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Taylor M, Raj Krishna G, Rammohan K, Fontaine E, Joshi V, Grant S, Granato F. Outcomes after Conversion from Video-Assisted Thoracoscopic Lobectomy to Thoracotomy. Thorac Cardiovasc Surg 2023. [PMID: 37967842 DOI: 10.1055/s-0043-1776706] [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: 11/17/2023]
Abstract
BACKGROUND Lung cancer resections are increasingly being performed via video-assisted thoracoscopic surgery (VATS). Conversion to thoracotomy can occur for many reasons and may affect outcomes. The objective of this study was to investigate the impact of VATS conversion on short- and mid-term outcomes and identify reasons for conversion. METHODS Consecutive patients undergoing lobectomy for primary non-small cell lung cancer between 2012 and 2019 in a single UK center were included. Primary outcomes were 90-day mortality, intraoperative conversion, and overall survival. Reasons for conversion were defined as bleeding or nonbleeding. Outcomes were compared between groups using univariable analysis. Multivariable logistic regression analysis was performed to identify risk factors for conversion. RESULTS A total of 2,622 patients were included with 20.6% (n = 541) completing surgery via VATS and 79.4% (n = 2,081) via thoracotomy. The rate of completed VATS surgery increased significantly over time (2012: 6.9%, 2019: 55.1%, p < 0.001). Overall conversion rate was 14.3% (n = 90/631) and has reduced significantly over time (p < 0.001). The rate of conversion due to intraoperative bleeding was 31.1% (n = 28/90). Obesity, male sex, and stage III disease were independent risk factors for conversion. The 90-day mortality rate after conversion was not significantly different from the rate for planned thoracotomy (3.3 vs. 3.4%, p = 0.987). There was no significant difference in overall survival between patients experiencing intraoperative conversion and those undergoing planned thoracotomy (p = 0.135). CONCLUSION This study demonstrates comparable outcomes for patients undergoing conversion from VATS to those undergoing planned surgery via thoracotomy. It remains unclear if reason for conversion is associated with outcomes.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Gokul Raj Krishna
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Kandadai Rammohan
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Eustace Fontaine
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Vijay Joshi
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Stuart Grant
- Division of Cardiovascular Sciences, The University of Manchester, Manchester, United Kingdom
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Whittaker G, Ghita IA, Taylor M, Salmasi MY, Granato F, Athanasiou T. Current Status of Simulation in Thoracic Surgical Training. Ann Thorac Surg 2023; 116:1107-1115. [PMID: 37201622 DOI: 10.1016/j.athoracsur.2023.05.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/21/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Simulation is playing an increasingly important role in surgical training but is not yet a mandatory part of most surgical curricula. A simulator must undergo rigorous validation to verify it as a reliable tool. The aim of this study was to review the literature to identify simulators that are currently available to augment thoracic surgical training and to analyze any evidence supporting or validating them. METHODS A literature search of the MEDLINE (1946 to November 2022) and Embase (1947 to November 2022) databases was performed to identify simulators for basic skills and procedures in thoracic surgery. A selection of keywords were used to perform the literature search. After identification of appropriate articles, data were extracted and analyzed. RESULTS Thirty-three simulators were found in 31 articles. Simulators for basic skills (n = 13) and thoracic lobectomy (n = 13) were most commonly described, followed by miscellaneous (n = 7). Most models were of a hybrid modality (n = 18). Evidence of validity was established in 48.5% (n = 16) of simulators. In total, 15.2% (n = 5) of simulators had 3 or more elements of validity demonstrated, and only 3.0% (n = 1) accomplished full validation. CONCLUSIONS Numerous simulators of varying modality and fidelity exist for a variety of thoracic surgical skills and procedures, although validation evidence is frequently inadequate. Simulation models may be able to provide training in basic surgical and procedural skills; however, further assessment of validity needs to be undertaken before consideration of their integration into training programs.
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Affiliation(s)
- George Whittaker
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
| | - Ioana-Alexandra Ghita
- Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - M Yousuf Salmasi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Thanos Athanasiou
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Taylor M, Soliman N, Paoletti E, King M, Crosbie PAJ, Granato F. Impact of skip mediastinal lymph node metastasis on outcomes after resection for primary lung cancer. Lung Cancer 2023; 184:107341. [PMID: 37573704 DOI: 10.1016/j.lungcan.2023.107341] [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: 05/24/2023] [Revised: 07/21/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Patients with non-small cell lung cancer and nodal disease are a heterogeneous group with varied patterns of disease. The aim of this study was to assess long-term outcomes of patients with skip N2 disease in comparison to those with N1 or non-skip N2 disease. MATERIALS AND METHODS A retrospective review of 445 patients undergoing anatomical lung resection for primary lung cancer between 2012 and 2019 with post-operative histological confirmation of nodal disease was undertaken. Log rank analysis was used to assess differences in estimated median overall survival according to nodal status. Multivariable Cox regression analysis was performed to determine whether skip N2 disease was independently associated with overall survival. RESULTS Mean patient age was 67.0 years (standard deviation ± 9.2 years) and 48.1% (n = 214) were male. In total, 20.7% (n = 92) of patients had N1 disease, 32.1% (n = 143) had skip N2 disease and 47.2% (n = 210) had non-skip N2 disease. Post-operative upstaging took place in 33.0% (n = 147) of patients. Median follow-up time was 35 months (interquartile range 14-68 months). Skip N2 patients had significantly longer estimated median overall survival in comparison to their non-skip N2 counterparts (47 months vs 28 months, log rank analysis p = 0.029) and non-skip N2 disease remained independently associated with reduced overall survival after multivariable analysis (hazard ratio 1.421, 95% confidence interval 1.060-1.907, p = 0.019). CONCLUSION Skip N2 disease is a positive prognostic factor for patients with N2 lung cancer, suggesting that lung cancer staging guidelines should consider separating N2 disease into additional subgroups in order to improve prognostic accuracy.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK.
| | - Nadine Soliman
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Emma Paoletti
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Megan King
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Philip A J Crosbie
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK; Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
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Colombo SAP, Brown SL, Hepworth MR, Hankinson J, Granato F, Kitchen SJ, Hussell T, Simpson A, Cook PC, MacDonald AS. Comparative phenotype of circulating versus tissue immune cells in human lung and blood compartments during health and disease. Discov Immunol 2023; 2:kyad009. [PMID: 37545765 PMCID: PMC10403752 DOI: 10.1093/discim/kyad009] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/31/2023] [Accepted: 07/18/2023] [Indexed: 08/08/2023]
Abstract
The lung is a dynamic mucosal surface constantly exposed to a variety of immunological challenges including harmless environmental antigens, pollutants, and potentially invasive microorganisms. Dysregulation of the immune system at this crucial site is associated with a range of chronic inflammatory conditions including asthma and Chronic Pulmonary Obstructive Disease (COPD). However, due to its relative inaccessibility, our fundamental understanding of the human lung immune compartment is limited. To address this, we performed flow cytometric immune phenotyping of human lung tissue and matched blood samples that were isolated from 115 donors undergoing lung tissue resection. We provide detailed characterization of the lung mononuclear phagocyte and T cell compartments, demonstrating clear phenotypic differences between lung tissue cells and those in peripheral circulation. Additionally, we show that CD103 expression demarcates pulmonary T cells that have undergone recent TCR and IL-7R signalling. Unexpectedly, we discovered that the immune landscape from asthmatic or COPD donors was broadly comparable to controls. Our data provide a much-needed expansion of our understanding of the pulmonary immune compartment in both health and disease.
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Affiliation(s)
- Stefano A P Colombo
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Sheila L Brown
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Matthew R Hepworth
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Jenny Hankinson
- Institute of Translational Genomics, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Felice Granato
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Semra J Kitchen
- GSK, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, UK
| | - Tracy Hussell
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Angela Simpson
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
| | - Peter C Cook
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
- MRC Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, UK
| | - Andrew S MacDonald
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK
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Herrera JA, Dingle LA, Monetero MA, Venkateswaran RV, Blaikley JF, Granato F, Pearson S, Lawless C, Thornton DJ. Morphologically intact airways in lung fibrosis have an abnormal proteome. Respir Res 2023; 24:99. [PMID: 37005656 PMCID: PMC10066954 DOI: 10.1186/s12931-023-02400-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/16/2023] [Indexed: 04/04/2023] Open
Abstract
Honeycombing is a histological pattern consistent with Usual Interstitial Pneumonia (UIP). Honeycombing refers to cystic airways located at sites of dense fibrosis with marked mucus accumulation. Utilizing laser capture microdissection coupled mass spectrometry (LCM-MS), we interrogated the fibrotic honeycomb airway cells and fibrotic uninvolved airway cells (distant from honeycomb airways and morphologically intact) in specimens from 10 patients with UIP. Non-fibrotic airway cell specimens from 6 patients served as controls. Furthermore, we performed LCM-MS on the mucus plugs found in 6 patients with UIP and 6 patients with mucinous adenocarcinoma. The mass spectrometry data were subject to both qualitative and quantitative analysis and validated by immunohistochemistry. Surprisingly, fibrotic uninvolved airway cells share a similar protein profile to honeycomb airway cells, showing deregulation of the slit and roundabout receptor (Slit and Robo) pathway as the strongest category. We find that (BPI) fold-containing family B member 1 (BPIFB1) is the most significantly increased secretome-associated protein in UIP, whereas Mucin-5AC (MUC5AC) is the most significantly increased in mucinous adenocarcinoma. We conclude that fibrotic uninvolved airway cells share pathological features with fibrotic honeycomb airway cells. In addition, fibrotic honeycomb airway cells are enriched in mucin biogenesis proteins with a marked derangement in proteins essential for ciliogenesis. This unbiased spatial proteomic approach generates novel and testable hypotheses to decipher fibrosis progression.
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Affiliation(s)
- Jeremy A Herrera
- The Wellcome Centre for Cell-Matrix Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK.
