversa S, Diso D, Anile M, Petrozza V, Facciolo F, Melis E, Pescarmona E, Venuta F, Marino M, Blandino G, Fontemaggi G, Fatica A, Fazi F. METTL3-dependent MALAT1 delocalization drives c-Myc induction in thymic epithelial tumors. Clin Epigenetics 2021; 13:173. [PMID: 34530916 PMCID: PMC8447796 DOI: 10.1186/s13148-021-01159-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Thymic epithelial tumors (TETs) are rare neoplasms, originating from epithelial thymic cells. The oncogenic potential of these rare neoplasms is still largely undefined, and a deeper molecular characterization could result in a relevant advance in their management, greatly improving diagnosis, prognosis and treatment choice. Deregulation of N6-methyladenosine (m6A) RNA modification, catalyzed by the METTL3/METTL14 methyltransferase complex, is emerging as a relevant event in cell differentiation and carcinogenesis. Various studies have reported that altered expression of METTL3 is associated with an aggressive malignant phenotype and favors migration and invasiveness, but its role in Thymic Tumors remains unknown. RESULTS In this study, we characterized that METTL3 contributes to Thymic Epithelial Tumor phenotype. We evidenced that METTL3 is overexpressed in tumor tissue compared to normal counterpart. Silencing of METTL3 expression in thymic carcinoma cells results in reduced cell proliferation and overall translation rate. Of note, METTL3 is responsible for the induction of c-MYC expression in TET cells. Specifically, high expression of c-MYC protein is enabled by lncRNA MALAT1, which is methylated and delocalized by METTL3. Interestingly, blocking of c-MYC by using JQ1 inhibitor cooperates with METTL3 depletion in the inhibition of proliferation and induction of cell death. CONCLUSION This study highlighted METTL3 as a tumor promoter in Thymic tumors and c-MYC as a promising target to be exploited for the treatment of TET.
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Affiliation(s)
- Alessia Iaiza
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Histology and Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Via A. Scarpa, 14-16, 00161, Rome, Italy
| | - Claudia Tito
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Histology and Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Via A. Scarpa, 14-16, 00161, Rome, Italy
| | - Zaira Ianniello
- Department of Biology and Biotechnology 'Charles Darwin', Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy
| | - Federica Ganci
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute - IFO, Rome, Italy
| | - Valentina Laquintana
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Rome, Italy
| | - Enzo Gallo
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Rome, Italy
| | - Andrea Sacconi
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute - IFO, Rome, Italy
| | - Silvia Masciarelli
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Histology and Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Via A. Scarpa, 14-16, 00161, Rome, Italy.,Histology and Embryology Section, Department of Life Science and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Luciana De Angelis
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Histology and Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Via A. Scarpa, 14-16, 00161, Rome, Italy
| | - Sara Aversa
- Pathology Unit, ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Petrozza
- Pathology Unit, ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Francesco Facciolo
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute - IFO, Rome, Italy
| | - Enrico Melis
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute - IFO, Rome, Italy
| | - Edoardo Pescarmona
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Mirella Marino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Rome, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute - IFO, Rome, Italy
| | - Giulia Fontemaggi
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute - IFO, Rome, Italy
| | - Alessandro Fatica
- Department of Biology and Biotechnology 'Charles Darwin', Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy.
| | - Francesco Fazi
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Histology and Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Via A. Scarpa, 14-16, 00161, Rome, Italy.
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15
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Cauti FM, Rossi P, Jacopo Vannucci MP, Luig Iaia CR, Katia Bruno SM, Stefano Bianchi FV, Anile M. B-PO02-132 MID TERM OUTCOME OF A MODIFIED SYMPATHICOTOMY FOR CARDIAC NEUROMODULATION OF UNTREATABLE VENTRICULAR TACHYCARDIA. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.385] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Fiorelli A, D'Andrilli A, Carlucci A, Vicidomini G, Argento G, Trabalza Marinucci B, Ardissone F, Rapanà R, Sobrero S, Carbognani P, Ventura L, Bocchialini G, Ragusa M, Tassi V, Sollitto F, Loizzi D, Ardò NP, Anile M, Puma F, Rendina EA, Venuta F, Serra N, Santini M. Pulmonary Hamartoma Associated With Lung Cancer (PHALC Study): Results of a Multicenter Study. Lung 2021; 199:369-378. [PMID: 34302497 PMCID: PMC8416857 DOI: 10.1007/s00408-021-00460-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022]
Abstract
Purpose Pulmonary hamartoma is the most common benign tumor of the lung. We analyzed a 20-year historical series of patients with pulmonary hamartoma undergoing surgical resection, aiming to evaluate the characteristics, the outcomes, and the association between hamartoma and lung cancer. Methods It was a retrospective multicenter study including the data of all consecutive patients with pulmonary hamartoma undergoing surgical resection. The end-points were to evaluate: (i) the characteristics of hamartoma, (ii) outcomes, and (iii) whether hamartoma was a predictive factor for lung cancer development Results Our study population included 540 patients. Upfront surgical or endoscopic resection was performed in 385 (71%) cases while in the remaining 155 (29%) cases, the lesions were resected 20 ± 3.5 months later due to increase in size. In most cases, lung sparing resection was carried out including enucleation (n = 259; 48%) and wedge resection (n = 230; 43%) while 5 (1%) patients underwent endoscopic resection. Only two patients (0, 2%) had major complications. One patient (0.23%) had recurrence after endoscopic resection, while no cases of malignant degeneration were seen (mean follow-up:103.3 ± 93 months). Seventy-six patients (14%) had associated lung cancer, synchronous in 9 (12%) and metachronous in 67 (88%). Only age > 70-year-old (p = 0.0059) and smokers > 20 cigarettes/day (p < 0.0001) were the significant risk factors for lung cancer. Conclusion PH was a benign tumor, with no evidence of recurrence and/or of malignant degeneration after resection. The association between hamartoma and lung cancer was a spurious phenomenon due to common risk factors.
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Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy.
| | - Antonio D'Andrilli
- Thoracic Surgery, Sant'Andrea Hospital, Università La Sapienza, Rome, Italy
| | - Annalisa Carlucci
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy
| | - Giacomo Argento
- Thoracic Surgery, Sant'Andrea Hospital, Università La Sapienza, Rome, Italy
| | | | - Francesco Ardissone
- Department of Oncology, Thoracic Surgery Unit, San Luigi Hospital, University of Torino, Orbassano, Italy
| | - Roberta Rapanà
- Department of Oncology, Thoracic Surgery Unit, San Luigi Hospital, University of Torino, Orbassano, Italy
| | - Simona Sobrero
- Department of Oncology, Thoracic Surgery Unit, San Luigi Hospital, University of Torino, Orbassano, Italy
| | - Paolo Carbognani
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Luigi Ventura
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Giovanni Bocchialini
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Mark Ragusa
- Division of Thoracic Surgery, S. Maria di Terni Hospital, University of Perugia Medical School, Terni, Italy
| | - Valentina Tassi
- Division of Thoracic Surgery, S. Maria di Terni Hospital, University of Perugia Medical School, Terni, Italy
| | | | | | | | - Marco Anile
- Department of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | | | | | - Federico Venuta
- Department of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Federico II, Naples, Italy
| | - Mario Santini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy
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17
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Cauti FM, Rossi P, Vannucci J, Polselli M, Rossi C, Iaia L, Mantovani S, Bruno K, Pugliese F, Quaglione R, Venuta F, Bianchi S, Anile M. Outcome of a modified sympathicotomy for cardiac neuromodulation of untreatable ventricular tachycardia. Europace 2021. [DOI: 10.1093/europace/euab116.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OBJECTIVES This study aimed to describe the results of a modified sympathicotomy (uniportal VATs with stellate ganglion sparing) for cardiac sympathetic denervation (CSD) in the setting of untreatable ventricular tachycardia.
BACKGROUND. CSD, in patients with refractory ventricular tachycardia (VT), is comprehensively recognized as an important treatment option for patients with structural heart disease as well as congenital inherited arrhythmia syndrome. A recent case series demostrated the feasibility of the modified technique.
METHODS We consecutively enrolled 8 patients with refractory VT. Baseline demographic, medical, and surgical data as well as arrhythmia outcomes and procedural complications were evaluated.
RESULTS A total of 8 patients ( 7 pts NIDCM, 1 pt IDCM with mean age:68+-8 years) were enrolled for the treatment of refractory VT with a modified CSD technique. Mean sympathicotomy length were 7.3 (SD 3) min per side. 3/8 patients underwent monolateral (LCSD) sympathicotomy due to strong adesion in the right pleural cavity. Mean follow up was 13 months (SD 6). No complication occurred during the sympathicotomy. An overall reduction in VT burden and VT number was observed after the CSD despite an in-hospital early recurrence in 3 patients.
