Improving Long-Term Survival after Minimally Invasive Lung Cancer Surgery: Comparison between Robotic- and Video-Assisted Surgery

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Background

Looking beyond the cancer itself, it is essential to consider the changing nature of the patients we operate on today compared to those of the past. With lung cancer remaining the leading cause of cancer mortality worldwide, characterized by its histological, molecular, and clinical variabilities, it is crucial to determine tailored treatments and multimodality therapy plans that integrate surgery.

To enhance long-term survival, this Research Topic delves into the modern advances in preoperative management, which contribute to short-term outcomes and subsequently impact long-term results. It explores the optimization of oncological resection techniques to achieve prolonged benefits. Moreover, comprehensive patient care beyond the cancer setting, encompassing rehabilitation, physiotherapy, patient selection guided by functional algorithms, and addressing the challenges faced by fragile patients, is thoroughly examined.

The collection also focuses on modern pre-operative preparation, planning, and improvements in oncological resection quality, while anticipating intraoperative complications such as conversions. Emphasizing the importance of maintaining control over all parameters during surgery, the concept of "operating by controlling everything" is explored.

Furthermore, the potential of artificial intelligence (AI) in decision-making for patient assessment, both in the operating room and during postoperative follow-up, is discussed. While AI is still in its infancy, it poses as a valuable tool for enhancing surgical practices.

We welcome high-quality papers on themes including, but not limited to:

1. The Thoracic Surgery Patient in the 20s

• Modern global conditioning of patients in an ERAS program or inspired by the ERAS program, focusing on improving patient information, preoperative care, and comparing home vs in-hospital rehabilitation, especially for frailty patients.
• Lung volume reduction surgery and its potential benefits for emphysematous patients, exploring upper vs lower lobectomy.
• Functional rehabilitation strategies for elderly patients, particularly those over 85 years old, before surgery.
• The role of functional algorithms in minimally invasive management.
• Assessing the timing of oncological surgery, including the potential benefits of delaying surgery for patient assessment and rehabilitation.
• Trends in the cardiological and vascular assessment of patients prior to lung surgery, examining the risks of myocardial ischemia and potential new cardiac biomarkers.
• A global perspective on smoking patients and the assessment of tobacco-related complications.
• The impact of mental health on adherence to care programs, ERAS programs, and short- and long-term postoperative mortality in lung cancer patients.


2. "Modern Preparation" for Thoracic Surgery in the 20s: Optimizing Oncological Factors and Ensuring Control in the Operating Room

• Imaging-guided surgery, from CT scans to 3D reconstructions and the simulation of resections.
• Selecting the most appropriate approach: evaluating prognostic scores and new tools for selecting between minimally invasive and alternative approaches for optimal patient treatment.
• Planning VATS vs RATS lung resection surgeries.
• Operating as a team with shared equipment, exploring the benefits and disadvantages of specializing in one minimally invasive approach compared to another.
• Predictive data for conversions from minimally invasive to open approaches, utilizing the thoracoscore in routine practice.
• Planning hybrid surgeries that combine open and minimally invasive approaches for complex cases.
• Managing non-patient-related events in the operating room that may lead to complications.
• Perioperative monitoring of patients undergoing lung resection in the 20s.

3. Utilizing Artificial Intelligence (AI) in Functional and Oncological Assessment, Peri- and Post-operative Procedures, Complications, and Long-Term Patient Care and Follow-Up

Keywords: Long-Term Survival, Lung Cancer, Surgery, Robotic Surgery, Video-Assisted Surgery, Patient Outcomes, Cancer Care

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