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK.
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - Lewis A Dingle
- Blond McIndoe Laboratories, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
| | - M Angeles Monetero
- Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Rajamiyer V Venkateswaran
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - John F Blaikley
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Felice Granato
- Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
| | - Stella Pearson
- The Wellcome Centre for Cell-Matrix Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
| | - Craig Lawless
- The Wellcome Centre for Cell-Matrix Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
| | - David J Thornton
- The Wellcome Centre for Cell-Matrix Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, Great Manchester, UK
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Ugolini S, Abdelghafar M, Vokkri E, Sharkey AJ, Fontaine E, Voltolini L, Morabito A, Ugolini D, Granato F. Case Report: Spontaneous lung intercostal hernia series and literature review. Front Surg 2023; 9:1091727. [PMID: 36776474 PMCID: PMC9911423 DOI: 10.3389/fsurg.2022.1091727] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
Spontaneous lung intercostal hernia (SLIH) is a rare condition potentially carrying severe morbidity. About 120 cases have been described so far, with an apparently increasing number of reports in recent years. The main presenting findings are chest pain and bulging, with ecchymosis in the affected area, hemoptysis, respiratory distress, and signs of infection or incarceration being described as well. The gold standard treatment has not been established, and conservative management has been advocated as first-line treatment for asymptomatic patients. Here, we report a case series of five patients, and surgical repair was deemed necessary for four of them either at first evaluation or after failure of conservative management. One patient remains under surveillance and conservative management. We believe that SLIH surgical repair should be considered as first-line treatment for fit patients, due to the uncertainty of its mid- and long-term impact and described pejorative trend/defect enlargement. A proposed algorithm for SLIH management is also presented.
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Affiliation(s)
- Sara Ugolini
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust (MFT), Wythenshawe Hospital, Manchester, United Kingdom,Correspondence: Sara Ugolini
| | - Moslem Abdelghafar
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust (MFT), Wythenshawe Hospital, Manchester, United Kingdom
| | - Eduart Vokkri
- Department Thoracic Surgery, University Hospital Careggi, University of Florence, Firenze, Italy
| | - Annabel J. Sharkey
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust (MFT), Wythenshawe Hospital, Manchester, United Kingdom
| | - Eustace Fontaine
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust (MFT), Wythenshawe Hospital, Manchester, United Kingdom
| | - Luca Voltolini
- Department Thoracic Surgery, University Hospital Careggi, University of Florence, Firenze, Italy
| | - Antonino Morabito
- Department of Pediatric Surgery, A. Meyer Children’s Hospital, University of Florence, Firenze, Italy
| | - Dario Ugolini
- Department Thoracic Surgery, University Hospital Careggi, University of Florence, Firenze, Italy
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust (MFT), Wythenshawe Hospital, Manchester, United Kingdom
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Garner M, Taylor M, Smith M, Abah U, Shackcloth M, Granato F, Rammohan K. Pre-existing pulmonary fibrosis is associated with adverse outcomes after lung resection. Respir Med 2022; 205:107037. [PMID: 36347082 DOI: 10.1016/j.rmed.2022.107037] [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: 08/13/2022] [Revised: 09/26/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Pulmonary fibrosis is a risk factor for the development of lung cancer. However, the low incidence of the pathology means that it is not well represented in thoracic surgery risk scoring systems. We aimed to assess whether short and long-term outcomes after lung resection for primary lung cancer were worse in patients with pre-existing pulmonary fibrosis. METHODS A total of 5029 consecutive patients undergoing lung resection for primary lung cancer between 2012 and 2018 in two UK centres were included. Primary outcomes were 90-day & 1-year mortality, post-operative complications and overall survival. Univariable analyses were used to compare outcomes between patients with and without pre-existing pulmonary fibrosis. RESULTS In total, 0.7% (n = 33) of patients had a pre-existing diagnosis of pulmonary fibrosis (idiopathic pulmonary fibrosis 48.5%, non-specific interstitial pneumonia 6.1%, unknown 45.5%). Overall, 90-day and 1-year mortality were all significantly higher amongst patients with fibrosis (90-day: 18.2% vs 3.6%, p < 0.001; 1-year: 36.4% vs 10.7%, p < 0.001). The rate of reintubation was significantly higher for patients with fibrosis (9.1% vs 2.9%, p = 0.038) yet there was no difference in post-operative length of stay between groups (fibrosis: 6 days [IQR 4-9 days] vs non-fibrosis: 5 days [IQR 4-8 days], p = 0.675). Overall survival was also significantly reduced for patients with pulmonary fibrosis (log-rank analysis, p < 0.001). CONCLUSIONS Despite its small size, this study suggests that short and long-term outcomes after lung resection are worse for patients with pre-existing pulmonary fibrosis. Segmental resections could be considered in these patients where oncologically appropriate to minimise peri-operative risk.
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Affiliation(s)
- Megan Garner
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK.
| | - Matthew Smith
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Udo Abah
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Michael Shackcloth
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Kandadai Rammohan
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
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Bradley P, Taylor M, Ugolini S, Crosbie PAJ, Granato F, Balata H, Booton R. Lung cancer screening in 2022: a narrative review. Video-assist Thorac Surg 2022. [DOI: 10.21037/vats-22-10] [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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Taylor M, Templeton R, Granato F, Eadington T, Shah R, Grant SW. The Impact of Initial Postoperative Destination on Unplanned Critical Care Admissions After Lung Resection. J Cardiothorac Vasc Anesth 2022; 36:2393-2399. [PMID: 35144870 DOI: 10.1053/j.jvca.2021.12.035] [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: 09/15/2021] [Revised: 11/27/2021] [Accepted: 12/29/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Despite an increasing proportion of patients undergoing lung resection being managed postoperatively in a ward-based environment, studies analyzing the impact of initial postoperative destination (IPD) on perioperative outcomes and unplanned critical care admission (UCCA) are lacking. DESIGN A single-center retrospective review. SETTING A cardiothoracic surgery center in the Northwest of England. PARTICIPANTS A total of 3,841 patients between 2012 and 2018. INTERVENTIONS All patients underwent lung resection. Patients were classified as either IPD ward or IPD critical care. MEASUREMENTS AND MAIN RESULTS Outcomes assessed included in-hospital and 90-day mortality and UCCA. Differences in mortality rates between groups were assessed using the chi-square test. Multivariate logistic regression analyses were performed to identify variables independently associated with 90-day mortality and UCCA. In total, 23.8% (n = 913) of patients went to critical care as their IPD. Overall in-hospital mortality was 1.6% (n = 62), and 90-day mortality was 2.9% (n = 112). The rate of UCCA was 10.5% (n = 404) and was significantly higher for IPD ward patients compared to IPD critical care patients (11.9% v 6.2%, p < 0.001). The 90-day mortality rates after UCCA were 5.2% (IPD ward) and 19.3% (IPD critical care) (p < 0.001). Advanced age, worse pulmonary function, IPD ward, and timing of surgery were all independently associated with UCCA. CONCLUSIONS Most patients undergoing lung resection can be managed safely postoperatively in a ward-based environment. Short-term mortality is higher after UCCA, with patients who experience readmission to critical care at the highest risk of death. Patients should receive additional monitoring immediately following discharge from critical care.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, United Kingdom.
| | - Richard Templeton
- Department of Cardiothoracic Anaesthesia, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, United Kingdom
| | - Felice Granato
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, United Kingdom
| | - Thomas Eadington
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, United Kingdom
| | - Rajesh Shah
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, United Kingdom
| | - Stuart W Grant
- Division of Cardiovascular Sciences, University of Manchester, ERC, Manchester University Hospitals Foundation Trust, Manchester, United Kingdom
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10
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Iyer A, Blackhall F, Bayman N, Cove-Smith L, Faivre-Finn C, Woolf D, Brown L, Bailey S, Grundy S, Fullerton D, Craig C, Granato F, Rammohan K, Fenemore J, Taylor P, Evison M. Early evaluation of a new regional pathway for tri-modality treatment in stage III-N2 NSCLC in Greater Manchester. Lung Cancer 2022. [DOI: 10.1016/s0169-5002(22)00054-x] [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: 11/15/2022]
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11
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Taylor M, Hashmi SF, Martin GP, Granato F, Abah U, Smith M, Shackcloth M, Booton R, Grant SW. External validation of a clinical prediction model for mid-term mortality after video-assisted thoracoscopic surgery lobectomy for non-small cell lung cancer. Video-assist Thorac Surg 2022. [DOI: 10.21037/vats-22-9] [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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Brunswicker A, Taylor M, Grant SW, Abah U, Smith M, Shackcloth M, Granato F, Shah R, Rammohan K. Pneumonectomy for primary lung cancer: contemporary outcomes, risk factors and model validation. Interact Cardiovasc Thorac Surg 2021; 34:1054-1061. [PMID: 34871415 PMCID: PMC9159428 DOI: 10.1093/icvts/ivab340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/24/2021] [Revised: 07/27/2021] [Accepted: 11/07/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Despite the increased rate of adverse outcomes compared to lobectomy, for selected patients with lung cancer, pneumonectomy is considered the optimal treatment option. The objective of this study was to identify risk factors for mortality in patients undergoing pneumonectomy for primary lung cancer. METHODS Data from all patients undergoing pneumonectomy for primary lung cancer at 2 large thoracic surgical centres between 2012 and 2018 were analysed. Multivariable logistic and Cox regression analyses were used to identify risk factors associated with 90-day and 1-year mortality and reduced long-term survival, respectively. RESULTS The study included 256 patients. The mean age was 65.2 (standard deviation 9.4) years. In-hospital, 90-day and 1-year mortality were 6.3% (n = 16), 9.8% (n = 25) and 28.1% (n = 72), respectively. The median follow-up time was 31.5 months (interquartile range 9-58 months). Patients who underwent neoadjuvant therapy had a significantly increased risk of 90-day [odds ratio 6.451, 95% confidence interval (CI) 1.867-22.291, P = 0.003] and 1-year mortality (odds ratio 2.454, 95% CI 1.079-7.185, P = 0.044). Higher Performance Status score was associated with higher 1-year mortality (odds ratio 2.055, 95% CI 1.248-3.386, P = 0.005) and reduced overall survival (hazard ratio 1.449, 95% CI 1.086-1.934, P = 0.012). Advanced (stage III/IV) disease was associated with reduced overall survival (hazard ratio 1.433, 95% CI 1.019-2.016, P = 0.039). Validation of a pneumonectomy-specific risk model demonstrated inadequate model performance (area under the curve 0.54). CONCLUSIONS Pneumonectomy remains associated with a high rate of perioperative mortality. Neoadjuvant chemoradiotherapy, Performance Status score and advanced disease emerged as the key variables associated with adverse outcomes after pneumonectomy in our cohort.
