The Experts below are selected from a list of 1527 Experts worldwide ranked by ideXlab platform
F. Macchini - One of the best experts on this subject based on the ideXlab platform.
-
thoracoscopic resection of Congenital Lung Malformation looking for the right preoperative assessment
European Journal of Pediatric Surgery, 2020Co-Authors: F. Macchini, M. Ichino, Irene Borzani, Silvia Cavalli, Anna Morandi, Ida Daniela Dangelo, Andrea Zanini, Carlo Ferrari, Ernesto LevaAbstract:Introduction Consensus on the best postnatal radiological evaluation of Congenital Lung Malformations (CLMs) is still lacking. In recent years, the interest on magnetic resonance imaging (MRI) has grown, but its role is still unknown. Aim The aim of the study was to identify the best preoperative diagnostic assessment for CLM. Materials and Methods All patients with a prenatal suspicion of CLM between January 2014 and February 2018 were studied. Asymptomatic newborns underwent MRI, during spontaneous sleep without contrast. Patients with a positive MRI were scheduled for computed tomography (CT) within the fourth month of life. Thoracoscopic resection was performed in cases with a pathological CT. MRI, CT, and surgical findings were compared based on dimension, localization, and features of the CLM using the Cohen's kappa test (K). Results A total of 20 patients were included (10 males). No difference was found in the diameter and site of the lesions always localized in the same side (K = 1) and in the same pulmonary lobe (K = 1). Infants who underwent thoracoscopic resection included: three Congenital pulmonary airway Malformations (CPAMs), five extralobar and eight intralobar sequestrations (bronchopulmonary sequestrations [BPSs]), three bronchogenic cysts, and one Congenital emphysema. The concordance between MRI and CT and between radiological investigations and pathology was satisfactory for the greatest part of the studied variables. MRI showed sensitivity of 100%, specificity of 82%, positive predictive value of 50% and negative predictive value of 100% for CPAM and 77, 100, 100, and 80% for BPS, respectively. Conclusion MRI proved to be a reliable diagnostic investigation for CLM with high sensitivity and specificity. Early MRI in spontaneous sleep without contrast and preoperative contrast CT scan is a valuable preoperatory assessment.
-
Thoracoscopic Surgery for Congenital Lung Malformation Using Miniaturized 3-mm Vessel Sealing and 5-mm Stapling Devices : Single-Center Experience
'Mary Ann Liebert Inc', 2020Co-Authors: F. Macchini, M. Ichino, A. Zanini, A. Morandi, E. LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight® (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients who underwent thoracoscopic resection of CLM in our Center from January 2016 to July 2019 were selected and divided into two groups: G1 (2018-2019), treated with the new JustRight instruments, and G2 (2016-2017), treated with Ligasure® and Hem-o-lok. Surgical outcomes in term of length of surgery and complications were compared between groups, stratifying the groups for type of resection (lobectomy, extralobar sequestration [ES] resection, and bronchogenic cyst [BC] resection). Results: Thirteen patients were included in G1, and 16 patients were included in G2. Seven lobectomies, 5 ES resections, and 1 BC resection were performed in G1; whereas 12 lobectomies, 3 ES resections, and 1 BC resection were performed in G2. Mean age at the time of surgery was 7.8 ± 6 months (G1) and 6.8 ± 3.3 months (G2) (P = .57). The average length of surgery was shorter for G1 (lobectomies: 120.7 ± 28.2 versus 171.7 ± 37.5, P = .006; ES resection: 63 ± 21.4 versus 91.7 ± 29.3, P = .15; BC 40 minutes versus 100 minutes). No significant difference was found for length of stay (4 ± 1 days versus 5 ± 2 days, P = .18). Neither the need for conversion nor major complications were observed in either group. Conclusion: In our experience, thoracoscopic resections of CLM with the new JustRight instruments were revealed to be safe and effective. On account of having adequate dimensions for small cavities, these instruments can facilitate the procedure and help to reduce the length of surgery
-
thoracoscopic surgery for Congenital Lung Malformation using miniaturized 3 mm vessel sealing and 5 mm stapling devices single center experience
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2020Co-Authors: F. Macchini, M. Ichino, Anna Morandi, Andrea Zanini, Ernesto LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight® (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients ...