CONCLUSIONS A modified CSD (sympathicotomy T2–T5) with stellate ganglion sparing and the use of unipolar radiofrequency is feasible, effective, and safe in the setting of untreatable VT. Abstract Figure. VT trend
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Affiliation(s)
- FM Cauti
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - P Rossi
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - J Vannucci
- Sapienza University of Rome, umberto, Rome, Italy
| | - M Polselli
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | | | - L Iaia
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - S Mantovani
- Sapienza University of Rome, umberto, Rome, Italy
| | - K Bruno
- Sapienza University of Rome, umberto, Rome, Italy
| | - F Pugliese
- Sapienza University of Rome, umberto, Rome, Italy
| | - R Quaglione
- Sapienza University of Rome, umberto, Rome, Italy
| | - F Venuta
- Sapienza University of Rome, umberto, Rome, Italy
| | - S Bianchi
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - M Anile
- Sapienza University of Rome, umberto, Rome, Italy
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18
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Bassi M, Ruberto F, Poggi C, Diso D, Anile M, De Giacomo T, Pecoraro Y, Carillo C, Pugliese F, Venuta F, Vannucci J. In Response. Anesth Analg 2021; 132:e92-e93. [PMID: 33428342 DOI: 10.1213/ane.0000000000005420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Massimiliano Bassi
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Franco Ruberto
- Department of Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Tiziano De Giacomo
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Ylenia Pecoraro
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Carolina Carillo
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Francesco Pugliese
- Department of Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy,
| | - Jacopo Vannucci
- Department of Thoracic Surgery and Lung Transplantation, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy,
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19
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Belardinilli F, Pernazza A, Mahdavian Y, Cerbelli B, Bassi M, Gradilone A, Coppa A, Pignataro MG, Anile M, Venuta F, Della Rocca C, Giannini G, d'Amati G. A multidisciplinary approach for the differential diagnosis between multiple primary lung adenocarcinomas and intrapulmonary metastases. Pathol Res Pract 2021; 220:153387. [PMID: 33647865 DOI: 10.1016/j.prp.2021.153387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/13/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The distinction between multiple primary lung cancers (MPLCs) and intrapulmonary metastases has a significant impact on tumor staging and therapeutic choices. Several criteria have been proposed to solve this diagnostic issue, but a definitive consensus is still missing. We tested the efficacy of a combined clinical, histopathological and molecular ("real world") approach for the correct classification of multiple lung tumors in a selected cohort of patients. METHODS 24 multiple lung tumors with a diagnosis of adenocarcinoma from 10 patients were retrospectively reviewed. Radiological, pathological and clinical information, including follow-up, were integrated with molecular profiling via a routine multigene panel sequencing. RESULTS Comprehensive histologic assessment revealed readily distinguishable histologic patterns between multiple tumors suggesting unrelated lesions in 7 cases, in agreement with clinical, radiological and molecular data, thus leading to final diagnosis of MPLCs. In the remaining 3 cases, the differential diagnosis between MPLCs and intrapulmonary metastases was challenging, since the histologic features of the lesions were similar or identical. The final interpretation (2 MPLCs and 1 most likely intrapulmonary metastases) was reached thanks to the integration of all available data, and was confirmed by follow-up. CONCLUSIONS A multidisciplinary approach including a routinely affordable multigene panel sequencing is a useful tool to discriminate MPLCs from intrapulmonary metastases in multiple lung nodules sharing the adenocarcinoma histotype.
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Affiliation(s)
- Francesca Belardinilli
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161, Rome, Italy
| | - Angelina Pernazza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina, 04100, Italy
| | - Yasaman Mahdavian
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161, Rome, Italy
| | - Bruna Cerbelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina, 04100, Italy
| | - Massimiliano Bassi
- Department of General and Specialist Surgery "P. Stefanini" Sapienza University, Rome, 00161, Italy
| | - Angela Gradilone
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161, Rome, Italy
| | | | - Maria Gemma Pignataro
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, 00161, Italy
| | - Marco Anile
- Department of General and Specialist Surgery "P. Stefanini" Sapienza University, Rome, 00161, Italy
| | - Federico Venuta
- Department of General and Specialist Surgery "P. Stefanini" Sapienza University, Rome, 00161, Italy
| | - Carlo Della Rocca
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina, 04100, Italy
| | - Giuseppe Giannini
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161, Rome, Italy.
| | - Giulia d'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, 00161, Italy.
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20
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Vannucci J, Mantovani S, Dolciami M, Bassi M, Venuta F, Anile M. Fissureless Technique Might Prevent the Middle Lobe Impairment After Right Upper Lobectomy. Surg Innov 2021; 28:659-660. [PMID: 33522440 DOI: 10.1177/1553350621991227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jacopo Vannucci
- Department of Thoracic Surgery, 9311University of Rome La Sapienza, Rome, Italy
| | | | - Miriam Dolciami
- Department of Radiological, Oncological and Pathological Sciences, 9311University of Rome La Sapienza, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, 9311University of Rome La Sapienza, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, 9311University of Rome La Sapienza, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, 9311University of Rome La Sapienza, Rome, Italy
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21
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Bianco M, Mantovani S, D'Agostino FG, Bassi M, Amore D, Cagnetti S, Mottola E, Vannucci J, Venuta F, Anile M. Deep venous thrombosis and abortion: an unusual clinical manifestation of severe form of pectus excavatum. Gen Thorac Cardiovasc Surg 2021; 69:897-901. [PMID: 33502689 PMCID: PMC8058001 DOI: 10.1007/s11748-020-01583-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
Pectus excavatum is a chest wall malformation with a strong psychological and aesthetic impact. Rarely, pectus excavatum patients can show respiratory or cardiac symptoms occurring mainly during physical exertion. We report a case of a 34-year-old pregnant woman with a severe degree of pectus excavatum who developed serious cardiovascular disease resulting in spontaneous twin abortion at the twenty-first week of gestation. Cardiovascular disease was resolved after open surgical correction of pectus excavatum. This case shows how a tardive diagnosis and a delayed surgical approach for pectus excavatum can lead to severe consequences.
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Affiliation(s)
- M Bianco
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - S Mantovani
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - F G D'Agostino
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Bassi
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - D Amore
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Cagnetti
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Mottola
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - J Vannucci
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - F Venuta
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Anile
- Department of Thoracic Surgery, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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22
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Bassi M, Russomando A, Vannucci J, Ciardiello A, Dolciami M, Ricci P, Pernazza A, D’Amati G, Mancini Terracciano C, Faccini R, Mantovani S, Venuta F, Voena C, Anile M. Role of radiomics in predicting lung cancer spread through air spaces in a heterogeneous dataset. Transl Lung Cancer Res 2021; 11:560-571. [PMID: 35529792 PMCID: PMC9073736 DOI: 10.21037/tlcr-21-895] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/12/2022] [Indexed: 11/06/2022]
Abstract
Background Methods Results Conclusions Trial Registration
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Affiliation(s)
- Massimiliano Bassi
- Thoracic Surgery Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - Jacopo Vannucci
- Thoracic Surgery Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - Miriam Dolciami
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Paolo Ricci
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Angelina Pernazza
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy
| | - Giulia D’Amati
- Pathological Science Unit, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Sara Mantovani
- Thoracic Surgery Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Federico Venuta
- Thoracic Surgery Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cecilia Voena
- National Institute of Nuclear Physics, Section of Rome, Rome, Italy
| | - Marco Anile
- Thoracic Surgery Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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23
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Vaz Souza R, Bassi M, Mantovani S, Poggi C, Diso D, Vannucci J, Pagini A, Amore D, Venuta F, Anile M. Comparison of preoperative scores predicting outcome in elderly undergoing lung malignancies resection. J Thorac Dis 2020; 12:7083-7088. [PMID: 33447396 PMCID: PMC7797853 DOI: 10.21037/jtd-20-1622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Increased age of cancer patients is not an absolute contraindication to pulmonary resection. Different scores have been developed to determine the risk of morbidity and mortality. We have compared four scores in a series of elderly patients with primary or metastatic lung neoplasms who underwent pulmonary resection. Methods Data from 150 patients with an age equal or more than 75 years were reviewed. Mean age was 78.3 (range, 75-86) years. Based on medical history and preoperative tests 4 predicting scores were calculated. Statistical analysis was performed to identify which score correlates better with postoperative morbidity and mortality. Results Mortality at 30 days was observed in 3 patients (2%). Postoperative morbidity was observed in 38 patients (25.3%). Univariate analysis showed that risk factors significantly predicting the onset of postoperative complications were type of resection (P=0.02), American Society of Anesthesiology (ASA) score (P<0.001) and Glasgow Prognostic Score (GPS) (P=0.02). At multivariate analysis smoking and type of resection were significant prognostic factors for both overall and pulmonary morbidity; the ASA score and GPS showed an impact only on overall morbidity. The Cox regression showed significant results for GPS greater than zero and cancer-related death. Age above 80 years was not a negative prognostic factor. A significant difference in terms of 1-year survival was noted in ASA I-II vs. ASA III-IV (90% vs. 78%; P=0.022) and GPS 0 vs. GPS 1 or 2 (90% vs. 77%; P=0.02). Conclusions Prognostic scores are useful to predict postoperative morbidity and mortality and GPS seems to correlate better with them.