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Affiliation(s)
- Annemarie Brunswicker
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Stuart W Grant
- Division of Cardiovascular Sciences, University of Manchester, ERC, Manchester University Hospital NHS Foundation Trust, Manchester, UK
| | - Udo Abah
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Matthew Smith
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Michael Shackcloth
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Rajesh Shah
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Kandadai Rammohan
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
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Taylor M, Evison M, Clayton B, Grant SW, Martin GP, Shah R, Krysiak P, Rammohan K, Fontaine E, Joshi V, Granato F. Adequacy of Mediastinal Lymph Node Sampling in Patients With Lung Cancer Undergoing Lung Resection. J Surg Res 2021; 270:271-278. [PMID: 34715539 DOI: 10.1016/j.jss.2021.09.014] [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: 05/30/2021] [Revised: 08/06/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intraoperative mediastinal lymph node sampling (MLNS) is a crucial component of lung cancer surgery. Whilst several sampling strategies have been clearly defined in guidelines from international organizations, reports of adherence to these guidelines are lacking. We aimed to assess our center's adherence to guidelines and determine whether adequacy of sampling is associated with survival. MATERIALS AND METHODS A single-center retrospective review of consecutive patients undergoing lung resection for primary lung cancer between January 2013 and December 2018 was undertaken. Sampling adequacy was assessed against standards outlined in the International Association for the Study of Lung Cancer 2009 guidelines. Multivariable logistic and Cox proportional hazards regression analyses were used to assess the impact of specific variables on adequacy and of specific variables on overall survival, respectively. RESULTS A total of 2380 patients were included in the study. Overall adequacy was 72.1% (n= 1717). Adherence improved from 44.8% in 2013 to 85.0% in 2018 (P< 0.001). Undergoing a right-sided resection increased the odds of adequate MLNS on multivariable logistic regression (odds ratio 1.666, 95% confidence interval [CI]: 1.385-2.003, P< 0.001). Inadequate MLNS was not significantly associated with reduced overall survival on log rank analysis (P= 0.340) or after adjustment with multivariable Cox proportional hazards (hazard ratio 0.839, 95% CI 0.643-1.093). CONCLUSIONS Adherence to standards improved significantly over time and was significantly higher for right-sided resections. We found no evidence of an association between adequate MLNS and overall survival in this cohort. A pressing need remains for the introduction of national guidelines defining acceptable performance.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK.
| | - Matthew Evison
- Department of Respiratory Medicine, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Bethan Clayton
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Stuart W Grant
- Division of Cardiovascular Sciences, University of Manchester, ERC, Manchester University Hospital Foundation Trust, Manchester, UK
| | - Glen P Martin
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Manchester Academic Heath Science Centre, University of Manchester, Manchester, UK
| | - Rajesh Shah
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Piotr Krysiak
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Kandadai Rammohan
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Eustace Fontaine
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Vijay Joshi
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University Hospital Foundation Trust, Wythenshawe Hospital, Manchester, UK
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14
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Taylor M, Abah U, Hayes T, Eadington T, Smith M, Shackcloth M, Granato F, Shah R, Booton R, Grant SW. Preoperative Anemia is Associated With Worse Long-Term Survival After Lung Cancer Resection: A Multicenter Cohort Study of 5,029 Patients. J Cardiothorac Vasc Anesth 2021; 36:1373-1379. [PMID: 34538557 DOI: 10.1053/j.jvca.2021.08.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 05/31/2021] [Revised: 07/28/2021] [Accepted: 08/18/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Although some evidence to suggest an association between preoperative anemia and reduced overall survival exists, contemporary studies investigating the impact of preoperative anemia on outcomes after resection for primary lung cancer are lacking. DESIGN A multicenter retrospective review. SETTING Two tertiary cardiothoracic surgery centers in the Northwest of England. PARTICIPANTS A total of 5,029 patients between 2012 and 2018. INTERVENTIONS All patients underwent lung resection for primary lung cancer. Patients were classified as anemic based on the World Health Organization definition. Men with hemoglobin <130 g/L and women with hemoglobin <120 g/L were considered to be anemic. MEASUREMENTS AND MAIN RESULTS Outcomes assessed included perioperative mortality, 90-day mortality, and overall survival. Multivariate logistic and Cox regression analyses were used to assess the impact of preoperative anemia on 90-day mortality and overall survival, respectively. Overall, preoperatively, 24.0% (n = 1207) of patients were anemic. The 90-day mortality for anemic and nonanemic patients was 5.6% and 3.1%, respectively (p < 0.001). After multivariate adjustment, preoperative anemia was not associated with increased 90-day mortality. However, a log-rank analysis demonstrated reduced overall survival for anemic patients (p < 0.001). After multivariate adjustment, preoperative anemia was found to be independently associated with reduced overall survival (hazard ratio 1.287, 95% confidence interval 1.141-1.451, p < 0.001). CONCLUSIONS Although anemia was not an independent predictor of short-term outcomes, it was independently associated with significantly reduced survival for patients undergoing resection for lung cancer. Further work is required to understand why anemia reduces long-term survival and whether pathways for anemic patients can be adapted to improve long-term outcomes.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom.
| | - Udo Abah
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Tim Hayes
- Department of Cardiothoracic Anaesthesia, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - Thomas Eadington
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - Matthew Smith
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Michael Shackcloth
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Felice Granato
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - Rajesh Shah
- Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - Richard Booton
- Department of Respiratory Medicine, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - Stuart W Grant
- Division of Cardiovascular Sciences, University of Manchester, ERC, Manchester University Hospital NHS Foundation Trust, Manchester, United Kingdom
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15
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Taylor M, Szafron B, Martin GP, Abah U, Smith M, Shackcloth M, Granato F, Shah R, Grant SW, Eadington T, Argus L, Michael S, Mason S, Bhullar D, Obale E, Fritsch NC, Shah R, Krysiak P, Rammohan K, Fontaine E, Granato F, Page R, Woolley S, Shackcloth M, Assante-Siaw J, Mediratta N. External validation of six existing multivariable clinical prediction models for short-term mortality in patients undergoing lung resection. Eur J Cardiothorac Surg 2020; 59:1030-1036. [DOI: 10.1093/ejcts/ezaa422] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 12/23/2022] Open
Abstract
Abstract
OBJECTIVES
National guidelines advocate the use of clinical prediction models to estimate perioperative mortality for patients undergoing lung resection. Several models have been developed that may potentially be useful but contemporary external validation studies are lacking. The aim of this study was to validate existing models in a multicentre patient cohort.
METHODS
The Thoracoscore, Modified Thoracoscore, Eurolung, Modified Eurolung, European Society Objective Score and Brunelli models were validated using a database of 6600 patients who underwent lung resection between 2012 and 2018. Models were validated for in-hospital or 30-day mortality (depending on intended outcome of each model) and also for 90-day mortality. Model calibration (calibration intercept, calibration slope, observed to expected ratio and calibration plots) and discrimination (area under receiver operating characteristic curve) were assessed as measures of model performance.
RESULTS
Mean age was 66.8 years (±10.9 years) and 49.7% (n = 3281) of patients were male. In-hospital, 30-day, perioperative (in-hospital or 30-day) and 90-day mortality were 1.5% (n = 99), 1.4% (n = 93), 1.8% (n = 121) and 3.1% (n = 204), respectively. Model area under the receiver operating characteristic curves ranged from 0.67 to 0.73. Calibration was inadequate in five models and mortality was significantly overestimated in five models. No model was able to adequately predict 90-day mortality.
CONCLUSIONS
Five of the validated models were poorly calibrated and had inadequate discriminatory ability. The modified Eurolung model demonstrated adequate statistical performance but lacked clinical validity. Development of accurate models that can be used to estimate the contemporary risk of lung resection is required.
