Maria Giovanna Mastromarino

Azienda Ospedaliera Universitaria Pisana

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Marco Lucchi

University of Pisa

Vittorio Aprile

Azienda Ospedaliera Universitaria Pisana

Marcello Carlo Ambrogi

University of Pisa

Diana Bacchin

Azienda Ospedaliera Universitaria Pisana

Stylianos Korasidis

Azienda Ospedaliera Universitaria Pisana

Stefano Margaritora

Istituti di Ricovero e Cura a Carattere Scientifico

Maria Letizia Vita

Istituti di Ricovero e Cura a Carattere Scientifico

Greta Alì

University of Pisa

Elisa Meacci

Agostino Gemelli University Polyclinic

Marco Chiappetta

Istituti di Ricovero e Cura a Carattere Scientifico

Cooperative Institutions

Istituti di Ricovero e Cura a Carattere Scientifico

Università Cattolica del Sacro Cuore

University of Padua

University of Pisa

Agostino Gemelli University Polyclinic

Azienda Ospedaliera Universitaria Pisana

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Thoracic Surgery Foundation

University of Milan

Azienda Ospedaliera San Camillo-Forlanini

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THE OUTCOMES OF SALVAGE SURGERY FOR NON-SMALL CELL LUNG CANCER AFTER IMMUNE CHECKPOINT INHIBITOR OR TARGETED THERAPY TREATMENT. A MULTI-CENTER INTERNATIONAL REAL-LIFE STUDY.

European Journal of Surgical Oncology (2025)

Francesco Guerrera Filippo Lococo Ludovic Fournel Domenico Viggiano Giuseppe Mangiameli

Salvage therapy

Immune checkpoint

10.1016/j.ejso.2025.109592

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A narrative review on lymphadenectomy: from open to minimally invasive surgery

Video-Assisted Thoracic Surgery (2021)

Vittorio Aprile Ilaria Ceccarelli Stylianos Korasidis Maria Giovanna Mastromarino Diana Bacchin

Objective: One of the most debated topics is minimally invasive lymphadenectomy’s safety and quality, in terms of number of lymph-nodes (LNs) dissected, number of mediastinal stations explored and nodal migration rate. With this narrative review, we retraced the history of lymphadenectomy for lung cancer by comparing the main features of open and minimally invasive techniques [video-assisted thoracic surgery (VATS) and robotic surgery].

Lymphadenectomy

Open surgery

Invasive surgery

Narrative review

Cardiothoracic surgery

10.21037/vats-21-33

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Intraoperative prevention and conservative management of postoperative prolonged air leak after lung resection: a systematic review

Journal of Thoracic Disease (2023)

Vittorio Aprile Diana Bacchin F Calabrò Stylianos Korasidis Maria Giovanna Mastromarino

Prolonged air leak (PAL) due to an alveolar-pleural fistula (APF) is the most common complication after lung surgery. PAL is associated with an increased risk of morbidity and mortality, a longer chest tube duration, hence a prolonged hospitalization. Management of PAL may be challenging, and the thoracic surgeon should be aware of the possible therapeutic strategies.A systematic literature review was performed in PubMed, Cochrane Library, EMBASE, Ovid and Google Scholar. Title, abstract and full-text screening was performed, followed by structured data extraction, methodological quality assessment and Cochrane risk of bias assessment. Inclusion criteria were: case-control studies/randomized controlled trials (RCTs) comparing the new tested method with the standard of care to manage PAL after lung surgery; PAL due to APF; at least 10 patients; English-written papers.A total of 942 initial papers from literature search, resulted in 43 papers after the selection. This systematic review found that the use of intraoperative measures as surgical sealants or pleural tenting, as well as a proper management of the chest drain and the use of blood patch or sclerosant agents seem to reduce postoperative air leaks incidence and/or duration and length of chest drain stay and hospitalization.Different measures have been described in literature to manage or prevent postoperative PAL. Most of them seem to be safe and efficient if compared to the "wait and see" strategy, even if large comparative studies that standardize the intra- and post-operative management of APF after lung resection are lacking and, actually, hard to conceptualize. However, there is a large consensus on the value of a preoperative PAL-risk stratification and on the necessity of tailoring PAL management or prevention's strategy and its timing on each patient's features.