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Affiliation(s)
- Rita Vaz Souza
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Sara Mantovani
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Andreina Pagini
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Davide Amore
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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24
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Anile M, Mantovani S, Vannucci J, Bassi M, Diso D, Venuta F. Seeking the holy grail of markers. J Thorac Dis 2020; 12:5259-5261. [PMID: 33209358 PMCID: PMC7656358 DOI: 10.21037/jtd.2020.04.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Sara Mantovani
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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25
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Vannucci J, Mantovani S, Poggi C, Diso D, Bassi M, Amore D, Venuta F, Anile M. Catamenial Pneumothorax: A Novel Thoracoscopic Uniportal Approach Using a Spiral Device to Stabilize the Diaphragmatic Prosthesis. Surg Innov 2020; 28:661-662. [PMID: 33153385 DOI: 10.1177/1553350620972552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jacopo Vannucci
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
| | - Sara Mantovani
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
| | | | - Davide Amore
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
| | - Marco Anile
- Department of Thoracic Surgery, 9311University of Rome Sapienza, Italy
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26
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Tito C, Ganci F, Sacconi A, Masciarelli S, Fontemaggi G, Pulito C, Gallo E, Laquintana V, Iaiza A, De Angelis L, Benedetti A, Cacciotti J, Miglietta S, Bellenghi M, Carè A, Fatica A, Diso D, Anile M, Petrozza V, Facciolo F, Alessandrini G, Pescarmona E, Venuta F, Marino M, Blandino G, Fazi F. LINC00174 is a novel prognostic factor in thymic epithelial tumors involved in cell migration and lipid metabolism. Cell Death Dis 2020; 11:959. [PMID: 33161413 PMCID: PMC7648846 DOI: 10.1038/s41419-020-03171-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023]
Abstract
Long non-coding RNAs are emerging as new molecular players involved in many biological processes, such as proliferation, apoptosis, cell cycle, migration, and differentiation. Their aberrant expression has been reported in variety of diseases. The aim of this study is the identification and functional characterization of clinically relevant lncRNAs responsible for the inhibition of miR-145-5p, a key tumor suppressor in thymic epithelial tumors (TETs). Starting from gene expression analysis by microarray in a cohort of fresh frozen thymic tumors and normal tissues, we identified LINC00174 as upregulated in TET. Interestingly, LINC00174 expression is positively correlated with a 5-genes signature in TETs. Survival analyses, performed on the TCGA dataset, showed that LINC00174 and its associated 5-genes signature are prognostic in TETs. Specifically, we show that LINC00174 favors the expression of SYBU, FEM1B, and SCD5 genes by sponging miR-145-5p, a well-known tumor suppressor microRNA downregulated in a variety of tumors, included TETs. Functionally, LINC00174 impacts on cell migration and lipid metabolism. Specifically, SCD5, one of the LINC00174-associated genes, is implicated in the control of lipid metabolism and promotes thymic cancer cells migration. Our study highlights that LINC00174 and its associated gene signature are relevant prognostic indicators in TETs. Of note, we here show that a key controller of lipid metabolism, SCD5, augments the migration ability of TET cells, creating a link between lipids and motility, and highlighting these pathways as relevant targets for the development of novel therapeutic approaches for TET.
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Affiliation(s)
- Claudia Tito
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy
| | - Federica Ganci
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Sacconi
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Silvia Masciarelli
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy.,Istituto di Istologia ed Embriologia, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - Giulia Fontemaggi
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Pulito
- Molecular Chemoprevention Unit, "Regina Elena" National Cancer Institute - IFO, Rome, Italy
| | - Enzo Gallo
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Laquintana
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessia Iaiza
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy
| | - Luciana De Angelis
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy
| | - Anna Benedetti
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy
| | - Jessica Cacciotti
- Pathology Unit, ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Selenia Miglietta
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Human Anatomy, Sapienza University of Rome, Rome, Italy
| | - Maria Bellenghi
- Center for Gender-Specific Medicine, Oncology Unit-Istituto Superiore di Sanita', Rome, Italy
| | - Alessandra Carè
- Center for Gender-Specific Medicine, Oncology Unit-Istituto Superiore di Sanita', Rome, Italy
| | - Alessandro Fatica
- Department of Biology and Biotechnology 'Charles Darwin', Sapienza University of Rome, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Petrozza
- Pathology Unit, ICOT, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Francesco Facciolo
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Edoardo Pescarmona
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy
| | - Mirella Marino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Francesco Fazi
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Section of Histology & Medical Embryology, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Rome, Italy.
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27
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Cauti FM, Rossi P, Bianchi S, Bruno K, Iaia L, Rossi C, Pugliese F, Quaglione R, Venuta F, Anile M. Outcome of a Modified Sympathicotomy for Cardiac Neuromodulation of Untreatable Ventricular Tachycardia. JACC Clin Electrophysiol 2020; 7:442-449. [PMID: 33888265 DOI: 10.1016/j.jacep.2020.08.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/13/2020] [Revised: 08/07/2020] [Accepted: 08/24/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study aimed to describe the preliminary results of a modified sympathicotomy for cardiac sympathetic denervation (CSD), which may reduce the predictive risk and intraoperative surgical time of the procedure. BACKGROUND CSD, in patients with refractory ventricular tachycardia (VT), is comprehensively recognized as an important treatment option for patients with structural heart disease as well as congenital inherited arrhythmia syndrome. METHODS We consecutively enrolled 5 patients with refractory VT. Baseline demographic, medical, and surgical data as well as arrhythmia outcomes and procedural complications were evaluated. RESULTS A total of 5 patients (mean age: 67.4 years) were enrolled for the treatment of refractory VT with a modified CSD technique. In 3 of 5 patients, an overall reduction in VT burden (ranging from 75% to 100%) and VT number was observed after the CSD despite an in-hospital early recurrence. CONCLUSIONS A modified CSD (sympathicotomy T2-T5) with stellate ganglion sparing and the use of unipolar radiofrequency is feasible, effective, and safe in the setting of untreatable VT.
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Affiliation(s)
- Filippo M Cauti
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebefratelli Isola Tiberina, Rome, Italy.
| | - Pietro Rossi
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebefratelli Isola Tiberina, Rome, Italy
| | - Stefano Bianchi
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebefratelli Isola Tiberina, Rome, Italy
| | - Katia Bruno
- Department of Anesthesiology, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Luigi Iaia
- Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebefratelli Isola Tiberina, Rome, Italy
| | | | - Francesco Pugliese
- Department of Anesthesiology, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Raffaele Quaglione
- Cardiology Unit, Dipartimento Cuore e Grossi Vasi, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Federico Venuta
- Thoracic Unit, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Marco Anile
- Thoracic Unit, Policlinico Umberto I, Sapienza University, Rome, Italy
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Bassi M, Ruberto F, Poggi C, Diso D, Anile M, De Giacomo T, Pecoraro Y, Carillo C, Pugliese F, Venuta F, Vannucci J. Is Surgical Tracheostomy Better Than Percutaneous Tracheostomy in COVID-19-Positive Patients? Anesth Analg 2020; 131:1000-1005. [PMID: 32925315 PMCID: PMC7340220 DOI: 10.1213/ane.0000000000005100] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 11/05/2022]
Affiliation(s)
| | - Franco Ruberto
- Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Camilla Poggi
- From the Departments of Thoracic Surgery and Lung Transplantation
| | - Daniele Diso
- From the Departments of Thoracic Surgery and Lung Transplantation
| | - Marco Anile
- From the Departments of Thoracic Surgery and Lung Transplantation
| | | | - Ylenia Pecoraro
- From the Departments of Thoracic Surgery and Lung Transplantation
| | - Carolina Carillo
- From the Departments of Thoracic Surgery and Lung Transplantation
| | - Francesco Pugliese
- Anesthesiology and Critical Care, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Federico Venuta
- From the Departments of Thoracic Surgery and Lung Transplantation
| | - Jacopo Vannucci
- From the Departments of Thoracic Surgery and Lung Transplantation
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Bassi M, Anile M, Pecoraro Y, Ruberto F, Martelli S, Piazzolla M, Pugliese F, Venuta F, De Giacomo T. Bedside Transcervical-Transtracheal Postintubation Injury Repair in a COVID-19 Patient. Ann Thorac Surg 2020; 110:e417-e419. [PMID: 32333850 PMCID: PMC7175871 DOI: 10.1016/j.athoracsur.2020.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2020] [Indexed: 12/18/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 disease 2019 (COVID-19) has rapidly spread worldwide since December 2019. An acute respiratory distress syndrome develops in a relevant rate of patients, who require hospitalization. Among them, a nonnegligible rate of 9.8% to 15.2% of patients requires tracheal intubation for invasive ventilation. We report the case of a pneumomediastinum and subcutaneous emphysema developing in a COVID-19 patient secondary to postintubation tracheal injury. The management of COVID-19 patients can be challenging due to the risk of disease transmission to caregivers and epidemic spread. We performed a bedside tracheal injury surgical repair, after failure of conservative management, with resolution of pneumomediastinum and subcutaneous emphysema and improvement of the patient’s conditions.