-
Thoracoscopic Surgery for Congenital Lung Malformation Using Miniaturized 3-mm Vessel Sealing and 5-mm Stapling Devices : Single-Center Experience
'Mary Ann Liebert Inc', 2020Co-Authors: F. Macchini, M. Ichino, A. Zanini, A. Morandi, E. LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight\uae (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients who underwent thoracoscopic resection of CLM in our Center from January 2016 to July 2019 were selected and divided into two groups: G1 (2018-2019), treated with the new JustRight instruments, and G2 (2016-2017), treated with Ligasure\uae and Hem-o-lok. Surgical outcomes in term of length of surgery and complications were compared between groups, stratifying the groups for type of resection (lobectomy, extralobar sequestration [ES] resection, and bronchogenic cyst [BC] resection). Results: Thirteen patients were included in G1, and 16 patients were included in G2. Seven lobectomies, 5 ES resections, and 1 BC resection were performed in G1; whereas 12 lobectomies, 3 ES resections, and 1 BC resection were performed in G2. Mean age at the time of surgery was 7.8 \ub1 6 months (G1) and 6.8 \ub1 3.3 months (G2) (P = .57). The average length of surgery was shorter for G1 (lobectomies: 120.7 \ub1 28.2 versus 171.7 \ub1 37.5, P = .006; ES resection: 63 \ub1 21.4 versus 91.7 \ub1 29.3, P = .15; BC 40 minutes versus 100 minutes). No significant difference was found for length of stay (4 \ub1 1 days versus 5 \ub1 2 days, P = .18). Neither the need for conversion nor major complications were observed in either group. Conclusion: In our experience, thoracoscopic resections of CLM with the new JustRight instruments were revealed to be safe and effective. On account of having adequate dimensions for small cavities, these instruments can facilitate the procedure and help to reduce the length of surgery
David M. Burge - One of the best experts on this subject based on the ideXlab platform.
-
management of antenatally diagnosed pulmonary sequestration associated with Congenital cystic adenomatoid Malformation
Thorax, 1999Co-Authors: Madan Samuel, David M. BurgeAbstract:BACKGROUND—Sequestration with associated cystic adenomatoid Malformation is rare. A study was undertaken to determine whether pulmonary sequestration associated with Congenital cystic adenomatoid Malformation has a more favourable natural history than that of sequestration without associated cystic adenomatoid Malformation. METHODS—An outline of the postnatal work up leading to the management of extralobar or intralobar pulmonary sequestration with Congenital cystic adenomatoid Malformation diagnosed antenatally as pulmonary Malformation is presented and the indications for surgical intervention are discussed. RESULTS—In five infants in whom an antenatal ultrasound scan had detected a Congenital Lung Malformation at 18-19 weeks gestation a final diagnosis of extralobar or intralobar pulmonary sequestration with Congenital cystic adenomatoid Malformation was made postnatally. Postnatal ultrasound and computerised axial tomographic scans confirmed the diagnosis of sequestration by delineating anomalous vascular supply. Cystic changes were also observed in the basal area of the sequestration in all patients. Four children remained asymptomatic and one infant presented at 10 months of age with pneumonia. The mean age at surgical resection was 6.8 months (range 2-10). Histopathological examination confirmed intralobar pulmonary sequestration with associated Stocker type 2 Congenital cystic adenomatoid Malformation in two patients and extralobar pulmonary sequestration with associated Stocker type 2 Congenital cystic adenomatoid Malformation in three patients. The mean period of follow up was four years (range 1-8). The children remain well and are developing normally. CONCLUSIONS—The importance of seeking an anomalous blood supply in children with Congenital Lung lesions is emphasised. Pulmonary sequestration and Congenital cystic adenomatoid Malformation probably share a common embryogenesis despite diverse morphology. The natural history of antenatally diagnosed Lung masses is variable. Early postnatal surgical resection of pulmonary sequestration with cystic adenomatoid Malformation is recommended. Surgical excision should be conservative, sparing the normal Lung parenchyma.
