Podcasts about segmentectomy

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the robotic market. He explores the new FDA approval for the Johnson & Johnson robotic surgical system for clinical trials, the background of Johnson & Johnson MedTech, and the location for this trial. He also discusses the details of TAVR, what we currently know about TAVR, and highlights an article by Steve Bell that discusses his own views on Johnson & Johnson and the robotic market.    Joel also reviews recent JANS articles on The Society of Thoracic Surgeons expert consensus on the multidisciplinary management and resectability of locally advanced non-small cell lung cancer, a European multicenter study evaluating the prognosis of peripheral early-stage lung adenocarcinoma patients operated on by segmentectomy or lobectomy, early intervention in patients with asymptomatic severe aortic stenosis and myocardial fibrosis, and the use of hybrid stage I to stratify between single ventricle palliation and biventricular repair.   In addition, Joel explores an off-pump ASD closure with a two-layer patch attached to the right atrium, a repair of Scimitar syndrome in a two-year-old via VRAT, and robotic-assisted carinal reconstruction using cross table ventilation. Before closing, he highlights upcoming events in CT surgery.   JANS Items Mentioned  1.) The Society of Thoracic Surgeons Expert Consensus on the Multidisciplinary Management and Resectability of Locally Advanced Non-small Cell Lung Cancer  2.) European Multicentre Study Evaluating the Prognosis of Peripheral Early-Stage Lung Adenocarcinoma Patients Operated on by Segmentectomy or Lobectomy  3.) Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis: The EVOLVED trial  4.) Use of Hybrid Stage I to Stratify Between Single Ventricle Palliation and Biventricular Repair  CTSNET Content Mentioned  1.) Off-Pump ASD Closure With a Two-Layer Patch Attached to the Right Atrium  2.) Repair of Scimitar Syndrome in a Two-Year-Old Via VRAT: Pitfalls of Intra-atrial Baffle  3.) Robotic-Assisted Carinal Reconstruction Using Cross Table Ventilation—A Novel Surgical Technique  Other Items Mentioned  Why am I so tough on Johnson & Johnson and Medtronic and their surgical robotic programs?  CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning had the opportunity to speak with Dr. Donald Nuss about the NUSS procedure at the 24th Annual Congress: Chest Wall International Group and Phoenix Advanced Pectus Course 2024. They discussed how this procedure was created, how it has evolved, and bar stabilization. They also discuss treatments for pectus excavatum and the Ravitch procedure.  Joel also reviews recent JANS articles on real-world outcomes of lobectomy, segmentectomy and wedge resection for the treatment of stage C-IA lung carcinoma, branched stented anastomosis frozen elephant trunk repair, selection for transcatheter versus surgical aortic valve replacement and mid-term survival, and treatment patterns and clinical outcomes of patients with resectable non-small cell lung cancer receiving neoadjuvant immunochemotherapy. In addition, Joel explores the Chrysalis technique, updates on Y-incision aortic annular enlargement, and redo mitral valve repair and left ventricular myectomy. Before closing, he shares upcoming events in CT surgery.  JANS Items Mentioned 1.) Real-World Outcomes of Lobectomy, Segmentectomy and Wedge Resection for the Treatment of Stage C-IA Lung Carcinoma 2.) Branched Stented Anastomosis Frozen Elephant Trunk Repair: Early Results From a Physician-Sponsored Investigational Device Exemption Study 3.) Selection for Transcatheter Versus Surgical Aortic Valve Replacement and Mid-Term Survival: Results of the AUTHEARTVISIT Study 4.) Treatment Patterns and Clinical Outcomes of Patients With Resectable Non–Small Cell Lung Cancer Receiving Neoadjuvant Immunochemotherapy: A Large-Scale, Multicenter, Real-World Study (NeoR-World) CTSNET Content Mentioned 1.) The Chrysalis Technique: A Unique New Way to Perform an Aortic Root Replacement 2.) Updates on Y-Incision Aortic Annular Enlargement 3.) Redo Mitral Valve Repair and Left Ventricular Myectomy Other Items Mentioned CTSNet Events Calendar Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Dr. Lauren Kim discusses efficacy and safety of Y-90 radiation segmentectomy for hepatocellular carcinoma with Dr. Ammar Sarwar.  Efficacy and Safety of Radiation Segmentectomy with 90Y Resin Microspheres for Hepatocellular Carcinoma. Sarwar et al. Radiology 2024; 311(2):e231386.  