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Affiliation(s)
- Massimiliano Bassi
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
| | - Marco Anile
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ylenia Pecoraro
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Franco Ruberto
- Department of Anesthesiology and Intensive Care Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Sabina Martelli
- Department of Anesthesiology and Intensive Care Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Mario Piazzolla
- Department of Anesthesiology and Intensive Care Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Francesco Pugliese
- Department of Anesthesiology and Intensive Care Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Tiziano De Giacomo
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Fiorelli A, D'Andrilli A, Carlucci A, Vicidomini G, Loizzi D, Ardò NP, Marasco RD, Ventura L, Ampollini L, Carbognani P, Bocchialini G, Lococo F, Paci M, Di Stefano TS, Ardissone F, Gagliasso M, Mendogni P, Rosso L, Mazzucco A, Vanni C, Marinucci BT, Potenza R, Matricardi A, Ragusa M, Tassi V, Anile M, Poggi C, Serra N, Sica A, Nosotti M, Sollitto F, Venuta F, Rendina EA, Puma F, Santini M. Prognostic factors of lung cancer in lymphoma survivors (the LuCiLyS study). Transl Lung Cancer Res 2020; 9:90-102. [PMID: 32206557 PMCID: PMC7082280 DOI: 10.21037/tlcr.2019.12.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Second cancer is the leading cause of death in lymphoma survivors, with lung cancer representing the most common solid tumor. Limited information exists about the treatment and prognosis of second lung cancer following lymphoma. Herein, we evaluated the outcome and prognostic factors of Lung Cancer in Lymphoma Survivors (the LuCiLyS study) to improve the patient selection for lung cancer treatment. Methods This is a retrospective multicentre study including consecutive patients treated for lymphoma disease that subsequently developed non-small cell lung cancer (NSCLC). Data regarding lymphoma including age, symptoms, histology, disease stage, treatment received and lymphoma status at the time of lung cancer diagnosis, and data on lung carcinoma as age, smoking history, latency from lymphoma, symptoms, histology, disease stage, treatment received, and survival were evaluated to identify the significant prognostic factors for overall survival. Results Our study population included 164 patients, 145 of which underwent lung cancer resection. The median overall survival was 63 (range, 58–85) months, and the 5-year survival rate 54%. At univariable analysis no-active lymphoma (HR: 2.19; P=0.0152); early lymphoma stage (HR: 1.95; P=0.01); adenocarcinoma histology (HR: 0.59; P=0.0421); early lung cancer stage (HR: 3.18; P<0.0001); incidental diagnosis of lung cancer (HR: 1.71; P<0.0001); and lung cancer resection (HR: 2.79; P<0.0001) were favorable prognostic factors. At multivariable analysis, no-active lymphoma (HR: 2.68; P=0.004); early lung cancer stage (HR: 2.37; P<0.0001); incidental diagnosis of lung cancer (HR: 2.00; P<0.0001); and lung cancer resection (HR: 2.07; P<0.0001) remained favorable prognostic factors. Patients with non-active lymphoma (n=146) versus those with active lymphoma (n=18) at lung cancer diagnosis presented better median survival (64 vs. 37 months; HR: 2.4; P=0.02), but median lung cancer specific survival showed no significant difference (27 vs. 19 months; HR: 0.3; P=0.17). Conclusions The presence and/or a history of lymphoma should not be a contraindication to resection of lung cancer. Inclusion of lymphoma survivors in a lung cancer-screening program may lead to early detection of lung cancer, and improve the survival.
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Affiliation(s)
- Alfonso Fiorelli
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio D'Andrilli
- Thoracic Surgery, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Annalisa Carlucci
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Vicidomini
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | | | - Luigi Ventura
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Luca Ampollini
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Paolo Carbognani
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Giovanni Bocchialini
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Filippo Lococo
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Paci
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Francesco Ardissone
- Department of Oncology, Thoracic Surgery Unit, University of Torino, San Luigi Hospital, Orbassano, Italy
| | - Matteo Gagliasso
- Department of Oncology, Thoracic Surgery Unit, University of Torino, San Luigi Hospital, Orbassano, Italy
| | - Paolo Mendogni
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Rosso
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Mazzucco
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Camilla Vanni
- Thoracic Surgery, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | | | | | | | - Mark Ragusa
- Thoracic Surgery Unit, S. Maria Hospital at Terni, Perugia University Medical School, Terni, Italy
| | - Valentina Tassi
- Thoracic Surgery Unit, S. Maria Hospital at Terni, Perugia University Medical School, Terni, Italy
| | - Marco Anile
- Unit of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Camilla Poggi
- Unit of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Federico Venuta
- Unit of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | | | | | - Mario Santini
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
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Mantovani S, Poggi C, Bassi M, Cagnetti S, Anile M, Venuta F. Surgical or conservative management of post intubation tracheal injury: when and how? J Vis Surg 2020. [DOI: 10.21037/jovs.2019.09.07] [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: 11/06/2022]
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Mendogni P, Vannucci J, Ghisalberti M, Anile M, Aramini B, Congedo MT, Nosotti M, Bertolaccini L, D’Ambrosio AE, De Vico A, Guerrera F, Imbriglio G, Pardolesi A, Schiavon M, Russo E. Epidemiology and management of primary spontaneous pneumothorax: a systematic review. Interact Cardiovasc Thorac Surg 2019; 30:337-345. [DOI: 10.1093/icvts/ivz290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/06/2019] [Accepted: 11/10/2019] [Indexed: 02/02/2023] Open
Abstract
Abstract
Primary spontaneous pneumothorax (PSP) is one of the most common thoracic diseases affecting adolescents and young adults. Despite the high incidence of PSP and the availability of several international guidelines for its diagnosis and treatment, a significant behavioural heterogeneity can be found among those management recommendations. A working group of the Italian Society of Thoracic Surgery summarized the best evidence available on PSP management with the methodological tool of a systematic review assessing the quality of previously published guidelines with the Appraisal of Guidelines for Research and Evaluation (AGREE) II. Concerning PSP physiopathology, the literature seems to be equally divided between those who support the hypothesis of a direct correlation between changes in atmospheric pressure and temperature and the incidence of PSP, so it is not currently possible to confirm or reject this theory with reasonable certainty. Regarding the choice between conservative treatment and chest drainage in the first episode, there is no evidence on whether one option is superior to the other. Video-assisted thoracic surgery represents the most common and preferred surgical approach. A primary surgical approach to patients with their first PSP seems to guarantee a lower recurrence rate than that of a primary approach consisting of a chest drainage positioning; conversely, the percentage of futile surgical interventions that would entail this aggressive attitude must be carefully evaluated. Surgical pleurodesis is recommended and frequently performed to limit recurrences; talc poudrage offers efficient pleurodesis, but a considerable number of surgeons are concerned about administering this inert material to young patients.
Clinical trial registration number
International Prospective Register of Systematic Reviews (PROSPERO): CRD42018084247.