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Affiliation(s)
- Marcus Taylor
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, UK
| | - Bartłomiej Szafron
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, UK
| | - Glen P Martin
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Manchester Academic Heath Science Centre, University of Manchester, Manchester, UK
| | - Udo Abah
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Matthew Smith
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Michael Shackcloth
- Department of Cardiothoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, UK
| | - Rajesh Shah
- Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, UK
| | - Stuart W Grant
- Division of Cardiovascular Sciences, University of Manchester, ERC, Manchester University Hospitals Foundation Trust, Manchester, UK
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16
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Argus L, Evison M, Granato F. Exploring variability in %predicted DLCO during pre-operative assessment for lung cancer resection across a cancer alliance. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30099-4] [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: 11/27/2022]
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17
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Granato F, Martelli F, Comini LV, Luparello P, Coscarelli S, Le Seac O, Carucci S, Graziani P, Santoro R, Alderotti G, Barillari MR, Mannelli G. The surgical treatment of unilateral vocal cord paralysis (UVCP): qualitative review analysis and meta-analysis study. Eur Arch Otorhinolaryngol 2019; 276:2649-2659. [PMID: 31375895 DOI: 10.1007/s00405-019-05587-2] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/27/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE The objectives of this meta-analysis were to summarize the key surgical procedures for UVCP and to evaluate which of these is associated with better results in terms of vocal improvement. METHODS A systematic review of the literature was conducted in search of articles focused on the comparison of voice outcome between different techniques for the UVCP treatment. Then, a quantitative analysis was carried out for papers published from 2013 onwards, reporting only adult patients with unilateral paralysis for each study, and each surgical technique was evaluated for its capability of achieving good functional outcomes in terms of GRBAS-I scale and maximum phonation time in seconds (MPT). RESULTS The search identified 1853 publications. A total of 159 articles were stratified and included according to our selection criteria. 21 out of 159 articles were selected for quantitative synthesis. For trans-oral techniques: the mean GRBAS-I scale were 2.33 before injection and 0.41 after injection. The mean MPT before injection were 4.78 and 12.50 after injection. For open techniques the mean GRBAS-I scale were 2.43 before surgery and 0.68 after surgery. For open technique, the mean MPT were 3.50 before surgery and 12.40 after surgery. CONCLUSIONS The two types of techniques lead to an improvement in terms of vocal outcomes emphasizing that from the examined literature an indication emerges to perform an early injection because this could reduce the possible need for a more invasive intervention of permanent medialization in the future.
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Affiliation(s)
- F Granato
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - F Martelli
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - L V Comini
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - P Luparello
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - S Coscarelli
- Phoniatrics Unit, University Hospital Careggi, Florence, Italy
| | - O Le Seac
- Phoniatrics Unit, University Hospital Careggi, Florence, Italy
| | - S Carucci
- Phoniatrics Unit, University Hospital Careggi, Florence, Italy
| | - P Graziani
- Head and Neck and Robotic Surgery, Azienda Ospedaliero Universitaria Careggi, 50141, Florence, Italy
| | - R Santoro
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, CAP 50134, Firenze, Italy
| | - G Alderotti
- Department of Statistics Science, University "La Sapienza" of Rome, Rome, Italy
| | - M R Barillari
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuditta Mannelli
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, CAP 50134, Firenze, Italy.
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18
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Apparau D, Montero-Fernandez A, Granato F. Pulmonary Bronchiectasis Mimicking a Giant Hydatid Cyst. Ann Thorac Surg 2018; 107:e359. [PMID: 30605645 DOI: 10.1016/j.athoracsur.2018.11.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/25/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Denish Apparau
- Department of Thoracic Surgery, Manchester University Foundation Trust, Manchester, United Kingdom.
| | | | - Felice Granato
- Department of Thoracic Surgery, Manchester University Foundation Trust, Manchester, United Kingdom
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19
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Agnes P, Albuquerque IFM, Alexander T, Alton AK, Araujo GR, Asner DM, Ave M, Back HO, Baldin B, Batignani G, Biery K, Bocci V, Bonfini G, Bonivento W, Bottino B, Budano F, Bussino S, Cadeddu M, Cadoni M, Calaprice F, Caminata A, Canci N, Candela A, Caravati M, Cariello M, Carlini M, Carpinelli M, Catalanotti S, Cataudella V, Cavalcante P, Cavuoti S, Cereseto R, Chepurnov A, Cicalò C, Cifarelli L, Cocco AG, Covone G, D'Angelo D, D'Incecco M, D'Urso D, Davini S, De Candia A, De Cecco S, De Deo M, De Filippis G, De Rosa G, De Vincenzi M, Demontis P, Derbin AV, Devoto A, Di Eusanio F, Di Pietro G, Dionisi C, Downing M, Edkins E, Empl A, Fan A, Fiorillo G, Fomenko K, Franco D, Gabriele F, Gabrieli A, Galbiati C, Garcia Abia P, Ghiano C, Giagu S, Giganti C, Giovanetti GK, Gorchakov O, Goretti AM, Granato F, Gromov M, Guan M, Guardincerri Y, Gulino M, Hackett BR, Hassanshahi MH, Herner K, Hosseini B, Hughes D, Humble P, Hungerford EV, Ianni A, Ianni A, Ippolito V, James I, Johnson TN, Kahn Y, Keeter K, Kendziora CL, Kochanek I, Koh G, Korablev D, Korga G, Kubankin A, Kuss M, La Commara M, Lai M, Li X, Lisanti M, Lissia M, Loer B, Longo G, Ma Y, Machado AA, Machulin IN, Mandarano A, Mapelli L, Mari SM, Maricic J, Martoff CJ, Messina A, Meyers PD, Milincic R, Mishra-Sharma S, Monte A, Morrocchi M, Mount BJ, Muratova VN, Musico P, Nania R, Navrer Agasson A, Nozdrina AO, Oleinik A, Orsini M, Ortica F, Pagani L, Pallavicini M, Pandola L, Pantic E, Paoloni E, Pazzona F, Pelczar K, Pelliccia N, Pesudo V, Picciau E, Pocar A, Pordes S, Poudel SS, Pugachev DA, Qian H, Ragusa F, Razeti M, Razeto A, Reinhold B, Renshaw AL, Rescigno M, Riffard Q, Romani A, Rossi B, Rossi N, Sablone D, Samoylov O, Sands W, Sanfilippo S, Sant M, Santorelli R, Savarese C, Scapparone E, Schlitzer B, Segreto E, Semenov DA, Shchagin A, Sheshukov A, Singh PN, Skorokhvatov MD, Smirnov O, Sotnikov A, Stanford C, Stracka S, Suffritti GB, Suvorov Y, Tartaglia R, Testera G, Tonazzo A, Trinchese P, Unzhakov EV, Verducci M, Vishneva A, Vogelaar B, Wada M, Waldrop TJ, Wang H, Wang Y, Watson AW, Westerdale S, Wojcik MM, Wojcik M, Xiang X, Xiao X, Yang C, Ye Z, Zhu C, Zichichi A, Zuzel G. Constraints on Sub-GeV Dark-Matter-Electron Scattering from the DarkSide-50 Experiment. Phys Rev Lett 2018; 121:111303. [PMID: 30265123 DOI: 10.1103/physrevlett.121.111303] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/16/2018] [Indexed: 06/08/2023]
Abstract
We present new constraints on sub-GeV dark-matter particles scattering off electrons based on 6780.0 kg d of data collected with the DarkSide-50 dual-phase argon time projection chamber. This analysis uses electroluminescence signals due to ionized electrons extracted from the liquid argon target. The detector has a very high trigger probability for these signals, allowing for an analysis threshold of three extracted electrons, or approximately 0.05 keVee. We calculate the expected recoil spectra for dark matter-electron scattering in argon and, under the assumption of momentum-independent scattering, improve upon existing limits from XENON10 for dark-matter particles with masses between 30 and 100 MeV/c^{2}.
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Affiliation(s)
- P Agnes
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - I F M Albuquerque
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - T Alexander
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - A K Alton
- Physics Department, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - G R Araujo
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - D M Asner
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Ave
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - H O Back
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Baldin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Batignani
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - K Biery
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Bocci
- INFN Sezione di Roma, Roma 00185, Italy
| | - G Bonfini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - B Bottino
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - F Budano
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - S Bussino
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - M Cadeddu
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - M Cadoni
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - F Calaprice
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - N Canci
- Department of Physics, University of Houston, Houston, Texas 77204, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A Candela
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Caravati
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | | | - M Carlini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Carpinelli
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - S Catalanotti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - V Cataudella
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - P Cavalcante
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | | | - A Chepurnov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - C Cicalò
- INFN Cagliari, Cagliari 09042, Italy
| | - L Cifarelli
- Physics Department, Università degli Studi di Bologna, Bologna 40126, Italy
- INFN Bologna, Bologna 40126, Italy
| | | | - G Covone
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D D'Angelo
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - M D'Incecco
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D D'Urso
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - S Davini
- INFN Genova, Genova 16146, Italy
| | - A De Candia
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - S De Cecco
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - M De Deo
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - G De Filippis
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - G De Rosa
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - M De Vincenzi
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - P Demontis
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Interuniversity Consortium for Science and Technology of Materials, Firenze 50121, Italy
| | - A V Derbin
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Devoto
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - F Di Eusanio
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - G Di Pietro
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- INFN Milano, Milano 20133, Italy
| | - C Dionisi
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - M Downing
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - E Edkins
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawai'i 96822, USA
| | - A Empl
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - A Fan
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - K Fomenko
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - D Franco
