Methods for Staging Non-small Cell Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

Neuroendocrine tumors account for approximately 20% of lung cancers; most (≈15%) are small cell lung cancer (SCLC). These NCCN Clinical Practice Guidelines in Oncology for SCLC focus on extensive-stage SCLC because it occurs more frequently than limited-stage disease. SCLC is highly sensitive to initial therapy; however, most patients eventually die of recurrent disease. In patients with extensive-stage disease, chemotherapy alone can palliate symptoms and prolong survival in most patients; however, long-term survival is rare. Most cases of SCLC are attributable to cigarette smoking; therefore, smoking cessation should be strongly promoted.

/pdf/non-small-cell-lung-cancer-clinical-practice-guidelines-in-3alu4woroj.pdf

Non-small cell lung cancer: Clinical practice guidelines in oncology

Video-assisted thoracic surgery lobectomy: experience with 1,100 cases.

Apparatus and method for forming a compression anastomosis of a hollow organ. The apparatus comprising a first collapsible member movable between an expanded configuration and a collapsed configuration, the first collapsible member having a longitudinal bore defined by an inner surface, a first mating member, locking structure disposed on the first collapsible member for locking the first collapsible member with the first mating member, a second collapsible member movable between an expanded configuration and a collapsed configuration, the second collapsible member having a longitudinal bore defined by an inner surface, a second mating member, locking structure disposed on the second collapsible member for locking the second collapsible member with the second mating member, and the first member adapted to interlock with the second member. A tissue retaining device is also provided which comprises a mating member having a receiving portion formed thereon, said receiving portion having an inner surface and securing structure comprising a ring having an outer surface dimensioned and configured for insertion into said receiving surface to compress tissue between said outer surface of said ring and an inner surface of said mating member receiving portion.

Apparatus and method for performing compressional anastomoses

This guideline is based on a comprehensive review of the literature on pulmonary nodules and expert opinion. Although the management pathway for the majority of nodules detected is straightforward it is sometimes more complex and this is helped by the inclusion of detailed and specific recommendations and the 4 management algorithms below. The Guideline Development Group (GDG) wanted to highlight the new research evidence which has led to significant changes in management recommendations from previously published guidelines. These include the use of two malignancy prediction calculators (section ‘Initial assessment of the probability of malignancy in pulmonary nodules’, algorithm 1) to better characterise risk of malignancy. There are recommendations for a higher nodule size threshold for follow-up (≥5 mm or ≥80 mm3) and a reduction of the follow-up period to 1 year for solid pulmonary nodules; both of these will reduce the number of follow-up CT scans (sections ‘Initial assessment of the probability of malignancy in pulmonary nodules’ and ‘Imaging follow-up’, algorithms 1 and 2). Volumetry is recommended as the preferred measurement method and there are recommendations for the management of nodules with extended volume doubling times (section ‘Imaging follow-up’, algorithm 2). Acknowledging the good prognosis of sub-solid nodules (SSNs), there are recommendations for less aggressive options for their management (section ‘Management of SSNs’, algorithm 3).

The guidelines provide more clarity in the use of further imaging, with ordinal scale reporting for PET-CT recommended to facilitate incorporation into risk models (section ‘Further imaging in management of pulmonary nodules’) and more clarity about the place of biopsy (section ‘Non-imaging tests and non-surgical biopsy’, algorithm 4). There are recommendations for the threshold for treatment without histological confirmation (sections ‘Surgical excision biopsy’ and ‘Non-surgical treatment without pathological confirmation of malignancy’, algorithm 4).

Finally, and possibly most importantly, there are evidence-based recommendations about the information that people …

https://thorax.bmj.com/content/thoraxjnl/70/Suppl_2/ii1.full.pdf

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

A videothoracoscopic right lower pulmonary lobectomy is reported. The excision was done in a 71-year-old man suffering from an adenocarcinoma of the right lower lobe, with an apparent absence of lymphnodal and systemic metastasis. The procedure has been performed using four 10-mm cannulas and a minimal inframammary thoracotomy (4 cm) by inserting a chip camera linked to the thoracoscope and connected to external monitors. The lobar hilar structures were dissected and then sutured-divided with Endo-GIA R shots. The specimen was extracted through the minimal thoracotomy. The postoperative course was uneventful with minimal postoperative pain, and the patient was discharged after complete surgical recovery with excellent functional and cosmetic results. This procedure in selected patients is a new and promising possibility in chest videoendoscopic surgery.

Videoendoscopic pulmonary lobectomy for cancer.

Major pulmonary resections: Pneumonectomies and lobectomies

Videothoracoscopic Approach to Primary Mediastinal Pathology

https://www.annalsthoracicsurgery.org/article/0003-4975(94)91658-6/pdf

Videothoracoscopic excision of mediastinal masses: indications and technique.

https://www.annalsthoracicsurgery.org/article/0003-4975(95)00029-K/pdf

Videothoracoscopic staging and treatment of lung cancer

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