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Affiliation(s)
- Paolo Mendogni
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, Umberto I Hospital, University of Rome Sapienza, Rome, Italy
| | | | - Marco Anile
- Department of Thoracic Surgery, Umberto I Hospital, University of Rome Sapienza, Rome, Italy
| | - Beatrice Aramini
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Maria Teresa Congedo
- Division of Thoracic Surgery, Fondazione Policlinico Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Bertolaccini
- Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Andrea De Vico
- Thoracic Surgery Unit, ASST Spedali Civili Brescia, Brescia, Italy
| | | | | | - Alessandro Pardolesi
- Unit of Thoracic Surgery, Foundation IRCCS National Cancer Institute of Milan, Milan, Italy
| | - Marco Schiavon
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Emanuele Russo
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT – UPMC, Palermo, Italy
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Andreetti C, Poggi C, Ibrahim M, D'Andrilli A, Maurizi G, Tiracorrendo M, Peritore V, Rendina EA, Venuta F, Anile M, Pagini A, Natale G, Santini M, Fiorelli A. Surgical treatment of lung cancer with adjacent lobe invasion in relation to fissure integrity. Thorac Cancer 2019; 11:232-242. [PMID: 31851771 PMCID: PMC6996991 DOI: 10.1111/1759-7714.13217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/21/2019] [Accepted: 09/22/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Tumor with adjacent lobe invasion (T-ALI) is an uncommon condition. Controversy still exists regarding the optimal resection of adjacent lobe invasion, and the prognostic value in relation to fissure integrity at the tumor invasion point. The aims of this paper were to evaluate the prognosis of T-ALI with regard to fissure integrity, and type of resection. METHODS This was a retrospective multicenter study which included all consecutive patients with T-ALI undergoing surgical treatment. Based on radiological, intraoperative and histological findings, T-ALI patients were differentiated into two groups based on whether the fissure was complete (T-ALI-A group) or incomplete (T-ALI-D Group) at the level of tumor invasion point. Clinico-pathological features and survival of two study groups were analyzed and compared. RESULTS Study population included 135 patients, of these 98 (72%) were included into T-ALI-A group, and 37 (38%) into T-ALI-D Group. T-ALI-D patients had better overall survival than T-ALI-A patients (63.9 ± 7.0 vs. 48.9 ± 3.9; respectively, P = 0.01) who presented with a higher incidence of lymph node involvement (35% vs. 4%; P = 0.004), and recurrence rate (43% vs. 16%; P = 0.01). At multivariable analysis, T-ALI-D (P = 0.01), pN0 stage (P = 0.0002), and pT≤5 cm (P = 0.0001) were favorable survival prognostic factors. CONCLUSIONS T-ALI-D presented a better prognosis than T-ALI-A while extent of resection had no effect on survival. Thus, in patients with small T-ALI-D and without lymph node involvement, sublobar resection of adjacent lobe rather than lobectomy could be indicated. KEY POINTS The extent of resection of adjacent lobe had no effect on survival while T-ALI-D, pN0 stage, and pT≤5 cm were significant prognostic factors. In patients with small T-ALI-D and without lymph node involvement, sublobar resection of adjacent lobe could be indicated as an alternative to lobectomy.
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Affiliation(s)
- Claudio Andreetti
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Camilla Poggi
- Division of Thoracic Surgery, Policlinico Umberto I, Faculty of Pharmacy and Medicine, University of Rome 'Sapienza', Rome, Italy
| | - Mohsen Ibrahim
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Antonio D'Andrilli
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Giulio Maurizi
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Matteo Tiracorrendo
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Valentina Peritore
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Erino Angelo Rendina
- Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy.,Fondazione Eleonora Lorillard Spencer Cenci, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery, Policlinico Umberto I, Faculty of Pharmacy and Medicine, University of Rome 'Sapienza', Rome, Italy.,Fondazione Eleonora Lorillard Spencer Cenci, Rome, Italy
| | - Marco Anile
- Division of Thoracic Surgery, Policlinico Umberto I, Faculty of Pharmacy and Medicine, University of Rome 'Sapienza', Rome, Italy
| | - Andreina Pagini
- Division of Thoracic Surgery, Policlinico Umberto I, Faculty of Pharmacy and Medicine, University of Rome 'Sapienza', Rome, Italy
| | - Giovanni Natale
- Division of Thoracic Surgery, UniversitàdegliStudidella Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Santini
- Division of Thoracic Surgery, UniversitàdegliStudidella Campania "Luigi Vanvitelli", Naples, Italy
| | - Alfonso Fiorelli
- Division of Thoracic Surgery, UniversitàdegliStudidella Campania "Luigi Vanvitelli", Naples, Italy
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Poggi C, Pecoraro Y, Carillo C, Anile M, Amore D, Mantovani S, Naldi G, Pagini A, Bassi M, Cagnetti S, Mottola E, D'Agostino F, Vannucci J, Pernazza A, Cimino G, Savi D, Gomellini S, Pugliese F, De Giacomo T, Rendina EA, Venuta F, Diso D. Inflammatory Myofibroblastic Tumor After Lung Transplant-A Rare and Aggressive Complication: A Case Report. Transplant Proc 2019; 51:2991-2994. [PMID: 31611127 DOI: 10.1016/j.transproceed.2019.08.011] [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: 05/04/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Malignant diseases are well-known complications after lung transplantation (LT). Among these, inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with a not well-known and often aggressive biological behavior. MATERIAL AND METHODS We hereby describe 2 cases of cystic fibrosis patients who underwent bilateral sequential LT (BSLT) complicated by IMT. RESULTS A 26-year-old man presented a right endobronchial lesion 6 months after BSLT. Two consecutive fiber bronchoscopic biopsies showed granulation tissue. For the persistent lesion growth, the patient underwent a transthoracic biopsy showing histologic diagnosis of IMT. Therefore, he underwent to right pneumonectomy that was unfortunately complicated after 6 months with a late bronchopleural fistula and empyema with exitus 6 months later. A 31-year-old woman 1 year after BSLT presented with a left voluminous pleural-parenchymal lesion; the histologic examination after biopsy revealed an IMT. She underwent a removal of the lesion with a macroscopic R0 resection. Histologic, immunophenotypic, and cytogenetic examinations showed a strong overexpression of anaplastic lymphoma kinase requiring biological adjuvant therapies; however, the patient refused it. Four years later, she presented a recurrence treated with debulking procedure and adjuvant radiotherapy. At last follow-up, the patient was alive with stable disease and optimal graft function. CONCLUSIONS Although IMT is a rare complication after lung transplant, to obtain a careful diagnosis, an early and aggressive treatment is mandatory.
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Affiliation(s)
- Camilla Poggi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I.
