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Andrea Zuin

Publications and source records attributed to Andrea Zuin.

7 recordsLinked to original sources
PubMed2006

Outcome and surgical strategy in bronchial carcinoid tumors: single institution experience with 252 patients.

OBJECTIVE: To evaluate type of surgery, long-term survival and factors influencing outcome in pulmonary carcinoid tumors. PATIENTS AND METHODS: We reviewed data of 252 patients who underwent surgery for carcinoid tumor in 1968-1989 (Group A) and in 1990-2005 (Group B). All cases were reviewed and classified as typical (TC) or atypical carcinoid (AC) according to WHO criteria (1999). RESULTS: There were 174 (69%) patients with TC (167 N0, 6 N1 and 1 N2) and 78 (31%) with AC (56 N0, 13 N1, 9 N2). Surgery consisted of 163 (64.7%) formal lung resections (121 lobectomies, 18 bilobectomies, 14 segmentectomies, 10 pneumonectomies), 76 (30.1%) sleeve or bronchoplastic resections and 13 (5.2%) wedge resections. No perioperative mortality occurred, 17 (6.7%) patients experienced complications. Overall 5, 10 and 15-year survival rate was 90%, 83% and 77%. TC showed a more favourable prognosis than AC (10-year survival rate 93% and 64%; p=0.00001) as well as N0 patients in comparison with N1-2 patients (10-year survival rate 87% and 50%; p=0.00005). Group A received lymph-node sampling, Group B received a systematic lymphadenectomy. No difference was found between Group A and B in detection of nodal metastases (10.9% versus 11.9%; p=0.79), but in Group A we observed 2 lymph-node relapses. In Group B number of sleeve resections significantly increased (2.7% versus 20.4%; p=0.0001) and number of pneumonectomies showed a significant reduction (7.2% versus 1.4%; p=0.01). CONCLUSIONS: Typical histology and N0 status were important prognostic factors in carcinoid tumors. Parenchyma-sparing procedures must be considered the treatment of choice with systematic lymphadenectomy.

Adolescent↗
PubMed2006

Giant localized fibrous tumours of the pleura: report of three subsequent cases.

Localized fibrous tumours of the pleura (LFTP) represent clinical entities rarely encountered, especially in giant forms. We report of three cases of giant localized fibrous tumours of the pleura found last year in a short time. The patients underwent surgery by thoracotomy. All tumours arose from visceral pleura and were radically excised by a wedge resection of the lung. The patients discharged from the hospital after a short postoperative period without complications. Two of three giant localized fibrous tumours were classified as benign forms; in one case a malignant characteristic was found.

Adult↗
PubMed2006

Experience with the "da Vinci" robotic system for thymectomy in patients with myasthenia gravis: report of 33 cases.

BACKGROUND: Our initial experience in applying robotic-assisted technologies for the treatment of myasthenia gravis (MG) in patients without thymoma is reported. METHODS: from April 2002 to October 2004, 33 patients (24 females and 9 males; mean age, 41 years), with clinical nonthymomatous myasthenia gravis, underwent robotic thoracoscopic thymectomy using the "da Vinci" (Intuitive Surgical, Inc, Mountain View, CA) system and adopting a 3 port, left-sided approach. RESULTS: Mean operative time was 120 minutes. No intraoperative complications or surgical mortality is reported and postoperative complications occurred in two patients (6%). Mean hospital stay was 2.6 days (range, 2-14 days). Histologic analysis of surgical specimens revealed 23 hyperplasia, 4 normal thymus, 4 atrophy, and 2 thymomas; in 12 patients (36.3%) ectopic thymic tissue was found. Follow-up evaluation of the first 24 patients (mean, 23.8 months; range, 12-31 months) showed that 4 patients (16.7%) had complete remission and 18 (75%) had significant clinical improvement for a global benefit rate of 91.7%. CONCLUSIONS: In patients with MG, robot-assisted thymectomy can be performed safely and efficiently. The improved visualization and dexterity of this instrument and its advanced technology may facilitate the minimally invasive approach to the thymus. We prefer to use the left-sided approach because it provides an enhanced visualization of the aortic window and it reduces the probability of phrenic nerves injury. A longer follow-up is necessary to verify long-term clinical results.

