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Guanà R, Carpino A, Miglietta M, Zambaiti E, Cerrina A, Lonati L, Guerrera F, Vallero S, Garofalo S, Bardessono M, Maletta F, Shilly S, Gennari F. Endobronchial Inflammatory Myofibroblastic Tumor in a 3-Year-Old Child. European J Pediatr Surg Rep 2023; 11:e5-e9. [PMID: 36911852 PMCID: PMC10019996 DOI: 10.1055/s-0043-1764289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/13/2022] [Indexed: 03/11/2023] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a mesenchymal tumor that can occur at any age. However, it is primarily seen in children, with the most common site being in the lung parenchyma, usually present with rare endobronchial lesions. This case reports the incidence in a 3-year-old girl diagnosed with pericardiac pneumonia treated with antibiotics with no clinical improvement. A chest computed tomography (CT) scan identified a 1.5-cm lesion in the left main bronchus. Bronchoscopy revealed complete obstruction of the left main stem bronchus. A left posterolateral thoracotomy was performed. Additionally, a left sleeve upper bronchial resection was conducted under fibroendoscopic control. Definitive histology confirmed IMT. After 2 years of endoscopic follow-up, there is no evidence of recurrence.
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Affiliation(s)
- Riccardo Guanà
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Andrea Carpino
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Marta Miglietta
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Elisa Zambaiti
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Alessia Cerrina
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Luca Lonati
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Francesco Guerrera
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Stefano Vallero
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Salvatore Garofalo
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Marco Bardessono
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Francesca Maletta
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
| | - Steffi Shilly
- Columbia University School of Nursing, New York, New York, United States
| | - Fabrizio Gennari
- Division of Pediatric General, Thoracic & Minimally Invasive Surgery, University Hospital of Health and Science, Turin University, Regina Margherita Children's Hospital, Torino, Italy
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Xie X, Li X, Tang W, Xie P, Tan X. Primary tumor location in lung cancer: the evaluation and administration. Chin Med J (Engl) 2021; 135:127-136. [PMID: 34784305 PMCID: PMC8769119 DOI: 10.1097/cm9.0000000000001802] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Lung cancer continues to be the leading cause of cancer-related death in the world, which is classically subgrouped into two major histological types: Non-small cell lung cancer (NSCLC) (85% of patients) and small-cell lung cancer (SCLC) (15%). Tumor location has been reported to be associated with the prognosis of various solid tumors. Several types of cancer often occur in a specific region and are more prone to spread to predilection locations, including colorectal cancer, prostate cancer, gastric cancer, ovarian cancer, cervical cancer, bladder cancer, lung tumor, and so on. Besides, tumor location is also considered as a risk factor for lung neoplasm with chronic obstructive pulmonary disease/emphysema. Additionally, the primary lung cancer location is associated with specific lymph node metastasis. And the recent analysis has shown that the primary location may affect metastasis pattern in metastatic NSCLC based on a large population. Numerous studies have enrolled the "location" factor in the risk model. Anatomy location and lobe-specific location are both important in prognosis. Therefore, it is important for us to clarify the characteristics about tumor location according to various definitions. However, the inconsistent definitions about tumor location among different articles are controversial. It is also a significant guidance in multimode therapy in the present time. In this review, we mainly aim to provide a new insight about tumor location, including anatomy, clinicopathology, and prognosis in patients with lung neoplasm.