| | - Ylenia Pecoraro
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Carolina Carillo
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Marco Anile
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Davide Amore
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Mantovani
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Giuseppe Naldi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Andreina Pagini
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Massimiliano Bassi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Cagnetti
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Emilia Mottola
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Federica D'Agostino
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Jacopo Vannucci
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Angelina Pernazza
- Division of Pathology, Sapienza University of Rome, Policlinico Umberto I
| | - Giuseppe Cimino
- Division of Adult Cystic Fibrosis Centre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Daniela Savi
- Division of Adult Cystic Fibrosis Centre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Gomellini
- Division of Oncologic Radiotherapy, AO S. Giovanni Addolorata, Rome
| | - Francesco Pugliese
- Division of Anesthesiology and Intensive Care Unit for Organ's Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Tiziano De Giacomo
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | | | - Federico Venuta
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Daniele Diso
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
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Anile M, Poggi C, Diso D, Mantovani S, Bassi M, Rendina EA, Venuta F. Do the right thing! J Thorac Dis 2019; 11:S266-S267. [PMID: 30997193 DOI: 10.21037/jtd.2019.01.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Sara Mantovani
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Massimilano Bassi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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36
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Fiorelli A, Poggi C, Anile M, Cascone R, Carlucci A, Cassiano F, Andreetti C, Tiracorrendo M, Diso D, Serra N, Venuta F, Rendina EA, Santini M, D’Andrilli A. Visual analysis versus quantitative CT analysis of interlobar fissure integrity in selecting emphysematous patients for endobronchial valve treatment. Interact Cardiovasc Thorac Surg 2018; 28:751-759. [DOI: 10.1093/icvts/ivy340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/04/2018] [Accepted: 11/19/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Camilla Poggi
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Marco Anile
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Roberto Cascone
- Thoracic Surgery Unit, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Annalisa Carlucci
- Thoracic Surgery Unit, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Cassiano
- Thoracic Surgery Unit, Università La Sapienza, Sant’Andrea Hospital, Rome, Italy
| | - Claudio Andreetti
- Thoracic Surgery Unit, Università La Sapienza, Sant’Andrea Hospital, Rome, Italy
| | - Matteo Tiracorrendo
- Thoracic Surgery Unit, Università La Sapienza, Sant’Andrea Hospital, Rome, Italy
| | - Daniele Diso
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Naples, ‘Federico II’, Naples, Italy
| | - Federico Venuta
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Erino Angelo Rendina
- Thoracic Surgery Unit, Università La Sapienza, Sant’Andrea Hospital, Rome, Italy
| | - Mario Santini
- Thoracic Surgery Unit, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonio D’Andrilli
- Thoracic Surgery Unit, Università La Sapienza, Sant’Andrea Hospital, Rome, Italy
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Fiorelli A, D'Andrilli A, Cascone R, Occhiati L, Anile M, Diso D, Cassiano F, Poggi C, Ibrahim M, Cusumano G, Terminella A, Failla G, La Sala A, Bezzi M, Innocenti M, Torricelli E, Venuta F, Rendina EA, Vicidomini G, Santini M, Andreetti C. Unidirectional endobronchial valves for management of persistent air-leaks: results of a multicenter study. J Thorac Dis 2018; 10:6158-6167. [PMID: 30622787 DOI: 10.21037/jtd.2018.10.61] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To evaluate the efficacy of Endo-Bronchial Valves in the management of persistent air-leaks (PALs) and the procedural cost. Methods It was a retrospective multicenter study including consecutive patients with PALs for alveolar pleural fistula (APF) undergoing valve treatment. We assessed the efficacy and the cost of the procedure. Results Seventy-four patients with persistent air leaks due to various etiologies were included in the analysis. In all cases the air leaks were severe and refractory to standard treatments. Sixty-seven (91%) patients underwent valve treatment obtaining a complete resolution of air-leaks in 59 (88%) patients; a reduction of air-leaks in 6 (9%); and no benefits in 2 (3%). The comparison of data before and after valve treatment showed a significant reduction of air-leak duration (16.2±8.8 versus 5.0±1.7 days; P<0.0001); chest tube removal (16.2±8.8 versus 7.3±2.7 days; P<0.0001); and length of hospital stay (LOS) (16.2±8.8 versus 9.7±2.8 days; P=0.004). Seven patients not undergoing valve treatment underwent pneumo-peritoneum with pleurodesis (n=6) or only pleurodesis (n=1). In only 1 (14%) patient, the chest drainage was removed 23 days later while the remaining 6 (86%) were discharged with a domiciliary chest drainage removed after 157±41 days. No significant difference was found in health cost before and after endobronchial valve (EBV) implant (P=0.3). Conclusions Valve treatment for persistent air leaks is an effective procedure. The reduction of hospitalization costs related to early resolution of air-leaks could overcome the procedural cost.
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Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio D'Andrilli
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Roberto Cascone
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Luisa Occhiati
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Anile
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Daniele Diso
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Francesco Cassiano
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Camilla Poggi
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Mohsen Ibrahim
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Giacomo Cusumano
- Thoracic Surgery Unit, Policlinico Vittorio Emanuele Hospital, Catania, Italy
| | - Alberto Terminella
- Thoracic Surgery Unit, Policlinico Vittorio Emanuele Hospital, Catania, Italy
| | - Giuseppe Failla
- Interventional Pneumology Unit, Ospedale Civico Palermo, Palermo, Italy
| | - Alba La Sala
- Interventional Pneumology Unit, Ospedale Civico Palermo, Palermo, Italy
| | - Michela Bezzi
- Interventional Pneumology Unit, Policlinico Firenze, Florence, Italy
| | | | - Elena Torricelli
- Interventional Pneumology Unit, Policlinico Firenze, Florence, Italy
| | - Federico Venuta
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Erino Angelo Rendina
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Santini
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudio Andreetti
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
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Poggi C, Mantovani S, Pecoraro Y, Carillo C, Bassi M, D'Andrilli A, Anile M, Rendina EA, Venuta F, Diso D. Bronchoscopic treatment of emphysema: an update. J Thorac Dis 2018; 10:6274-6284. [PMID: 30622803 DOI: 10.21037/jtd.2018.10.43] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is the major causes of disability and mortality. The efficacy of maximal medical treatment, although effective at the early stages of the disease, becomes limited when extensive alveolar destruction is the main cause of respiratory failure. At this stage of the disease more aggressive options, when feasible, should be considered. Lung transplantation and lung volume reduction surgery (LVRS) are currently available for a selected group of patients. Endoscopic alternatives to LVRS have progressively gained acceptance and are currently employed in patients with COPD. They promote lung deflation searching the same outcome as LVRS in terms of respiratory mechanics, ameliorating the distressing symptom of chronic dyspnea by decreasing the physiological dead space.
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Affiliation(s)
- Camilla Poggi
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Sara Mantovani
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Ylenia Pecoraro
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Carolina Carillo
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Massimiliano Bassi
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Antonio D'Andrilli
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
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Affiliation(s)
- Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Roma, Italy
| | - Camilla Poggi
- Department of Thoracic Surgery, University of Rome Sapienza, Roma, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Roma, Italy
| | - Ylenia Pecoraro
- Department of Thoracic Surgery, University of Rome Sapienza, Roma, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, University of Rome Sapienza, Roma, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Roma, Italy
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Fiorelli A, D'Andrilli A, Bezzi M, Ibrahim M, Anile M, Diso D, Cusumano G, Terminella A, Luzzi V, Innocenti M, Novali M, Carelli E, Freda C, Natale G, Peritore V, Poggi C, Failla G, Basile M, Mazzucca E, Conforti S, Serra N, Torre M, Venuta F, Rendina EA, Santini M, Andreetti C. Complications related to endoscopic lung volume reduction for emphysema with endobronchial valves: results of a multicenter study. J Thorac Dis 2018; 10:S3315-S3325. [PMID: 30450237 DOI: 10.21037/jtd.2018.06.69] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Despite bronchoscopic lung volume reduction (BLVR) with valves is a minimally invasive treatment for emphysema, it can associate with some complications. We aimed at evaluating the rate and type of complications related to valve treatment and their impact on clinical outcomes. Methods It is a retrospective multicenter study including all consecutive patients with severe heterogeneous emphysema undergoing BLVR with endobronchial valve treatment and developed any complications related to this procedure. The type of complication, the time of onset, the treatment required and the out-come were evaluated. Response to treatment was assessed according to the minimal clinically important difference (MCID) as follows: an improvement of ≥15% in forced expiratory volume in one second (FEV1); of -8% in residual volume (RV); of ≥26 m in 6-minnute walking distance (6MWD); and of ≥4 points on the St. George's Respiratory Questionnaire (SGRQ). Target lobe volume reduction (TLVR) ≥350 mL was considered significant. Results One hundred and seven out of 423 (25.3%) treated patients had complications related to valve treatment including pneumothorax (17.3%); pneumonia (1.7%), chronic obstructive pulmonary disease (COPD) exacerbation (0.9%), respiratory failure (1.4%), valve migration (2.1%), and hemoptysis (1.9%). In all cases complications resolved with appropriate treatment including removal of valves in 21/107 cases (19.6%). Patients with TLVR ≥350 mL (n=64) vs. those <350 mL (n=43) had a statistically significant higher improvement in FEV1 (19.0%±3.9% vs. 3.0%±0.9%; P=0.0003); in RV (-10.0%±4.8% vs. -4.0%±2.9%; P=0.002); in 6MWD (33.0±19.0 vs. 12.0±6.3 metres; P=0.001); and in SGRQ (-15.0±2.9 vs. -8.0±3.5 points; P=0.01). Only patients with TLVR ≥350 mL met or exceeded the MCID cut-off criteria for FEV1 (19.0%±3.9%), RV (-10.0%±4.8%), 6MWT (33.0±19.0 metres), and SGQR (-15.0±2.9 points). Five patients (1.2%) died during follow-up for causes not related to valves treatment neither to any of the complications described. Conclusions Valve treatment is a safe and reversible procedure. The presence of complications seems not to have a significant impact on clinical outcome in patients with lobar atelectasis. Due to poor clinical conditions and possible complications, BLVR should be performed in high volume centers with a multidisciplinary approach.