In this episode our team reviews the two groundbreaking RCTs which challenged the long-held dogma that a lobectomy is the only acceptable oncologic procedure for NSCLC. Listen as we compare and contrast the North American CALGB trial and Japanese JCOG trial which were both designed to investigate survival and recurrence outcomes by randomizing stage 1A patients to lobectomy versus a sublobar resection. Learning Objectives: -Compare and contrast the patient characteristics of the CALGB and JCOG trials -Understand the methodology each trial and be able to explain their nuanced differences -Analyze the results of the CALGB and JCOG trials and how they apply to patients today Hosts: Kelly Daus MD, Peter White MD, Eric Vallieres, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/36780674/ Altorki N, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083. PMID: 36780674; PMCID: PMC10036605. https://pubmed.ncbi.nlm.nih.gov/35461558/' Saji H, et al. West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3. PMID: 35461558. https://pubmed.ncbi.nlm.nih.gov/37473998/ Altorki N, et al. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2023 Jul 18:S0022-5223(23)00612-8. doi: 10.1016/j.jtcvs.2023.07.008. Epub ahead of print. PMID: 37473998. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our other Cardiothoracic episodes: https://behindtheknife.org/podcast-category/cardiothoracic/

In this episode, host Dr. Chris Beck continues the discussion on managing hepatocellular carcinoma (HCC) with Dr. Tyler Sandow and Dr. Juan Gimenez, interventional radiologists at Ochsner Health in New Orleans, Louisiana. --- CHECK OUT OUR SPONSOR Boston Scientific TheraSphere https://www.bostonscientific.com/therasphere --- SHOW NOTES We continue the conversation where we left off in Part 1. Tyler and Juan share their thoughts on lobar treatment vs. radiation segmentectomy, selection strategies, and their preferred combination of ablation and Y-90. Tyler also reviews the core tenets of Y-90 treatment and references a handful of major landmark trials and studies. Juan highlights more studies that guide their approach to preoperative mapping and intraoperative delivery of Y-90. Juan emphasizes cone-beam CT and how this technique has significantly evolved over the years. We cover dosimetry software, navigation software, and the calculation of treated tumor volumes. Additionally, Tyler and Juan discuss their change in treatment approach for especially complex cases, which can involve factors such as extrahepatic feeders and difficult treatment locations. We also discuss the redistribution of flow and how underlying liver disease may affect treatment plans. We wrap up Part 2 of our discussion by highlighting the doctors' current research pursuits. Tyler tells us about exciting new developments in the tumor marker arena, the emerging role of albumin in HCC, and the rising popularity of radiation segmentectomy in metastatic disease. Juan shares a few closing thoughts on the extrahepatic applications of Y-90 and the advantages of using AI in interventional radiology. --- RESOURCES LEGACY Trial: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/legacy-study.html RASER Trial: https://pubmed.ncbi.nlm.nih.gov/35617978/ DOSISPHERE Trial: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/dosisphere-01.html TARGET Study: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/target-study.html Radiation Lobectomy: Preliminary Findings of Hepatic Volumetric Response to Lobar Yttrium-90 Radioembolization: https://link.springer.com/article/10.1245/s10434-009-0454-0 Radiation lobectomy: Time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection: https://www.sciencedirect.com/science/article/abs/pii/S0168827813004315 ACR–ABS–ACNM–ASTRO–SIR–SNMMI PRACTICE PARAMETER FOR SELECTIVE INTERNAL RADIATION THERAPY (SIRT) OR RADIOEMBOLIZATION FOR TREATMENT OF LIVER MALIGNANCIES: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/rmbd.pdf Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group: https://pubmed.ncbi.nlm.nih.gov/36114872/ “Simplicit90y” Boston Scientific Dosimetry Software: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/dosage-and-administration.html

