Journal and News Scan

This retrospective single-center study analyzed 143 patients who underwent chest wall resection and reconstruction from 2010–2023. Among these, 55.2 percent had lung cancer invading the chest wall, predominantly adenocarcinoma and squamous cell carcinoma. Rib resection alone was performed in 69.9 percent of cases, with reconstruction utilizing synthetic, metallic, or combined materials, often alongside muscle or myocutaneous flaps. R0 resection was achieved in 85.9 percent of cases. The median tumor size was 10 cm. Perioperative complications occurred in 25.7 percent, associated with factors such as age, sternal resection, and longer surgery duration. Neuropathic pain was more frequent after posterolateral thoracotomy. The median disease-free survival was 36 months, and the median overall survival was 80 months, with a five-year overall survival of 74.1 percent. The type of reconstruction did not affect survival or the incidence of complications. Reduced survival was linked to older age, squamous histology, larger resections, postoperative complications, and poor postoperative performance status. 

This article examined patients in Singapore who were ineligible for transplantation and evaluated the cost-effectiveness of left ventricular assist device (LVAD) use compared to optimal medical therapy. The authors found that LVAD use resulted in higher quality-adjusted survival for the transplant-ineligible population; however, its value varied based on inotrope dependance. Patients who were inotrope dependent were found to have more cost-effective use of LVADs compared to those who were inotrope independent. The authors suggest that this information could be utilized to adjust device prices nationally as part of public health initiatives. 

Surgeons at Baylor St Luke’s Medical Center in Houston, Texas, successfully performed the first robotic heart transplant in the U.S. without opening the chest, using small abdominal incisions. This minimally invasive procedure reduced trauma, blood loss, and infection risk, allowing for quicker recovery. The patient, who had been hospitalized since November 2024, underwent the transplant in March 2025, recovering without complications. Lead surgeon Dr. Kenneth Liao, chief of cardiothoracic transplantation and mechanical circulatory support at Baylor, emphasized the advantages of avoiding chest opening. Dr. Todd Rosengart, chair of the department of surgery at Baylor, noted that this innovative approach significantly enhances safety in complex surgery.  

This study investigates the prognostic impact of tumor spread through air spaces (STAS) in early-stage synchronous multiple primary lung adenocarcinoma (sMPLA) and its interaction with surgical strategies. Among 131 patients with cT1-3N0M0 sMPLA, STAS was detected in 52 percent, including 16 percent with STAS in both tumors (bi-STAS). Bi-STAS independently predicted significantly worse overall survival and recurrence-free survival compared to mono-STAS or no STAS. Patients with bi-STAS exhibited higher mortality and recurrence rates, regardless of whether they underwent lobectomy or sublobar resection, indicating limited benefit from more extensive surgery. Prognostic factors also included tumor size, pleural invasion, and lung diffusion capacity. These findings underscore the importance of comprehensive STAS evaluation in all dominant tumors for postoperative risk stratification in sMPLA.