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Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio D'Andrilli
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Michela Bezzi
- Interventional Pneumology Unit, Policlinico Firenze, Florence, Italy
| | - Mohsen Ibrahim
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Marco Anile
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Daniele Diso
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Giacomo Cusumano
- Thoracic Surgery Unit, Policlinico Vittorio Emanuele Hospital, Catania, Italy
| | - Alberto Terminella
- Thoracic Surgery Unit, Policlinico Vittorio Emanuele Hospital, Catania, Italy
| | - Valentina Luzzi
- Interventional Pneumology Unit, Policlinico Firenze, Florence, Italy
| | | | - Mauro Novali
- Interventional Pneumology Unit, Spedili Civili Brescia, Brescia, Italy
| | - Emanuele Carelli
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Freda
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Natale
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Valentina Peritore
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Camilla Poggi
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Giuseppe Failla
- Interventional Pneumology Unit, Ospedale Civico Palermo, Palermo, Italy
| | - Marco Basile
- Interventional Pneumology Unit, Ospedale Civico Palermo, Palermo, Italy
| | - Emilia Mazzucca
- Interventional Pneumology Unit, Ospedale Civico Palermo, Palermo, Italy
| | | | - Nicola Serra
- Department of Pediatrics, University Federico II of Naples, Naples, Italy
| | - Massimo Torre
- Thoracic Surgery Unit, Ospedale Niguarda, Milan, Italy
| | - Federico Venuta
- Thoracic Surgery Unit, Università La Sapienza, Policlinico Hospital, Rome, Italy
| | - Erino Angelo Rendina
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Mario Santini
- Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudio Andreetti
- Thoracic Surgery Unit, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
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Carillo C, Pecoraro Y, Anile M, Poggi C, Oliva A, Amore D, Bruschini P, Naldi G, Mantovani S, Francioni F, Pugliese F, De Giacomo T, Venuta F, Diso D. Colistin-based Treatment of Multidrug-resistant Gram-negative Bacterial Pulmonary Infections After Lung Transplantation. Transplant Proc 2018; 51:202-205. [PMID: 30661895 DOI: 10.1016/j.transproceed.2018.04.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/13/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Lung transplantation (LT) is a viable option for a select group of patients with end-stage lung disease. However, infections are a major complication after LT, accounting for significant morbidity and mortality. Several germs may be responsible; multidrug-resistant Gram-negative (MDR-GN) bacteria are emerging. Colistin is widely used in the treatment of these infections and is administered by inhalation and/or parenterally. At our institution, in patients with tracheostomy, colistin is administered by direct instillation in the airway during bronchoscopy. We reviewed a series of patients who underwent LT complicated by postoperative MDR-GN bacterial pulmonary infection. METHODS From January 2015 to May 2017, 26 lung transplants were performed. In the postoperative course, 14 (54%) developed MDR-GN bacterial infection; respiratory specimen culture, blood tests, and chest X-ray were considered. Colistin was the only antibiotic usable. Thirteen patients received intravenous (IV) colistin; in the subgroup of patients with tracheostomy, colistin was instilled directly in the airway, and 6 patients received inhaled colistin. RESULTS Seven patients needed tracheostomy. Pseudomonas aeruginosa was the predominant infection (86%), with Acinetobacter baumanii seen in 2 cases (14%). An early clinical-laboratory response was observed in 9 patients (64%). White blood cell count and C-reactive protein values improved (P = .02 and P = .001, respectively). A significant reduction in bacterial load was observed on microbiologic bronchoalveolar lavage specimens. CONCLUSION Colistin instilled directly in the airway did not show side effects. The combination of IV and inhaled/instilled colistin could be a useful treatment option for MDR-GN infections after LT.
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Affiliation(s)
- C Carillo
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
| | - Y Pecoraro
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - M Anile
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - C Poggi
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - A Oliva
- Department of Public Health and Infectious Disease, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - D Amore
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - P Bruschini
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - G Naldi
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - S Mantovani
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - F Francioni
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - F Pugliese
- Division of Anesthesia and Transplant Intensive Care Unit, Department of General Surgery and Organ Transplant, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - T De Giacomo
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - F Venuta
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - D Diso
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Pagini A, Bassi M, Diso D, Anzidei M, Mantovani S, Poggi C, Venuta F, Anile M. Vena cava anomalies in thoracic surgery. J Cardiothorac Surg 2018; 13:19. [PMID: 29391034 PMCID: PMC5795860 DOI: 10.1186/s13019-018-0704-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vena cava anomalies are a rare group of anatomical variations due to an incorrect development of the superior or inferior vena cava during fetal life. They generally show no clinical relevance and the diagnosis is done due to the association with congenital heart diseases in most of cases. However, preoperative identification of these anomalies is mandatory for surgeons to proper surgical planning. If not recognized, lethal complications may occur, as already reported in literature. CASE PRESENTATION We report a case series of three different unidentified vena cava anomalies in patients undergoing lung resection. These unrecognized anomalies led to minor complications in two cases and required an accurate intraoperative evaluation in another. A careful retrospective evaluation of preoperative radiological images showed the anomalies. CONCLUSIONS A careful evaluation of the vena cava anatomy at pre-operative imaging is mandatory for thoracic surgeons to properly plan the surgery and avoid complications.
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Affiliation(s)
- Andreina Pagini
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Massimiliano Bassi
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Daniele Diso
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Michele Anzidei
- Department of Radiology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Sara Mantovani
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Camilla Poggi
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Anile
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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Iannarelli A, Sacconi B, Tomei F, Anile M, Longo F, Bezzi M, Napoli A, Saba L, Anzidei M, D’Ovidio G, Scipione R, Catalano C. Analysis of CT features and quantitative texture analysis in patients with thymic tumors: correlation with grading and staging. Radiol Med 2018; 123:345-350. [DOI: 10.1007/s11547-017-0845-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 12/17/2017] [Indexed: 10/18/2022]
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Pecoraro Y, Carillo C, Diso D, Mantovani S, Cimino G, De Giacomo T, Troiani P, Shafii M, Gherzi L, Amore D, Rendina EA, Venuta F, Anile M. Efficacy of Extracorporeal Photopheresis in Patients With Bronchiolitis Obliterans Syndrome After Lung Transplantation. Transplant Proc 2017; 49:695-698. [PMID: 28457374 DOI: 10.1016/j.transproceed.2017.02.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 11/18/2022]
Abstract
BACKGROUND Lung transplantation (LT) is only therapeutic option for patients affected by chronic respiratory failure. Chronic rejection, also known as bronchiolitis obliterans syndrome (BOS), is still the main cause of death and the most important factor that influences post-transplantation quality of life. Currently available therapies have not been proven to result in significant benefit in the prevention or treatment of BOS. Extracorporeal photopheresis (ECP) seems to reduce the rate of lung function decline in transplant recipients with progressive BOS. METHODS From 1991 until now, 239 LTs were performed at our center. Fifty-four patients (22.5%) developed BOS; 15 of these (27.7%) were treated with ECP. At the beginning of the treatment, all patients showed a mean decline of forced expiratory volume in 1 second (FEV1) from baseline values of 45.8% ± 17.2%; 2 patients were in long-term oxygen therapy. RESULTS Mean follow-up from November 2013 to June 2016 was 11.6 ± 7 months. Twelve patients (80%) showed lung function stabilization with an FEV1 range after treatment between -6% to +8% from the pre-treatment values. We did not report any adverse effects or increase of infections incidence. DISCUSSION ECP seems to be an effective and well-tolerated therapeutic option for LT patients with BOS in terms of stabilization of lung function and increased survival.
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Affiliation(s)
- Y Pecoraro
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy.
| | - C Carillo
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - D Diso
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - S Mantovani
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - G Cimino
- Department of Pediatrics, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - T De Giacomo
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - P Troiani
- Department of Pediatrics, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - M Shafii
- Department of Hematology, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - L Gherzi
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - D Amore
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - E A Rendina
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - F Venuta
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - M Anile
- Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University of Rome, Italy
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Carillo C, Pecoraro Y, Anile M, Mantovani S, Oliva A, D'Abramo A, Amore D, Pagini A, De Giacomo T, Pugliese F, Rendina EA, Venuta F, Diso D. Evaluation of Renal Function in Patients Undergoing Lung Transplantation. Transplant Proc 2017; 49:699-701. [PMID: 28457375 DOI: 10.1016/j.transproceed.2017.02.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Acute kidney injury and chronic kidney failure are serious complications after lung transplantation. Glomerular filtration rate (GFR) is the primary indicator of renal function. Several equations have been proposed to evaluate the estimated GFR (eGFR). We compared three different equations to determine which has the better correlation with the development of acute and chronic renal failure in lung recipients. METHODS Twenty-two patients with a mean age of 54.4 ± 8.5 years underwent lung transplantation from 2010 to 2015. Thirteen (59%) had pulmonary fibrosis, 7 (32%) emphysema, 1 (4.5%) bronchiectasis, and 1 (4.5%) lymphangioleiomyomatosis. In all patients, eGFR was measured preoperatively using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Levey's Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. In 20 patients (90%) eGFR was calculated at 1, 3, and 6 months. RESULTS According to CKD-EPI and MDRD, eight patients (36.3%) had preoperative reduction in eGFR, whereas 6 patients (27.2%) had preoperative reduction according to the CG (P = .04). The mean values were higher for the CG (103.2 vs. 102 vs. 94.4). Five patients (22.7%) developed perioperative acute renal failure requesting a dialysis treatment; four of these showed a preoperative eGFR to the highest CG (P = .05). At 1 and 6 months after lung transplantation, the CG, MDRD and CKD-EPI eGFR values were, respectively, 86.6, 84.1 and 76.6 mL/min/1.73m2 and 75.8, 72.7, and 72.3 mL/min/1.73m2. CKD-EPI eGFR values are more predictable than the other equations of AKI. CONCLUSIONS Preoperative assessment of eGFR using the MDRD and CKD-EPI seems to correlate better than the CG to the prediction of acute renal failure, whereas for the chronic form the three equations seem equivalent.