- APC, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, USPC, Paris 75205, France
| | - F Gabriele
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A Gabrieli
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - C Galbiati
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - P Garcia Abia
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C Ghiano
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - S Giagu
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - C Giganti
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - G K Giovanetti
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - O Gorchakov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A M Goretti
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - F Granato
- Physics Department, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - M Gromov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - M Guan
- Institute of High Energy Physics, Beijing 100049, China
| | - Y Guardincerri
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Gulino
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Engineering and Architecture Faculty, Università di Enna Kore, Enna 94100, Italy
| | - B R Hackett
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawai'i 96822, USA
| | - M H Hassanshahi
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - K Herner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - D Hughes
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - P Humble
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E V Hungerford
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - Al Ianni
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - An Ianni
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - I James
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - T N Johnson
- Department of Physics, University of California, Davis, California 95616, USA
| | - Y Kahn
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - K Keeter
- School of Natural Sciences, Black Hills State University, Spearfish, South Dakota 57799, USA
| | - C L Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - G Koh
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - D Korablev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - G Korga
- Department of Physics, University of Houston, Houston, Texas 77204, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A Kubankin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - M Kuss
- INFN Pisa, Pisa 56127, Italy
| | - M La Commara
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - M Lai
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lisanti
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - Y Ma
- Institute of High Energy Physics, Beijing 100049, China
| | - A A Machado
- Physics Institute, Universidade Estadual de Campinas, Campinas 13083, Brazil
| | - I N Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Mandarano
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - L Mapelli
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - S M Mari
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - J Maricic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawai'i 96822, USA
| | - C J Martoff
- Physics Department, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - A Messina
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - P D Meyers
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - R Milincic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawai'i 96822, USA
| | - S Mishra-Sharma
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - A Monte
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | | | - B J Mount
- School of Natural Sciences, Black Hills State University, Spearfish, South Dakota 57799, USA
| | - V N Muratova
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - P Musico
- INFN Genova, Genova 16146, Italy
| | - R Nania
- INFN Bologna, Bologna 40126, Italy
| | - A Navrer Agasson
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - A O Nozdrina
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Oleinik
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - M Orsini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - F Ortica
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - L Pagani
- Department of Physics, University of California, Davis, California 95616, USA
| | - M Pallavicini
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - L Pandola
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - E Pantic
- Department of Physics, University of California, Davis, California 95616, USA
| | - E Paoloni
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - F Pazzona
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - K Pelczar
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - N Pelliccia
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - V Pesudo
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - E Picciau
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - A Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - S Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S S Poudel
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - D A Pugachev
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
| | - H Qian
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - F Ragusa
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - M Razeti
- INFN Cagliari, Cagliari 09042, Italy
| | - A Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - B Reinhold
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawai'i 96822, USA
| | - A L Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | | | - Q Riffard
- APC, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, USPC, Paris 75205, France
| | - A Romani
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - B Rossi
- INFN Napoli, Napoli 80126, Italy
| | - N Rossi
- INFN Sezione di Roma, Roma 00185, Italy
| | - D Sablone
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - O Samoylov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - W Sands
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - S Sanfilippo
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - M Sant
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - R Santorelli
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C Savarese
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | | | - B Schlitzer
- Department of Physics, University of California, Davis, California 95616, USA
| | - E Segreto
- Physics Institute, Universidade Estadual de Campinas, Campinas 13083, Brazil
| | - D A Semenov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Shchagin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - A Sheshukov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - P N Singh
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - M D Skorokhvatov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - O Smirnov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A Sotnikov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - C Stanford
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - G B Suffritti
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Interuniversity Consortium for Science and Technology of Materials, Firenze 50121, Italy
| | - Y Suvorov
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
| | - R Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - A Tonazzo
- APC, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, USPC, Paris 75205, France
| | - P Trinchese
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - E V Unzhakov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - M Verducci
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - A Vishneva
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - B Vogelaar
- Virginia Tech, Blacksburg, Virginia 24061, USA
| | - M Wada
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - T J Waldrop
- Physics Department, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - H Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - Y Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - A W Watson
- Physics Department, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - S Westerdale
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M M Wojcik
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
| | - M Wojcik
- Institute of Applied Radiation Chemistry, Lodz University of Technology, 93-590 Lodz, Poland
| | - X Xiang
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - X Xiao
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - C Yang
- Institute of High Energy Physics, Beijing 100049, China
| | - Z Ye
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - C Zhu
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - A Zichichi
- Physics Department, Università degli Studi di Bologna, Bologna 40126, Italy
- INFN Bologna, Bologna 40126, Italy
| | - G Zuzel
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
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20
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Agnes P, Albuquerque IFM, Alexander T, Alton AK, Araujo GR, Asner DM, Ave M, Back HO, Baldin B, Batignani G, Biery K, Bocci V, Bonfini G, Bonivento W, Bottino B, Budano F, Bussino S, Cadeddu M, Cadoni M, Calaprice F, Caminata A, Canci N, Candela A, Caravati M, Cariello M, Carlini M, Carpinelli M, Catalanotti S, Cataudella V, Cavalcante P, Cavuoti S, Cereseto R, Chepurnov A, Cicalò C, Cifarelli L, Cocco AG, Covone G, D'Angelo D, D'Incecco M, D'Urso D, Davini S, De Candia A, De Cecco S, De Deo M, De Filippis G, De Rosa G, De Vincenzi M, Demontis P, Derbin AV, Devoto A, Di Eusanio F, Di Pietro G, Dionisi C, Downing M, Edkins E, Empl A, Fan A, Fiorillo G, Fomenko K, Franco D, Gabriele F, Gabrieli A, Galbiati C, Garcia Abia P, Ghiano C, Giagu S, Giganti C, Giovanetti GK, Gorchakov O, Goretti AM, Granato F, Gromov M, Guan M, Guardincerri Y, Gulino M, Hackett BR, Hassanshahi MH, Herner K, Hosseini B, Hughes D, Humble P, Hungerford EV, Ianni A, Ianni A, Ippolito V, James I, Johnson TN, Kahn Y, Keeter K, Kendziora CL, Kochanek I, Koh G, Korablev D, Korga G, Kubankin A, Kuss M, La Commara M, Lai M, Li X, Lisanti M, Lissia M, Loer B, Longo G, Ma Y, Machado AA, Machulin IN, Mandarano A, Mapelli L, Mari SM, Maricic J, Martoff CJ, Messina A, Meyers PD, Milincic R, Mishra-Sharma S, Monte A, Morrocchi M, Mount BJ, Muratova VN, Musico P, Nania R, Navrer Agasson A, Nozdrina AO, Oleinik A, Orsini M, Ortica F, Pagani L, Pallavicini M, Pandola L, Pantic E, Paoloni E, Pazzona F, Pelczar K, Pelliccia N, Pesudo V, Pocar A, Pordes S, Poudel SS, Pugachev DA, Qian H, Ragusa F, Razeti M, Razeto A, Reinhold B, Renshaw AL, Rescigno M, Riffard Q, Romani A, Rossi B, Rossi N, Sablone D, Samoylov O, Sands W, Sanfilippo S, Sant M, Santorelli R, Savarese C, Scapparone E, Schlitzer B, Segreto E, Semenov DA, Shchagin A, Sheshukov A, Singh PN, Skorokhvatov MD, Smirnov O, Sotnikov A, Stanford C, Stracka S, Suffritti GB, Suvorov Y, Tartaglia R, Testera G, Tonazzo A, Trinchese P, Unzhakov EV, Verducci M, Vishneva A, Vogelaar B, Wada M, Waldrop TJ, Wang H, Wang Y, Watson AW, Westerdale S, Wojcik MM, Wojcik M, Xiang X, Xiao X, Yang C, Ye Z, Zhu C, Zichichi A, Zuzel G. Low-Mass Dark Matter Search with the DarkSide-50 Experiment. Phys Rev Lett 2018; 121:081307. [PMID: 30192596 DOI: 10.1103/physrevlett.121.081307] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Indexed: 06/08/2023]
Abstract
We present the results of a search for dark matter weakly interacting massive particles (WIMPs) in the mass range below 20 GeV/c^{2} using a target of low-radioactivity argon with a 6786.0 kg d exposure. The data were obtained using the DarkSide-50 apparatus at Laboratori Nazionali del Gran Sasso. The analysis is based on the ionization signal, for which the DarkSide-50 time projection chamber is fully efficient at 0.1 keVee. The observed rate in the detector at 0.5 keVee is about 1.5 event/keVee/kg/d and is almost entirely accounted for by known background sources. We obtain a 90% C.L. exclusion limit above 1.8 GeV/c^{2} for the spin-independent cross section of dark matter WIMPs on nucleons, extending the exclusion region for dark matter below previous limits in the range 1.8-6 GeV/c^{2}.