Conservative Management

10.21037/jtd-22-736

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Tracheal surgery: still a challenge or a reality for thoracic surgeons?—A 30 months single-centre experience

Current Challenges in Thoracic Surgery (2020)

Massimo Osvaldo Jaus Maria Giovanna Mastromarino Giuseppe Cardillo

Background: Tracheal surgery is still a challenge for thoracic surgeons, owing to the anatomical features, the relative rarity and the technical troubles of surgery of this airway tract.We report our experience over the past 30 months.Methods: From February 2017 to August 2019, the prospectively collected clinical data of 22 patients who underwent surgery for idiopathic laryngotracheal stenosis (ILTS), post-intubation laryngotracheal and tracheal stenosis, tracheal cancers, tracheoesophageal fistulas (TEF) and post-traumatic tracheal lacerations were reviewed and outcomes evaluated. Results:The mean age of the population was 54 (range, 21-83) years.Fourteen (63.6%) patients were male.Thirteen (59.1%) patients presented a laryngotracheal involvement, while 9 (40.9%)patients had a tracheal disease localization.Surgical procedures were: 10 (45.5%)Pearson modified subglottic laryngotracheal resection and reconstruction (LTRR) according to Liberman-Mathisen, 3 (13.6%)tracheal resection with primary anastomosis, 3 (13.6%)single-stage tracheal resection and reconstruction (TRR) with direct esophageal closure, 3 (13.6%)direct suture of tracheal defect according to Angelillo-Mackinlay, 2 (9.1%)Grillo laryngotracheal resection with Liberman-Mathisen plasty and 1 (4.5%) thyroidectomy combined to Pearson modified subglottic laryngotracheal reconstruction according to Liberman-Mathisen for laryngeal infiltration from thyroid cancer.The mean length of the resected trachea was 32.17±6.15mm.Six (27.3%) patients developed postoperative complications.Perioperative mortality was 4.5% (1 patient).No patient had tumour recurrence or recurrent stenosis.The mean follow-up time was 19.68±10.17months.One-and 2-year overall survival (OS) was 95% and 80%, respectively.Post-operative complications and OS were not significantly correlated to site of disease, length of tracheal resection or type of surgery.Conclusions: Tracheal surgery appears feasible, safe and effective, even in the most challenging subset of laryngotracheal resections, allowing excellent long-term outcomes.However, it should be performed in specialized, high-volume centres, by experienced surgeons, and a careful preoperative patient assessment is mandatory.

Cardiothoracic surgery

10.21037/ccts.2020.01.04

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Cold coagulation in thoracoscopic treatment of primary pneumothorax: a comparison with apicectomy

Interdisciplinary CardioVascular and Thoracic Surgery (2023)

Vittorio Aprile Diana Bacchin Elena Marrama Stylianos Korasidis Maria Giovanna Mastromarino

Abstract OBJECTIVES Primary spontaneous pneumothorax is a common disease, whose surgical treatment is still enigmatic in terms of timing and technique. Herein, we reported our experience with the parenchymal-sparing technique via cold coagulation (CC), in comparison to stapler apicectomy (SA). METHODS We retrospectively collected data of all patients with apical blebs or <2 cm bullae treated with minimally invasive surgery for recurrent or persistent spontaneous pneumothorax, from 2010 to 2020. Two different surgical techniques were used: SA and the parenchymal-sparing CC of the apex. Perioperative and long-term results were analysed and compared. RESULTS Out of 177 patients enrolled, 77 patients (CC group) underwent cold-coagulation of the apex while 100 patients (SA group) were treated with SA. Two groups were comparable in terms of age, surgical indication, intraoperative findings and affected side. CC group had a mean operative time of 43.2 min (standard deviation ± 19.5), shorter than SA group with 49.3 min (standard deviation ± 20.1, P-value: 0.050). Complication rate was significantly different between 2 groups, 5 (7%) and 16 (16%), for the CC and SA groups, respectively (P: 0.048), even if not in terms of prolonged postoperative air leak (P: 0.16). During the follow-up, 13 homolateral recurrences were reported: 2 (3%) in group CC and 11 (11%) in group SA; with a significant difference (P: 0.044). All reinterventions (postoperative prolonged air leak and recurrences) required an SA. CONCLUSIONS Parenchymal-sparing technique through CC of apical blebs and bullae is an effective treatment for primary spontaneous pneumothorax and guarantees a good immediate lung sealing, despite stapling still represents the choice treatment in complex cases.