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Affiliation(s)
- Xueqi Xie
- School of Medicine and Life Sciences, Shandong First Medical University, Jinan, Shandong 250117, China Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250117, China
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3
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Li C, Liu J, Lin J, Li Z, Shang X, Wang H. Poor survival of non-small-cell lung cancer patients with main bronchus tumor: a large population-based study. Future Oncol 2019; 15:2819-2827. [PMID: 31393163 DOI: 10.2217/fon-2019-0098] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: In this study, we evaluated the association between tumor location and prognosis in non-small-cell lung cancer patients. Patients & methods: The SEER database was used to screen for suitable patients using our inclusion criteria. The χ2 test was used to compare baseline patient characteristics and the Kaplan–Meier method as well as the log-rank test were used to compare survival differences. At last, univariate and multivariate Cox proportional hazards regression models were used to analyze the influence of different variables on overall survival. Results: The results found no significant difference in overall survival between patients in laterality (p = 0.071). However, patients with main bronchial tumors had worse prognosis than tumors at other locations (p < 0.001). Our results also showed that tumor location including main bronchus, upper lobe, middle lobe, lower lobe and overlapping lesion was a significant factor affecting survival (p < 0.001). Subgroup analysis revealed that regardless of histology or M stage, patients with main bronchial tumors had a worse survival compared with other tumor locations (all; p < 0.001). Interestingly, we found that patients with tumor main bronchial tumors were more likely to be squamous carcinoma and terminal Tumor, Node, Metastasis stage (all; p < 0.001). Conclusion: Non-small-cell lung cancer patients’ prognosis was related to the tumor location. And patients with tumors located in main bronchus had worse outcomes than those located in other locations. Tumor primary site should be considered in treatment management and prognosis assessment.
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Affiliation(s)
- Cheng Li
- School of Health Care Management, NHC Key Laboratory of Health Economics & Policy Research, Shandong University, Jinan 250100, PR China
- Department of Dean’s Office, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, PR China
| | - Jia Liu
- Respiratory Department, Shandong Qianfoshan Hospital, Jinan 250014, PR China
| | - Jiamao Lin
- Department of Internal Medicine-Oncology, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, PR China
| | - Zhenxiang Li
- Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, PR China
| | - Xiaoling Shang
- Department of Clinical Laboratory, Shandong University, Jinan 250012, PR China
- Department of Clinical Laboratory, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, PR China
| | - Haiyong Wang
- Department of Internal Medicine-Oncology, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, PR China
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Pio L, Varela P, Eliott MJ, Couloigner V, Guillén Burrieza G, Paraboschi I, Virgone C, Maunsell R, Rachkov V, Rutter MJ, Boglione M, Penchyna Grub J, Bellía Munzón G, Sarnacki S, Irtan S, Schweiger C, Larroquet M, Khen Dunlop N, Ramaswamy M, Pistorio A, Cecchetto G, Ferrari A, Bisogno G, Torre M. Pediatric airway tumors: A report from the International Network of Pediatric Airway Teams (INPAT). Laryngoscope 2019; 130:E243-E251. [PMID: 31090942 DOI: 10.1002/lary.28062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 04/11/2019] [Accepted: 04/22/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Primary tracheobronchial tumors (PTTs) are rare heterogeneous lesions arising from any part of the tracheobronchial tree. Nonspecific symptoms may lead to delayed diagnosis that requires more aggressive surgical treatment. An analysis of cases collected by the International Network of Pediatric Airway Team was undertaken to ensure proper insight into the behavior and management of PTTs. METHODS Patients <18 years of age with a histological confirmation of PTT diagnosed from 2000 to 2015 were included in this multicenter international retrospective study. Medical records, treatment modalities, and outcomes were analyzed. The patient presentation, tumor management, and clinical course were compared between malignant and benign histotypes. Clinical and surgical variables that might influence event-free survival were considered. RESULTS Among the 78 children identified, PTTs were more likely to be malignant than benign; bronchial carcinoid tumor (n = 31; 40%) was the most common histological subtype, followed by inflammatory myofibroblastic tumor (n = 19; 25%) and mucoepidermoid carcinoma (n = 15; 19%). Regarding symptoms at presentation, wheezing (P = 0.001) and dyspnea (P = 0.03) were more often associated with benign growth, whereas hemoptysis was more frequently associated with malignancy (P = 0.042). Factors that significantly worsened event-free survival were age at diagnosis earlier than 112 months (P = 0.0035) and duration of symptoms lasting more than 2 months (P = 0.0029). CONCLUSION The results of this international study provide important information regarding the clinical presentation, diagnostic workup, and treatment of PTTs in children, casting new light on the biological behavior of PTTs to ensure appropriate treatments. LEVEL OF EVIDENCE NA Laryngoscope, 130:E243-E251, 2020.