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Affiliation(s)
- P Agnes
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - I F M Albuquerque
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - T Alexander
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - A K Alton
- Physics Department, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - G R Araujo
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - D M Asner
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Ave
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - H O Back
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Baldin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Batignani
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - K Biery
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Bocci
- INFN Sezione di Roma, Roma 00185, Italy
| | - G Bonfini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - B Bottino
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - F Budano
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - S Bussino
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - M Cadeddu
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - M Cadoni
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - F Calaprice
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - N Canci
- Department of Physics, University of Houston, Houston, Texas 77204, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A Candela
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Caravati
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | | | - M Carlini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Carpinelli
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - S Catalanotti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - V Cataudella
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - P Cavalcante
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | | | - A Chepurnov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - C Cicalò
- INFN Cagliari, Cagliari 09042, Italy
| | - L Cifarelli
- Physics Department, Università degli Studi di Bologna, Bologna 40126, Italy
- INFN Bologna, Bologna 40126, Italy
| | | | - G Covone
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D D'Angelo
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - M D'Incecco
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D D'Urso
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - S Davini
- INFN Genova, Genova 16146, Italy
| | - A De Candia
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - S De Cecco
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - M De Deo
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - G De Filippis
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - G De Rosa
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - M De Vincenzi
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - P Demontis
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Interuniversity Consortium for Science and Technology of Materials, Firenze 50121, Italy
| | - A V Derbin
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Devoto
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - F Di Eusanio
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - G Di Pietro
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- INFN Milano, Milano 20133, Italy
| | - C Dionisi
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - M Downing
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - E Edkins
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - A Empl
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - A Fan
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - K Fomenko
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - D Franco
- APC, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, USPC, Paris 75205, France
| | - F Gabriele
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A Gabrieli
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - C Galbiati
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - P Garcia Abia
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - Chiara Ghiano
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - S Giagu
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - C Giganti
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - G K Giovanetti
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - O Gorchakov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A M Goretti
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - F Granato
- Physics Department, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - M Gromov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - M Guan
- Institute of High Energy Physics, Beijing 100049, China
| | - Y Guardincerri
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Gulino
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Engineering and Architecture Faculty, Università di Enna Kore, Enna 94100, Italy
| | - B R Hackett
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - M H Hassanshahi
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - K Herner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - D Hughes
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - P Humble
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E V Hungerford
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - Al Ianni
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - An Ianni
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - I James
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - T N Johnson
- Department of Physics, University of California, Davis, California 95616, USA
| | - Y Kahn
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - K Keeter
- School of Natural Sciences, Black Hills State University, Spearfish, South Dakota 57799, USA
| | - C L Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - G Koh
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - D Korablev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - G Korga
- Department of Physics, University of Houston, Houston, Texas 77204, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A Kubankin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - M Kuss
- INFN Pisa, Pisa 56127, Italy
| | - M La Commara
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - M Lai
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lisanti
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - Y Ma
- Institute of High Energy Physics, Beijing 100049, China
| | - A A Machado
- Physics Institute, Universidade Estadual de Campinas, Campinas 13083, Brazil
| | - I N Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Mandarano
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - L Mapelli
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - S M Mari
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - J Maricic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - C J Martoff
- Physics Department, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - A Messina
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - P D Meyers
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - R Milincic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - S Mishra-Sharma
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - A Monte
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | | | - B J Mount
- School of Natural Sciences, Black Hills State University, Spearfish, South Dakota 57799, USA
| | - V N Muratova
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - P Musico
- INFN Genova, Genova 16146, Italy
| | - R Nania
- INFN Bologna, Bologna 40126, Italy
| | - A Navrer Agasson
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - A O Nozdrina
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Oleinik
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - M Orsini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - F Ortica
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - L Pagani
- Department of Physics, University of California, Davis, California 95616, USA
| | - M Pallavicini
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - L Pandola
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - E Pantic
- Department of Physics, University of California, Davis, California 95616, USA
| | - E Paoloni
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - F Pazzona
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - K Pelczar
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - N Pelliccia
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - V Pesudo
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - A Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - S Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S S Poudel
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - D A Pugachev
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
| | - H Qian
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - F Ragusa
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - M Razeti
- INFN Cagliari, Cagliari 09042, Italy
| | - A Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - B Reinhold
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - A L Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | | | - Q Riffard
- APC, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, USPC, Paris 75205, France
| | - A Romani
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - B Rossi
- INFN Napoli, Napoli 80126, Italy
| | - N Rossi
- INFN Sezione di Roma, Roma 00185, Italy
| | - D Sablone
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - O Samoylov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - W Sands
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - S Sanfilippo
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - M Sant
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - R Santorelli
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C Savarese
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | | | - B Schlitzer
- Department of Physics, University of California, Davis, California 95616, USA
| | - E Segreto
- Physics Institute, Universidade Estadual de Campinas, Campinas 13083, Brazil
| | - D A Semenov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Shchagin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - A Sheshukov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - P N Singh
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - M D Skorokhvatov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - O Smirnov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A Sotnikov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - C Stanford
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - G B Suffritti
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Interuniversity Consortium for Science and Technology of Materials, Firenze 50121, Italy
| | - Y Suvorov
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
| | - R Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - A Tonazzo
- APC, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, USPC, Paris 75205, France
| | - P Trinchese
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - E V Unzhakov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - M Verducci
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - A Vishneva
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - B Vogelaar
- Virginia Tech, Blacksburg, Virginia 24061, USA
| | - M Wada
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - T J Waldrop
- Physics Department, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - H Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - Y Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - A W Watson
- Physics Department, Temple University, Philadelphia, Pennsylvania 19122, USA
| | - S Westerdale
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M M Wojcik
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
| | - M Wojcik
- Institute of Applied Radiation Chemistry, Lodz University of Technology, 93-590 Lodz, Poland
| | - X Xiang
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - X Xiao
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - C Yang
- Institute of High Energy Physics, Beijing 100049, China
| | - Z Ye
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - C Zhu
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - A Zichichi
- Physics Department, Università degli Studi di Bologna, Bologna 40126, Italy
- INFN Bologna, Bologna 40126, Italy
| | - G Zuzel
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
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Proli C, De Sousa P, Jordan S, Anikin V, Devaraj A, Love SM, Shackcloth M, Kostoulas N, Papagiannopoulos K, Haqzad Y, Loubani M, Sellitri F, Granato F, Bush A, Marchbank A, Iyer S, Scarci M, Lim E. A diagnostic cohort study on the accuracy of 18-fluorodeoxyglucose ( 18FDG) positron emission tomography (PET)-CT for evaluation of malignancy in anterior mediastinal lesions: the DECiMaL study. BMJ Open 2018; 8:e019471. [PMID: 29437755 PMCID: PMC5829887 DOI: 10.1136/bmjopen-2017-019471] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The aim of this study is to collate multi-institutional data to determine the value by defining the diagnostic performance of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for malignancy in patients undergoing surgery with an anterior mediastinal mass in order to ascertain the clinical utility of PET/CT to differentiate malignant from benign aetiologies in patients presenting with an anterior mediastinal mass SETTING: DECiMaL Study is a multicentre, retrospective, collaborative cohort study in seven UK surgical sites. PARTICIPANTS Between January 2002 and June 2015, a total of 134 patients were submitted with a mean age (SD) of 55 years (16) of which 69 (51%) were men. We included all patients undergoing surgery who presented with an anterior mediastinal mass and underwent PET/CT. PET/CT was considered positive for any reported avidity as stated in the official report and the reference was the resected specimen reported by histopathology using WHO criteria. PRIMARY AND SECONDARY OUTCOME MEASURES Sensitivity, specificity, positive and negative predicted values of [18F]-FDG PET in determining malignant aetiology for an anterior mediastinal mass. RESULTS The sensitivity and specificity of PET/CT to correctly classify malignant disease were 83% (95% CI 74 to 89) and 58% (95% CI 37 to 78). The positive and negative predictive values were 90% (95% CI 83% to 95%) and 42% (95% CI 26% to 61%). CONCLUSIONS The results of our study suggest reasonable sensitivity but no specificity implying that a negative PET/CT is useful to rule out the diagnosis of malignant disease whereas a positive result has no value in the discrimination between malignant and benign diseases of the anterior mediastinum.
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Affiliation(s)
- Chiara Proli
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Paulo De Sousa
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Simon Jordan
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Vladimir Anikin
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Anand Devaraj
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Susannah M Love
- Department of Thoracic Surgery, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
| | - Michael Shackcloth
- Department of Thoracic Surgery, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
| | - Nikolaos Kostoulas
- Department of Thoracic Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Yama Haqzad
- Department of Thoracic Surgery, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Mahmoud Loubani
- Department of Thoracic Surgery, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Francesco Sellitri
- Department of Cardiothoracic Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Felice Granato
- Department of Cardiothoracic Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Alexander Bush
- Department of Thoracic Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Adrian Marchbank
- Department of Thoracic Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Swetha Iyer
- Thoracic Services, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Marco Scarci
- Thoracic Services, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Eric Lim
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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Abah U, Mahendran H, Scarci M, Rassl D, Bartosik W, Granato F. Video-assisted anatomical resection for pulmonary blastoma. Video-assist Thorac Surg 2017. [DOI: 10.21037/vats.2017.02.06] [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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Solli P, Caruana E, Abah U, Granato F. 78: Complete pathological response after TK-inhibitor therapy in adenocarcinoma of the lung. The role of surgery. Lung Cancer 2015. [DOI: 10.1016/s0169-5002(15)50077-9] [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: 11/28/2022]
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Pattenden HA, Leung M, Beddow E, Dusmet M, Nicholson AG, Shackcloth M, Mohamed S, Darr A, Naidu B, Iyer S, Marchbank A, Greenwood A, West D, Granato F, Kirk A, Ariyaratnam P, Loubani M, Lim E. Test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours. Thorax 2014; 70:379-81. [DOI: 10.1136/thoraxjnl-2014-205899] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Raut S, Granato F, Kelly L, Kirk A, Scarci M. F-093 * THE ROLE OF HAEMATOLOGICAL MARKERS IN PATIENTS UNDERGOING THYMECTOMY: A MULTICENTRE STUDY FROM THE UNITED KINGDOM. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.93] [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: 11/12/2022] Open
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Granato F, Blackhall V, Alessandra R, Spina D, Luca V, Piero P, Mohiyaddin S, Asif M, Kirk AJB, Giuseppe G. Outcome in excised thymomas: role of prognostic factors and impact of additional malignancies on survival. Scott Med J 2014; 59:22-9. [DOI: 10.1177/0036933013518147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background and aims: Although the management of thymomas has been extensively evaluated, the value of prognostic factors in the outcome of these patients remains unclear. Methods and results: The medical records of all patients who underwent resection of thymoma between January 1985 and September 2010 at a single thoracic unit were reviewed. Patients were followed up with reference to disease recurrence and development of additional malignancies (AM). Total thymectomy was performed in all 68 cases. Mean follow-up time was four years. Mean survival was 63.9 months. Mean disease-free interval was 13 months. Factors affecting prognosis were Masaoka staging and WHO histological sub-type. Patients with thymomas had a higher risk of developing AM when compared with a control population of individuals with other tumours ( p = 0.0002). Among thymomas, the cortical subtype was associated with a higher risk of AM ( p = 0.047) and mortality ( p = 0.001). Conclusions: This data confirms that Masaoka staging and WHO histologic sub-type are the most important prognostic factors in patients with thymoma. Moreover, thymomas predominantly arising from the thymic cortex are associated with a higher risk of developing other malignancies and with poorer survival. The cortical origin of thymoma could therefore be considered as a significant prognostic factor.
