Commentary: coronavirus disease 2019 (COVID-19) and the airway: how can surgery help?

a large number of cases of benign tracheal stenosis is eventually expected because of the prolonged intubation and/or tracheostomy performed to manage the severe respiratory impairment occurring in many patients with COVID-19. The authors reported the presence of a process of coagulative necrosis in the tissue of the resected airway (documented at the pathologic examination), thus confirming the recently published literature that points out the systemic effect of the COVID-19 that sometimes leads to multiorgan involvement

Thoracic surgery for malignancy and emergency irrespective of COVID-19

until March 24, 2020, a COVID-19 test by nasopharyngeal swab was offered to the patients presenting with symptoms of COVID-19. However, from April 2, 2020, we changed that policy, offering 2 COVID-19 tests by nasopharyngeal swab to everyone undergoing thoracic surgery for malignancies before admission to our general university hospital, even if asymptomatic

A high-volume thoracic surgery division into the storm of the COVID-19 pandemic

Since the coronavirus 2019 (COVID-19) crisis broke out in Italy at the end of February 2020, days before the World Health Organization declared the pandemic,1,2 two crucial issues urgently emerged and needed to be addressed by our institution. First was the containment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic together with the restructuring of national public and private health care to face the spread of the new viral disease among the population. Second, central as well, was to maintain the offer of medical and surgical treatments to the patients who still presented with other severe diseases—of these in particular, oncologic patients

Bronchovascular reconstruction in the era of mini-invasiveness

bronchovascular reconstruction in the era of mininvasivenes

The advantage of sleeve lobectomy over pneumonectomy

Answer to Dr. Ludwig about lower sleeve lobectomy, the so-called “Y” sleeve

Pseudo-aneurysm of the external carotid artery: report of a case

The authors report a case of left otorrhagia in a 1-year-old male infant in the presence of a mass involving the parotideal and upper cervical regions, which had appeared after an infection of the upper airways. Non-invasive techniques, such as echography and CT scan, provided useful but contradicting information. Surgery allowed us to define the diagnosis of mycotic aneurysm of the external carotid artery. The authors, after pointing out the extreme rarity of such a pathology, discuss the ethiopathogenetic theories, the clinical features, the diagnosis and the surgical and medical treatment of the disease. Concerning surgery ligation of the external carotid artery is the treatment of choice, since distally the blood flow is provided by a conspicuous collateral circle and because a possible postoperative septic dissemination is avoided

Oncological and functional outcome of conservative surgery for primary supraglottic cancer

The aim of this study was to verify the oncological and functional outcome of conservative surgical treatment of primary supraglottic squamous cell carcinoma (SGSCC) and related neck disease in order to verify the effectiveness of supraglottic laryngectomy (SL) and the validity of an "observation" policy in the control of clinically negative (NO) necks. Of a total of 252 consecutive patients affected by primary SGSCC seen between 1975 and 1990 at the Department of Otolaryngology of the University of Perugia (1975-1987) and the Catholic University of the Sacred Heart of Rome (1988-1990), a subset of 132 patients treated with classical SL was evaluated after presenting sufficient clinicopathological data and a follow-up period of at least 5 years. Tumors were staged according to the 1992 UICC TNM classification and grouped into stages I-II (n = 94) and III-IV (n = 38). Comprehensive neck dissections were performed only in the clinically positive (N+) necks (25/132 cases), while in the clinically NO ones (107/132 cases) an "observation" policy under strict follow-up conditions was adopted. After primary surgery, the 5-year relapse-free survival (RFS) was 74%. The RFS was 80% for T1-2 disease and 65% for T3. The RFS was 80% for stages I-II tumors and 71% for stages III-IV. The actual 5-year overall survival (OS) was 89% for T1-T2 tumors and 67% for T3 disease or 93% for stages I-II and 69% for stages III-IV. The OS was 89% for NO neck and 73% for N+. The 5-year-metastasis-free survival (MFS) was 83% for NO patients, 74% for N+, 84% for T1-T2 NO, 71% for T1-T2 N+, 81% for T3 NO and 68% for T3 N+. In all, SL was found to be highly effective in the management of primary SGSCC. In the presence of clinically NO neck "observation" under strict follow-up with therapeutic comprehensive neck dissection for delayed nodal recurrence, SL was suitable for controlling the neck cancer, as well as for salvaging recurrent disease. Bilateral elective, selective or functional neck dissection in every instance of supraglottic cancer was best performed only in those SGSCC patients who were more likely to have occult nodal disease on the basis of biological factors and imaging data

Stereotactic Irradiation of GH-Secreting Pituitary Adenomas

Radiotherapy (RT) is often employed in patients with acromegaly refractory to medical and/or surgical interventions in order to prevent tumour regrowth and normalize elevated GH and IGF-I levels. It achieves tumour control and hormone normalization up to 90% and 70% of patients at 10–15 years. Despite the excellent tumour control, conventional RT is associated with a potential risk of developing late toxicity, especially hypopituitarism, and its role in the management of patients with GH-secreting pituitary adenomas remains a matter of debate. Stereotactic techniques have been developed with the aim to deliver more localized irradiation and minimize the long-term consequences of treatment, while improving its efficacy. Stereotactic irradiation can be given in a single dose as stereotactic radiosurgery (SRS) or in multiple doses as fractionated stereotactic radiotherapy (FSRT). We have reviewed the recent published literature on stereotactic techniques for GH-secreting pituitary tumors with the aim to define the efficacy and potential adverse effects of each of these techniques

Guidelines for the monitoring of Lucanus cervus

Lucanus cervus is one of the most charismatic saproxylic beetles, widely distributed in Europe. The species is typical of mature deciduous forests, especially oak woodlands. Loss and fragmentation of suitable habitats is one of the major threats for this species which is included in Annex II of the Habitats Directive. Despite several studies carried out in the last years for the monitoring methods of the species, an analytical comparison between them is still lacking. The aims of this paper are (i) to review the current knowledge about systematics, ecology and conservation practices on L. cervus and (ii) to present the research carried out during the Life MIPP project, in order to define a standard monitoring method with a suitable protocol to be used for addressing the obligations of the Habitats Directive. Overall, five methods were tested during three years in two different study areas. Based on these results, a suitable standard method for L. cervus is proposed in this paper and, in order to assess the conservation status of populations and to compare them over time, a simple method for the calculation of a reference value is provided