M. Ichino - One of the best experts on this subject based on the ideXlab platform.
-
thoracoscopic resection of Congenital Lung Malformation looking for the right preoperative assessment
European Journal of Pediatric Surgery, 2020Co-Authors: F. Macchini, M. Ichino, Irene Borzani, Silvia Cavalli, Anna Morandi, Ida Daniela Dangelo, Andrea Zanini, Carlo Ferrari, Ernesto LevaAbstract:Introduction Consensus on the best postnatal radiological evaluation of Congenital Lung Malformations (CLMs) is still lacking. In recent years, the interest on magnetic resonance imaging (MRI) has grown, but its role is still unknown. Aim The aim of the study was to identify the best preoperative diagnostic assessment for CLM. Materials and Methods All patients with a prenatal suspicion of CLM between January 2014 and February 2018 were studied. Asymptomatic newborns underwent MRI, during spontaneous sleep without contrast. Patients with a positive MRI were scheduled for computed tomography (CT) within the fourth month of life. Thoracoscopic resection was performed in cases with a pathological CT. MRI, CT, and surgical findings were compared based on dimension, localization, and features of the CLM using the Cohen's kappa test (K). Results A total of 20 patients were included (10 males). No difference was found in the diameter and site of the lesions always localized in the same side (K = 1) and in the same pulmonary lobe (K = 1). Infants who underwent thoracoscopic resection included: three Congenital pulmonary airway Malformations (CPAMs), five extralobar and eight intralobar sequestrations (bronchopulmonary sequestrations [BPSs]), three bronchogenic cysts, and one Congenital emphysema. The concordance between MRI and CT and between radiological investigations and pathology was satisfactory for the greatest part of the studied variables. MRI showed sensitivity of 100%, specificity of 82%, positive predictive value of 50% and negative predictive value of 100% for CPAM and 77, 100, 100, and 80% for BPS, respectively. Conclusion MRI proved to be a reliable diagnostic investigation for CLM with high sensitivity and specificity. Early MRI in spontaneous sleep without contrast and preoperative contrast CT scan is a valuable preoperatory assessment.
-
Thoracoscopic Surgery for Congenital Lung Malformation Using Miniaturized 3-mm Vessel Sealing and 5-mm Stapling Devices : Single-Center Experience
'Mary Ann Liebert Inc', 2020Co-Authors: F. Macchini, M. Ichino, A. Zanini, A. Morandi, E. LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight® (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients who underwent thoracoscopic resection of CLM in our Center from January 2016 to July 2019 were selected and divided into two groups: G1 (2018-2019), treated with the new JustRight instruments, and G2 (2016-2017), treated with Ligasure® and Hem-o-lok. Surgical outcomes in term of length of surgery and complications were compared between groups, stratifying the groups for type of resection (lobectomy, extralobar sequestration [ES] resection, and bronchogenic cyst [BC] resection). Results: Thirteen patients were included in G1, and 16 patients were included in G2. Seven lobectomies, 5 ES resections, and 1 BC resection were performed in G1; whereas 12 lobectomies, 3 ES resections, and 1 BC resection were performed in G2. Mean age at the time of surgery was 7.8 ± 6 months (G1) and 6.8 ± 3.3 months (G2) (P = .57). The average length of surgery was shorter for G1 (lobectomies: 120.7 ± 28.2 versus 171.7 ± 37.5, P = .006; ES resection: 63 ± 21.4 versus 91.7 ± 29.3, P = .15; BC 40 minutes versus 100 minutes). No significant difference was found for length of stay (4 ± 1 days versus 5 ± 2 days, P = .18). Neither the need for conversion nor major complications were observed in either group. Conclusion: In our experience, thoracoscopic resections of CLM with the new JustRight instruments were revealed to be safe and effective. On account of having adequate dimensions for small cavities, these instruments can facilitate the procedure and help to reduce the length of surgery
-
thoracoscopic surgery for Congenital Lung Malformation using miniaturized 3 mm vessel sealing and 5 mm stapling devices single center experience
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2020Co-Authors: F. Macchini, M. Ichino, Anna Morandi, Andrea Zanini, Ernesto LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight® (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients ...