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Affiliation(s)
- F Granato
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
- Professor of Genetics, Doctorate School of Oncology and Genetic, University Hospital of Siena, Italy
| | - V Blackhall
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - R Alessandra
- Professor of Genetics, Doctorate School of Oncology and Genetic, University Hospital of Siena, Italy
| | - D Spina
- Consultant Pathologist, Department of Pathology, University Hospital of Siena, Italy
| | - V Luca
- Professor of Thoracic Surgery, Department of Thoracic Surgery, University Hospital of Siena, Italy
| | - P Piero
- Professor of Thoracic Surgery, Department of Thoracic Surgery, University Hospital of Siena, Italy
| | - S Mohiyaddin
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - M Asif
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - A JB Kirk
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - Gotti Giuseppe
- Professor of Thoracic Surgery, Department of Thoracic Surgery, University Hospital of Siena, Italy
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Pattenden H, Beddow E, Dusmet M, Nicholson AG, Swetha I, Marchbank A, Greenwood A, West D, Ariyaratnam P, Loubani M, Granato F, Kirk A, Lim EKS. Test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumors. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.7544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7544 Background: PET-CT is a standard investigation to stage the mediastinum in non-small cell lung cancer when radical management is planned. The clinical utility of PET-CT in carcinoid tumours is uncertain as its test performance at identifying mediastinal lymph node disease in these tumours is as yet undefined with such tumours being rare and FDG avidity often variable or low. We sought to determine the test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours. Methods: We collated retrospective data from 5 institutions for a consecutive series of patients who underwent thoracic surgery for carcinoid tumours and had preoperative PET-CT staging prior to surgery (with lymph nodal dissection). PET-CT results were compared against the reference standard of pathologic results obtained from lymph node dissection, and test performance reported using sensitivity and specificity. Results: From November 1999 to May 2012, a total of 153 patients with a preoperative PET-CT scan from 5 institutions underwent surgery for a carcinoid tumour. The mean age of the patients was 60 (SD 16) and 67 were male (44%). The pathologic sub-type was typical carcinoid in 138 patients (90%) and atypical carcinoid in 15 patients (10%). The mean SUV uptake in the primary tumour was 4.9 (SD 5). Results from lymph node dissection were obtained in 125 patients and the sensitivity and specificity of PET-CT to identify mediastinal lymph node disease was 40% (95% CI 5-85%) and 93% (93-99%) respectively. Conclusions: In this largest cohort study to date, our results suggest that PET-CT has a poor sensitivity but good specificity for mediastinal lymph node metastases for pulmonary carcinoid tumours. Therefore lymph node metastases cannot accurately be ruled out in carcinoid tumours with a negative PET-CT. If treatment decisions are based on the N2 status, invasive mediastinal staging should be undertaken in carcinoid tumours.
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Affiliation(s)
| | - Emma Beddow
- Royal Brompton & Harefield Trust, London, United Kingdom
| | - Michael Dusmet
- Royal Brompton & Harefield Trust, London, United Kingdom
| | | | - Iyer Swetha
- Derriford Hospital, Plymouth, United Kingdom
| | | | | | - Douglas West
- Bristol Royal Infirmary, Bristol, United Kingdom
| | | | | | - Felice Granato
- Golden Jubilee National Hospital, Clydebank, United Kingdom
| | - Alan Kirk
- Golden Jubilee National Hospital, Clydebank, United Kingdom
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Blackhall V, Asif M, Renieri A, Civitelli S, Kirk A, Jilaihawi A, Granato F. The role of surgical lung biopsy in the management of interstitial lung disease: experience from a single institution in the UK. Interact Cardiovasc Thorac Surg 2013; 17:253-7. [PMID: 23674563 DOI: 10.1093/icvts/ivt217] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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: 11/14/2022] Open
Abstract
OBJECTIVES Interstitial lung disease (ILD) includes a wide spectrum of pulmonary pathologies. The role of surgical lung biopsy (SLB) in the diagnosis of ILD is still controversial. The purpose of this study was to ascertain whether SLB is worthwhile in the management of ILD. METHODS One hundred and three patients underwent SLB for ILD from April 2008 to March 2010 at a single institution. Outcomes included patient demographics, preoperative investigations, preoperative diagnosis and treatment, surgical approach, number and site of biopsies, complications, length of postoperative stay and postoperative pathological diagnosis and treatment. RESULTS Fifty-one (49.6%) patients were male and 52 (50.4%) were female. The median age was 58 (range 26-78). Major complications were seen in 7 patients (6.8%). Five patients (4.9%) died within 30 days following surgery. Definitive pathological diagnosis (DPD) was reached in 72 (69.9%) patients, whereas no DPD was achieved in 31 (30.1%). Within the group of patients who received DPD, this differed from the clinical diagnosis in 53 patients (51.5%), and was concordant in 19 (18.4%). The DPD was helpful in guiding the management of 47 patients (45.6%), who had a change in their treatment following the procedure. The median hospital stay was 4 days (range 2-42 days). CONCLUSIONS SLB is a well-recognized procedure. Although it provides a diagnosis for the majority of patients, in our series SLB was inconclusive in a considerable number of cases and did not lead to a therapeutic change for more than half of all patients. Furthermore, SLB is not without risk and can be associated with a prolonged hospital stay. We believe that SLB should be performed in a select group of patients with ILD after discussion by a multidisciplinary panel.
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Affiliation(s)
- Vivienne Blackhall
- Department of Thoracic Surgery, Golden Jubilee National Hospital, Glasgow, UK
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Morcos K, Granato F, Kerr L, Aftab S, Kirk A. 199 Early experience of a digital chest drainage system in the management of patients with malignant pleural effusion. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70199-5] [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: 10/26/2022]
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Granato F, Ambrosio MR, Spina D, Lazzi S, Rocca BJ, Voltolini L, Bongiolatti S, Luzzi L, Gotti G, Leoncini L, Tosi P. Patients with thymomas have an increased risk of developing additional malignancies: lack of immunological surveillance? Histopathology 2012; 60:437-42. [PMID: 22276606 DOI: 10.1111/j.1365-2559.2011.04111.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIMS To assess the risk, for patients with thymoma, of developing an additional malignancy (AM). METHODS AND RESULTS We studied 68 patients with thymomas. Based on the World Health Organization classification, the tumours were categorised as A, AB or B (B1, B2, B3) thymomas. Control populations comprised 114 patients with colorectal cancer, 108 patients with lymphoma and 123 patients with thyroid carcinoma. Patients with thymomas showed a higher risk of developing an AM (22 of 68 patients versus 11 of 114, eight of 108, and eight of 123 patients, respectively; P = 0.0002). The association between thymomas and AMs was related to the thymoma histotype, with B1, B2, B3 and AB tumours showing a higher risk of developing an AM than A thymomas (P = 0.0474). CONCLUSIONS Patients affected by thymomas showed a significantly higher risk of developing additional malignancies than those in the control groups, and cases that exhibited a predominantly cortical component were more likely to develop other neoplasms. This may be related to the functions of cortical thymic epithelial cells in providing for T lymphocyte maturation through interaction with major histocompatibility complexes.
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Affiliation(s)
- Felice Granato
- Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Surgery, Siena University Hospital, Siena, Italy
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Granato F, Knight K, Blackhall V, Will M, Cetta F, Jilaihawi A, Asif M, Kirk A. 128 Outcome in excised thymomas: role of prognostic factors and impact of additional malignancies on survival. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70129-0] [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: 11/16/2022]
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Knight K, Will M, Granato F, Blackhall V, Quinn M, Jilaihawi A, Kirk A, Asif M. 189 Intra-operative lymph node assessment in lung cancer resection. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70190-3] [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: 11/29/2022]
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Granato F, Kirk A, Spina D, Bellan C, Cetta F, Bongiolatti S, Gotti G. 124 Predictive prognostic factors of surgically treated intra-pulmonary metastases from colorectal carcinomas: a 30 years retrospective analysis. Lung Cancer 2011. [DOI: 10.1016/s0169-5002(11)70124-6] [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: 11/29/2022]
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Granato F, Luzzi L, Voltolini L, Gotti G. Video-assisted mediastinoscopic resection of two bronchogenic cysts: a novel approach. Interact Cardiovasc Thorac Surg 2010; 11:335-6. [DOI: 10.1510/icvts.2010.235242] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Tenconi S, Luzzi L, Paladini P, Voltolini L, Gallazzi MS, Granato F, Gotti G. Pleural granuloma mimicking malignancy 42 years after slurry talc injection for primary spontaneous pneumothorax. Eur Surg Res 2010; 44:201-3. [PMID: 20523052 DOI: 10.1159/000313503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Accepted: 04/13/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Talc poudrage is considered a safe pleurodesis technique to improve the results of video-assisted thoracoscopic surgery in cases of primary spontaneous pneumothorax (PSP). METHODS We report the case of a patient with left pleural pseudo-nodular plaque and a high metabolic rate upon PET scan suspected for malignancy, occurring 42 years after slurry talc injection for conservative treatment of PSP. The patient presented with coughing, chest pain and weight loss. Thoracotomy was required to obtain a diagnosis and perform a complete pleurectomy. RESULTS Histology was conclusive for pleural talc granuloma. CONCLUSIONS Indications and possible complications of talc use in young patients with PSP, and the management of possible consequent pleural lesions suspected for malignancy, need to be investigated.
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Affiliation(s)
- S Tenconi
- Thoracic Surgery Unit, University Hospital of Siena, Siena, Italy. tenconi.sara @ gmail.com
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Guarnieri G, Lavanga A, Granato F, Vassallo P, Cavaliere C, Capobianco E, Izzo R, Ambrosanio G, Muto M. Endovascular treatment of a fusiform cerebral aneurysm by stenting alone. Two case reports and literature review. Neuroradiol J 2010; 23:368-75. [PMID: 24148601 DOI: 10.1177/197140091002300320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 04/04/2010] [Indexed: 11/16/2022] Open
Abstract
This paper illustrates two cases of stent-in-stenting treatment of unruptured, symptomatic, fusiform intracerebral aneurysms. Two unruptured symptomatic fusiform intracerebral aneurysms were treated by the stent-in-stent only technique. The first patient, a 35-year-old woman, had a partially thrombosed fusiform aneurysm in the left carotid siphon with the chief complaint of headache and left ophthalmoplegia. The second patient, a 60-year-old man, had a symptomatic fusiform aneurysm of the left V4 with recurrent transient ischemic attacks. No cervical trauma or infection was present in either patient. A CT, CTA and DSA were performed on hospital admission. Both patients were previously premedicated with Clopidrogel + ASA for five days before treatment. By DSA, both patients were treated under general anesthesia with a heparin protocol plus ASA (500mg) at stent placement. A double stent-in stent was placed in both patients. Post-intervention medical therapy was clopridogel and ASA for three months, then aspirin (100mg) daily for six months. CTA and DSA were performed at six and 12 months. Both stents were positioned without any difficulty and could be navigated within cerebral arteries without any exchange procedure, and thanks to their retractability, they were accurately positioned. No bleeding at post-treatment CT was noted. At 12 months follow-up, a complete disappearance of the aneurysm and preservation of the parent vessel was observed for both patients. No procedure-related complication occurred. No intra-stent stenosis or intimal hyperplasia was observed. Stenting for fusiform aneurysms is a safe procedure without complications. Medical therapy pre-post procedure associated with follow-up is necessary to prevent/establish the incidence of occlusion.