In this episode, host Dr. Chris Beck interviews Dr. Juan Gimenez and Dr. Tyler Sandow. Juan and Tyler are both interventional radiologists in New Orleans, Louisiana who practice at Ochsner Health System - one of the United States' leading transplant centers. As a result, both doctors have significant experience in Y-90 radiation segmentectomy and other complex procedures for treatment of hepatocellular carcinoma (HCC). --- CHECK OUT OUR SPONSOR Boston Scientific TheraSphere https://www.bostonscientific.com/therasphere --- SHOW NOTES Juan and Tyler start the episode by telling us about how their practice has evolved over the years, their experience on tumor boards, and advice for building strong relations with transplant surgeons. The doctors also tell us about their approach to working-up patients with HCC, the variety of treatment modalities, and overall timeline to transplant. Next we discuss considerations for building an effective interventional oncology service. Taking full ownership at every step of the way is critical to this goal. To conclude the episode, Juan and Tyler discuss the Barcelona Clinic Liver Cancer (BCLC) staging algorithm, their research, and other factors that guide their treatment plan. Stay tuned for Part 2 of this discussion, releasing later this week! --- RESOURCES Premiere and TRACE Trials: https://www.bostonscientific.com/en-US/medical-specialties/interventional-radiology/interventional-oncology/therasphere/clinical-data/premiere-trial-and-trace-trial.html

Dr Keiju Aokage discusses segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less.Read the full article:Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity (JCOG1211): a multicentre, single-arm, confirmatory, phase 3 trialContinue this conversation on social!Follow us today at...https://twitter.com/thelancethttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we sit down with Thoracic Surgeon, Dr. Jane Yanagawa to discuss surgical considerations in treatment of NSCLC. * How do you choose what type of surgical resection to do?- Considerations: --Lung anatomy --Location of the nodule within lung--Lymph node involvement-Options: --Pneumonectomy: removal of whole lung --Lobectomy: remove a whole lobe--Segmentectomy/sublobar resection: part of a lobe* What does “adequate margins” mean? And how do you know if it's enough?- If you're removing the whole lobe, it does not matter as much - If you're doing a segmentectomy, you want to have samples evaluated while in the OR because if there is signs of more disease that initially thought, you would take this one step further and do a lobectomy. - Need to consider the patient's situation - how good is their status * Why does preoperative workup matter?- Pulmonary function tests: Surgeons are looking at the %FEV1 and %DLCO to then predict what their function would be AFTER surgery. After surgery, they want to ensure patient has %FEV1 or %DLCO >40%. - Lung anatomy: In patients with COPD and endobronchial lesions, sometimes they also get V/Q scans to evaluate ratio- Cardiac echo: Important in pneumonectomy where removal of lung tissue will also remove a significant amount of blood vessels. Want to rule out pulmonary hypertension pre-operatively. - Pulmonary hypertension can also affect someone's survival while they're ventilating with only one lung during the procedure (“single lung ventilation”). - Smoking status: Smoking can increase complications by ~60%. - Pre-habilitation: Encouraging patients to be fit prior to surgery with walking, nutrition, +/- pulmonary rehabilitation* What is “VATS”?- VATS stands for video-assisted thoracoscopic surgery; it is not, in itself, a procedure. But a VATS allows for minimally invasive surgery through the use of a camera. - It involves three incisions (axilla, lowest part of mid-axillary line, one posterior)* In what scenario is a mediastinoscopy warranted? - Needed after EBUS if there is still high index of suspicion for cancer involvement in lymph nodes, even if lymph nodes are negative from EBUS* What is “systematic lymph node sampling”?- An organized way to sample lymph nodes, including all lymph nodes that are along the way, not just the ones that may be involved * As a surgeon, how do you determine if a patient is okay for surgery if the mass is invading another structure?- Need to take the anatomy into consideration - are there major blood vessels or nerves there, for instance, which can impact outcome and recovery.* When should we consider induction chemotherapy from a surgeon's perspective?- Lots of changes in this sphere coming; lots of discrepancy between institutions when there is N2 disease - In Dr. Yanagawa's opinion, anyone with N2 disease should get neoadjuvant therapy * If there is neoadjuvant chemoradiation given, how does that effect your surgery?- Radiation increases scar tissue in the lung tissue. But what is worse is that radiation neoadjuvantly may make wound healing more difficult. She does not prefer radiation pre-operatively- Chemotherapy also adds scar tissue*How does neoadjuvant IO therapy affect scar tissue formation?- The hilum and lymph nodes are more swollen, but does not translate to more complications - She has even seen patients who had gotten IO for another cancer and then get lung cancer, she can still appreciate swollen nodes!* How long after surgery is it safe to start adjuvant therapy?- If patient has a complication from surgery, would not start right away. It is important to discuss with the surgeon about when it is okay to proceed with adjuvant therapy. - If patient has good recovery/without complications, okay to start about 4 weeks after- There is no good guidance yet about when it is safe to start IO after surgery About our guest: Jane Yanagawa, MD is an Assistant Professor of Thoracic Surgery at the UCLA David Geffen School of Medicine and the UCLA Jonsson Comprehensive Cancer Center. She completed medical school at Baylor College of Medicine, after which she went to UCLA for her surgical residency. She went onto Memorial Sloan-Kettering for her Thoracic Surgery Fellowship. In addition to her practice as a thoracic surgeon at UCLA, Dr. Yanagawa also sits on the NCCN NSCLC guidelines committee! We are so grateful she was able to join us despite her very busy schedule! Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Edward Kim (Icahn School of Medicine at Mount Sinai) discusses the single-arm RASER study of radiation segmentectomy for patients with unresectable very early to early stage hepatocellular carcinoma.Read the full article:Radiation segmentectomy for curative intent of unresectable very early to early stage hepatocellular carcinoma (RASER): a single-centre, single-arm study