-
Thoracoscopic Surgery for Congenital Lung Malformation Using Miniaturized 3-mm Vessel Sealing and 5-mm Stapling Devices : Single-Center Experience
'Mary Ann Liebert Inc', 2020Co-Authors: F. Macchini, M. Ichino, A. Zanini, A. Morandi, E. LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight\uae (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients who underwent thoracoscopic resection of CLM in our Center from January 2016 to July 2019 were selected and divided into two groups: G1 (2018-2019), treated with the new JustRight instruments, and G2 (2016-2017), treated with Ligasure\uae and Hem-o-lok. Surgical outcomes in term of length of surgery and complications were compared between groups, stratifying the groups for type of resection (lobectomy, extralobar sequestration [ES] resection, and bronchogenic cyst [BC] resection). Results: Thirteen patients were included in G1, and 16 patients were included in G2. Seven lobectomies, 5 ES resections, and 1 BC resection were performed in G1; whereas 12 lobectomies, 3 ES resections, and 1 BC resection were performed in G2. Mean age at the time of surgery was 7.8 \ub1 6 months (G1) and 6.8 \ub1 3.3 months (G2) (P = .57). The average length of surgery was shorter for G1 (lobectomies: 120.7 \ub1 28.2 versus 171.7 \ub1 37.5, P = .006; ES resection: 63 \ub1 21.4 versus 91.7 \ub1 29.3, P = .15; BC 40 minutes versus 100 minutes). No significant difference was found for length of stay (4 \ub1 1 days versus 5 \ub1 2 days, P = .18). Neither the need for conversion nor major complications were observed in either group. Conclusion: In our experience, thoracoscopic resections of CLM with the new JustRight instruments were revealed to be safe and effective. On account of having adequate dimensions for small cavities, these instruments can facilitate the procedure and help to reduce the length of surgery
E. Leva - One of the best experts on this subject based on the ideXlab platform.
-
Thoracoscopic Surgery for Congenital Lung Malformation Using Miniaturized 3-mm Vessel Sealing and 5-mm Stapling Devices : Single-Center Experience
'Mary Ann Liebert Inc', 2020Co-Authors: F. Macchini, M. Ichino, A. Zanini, A. Morandi, E. LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight® (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients who underwent thoracoscopic resection of CLM in our Center from January 2016 to July 2019 were selected and divided into two groups: G1 (2018-2019), treated with the new JustRight instruments, and G2 (2016-2017), treated with Ligasure® and Hem-o-lok. Surgical outcomes in term of length of surgery and complications were compared between groups, stratifying the groups for type of resection (lobectomy, extralobar sequestration [ES] resection, and bronchogenic cyst [BC] resection). Results: Thirteen patients were included in G1, and 16 patients were included in G2. Seven lobectomies, 5 ES resections, and 1 BC resection were performed in G1; whereas 12 lobectomies, 3 ES resections, and 1 BC resection were performed in G2. Mean age at the time of surgery was 7.8 ± 6 months (G1) and 6.8 ± 3.3 months (G2) (P = .57). The average length of surgery was shorter for G1 (lobectomies: 120.7 ± 28.2 versus 171.7 ± 37.5, P = .006; ES resection: 63 ± 21.4 versus 91.7 ± 29.3, P = .15; BC 40 minutes versus 100 minutes). No significant difference was found for length of stay (4 ± 1 days versus 5 ± 2 days, P = .18). Neither the need for conversion nor major complications were observed in either group. Conclusion: In our experience, thoracoscopic resections of CLM with the new JustRight instruments were revealed to be safe and effective. On account of having adequate dimensions for small cavities, these instruments can facilitate the procedure and help to reduce the length of surgery
-
Thoracoscopic Surgery for Congenital Lung Malformation Using Miniaturized 3-mm Vessel Sealing and 5-mm Stapling Devices : Single-Center Experience