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Affiliation(s)
- C Carillo
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
| | - Y Pecoraro
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - M Anile
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - S Mantovani
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - A Oliva
- Department of Public Health and Infectious Disease, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - A D'Abramo
- Department of Public Health and Infectious Disease, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - D Amore
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - A Pagini
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - T De Giacomo
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - F Pugliese
- Division of Anesthesia and Transplant Intensive Care Unit, Department of General Surgery and Organ Transplant, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - E A Rendina
- Division of Thoracic Surgery, Sant'Andrea Hospital, Sapienza Univeristy of Rome, Rome, Italy
| | - F Venuta
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - D Diso
- Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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46
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Gherzi L, Carillo C, Diso D, Mantovani S, de Giacomo T, Venuta F, Anile M. Devastating fast-growing lung cancer after single lung transplantation. J Thorac Dis 2017; 9:E1071-E1073. [PMID: 29312768 DOI: 10.21037/jtd.2017.11.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Patients receiving lung transplantation are at increasing risk for the development of cancer due to the administration of immunosuppressive drugs. We hereby report the case of a patient with a devastating fast-growing lung cancer after single lung transplantation for pulmonary fibrosis.
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Affiliation(s)
- Lorenzo Gherzi
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Carolina Carillo
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Sara Mantovani
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Tiziano de Giacomo
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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47
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Anile M, Mantovani S, Pecoraro Y, Carillo C, Gherzi L, Pagini A, Rendina EA, Venuta F, Diso D. Pulmonary metastasectomy in uterine malignancies: outcome and prognostic factors. J Thorac Dis 2017; 9:S1273-S1277. [PMID: 29119014 DOI: 10.21037/jtd.2017.07.46] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background This retrospective study is designed to evaluate factors affecting survival in a population of patients receiving pulmonary metastasectomy after gynecologic cancers. Methods Nineteen patients with isolated lung metastases (one or two) were surgically treated with R0 resection. Four of them underwent lobectomies. Results Six patients (31.6%) received adjuvant therapy and 11 (58%) experienced recurrences after metastasectomy. Five- and ten-year survival were 40.9% and 31.4%, respectively. Five-year survival in patients receiving adjuvant therapy was 52.4%. At multivariate analysis factors negatively influencing survival were a disease-free interval (DFI) of less than 24 months and recurrence after pulmonary metastasectomy. Conclusions Pulmonary resection for metastatic gynecologic cancer is feasible and effective; adequate selection of patients is mandatory to achieve satisfactory results and long-term survival.
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Affiliation(s)
- Marco Anile
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Sara Mantovani
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Ylenia Pecoraro
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Carolina Carillo
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Lorenzo Gherzi
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Andreina Pagini
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Erino Angelo Rendina
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Federico Venuta
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
| | - Daniele Diso
- University of Rome Sapienza, Policlinico Umberto I Viale del Policlinico, Rome, Italy
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48
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Fiorelli A, D’Andrilli A, Anile M, Cascone R, Occhiati L, Diso D, Cassiano F, Poggi C, Ibrahim M, Cusumano G, Terminella A, Failla G, La Sala A, Bezzi M, Innocenti M, Torricelli E, Venuta F, Rendina EA, Santini M, Andreetti C. F-075THE COST/BENEFIT OF UNIDIRECTIONAL ENDOBRONCHIAL VALVES IMPLANT FOR MANAGEMENT OF PERSISTENT AIR-LEAKS: RESULTS OF A MULTICENTRE STUDY. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.087] [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: 11/13/2022] Open
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49
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Venuta F, Diso D, Rendina EA, Anile M. Searching for the perfect lymphadenectomy. Ann Transl Med 2017; 5:311. [PMID: 28856151 DOI: 10.21037/atm.2017.05.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Federico Venuta
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome Sapienza, Rome, Italy
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50
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Totani L, Plebani R, Piccoli A, Di Silvestre S, Lanuti P, Recchiuti A, Cianci E, Dell'Elba G, Sacchetti S, Patruno S, Guarnieri S, Mariggiò MA, Mari VC, Anile M, Venuta F, Del Porto P, Moretti P, Prioletta M, Mucilli F, Marchisio M, Pandolfi A, Evangelista V, Romano M. Mechanisms of endothelial cell dysfunction in cystic fibrosis. Biochim Biophys Acta Mol Basis Dis 2017; 1863:3243-3253. [PMID: 28847515 DOI: 10.1016/j.bbadis.2017.08.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 06/24/2017] [Accepted: 08/13/2017] [Indexed: 12/18/2022]
Abstract
Although cystic fibrosis (CF) patients exhibit signs of endothelial perturbation, the functions of the cystic fibrosis conductance regulator (CFTR) in vascular endothelial cells (EC) are poorly defined. We sought to uncover biological activities of endothelial CFTR, relevant for vascular homeostasis and inflammation. We examined cells from human umbilical cords (HUVEC) and pulmonary artery isolated from non-cystic fibrosis (PAEC) and CF human lungs (CF-PAEC), under static conditions or physiological shear. CFTR activity, clearly detected in HUVEC and PAEC, was markedly reduced in CF-PAEC. CFTR blockade increased endothelial permeability to macromolecules and reduced trans‑endothelial electrical resistance (TEER). Consistent with this, CF-PAEC displayed lower TEER compared to PAEC. Under shear, CFTR blockade reduced VE-cadherin and p120 catenin membrane expression and triggered the formation of paxillin- and vinculin-enriched membrane blebs that evolved in shrinking of the cell body and disruption of cell-cell contacts. These changes were accompanied by enhanced release of microvesicles, which displayed reduced capability to stimulate proliferation in recipient EC. CFTR blockade also suppressed insulin-induced NO generation by EC, likely by inhibiting eNOS and AKT phosphorylation, whereas it enhanced IL-8 release. Remarkably, phosphodiesterase inhibitors in combination with a β2 adrenergic receptor agonist corrected functional and morphological changes triggered by CFTR dysfunction in EC. Our results uncover regulatory functions of CFTR in EC, suggesting a physiological role of CFTR in the maintenance EC homeostasis and its involvement in pathogenetic aspects of CF. Moreover, our findings open avenues for novel pharmacology to control endothelial dysfunction and its consequences in CF.
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Affiliation(s)
- Licia Totani
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Roberto Plebani
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Antonio Piccoli
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Sara Di Silvestre
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Paola Lanuti
- Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy; Department of Medicine and Aging Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | - Antonio Recchiuti
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Eleonora Cianci
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Giuseppe Dell'Elba
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Silvio Sacchetti
- Center for Synaptic Neuroscience, Italian Institute of Technology, Genoa, Italy
| | - Sara Patruno
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Simone Guarnieri
- Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy; Department of Neurosciences, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | - Maria A Mariggiò
- Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy; Department of Neurosciences, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | - Veronica C Mari
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome "Sapienza", Rome, Italy
| | - Paola Del Porto
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University, Rome, Italy
| | - Paolo Moretti
- Cystic Fibrosis Center, S. Liberatore Hospital, Atri, TE, Italy
| | - Marco Prioletta
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | - Felice Mucilli
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | - Marco Marchisio
- Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy; Department of Medicine and Aging Sciences, G. D'Annunzio University, Chieti-Pescara, Italy
| | - Assunta Pandolfi
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy
| | - Virgilio Evangelista
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Mario Romano
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti-Pescara, Italy; Center on Aging Sciences and Translational Medicine (CeSI-MeT), G. D'Annunzio University, Chieti-Pescara, Italy.
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