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Affiliation(s)
- G Guarnieri
- Neuroradiology Service, Cardarelli Hospital; Naples, Italy -
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Ambrosanio G, Vassallo P, Guarnieri G, Granato F, Muto M. Combined treatment with stenting and coiling for complex cerebral aneurysms: preliminary experience of twenty aneurysms treated by new generation intracranial stents. Neuroradiol J 2010; 23:213-9. [PMID: 24148541 DOI: 10.1177/197140091002300211] [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] [Received: 12/30/2009] [Accepted: 02/05/2010] [Indexed: 11/17/2022] Open
Abstract
We describe our preliminary experience of a combined treatment with stenting and coiling for ruptured and unruptured complex cerebral aneurysms (AA) using new generation stents (Enterprise(®), LeoPlus(®), Solitaire(®)). Eighteen patients, 20 AA, were treated by stenting and coiling. Some had sacciform wide-necked partially thrombosed aneurysms, other had fusiform AA. Six ruptured AA were treated early, while the other 14 were treated electively. In four out of 20 AA coiling was performed by Jailing technique and in three cases a remodelling technique was also performed. Patients with ruptured AA were previously administered a heparin protocol during the procedure and given aspirin (500 mg) after stenting. Patients with unruptured AA were administered plavix and aspirin for seven days before the procedure. Post-intervention medical therapy was plavix and aspirin for six months, then aspirin (100 mg). MRA and DSA at were performed after six to 12 months. Treatment was successfully performed in all cases. The stent could be navigated within the cerebral arteries without any exchange procedure, and thanks to its retractability, it was positioned accurately. No procedure-related complication occurred. Complete occlusion of the aneurysm was observed in 14/20 AA, partial occlusion with residual sac in 2/20. At four months a residual neck was observed in 4/20 with an increase in residual sac at one year in one case treated by coiling. At one year, MRA showed a reduction of the neck in one case and a stable residual neck in the other. Stenting and coiling for sacciform wide-necked or fusiform aneurysms is a safe procedure without complications. Medical-therapy pre and post procedure associated with follow-up are necessary to establish the occlusion rate.
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Affiliation(s)
- G Ambrosanio
- Neuroradiology Service, The Cardarelli Hospital; Naples, Italy -
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Guarnieri G, Ambrosanio G, Vassallo P, Granato F, Setola FR, Greco B, Izzo R, Muto M. Combined Percutaneous and Endovascular Treatment of Symptomatic Aneurysmal Bone Cyst of the Spine: Clinical Six Months. Follow-up of Six Cases. Neuroradiol J 2010; 23:74-84. [PMID: 24148337 DOI: 10.1177/197140091002300113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 12/22/2009] [Indexed: 11/16/2022] Open
Abstract
We describe the usefulness of endovascular and direct percutaneous treatment as a therapy option for aneurysmal bone cysts (ABCs) of the spine. From January 2007 to December 2008, we treated six consecutive patients with symptomatic ABCs resistant to continuous medical management or with acute clinical onset of paraparesis at cervical, thoracic and lumbar spine level. Two patients were treated after emergency laminectomy. All patients were studied with an MRI protocol and multidetector CT with MPR reconstructions followed by angiographic control before treatment. The procedure was performed under general anaesthesia for all patients. Under CT or fluoroscopy guidance, percutaneous treatment was performed either by direct injection of Glubran(®) diluted at 30% with Lipiodol(®) only, or combined with endovascular treatment by Onyx® injection. Clinical and X-ray follow-up was performed at three and six months. Combined endovascular and percutaneous treatment for ABCs was successful and led to an excellent outcome in five out of six patients with clinical improvement. There were no periprocedural or subsequent clinical complications and the glue resulted in successful selective permanent occlusion with intralesional penetration. Direct sclerotherapy resulted in immediate thrombosis of the malformation with no progression of symptoms. Complete healing was observed in five out of six aggressive lesions. No major complications were noted. At six month follow-up the symptoms had completely resolved and X-ray control showed a partial or total sclerotic reaction of the lesion with stable clinical results (no partial or clinical abnormalities). One patient had a recurrence of the ABC with spinal cord cervical clinical symptomatology. Combined endovascular and percutaneous treatment or direct percutaneous sclerotherapy with glue alone are important, safe, effective therapy options for symptomatic aneurysmal bone cyst. Results are stable and confirmed by clinical and X-ray follow-up six months after treatment.
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Affiliation(s)
- G Guarnieri
- Neuroradiology Service, A. Cardarelli Hospital; Naples, Italy -
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Abstract
A few cases of major complications after surgery for bronchogenic cyst have been reported. The purpose of this study was to analyze the complicated and unusual cases among 30 consecutive patients with bronchogenic cysts treated surgically at our institution between 1975 and 2007. There were 3 cases of mediastinal bronchogenic cyst characterized by significant surgical complications or very unusual pathological findings. The operations were performed through a thoracotomy in 25 patients, and by video-assisted thoracoscopic surgery in 5. Two patients suffered iatrogenic injury of the contralateral main bronchus during excision of a mediastinal cyst; in one of them, late development of foreign body granuloma was related to migration towards the bronchial wall of cyanoacrylate used to reinforce suturing of the bronchial tear. Histological examination of one resected specimen showed a large-cell anaplastic carcinoma arising from the wall of a mediastinal bronchogenic cyst. Bronchogenic cysts should be excised before they become symptomatic or infected, which leads to more difficult surgery and complications. The small risk of developing malignancy within a bronchogenic cyst also justifies early intervention.
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Affiliation(s)
- Felice Granato
- Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Surgery, Siena University Hospital, Siena, Italy.
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Granato F, Voltolini L, Spina D, Paladini P, Gallazzi M, Gotti G. VATS for congenital lobar emphysema: a case report. MINERVA CHIR 2009; 64:111-115. [PMID: 19202540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED Congenital lobar emphysema (CLE) is a rare congenital lung disease consisting in overinflation of a pulmonary lobe. Adult onset of CLE is therefore unusual, often presented with mild symptoms. The authors report a very uncommon case of congenital segmental emphysema diagnosed in a 21-year-old non-smoking man because of recurrent right pneumothorax. Indication to pulmonary resection was established according to functional limitation, radiological findings of right upper lobe segmental emphysema with corresponding bronchial agenesia, scintigraphic result of extremely reduced ventilation and perfusion of lung emphysematous area and recurrency of pneumothorax. The intervention was carried out by 3-portal video-assisted thoracic surgery (VATS) using single-lung ventilation leading to determine precisely how much lung to resect thanks to the obvious and clear-cut distinction between functioning and non functioning parenchyma of the upper lobe. A stapler wedge resection by VATS was thus obtained, that, as far as the author's knowledge, it is the first case of endoscopic parenchymal sparing resection in CLE. Even though congenital lobar emphysema is rare, clinical awareness of this condition is important for early diagnosis and effective surgical treatment that in this case led to favourable RESULTS The VATS procedure seems to be an advantageous approach.
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Affiliation(s)
- F Granato
- Thoracic Surgery Unit, Department of Cardio-Thoracic and Vascular Surgery, University Hospital of Siena, Siena, Italy.
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Docimo L, Manzi F, Sparavigna L, De Rosa M, Granato F, Amoroso V, Docimo G, Ferraraccio F. Dynamic suture less repair of incisional hernia. Acta Biomed 2003; 74 Suppl 2:38-40. [PMID: 15055032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY An incisional hernia is represented by the escape of organs from their physiologic position through an area of weakness on the surgical scar. An original technique, based on a Rives intervention, which is the golden standard in the treatment of incisional hernias, is presented in this study. METHODS From January 1995 to December 2003, 93 patients underwent surgery for incisional hernia in our Division. The intervention was performed in 52 cases (Group A) with a classic Rives technique, with apposition of a prolene mesh in the subaponeurotic space, and fixation of the mesh with transcutaneous stitches. In 41 cases (Group B) the intervention was performed with a personal technique, with apposition of an "Hertra 0", a rigid and memory controlled mesh between the rectum abdomini muscle and its posterior fascia, tension free without fixation with stitches. RESULTS The mean follow-up was of 23 months. In Group A we observed immediately 3 postoperative cases (5%) of intraparietal haematoma, 2 (4%) of subcutaneous haematoma, 4 (7%) of retrofascial haematoma, 4 (7%) of wound infection (in 1 it was necessary to remove the prosthesis), 3 (6%) of respiratory complications, and 1 case (2%) of cardiovascular complication. In Group B we observed only 3 cases (7%) of subcutaneous seroma. The mean postoperative stay was 6 days in both groups. There was no postoperative mortality or relapses. CONCLUSIONS The presented technique seems to offer advantages in the management of incisional hernia; the use of "Hertra 0" mesh simplifies Rives technique, improving its resistance to infections.
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Affiliation(s)
- Ludovico Docimo
- Facoltà di Medicina e Chirurgia, Insegnamento di Clinica Chirurgica, 11 Divisione di Chirurgia Generale e dell'Obesità, Seconda Università degli Studi di Napoli, Napoli.
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