Adolescent↗
PubMed2004

Prognostic significance of main bronchial lymph nodes involvement in non-small cell lung carcinoma: N1 or N2?

STUDY OBJECTIVES: Accurate TNM staging is the basis to evaluate prognosis and to plan treatment of patients with non-small cell lung cancer. Exact definition of N status is fundamental and the boundary line between N1 and N2 stations is one of the most controversial issue. Purpose of this study is to evaluate the prognostic significance of main bronchus nodes, that we classified as station number 10 (N1). METHODS: We reviewed retrospectively lymph node patterns and survival of 175 patients with N1 and 154 with N2 disease, that underwent surgical resection with hilar and mediastinal lymphadenectomy from January 1990 to December 2000. These two groups were subdivided in N1 without station number 10 involvement (N1-, n = 144), N1 with station number 10 involvement (N1+, n = 31), N2 single station (N2s, n = 107) and N2 multiple stations (N2m, n = 47), respectively. A univariate and multivariate analysis of prognostic factors predicting survival has been performed. RESULTS: Overall 5-year survival rate for 175 N1 patients and 154 N2 patients was 42 and 13%, respectively and the difference was statistically significant (P < 0.001). The prognosis between N1-, N1+, N2 was compared: 5-year survival rate was 44, 31 and 13%, respectively and the difference reached a statistical value between N1+ and N2 (P < 0.05), but not between N1- and N1+. When the comparison was made with N1-, N1+, N2s and N2m, the difference was significant between N1- and N2s (P = 0.0003), between N1+ and N2m (P = 0.0001), but not between N1+ and N2s. CONCLUSIONS: The aim of a uniform anatomical and clinical classification of nodal stations has not been thoroughly achieved, particularly regarding the boundary line between N1 and N2. Our study points out that the involvement of main bronchial nodes has a prognostic significance similar to that of N2 single station and should be considered as an early N2 disease.

Aged↗
PubMed2002

Benign tracheal and laryngotracheal stenosis: surgical treatment and results.

OBJECTIVES: Benign tracheal stenoses remain the most common indications for tracheal resection. We report lessons learned with surgical management of tracheal stenoses in a consecutive series of 65 patients from the beginning of our experience to date. METHODS: From December 1991 to January 2001 65 patients underwent primary tracheal and laryngotracheal resection and reconstruction for non-neoplastic stenoses. There were 39 males and 26 females with a median age of 33 years (range 14-74 years). There were 58 cases of postintubation and seven of idiopathic stenosis. A cervical approach was used in 60 patients, and a cervical incision with sternal split in four and with sternotomy in one. We performed 45 (69.2%) tracheal resections and 20 (30.8%) laryngotracheal resections. The length of resection ranged between 1.5 and 4 cm (median 2.5 cm). The range of resected rings was two to eight (median five). RESULTS: Fifty-four patients received a preoperative treatment. Preoperative procedures consisted of laser therapy (37), tracheostomy (38) and endotracheal prosthesis (16). We had major complications in eight patients (12.3%) and minor complications in 15 patients (23%). The most frequent complications were: temporary vocal cord dysfunction (eight patients), wound infection (five patients), anastomotic dehiscence (four patients), vocal cord paralysis (two patients), granulation tissue (two patients), deglutition dysfunction (one patient) and restenosis (one patient). Perioperative mortality was 1.5% (one patient). In classifying final results obtained, 54 patients achieved an excellent result, eight a good result and two satisfactory. CONCLUSIONS: The strategy for treatment of airway stenoses is now well established and leads to a high level of success with minimal or no sequelae. Meticulous preoperative assessment and preparation associated with a perfect surgical technique is mandatory to obtain good results. Preoperative treatments (laser and/or endotracheal prosthesis) could increase the extent of injury and the length of stenosis.

Adolescent↗