The Experts below are selected from a list of 135 Experts worldwide ranked by ideXlab platform
F. Macchini - One of the best experts on this subject based on the ideXlab platform.
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thoracoscopic resection of congenital Lung Malformation looking for the right preoperative assessment
European Journal of Pediatric Surgery, 2020Co-Authors: F. Macchini, Irene Borzani, Silvia Cavalli, Anna Morandi, Ida Daniela Dangelo, Andrea Zanini, Carlo Ferrari, Martina Ichino, 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.
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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, A. Zanini, A. Morandi, M. Ichino, 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
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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, Anna Morandi, Andrea Zanini, Martina Ichino, 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 ...
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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, A. Zanini, A. Morandi, M. Ichino, 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
Shaun M Kunisaki - One of the best experts on this subject based on the ideXlab platform.
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surveillance of fetal Lung lesions using the congenital pulmonary airway Malformation volume ratio natural history and outcomes
Prenatal Diagnosis, 2016Co-Authors: Catriona A Macardle, Stacey Ehrenbergbuchner, Ethan A Smith, Jonathan R Dillman, George B Mychaliska, Marjorie C Treadwell, Shaun M KunisakiAbstract:OBJECTIVES The congenital pulmonary airway Malformation volume ratio (CVR) is a widely used sonographic measure of relative mass size in fetuses with Lung Malformations. The purposes of this study were to examine serial CVR measurements to understand longitudinal growth patterns and to determine correlation with postnatal imaging. METHODS An institutional review board-approved retrospective review was performed on fetuses referred for an echogenic Lung Malformation between 2002 and 2014. For each fetus, the CVR was prospectively calculated using 2D ultrasound and followed with advancing gestation. RESULTS Based on 40 fetuses, the mean initial CVR was 0.51 ± 0.07 at 20.5 ± 0.3 weeks of gestation. The CVR increased after 24 weeks of gestation (p = 0.0014), peaking at a CVR of 0.96 ± 0.11 at 25.5 ± 0.05 weeks, followed by a significant decrease in the CVR to 0.43 ± 0.07 prior to term (p < 0.0001). However, approximately one third showed no appreciable increase in size. The mean CVR was significantly correlated with postnatal chest computed tomography (CT) size dimensions (p = 0.0032) and likelihood for Lung resection (p = 0.0055). CONCLUSIONS Fetal Lung Malformations tend to follow one of two distinct growth patterns, characterized by either (1) a maximal CVR between 25 and 26 weeks of gestation or (2) minimal change in relative growth. The mean CVR correlates with postnatal CT size and operative management.
E. Leva - One of the best experts on this subject based on the ideXlab platform.
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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, A. Zanini, A. Morandi, M. Ichino, 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
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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, A. Zanini, A. Morandi, M. Ichino, 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.
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thoracoscopic resection of congenital Lung Malformation looking for the right preoperative assessment
European Journal of Pediatric Surgery, 2020Co-Authors: F. Macchini, Irene Borzani, Silvia Cavalli, Anna Morandi, Ida Daniela Dangelo, Andrea Zanini, Carlo Ferrari, Martina Ichino, 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.
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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, Anna Morandi, Andrea Zanini, Martina Ichino, 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 ...
Pascal De Lagausie - One of the best experts on this subject based on the ideXlab platform.
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congenital Lung Malformation evaluation of prenatal and postnatal radiological findings
Respirology, 2009Co-Authors: Smart Zeidan, G Gorincour, Alain Potier, Fabrice Ughetto, Jean Christophe Dubus, Marieanne Chrestian, Camille Grosse, Marc Gamerre, J M Guys, Pascal De LagausieAbstract:Background and objective: This study evaluated the accuracy of prenatal MRI and postnatal CT imaging in the identification of congenital cystic adenomatoid Malformation and bronchopulmonary sequestration by comparison with histological analysis. Methods: Over a 3-year period, 15 patients with Lung Malformations diagnosed prenatally by ultrasound were referred for prenatal MRI, and all were investigated postnatally by chest CT. All asymptomatic newborns with unresolved lesions underwent elective surgery by thoracoscopy. All surgical specimens were analysed histologically. Results: Among the 15 patients with an abnormality diagnosed by ultrasound, prenatal MRI findings differed from the final histological diagnosis with respect to extent (n = 3), type of lesion (n = 1) and aberrant vessel identification (n = 4). Postnatal chest CT failed to visualize the aberrant vessel in one patient. Complete regression of the lesion was noted in two patients with bronchopulmonary sequestration, and in one patient with congenital cystic adenomatoid Malformation and was confirmed by CT. Elective thoracoscopic lobectomy of the affected lobe was performed for 12 patients. Two conversions to thoracotomy were required. All operated patients had an uneventful hospital course. Conclusions: Prenatal MRI is less accurate than postnatal CT scan, which remains the most reliable diagnostic modality to specify the location and extent and kind of lesions.