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Affiliation(s)
- Luca Pio
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Patricio Varela
- Department of Pediatric Surgery, Clinica Las Condes Medical Center, Hospital de Niños Calvo Mackenna, University of Chile, Santiago, Chile
| | - Martin J Eliott
- Tracheal Team, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Vincent Couloigner
- Pediatric Ear, Nose, and Throat Department, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France
| | | | | | - Calogero Virgone
- Pediatric Surgery, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Rebecca Maunsell
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas, Campinas, São Paulo, Brazil
| | - Victor Rachkov
- Chair of Pediatric Surgery of N.I. Pirogov Russian Research Medical University, Dmitry Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology; ZAO European Medical Center, Moscow, Russia
| | - Michael J Rutter
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Mariano Boglione
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha, 1850, Ciudad De Buenos Aires
| | - Jaime Penchyna Grub
- Department of Thoracic Surgery and Endoscopy, Hospital Infantil de México, Federico Gómez, Mexico
| | - Gastón Bellía Munzón
- Department of Surgery, Fundación Hospitalaria, Private Children's Hospital, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Sabine Irtan
- Department of Surgery, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (AP-HP), Université Pierre et Marie Curie, Paris, France
| | - Claudia Schweiger
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Michèle Larroquet
- Department of Surgery, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (AP-HP), Université Pierre et Marie Curie, Paris, France
| | - Naziha Khen Dunlop
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Madhavan Ramaswamy
- Tracheal Team, Great Ormond Street Children's Hospital, London, United Kingdom
| | | | - Giovanni Cecchetto
- Pediatric Surgery, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Gianni Bisogno
- Pediatric Hematology and Oncology Division, University of Padua, Padua, Italy
| | - Michele Torre
- Airway Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Abstract
Bronchial carcinoid tumor, while rare, remains the most common primary malignant lung tumor in children. We present a retrospective analysis of 7 patients with typical bronchial carcinoid tumors diagnosed at 2 pediatric tertiary care referral centers between 1990 and 2014. The most common presenting symptom was pneumonia, followed by respiratory distress. Somatostatin scans were performed in selected patients. All patients had negative resection margin following surgery and were alive without disease at last follow-up. Typical carcinoid tumors have a good prognosis following definitive surgical resection. A review of published literature on pediatric bronchial carcinoid tumors is provided.
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Petrella F, Mariolo AV, Guarize J, Donghi S, Girelli L, Rizzo S, Spaggiari L. Bronchial carcinoid in anomalous right upper bronchus: a "patient-tailored" bronchoplasty resection technique. J Vis Surg 2018; 4:81. [PMID: 29780727 DOI: 10.21037/jovs.2018.03.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/16/2018] [Indexed: 11/06/2022]
Abstract
Bronchial carcinoids (BC) are indolent neuroendocrine tumors (NET) that are classified as malignant because they can locally infiltrate and metastasize. Resection is the primary treatment for most localized carcinoid tumors, with lung parenchymal-sparing surgery the favoured objective for patients with central airway tumors. Sleeve bronchoplasty techniques are complex surgical procedures defined as parenchyma-saving because they allow a radical resection with tumor-free margins while preserving the maximum amount of parenchyma. They are mainly indicated for tumors arising at the origin of a lobar bronchus, precluding simple lobectomy but not infiltrating so far as to require pneumonectomy. We describe a case of typical bronchial carcinoid of an anomalous right upper bronchus requiring a "patient-tailored" bronchoplasty technique. The surgical aspects and preoperative work-up are discussed.