'Mary Ann Liebert Inc', 2020Co-Authors: F. Macchini, M. Ichino, A. Zanini, A. Morandi, E. LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight\uae (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients who underwent thoracoscopic resection of CLM in our Center from January 2016 to July 2019 were selected and divided into two groups: G1 (2018-2019), treated with the new JustRight instruments, and G2 (2016-2017), treated with Ligasure\uae and Hem-o-lok. Surgical outcomes in term of length of surgery and complications were compared between groups, stratifying the groups for type of resection (lobectomy, extralobar sequestration [ES] resection, and bronchogenic cyst [BC] resection). Results: Thirteen patients were included in G1, and 16 patients were included in G2. Seven lobectomies, 5 ES resections, and 1 BC resection were performed in G1; whereas 12 lobectomies, 3 ES resections, and 1 BC resection were performed in G2. Mean age at the time of surgery was 7.8 \ub1 6 months (G1) and 6.8 \ub1 3.3 months (G2) (P = .57). The average length of surgery was shorter for G1 (lobectomies: 120.7 \ub1 28.2 versus 171.7 \ub1 37.5, P = .006; ES resection: 63 \ub1 21.4 versus 91.7 \ub1 29.3, P = .15; BC 40 minutes versus 100 minutes). No significant difference was found for length of stay (4 \ub1 1 days versus 5 \ub1 2 days, P = .18). Neither the need for conversion nor major complications were observed in either group. Conclusion: In our experience, thoracoscopic resections of CLM with the new JustRight instruments were revealed to be safe and effective. On account of having adequate dimensions for small cavities, these instruments can facilitate the procedure and help to reduce the length of surgery
Ernesto Leva - One of the best experts on this subject based on the ideXlab platform.
-
thoracoscopic resection of Congenital Lung Malformation looking for the right preoperative assessment
European Journal of Pediatric Surgery, 2020Co-Authors: F. Macchini, M. Ichino, Irene Borzani, Silvia Cavalli, Anna Morandi, Ida Daniela Dangelo, Andrea Zanini, Carlo Ferrari, Ernesto LevaAbstract:Introduction Consensus on the best postnatal radiological evaluation of Congenital Lung Malformations (CLMs) is still lacking. In recent years, the interest on magnetic resonance imaging (MRI) has grown, but its role is still unknown. Aim The aim of the study was to identify the best preoperative diagnostic assessment for CLM. Materials and Methods All patients with a prenatal suspicion of CLM between January 2014 and February 2018 were studied. Asymptomatic newborns underwent MRI, during spontaneous sleep without contrast. Patients with a positive MRI were scheduled for computed tomography (CT) within the fourth month of life. Thoracoscopic resection was performed in cases with a pathological CT. MRI, CT, and surgical findings were compared based on dimension, localization, and features of the CLM using the Cohen's kappa test (K). Results A total of 20 patients were included (10 males). No difference was found in the diameter and site of the lesions always localized in the same side (K = 1) and in the same pulmonary lobe (K = 1). Infants who underwent thoracoscopic resection included: three Congenital pulmonary airway Malformations (CPAMs), five extralobar and eight intralobar sequestrations (bronchopulmonary sequestrations [BPSs]), three bronchogenic cysts, and one Congenital emphysema. The concordance between MRI and CT and between radiological investigations and pathology was satisfactory for the greatest part of the studied variables. MRI showed sensitivity of 100%, specificity of 82%, positive predictive value of 50% and negative predictive value of 100% for CPAM and 77, 100, 100, and 80% for BPS, respectively. Conclusion MRI proved to be a reliable diagnostic investigation for CLM with high sensitivity and specificity. Early MRI in spontaneous sleep without contrast and preoperative contrast CT scan is a valuable preoperatory assessment.
-
thoracoscopic surgery for Congenital Lung Malformation using miniaturized 3 mm vessel sealing and 5 mm stapling devices single center experience
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2020Co-Authors: F. Macchini, M. Ichino, Anna Morandi, Andrea Zanini, Ernesto LevaAbstract:Aim: To evaluate the outcomes of thoracoscopic resection of Congenital Lung Malformations (CLM) by using JustRight® (Bolder Surgical) 3-mm vessel sealing system and 5-mm stapler. Methods: Patients ...