SCORE Modules Covered: Diseases/Conditions: Primary Hepatic Neoplasms - Benign and Malignant (Core, Malignant Only, See Also: 4.2 Benign Hepatic Neoplasms)

Dr. Eric Vallieres, thoracic surgeon, discusses the potential to do smaller lung surgeries on patients with a lung cancer that poses a minimal risk of recurrence.

Dr. Eric Vallieres, thoracic surgeon, discusses the potential to do smaller lung surgeries on patients with a lung cancer that poses a minimal risk of recurrence.

Dr. Eric Vallieres, thoracic surgeon, discusses the potential to do smaller lung surgeries on patients with a lung cancer that poses a minimal risk of recurrence.

There are multiple different types of lung cancer surgery. Dr. Eric Vallières, thoracic surgeon, reviews the different forms of lung surgery, include wedge resection, segmentectomy, lobectomy, and pneumonectomy.

There are multiple different types of lung cancer surgery. Dr. Eric Vallières, thoracic surgeon, reviews the different forms of lung surgery, include wedge resection, segmentectomy, lobectomy, and pneumonectomy.

There are multiple different types of lung cancer surgery. Dr. Eric Vallières, thoracic surgeon, reviews the different forms of lung surgery, include wedge resection, segmentectomy, lobectomy, and pneumonectomy.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, covering techniques ranging from video-assisted thoracic surgery to robotic surgery to sub-lobar resections and other developments offering new promising alternatives.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, covering techniques ranging from video-assisted thoracic surgery to robotic surgery to sub-lobar resections and other developments offering new promising alternatives.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, covering techniques ranging from video-assisted thoracic surgery to robotic surgery to sub-lobar resections and other developments offering new promising alternatives.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, covering techniques ranging from video-assisted thoracic surgery to robotic surgery to sub-lobar resections and other developments offering new promising alternatives.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, covering techniques ranging from video-assisted thoracic surgery to robotic surgery to sub-lobar resections and other developments offering new promising alternatives.

Dr. David Harpole of Duke University reviews advances in lung cancer surgery, covering techniques ranging from video-assisted thoracic surgery to robotic surgery to sub-lobar resections and other developments offering new promising alternatives.