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Affiliation(s)
- Francesco Petrella
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | | | - Juliana Guarize
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy
| | - Stefano Donghi
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy
| | - Lara Girelli
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy
| | - Stefania Rizzo
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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AlKharashi N, Al-Namshan M, AlShammari J, Gieballa M, AlJadaan S, Crankson S. Surgical options in the treatment of endobronchial carcinoid tumor. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Varela P, Pio L, Brandigi E, Paraboschi I, Khen-Dunlop N, Hervieux E, Muller C, Mattioli G, Sarnacki S, Torre M. Tracheal and bronchial tumors. J Thorac Dis 2016; 8:3781-3786. [PMID: 28149577 PMCID: PMC5227203 DOI: 10.21037/jtd.2016.12.67] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/05/2016] [Indexed: 11/06/2022]
Abstract
Although primary tracheobronchial tumors are extremely rare in children, recurrent respiratory symptoms resistant to conventional therapy require further investigations to exclude possible malignant obstructive causes. As the matter of fact, early diagnosis may allow minimally invasive surgeries, improving the standard of living and the globally survival rate. The aim of this article is to provide an overview of diagnosis and management of tracheobronchial tumors in the early age, since only few reports are reported in the worldwide literature.
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Affiliation(s)
- Patricio Varela
- Department of Pediatric Surgery, Clinica Las Condes Medical Center, Hospital de Niños Calvo Mackenna, University of Chile, Santiago, Chile
| | - Luca Pio
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Elisa Brandigi
- Department of Medical Sciences, Surgery and Neurosciences, Clinic Pediatric Surgery, University of Siena, Siena, Italy
| | - Irene Paraboschi
- DINOGMI University of Genoa, Genoa, Italy
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Nazhia Khen-Dunlop
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Erik Hervieux
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Cecile Muller
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Girolamo Mattioli
- DINOGMI University of Genoa, Genoa, Italy
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cite, Paris, France
| | - Michele Torre
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy
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Gonzalez-Rivas D, Marin JC, Granados JPO, Llano JDU, Cañas SR, Arqueta AO, de la Torre M. Uniportal video-assisted thoracoscopic right upper sleeve lobectomy and tracheoplasty in a 10-year-old patient. J Thorac Dis 2016; 8:E966-E969. [PMID: 27747037 DOI: 10.21037/jtd.2016.08.06] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Tracheobronchial pediatric tumors are very rare and procedures like pneumonectomy are seldomly indicated due to the associated morbidity. If a surgical approach is considered, the ideal oncological technique would be the minimally invasive sleeve resection, allowing preservation of lung parenchyma (very important in pediatric patients). Here we present the first report of a thoracoscopic right upper tracheo-bronchial sleeve lobectomy in a pediatric patient. A 10-year-old female patient, who received multiple antibiotic treatments for recurrent pneumonia without improvement, was diagnosed with a right upper lobe (RUL) carcinoid tumor. The patient was proposed for uniportal thoracoscopic surgery. The patient was placed in a lateral decubitus position and a single 3 cm incision was performed at the anterior level of 4th intercostal space. A right upper lobectomy with a tracheo-bronchial sleeve resection using the uniportal technique was successfully performed. The postoperative course was uneventful and the patient was discharged home on the 7th postoperative day. The bronchoscopic control showed excellent caliber of the anastomosis with no complications. The uniportal video-assisted thoracoscopic surgery (VATS) approach is an excellent option for endobronchial tumor management in pediatric patients, offering a quick recovery and low morbidity. The performance of a thoracoscopic sleeve anastomosis in young patients is crucial and should only be performed by very experienced thoracoscopic surgeons.
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Affiliation(s)
- Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain; ; Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | | | - Juan Pablo Ovalle Granados
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
| | | | - Sonia Roque Cañas
- Department of General Surgery, Salvadoran Social Security Institute, San Salvador, El Salvador
| | - Alonso Oviedo Arqueta
- Department of General Surgery, Salvadoran Social Security Institute, San Salvador, El Salvador
| | - Mercedes de la Torre
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
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