Evidence map›Paper›PMID 39806444›Full record

ReviewJournal of cardiothoracic surgery2025

Awake thoracic surgery for lung cancer treatment: where we are and future perspectives-our experience and review of literature.

Giovanni Mugnaini, Simone Tombelli, Antonio Burlone, Stefano Bongiolatti, Domenico Viggiano, Rossella Indino, Ottavia Salimbene, Lavinia Gatteschi, Luca Voltolini, Alessandro Gonfiotti

Abstract readReview
In one paragraph

Review in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Giovanni MugnainiThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Simone TombelliThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Antonio BurloneThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Stefano BongiolattiThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Domenico ViggianoThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Rossella IndinoThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Ottavia SalimbeneThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Lavinia GatteschiThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Luca VoltoliniThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Alessandro GonfiottiThoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy. a.gonfiotti@unifi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLung cancer is the first cause of cancer-related death. Awake lung resection is a new frontier of the concept of minimally invasive surgery. Our purpose is to demonstrate the feasibility of this technique for lobar and sublobar lung resection in NSCLC patients.

methodsWe retrospective reviewed all the medical charts of patients who underwent awake lung resection in our center between March 2018 and March 2024, focusing on patients with NSCLC, and we compared our results with the ones found in literature.

resultsAmong 45 patients treated with awake lung resections, we selected 15 patients with NSCLC and finally analyzed the results of 12 patients who underwent VATS awake lung resection, 3 lobectomies and 9 wedge resections. The median Charlson comorbidity index (CCI) was 3 and we had 5 patients (41.67%) with a CCI ≥ 4 and a median FEV1 of 56%. We report only 2 conversions to general anesthesia (16.67%) and no conversion to open thoracotomy. We used a nebulizator for the atomization of lidocaine on the lung surface to reduce the cough reflex. Our post-operative results are in line with literature, with a low complication rate (2 patients, 16.67%) and a median length of stay of 5 days. We safely performed a proper lymph node dissection in all 3 lobectomies. Median Overall Survival and Disease-Free Survival were 11 months.

conclusionsAwake lung resections are a feasible way to perform a minimally invasive surgical procedure in NSCLC patients, with low risk of conversion to open surgery.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsPneumonectomyThoracic Surgery, Video-AssistedWakefulnessAgedFeasibility StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesAwake lung resectionsMinimally invasive lung surgeryNSCLC surgery, uniportal VATS surgerySpontaneous breathing patientsVATS lung resections

Identifiers

PMID39806444
PMCPMC11726905

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.