10.1093/icvts/ivad036

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ERS Congress 2024: highlights from the Thoracic Surgery and Lung Transplantation Assembly

ERJ Open Research (2025)

Dorina Esendağlı Maria Giovanna Mastromarino Álvaro Zúñiga Marcello Migliore Federica Meloni

Assembly 8, which includes groups 8.01 Thoracic surgery and 8.02 Lung transplantation, arranged many interesting sessions for #ERSCongress 2024, and we highlight some of them in this article https://bit.ly/3AgC5Yv.

Cardiothoracic surgery

10.1183/23120541.01046-2024

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Successful Three-Stage Ethanol Ablation of Esophageal Mucocele

Journal of Vascular and Interventional Radiology (2015)

Dania Nachira Marco Chiappetta Maria Teresa Congedo Leonardo Petracca-Ciavarella Maria Giovanna Mastromarino

Mucocele

10.1016/j.jvir.2015.08.010

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Citations (4)

Multimodality treatment of oligometastatic non-small cell lung cancer: review of literature

Shanghai Chest (2017)

Antonio Mazzella Maria Giovanna Mastromarino Xiaomiao Zhang Antonio Bobbio Marco Alifano

Oligometastasis represents a sub-group of systemic cancer diseases characterized by a limited (1 to 5) number of metastatic or recurrent lesions; when the disease presents in this particular state of progression the possibility to associate a local therapy to systemic treatment can lead to a favourable evolution with long-term survival and even cure. We have reviewed the literature in order to clarify the different trends of treatment in oligometastatic non-small cell lung cancer (NSCLC), particularly referring to single brain or isolated adrenal gland metastasis. The cornerstone of treatment of oligometastatic disease is still represented by systemic therapy (chemotherapy and/or immunotherapy). Local aggressive therapy (surgery and/or radiotherapy) is mandatory to eradicate all known sites of disease (primary tumor and metastases). If technically possible and in fitting patients, surgical resection represents the gold standard in the “local” treatment of isolated metastasis. Radiotherapy is considered as a noninvasive alternative to the reference of surgery in not-fitting patients. Five-year survival ranges between 10% and 30% for brain metastases and between 11% and 34% in isolated adrenal gland metastases. Mediastinal node involvement of primary lung cancer, number of metastases and number of metastatic sites are the prominent predictors of survival in brain oligometastatic disease. Synchronous or metachronous character, side of adrenal metastasis with respect to primary lung cancer and N0/N1 versus N2 lung cancer stage are the principal prognostic factors in adrenal oligometastatic disease. Oligometastatic disease seems to be a less aggressive and slowly-growing cancer, characterized by a different biological and immunological environment, with a more indolent evolution; in this subgroup of patients, if primary tumour is controlled, in the absence of disseminated metastatic disease and in fitting population, an aggressive local approach seems to be not only efficacy, but even mandatory. However it has to be integrated in the setting of a multidisciplinary approach including surgery, chemotherapy, radiotherapy, and targeted therapies.

Multimodality

10.21037/shc.2017.12.06

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Analysis of pneumothorax recurrence risk factors in 843 patients underwent video-assisted thoracoscopic surgery (VATS) treatment for primary spontaneous pneumothorax: results of a multicenter study

Maria Cattoni Nicola Rotolo Maria Giovanna Mastromarino Giuseppe Cardillo Mario Nosotti

Video-assisted thoracoscopic surgery

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The Overweight Paradox: Impact of Body Mass Index on Patients Undergoing VATS Lobectomy or Segmentectomy

Seminars in Thoracic and Cardiovascular Surgery (2022)

Sara Parini Danila Azzolina Fabio Massera Maria Giovanna Mastromarino Esther Papalia

Underweight

10.1053/j.semtcvs.2022.02.004

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Citations (7)