Didier Schneiter

• Staff member at University of Zurich

Background Lung volume reduction surgery (LVRS) provides benefit in survival, lung function, gas exchange and quality of life in patients with emphysema. Pulmonary hypertension (PH) is a late and serious complication in patients suffering from emphysema. Given the high-risk profile, LVRS remains controversial in this patient subgroup. Aims We aim...

Background Neoadjuvant and perioperative immune checkpoint inhibition (ICI) has been shown to provide excellent outcomes within recently published phase III trials on resectable non-small cell lung cancer (NSCLC). However, high preoperative attrition rates of up to 20% after neoadjuvant ICI remain a central challenge and real-world data that suppor...

Background Despite the current advancements in systemic treatment, cancer persistence, progression or recurrence remain common after nonoperative treatment of unresectable non-small cell lung cancer (NSCLC). In this situation, lung resection frequently remains among the last options to achieve local cancer control. Aims We aimed to assess the outc...

Background Abdominal wall reconstruction represents an ambitious and demanding challenge. This study aimed to illustrate the versatility of the anterolateral thigh (ALT) flap in its different designs for the reconstruction of complex defects of the abdominal wall. Methods Charts of patients with complex abdominal wall defects who underwent a recon...

Treatment of postpneumonectomy empyema remains challenging, especially in presence of bronchopleural fistula. We analysed clinical outcome data of patients with and without bronchopleural fistula undergoing an accelerated empyema treatment concept. From November 2005 to July 2020, all patients with postpneumonectomy empyema were included. Therapy c...

Background: There is a paucity of data concerning the feasibility and value of thoracic aortic stent graft implantation (TEVAR) applications for removing tumors infiltrating the aortic wall. This analysis aimed to demonstrate the feasibility of TEVAR and monitor the perioperative risks of morbidity and mortality. Additionally, a literature review w...

OBJECTIVES Postoperative empyema is a severe, potentially lethal complication also present, but poorly studied in patients undergoing surgery for pleural mesothelioma. We aimed to analyse which perioperative characteristics might be associated with an increased risk for postoperative empyema. METHODS From September 1999 to February 2023 a retrospe...

Selection of patients who may benefit from extracorporeal life support (ECLS) as a bridge to lung transplant (LTx) is crucial. The aim was to assess if validated prognostic scores could help in selecting patients who may benefit from ECLS-bridging predicting their outcomes. Clinical data of patients successfully ECLS-bridged to LTx from 2009 to 202...

More than 20 years ago, surgical lung volume reduction (LVRS) was already established in patients with advanced emphysema as a palliative therapy option that reduces respiratory distress and improves lung function and quality of life. In addition, bronchoscopic procedures (BLVR) aimed at volume reduction have existed for just over 10 years. The adv...

Objective Pleural adhesions (PLAs) have been shown to be a possible risk factor for air leak after lung volume reduction surgery (LVRS), but the relevance of PLA for lung function outcome remains unclear. We analyzed our LVRS cohort for the influence of PLA on short-term (ie, prolonged air leak) and long-term outcomes. Methods Retrospective observ...

Background Bronchoscopic lung volume reduction (BLVR) with valves excludes one whole lobe while lung volume reduction surgery (LVRS) allows tailored treatment by resection of only heterogeneous, hardly perfused target areas. Aims We hypothesize that by (bilateral) LVRS, more areas of low attenuation (LAA, ≤ - 950 houndsfield units) can be resected...

Introduction There is limited data in the literature on the use of thoracic aortic stent graft implantation (TEVAR) to facilitate en-bloc resection of tumors that have invaded the aortic wall. After TEVAR, extended resections can be performed, avoiding aortic wall replacement or catastrophic situations such as life-threatening bleeding from aortic...

Background In patients with stage IIIB, stage IIIC and stage IV non-small cell lung cancer (NSCLC), guidelines generally recommend systemic therapy with or without radiotherapy. Despite this treatment, complete response remains rare. However, in a selected group of patients with either residual disease after partial response to first-line systemic...

Smoking prevention in schoolchildren to inform and prevent smoking initiation has been widely studied; however, the potential effect of interventions provided in a hospital setting is unknown. An intervention program named “Schoolchildren smoking prevention in the hospital” was developed in which the health aspects of smoking and its individual con...

Objective Low-dose computed tomography (LDCT) lung cancer screening is endorsed by US guidelines and has recently been shown effective in a large European randomized controlled trial. Nevertheless, actual realization of a lung cancer screening program is challenging and depends on country-specific factors. This pilot study aimed to evaluate impleme...

Zusammenfassung. Die Standardtherapie bei Lungenkrebs im Frühstadium ist die chirurgische, anatomische Resektion, am häufigsten im Sinn einer Lobektomie oder Segmentektomie. Dies setzt die sogenannte Operabiltät voraus, das heisst u.a. gewisse lungenfunktionelle Reserven. Patientinnen und Patienten mit COPD und Emphysem weisen häufig hierfür inakze...

Background: Lung cancer is the leading cause of cancer-related deaths in Switzerland. Despite this, there is no lung cancer screening program in the country. In the United States, low-dose computed tomography (LDCT) lung cancer screening is partially established and endorsed by guidelines. Moreover, evidence is growing that screening reduces lung...

The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on oncological and thoracic surgical practice worldwide. In many hospitals, the care of COVID-19 patients required a reduction of elective surgery, to avoid viral transmission within the hospital, and to save and preserve personnel and material resources. Cancer patients are m...

Myasthenia gravis (MG) is an autoimmune disease characterized by impaired neuromuscular signaling due to autoantibodies targeting the acetylcholine receptor. Although its auto-antigens and effector mechanisms are well defined, the cellular and molecular drivers underpinning MG remain elusive. Here, we employed high-dimensional single-cell mass and...

Randomized controlled trials have demonstrated that lung volume reduction surgery (LVRS) improves exercise capacity, lung function, and quality of life in patients with heterogenous emphysema on computed tomographic and perfusion scan. However, most patients have a nonheterogenous type of destruction. These patients, summarized under "homogeneous e...

Purpose Postoperative cause of death in lung transplantation and time to its occurrence is reported occasionally. This study investigated all causes of death in our lung transplant recipients. Methods All recipients transplanted between 1992 and 2018 were included. Follow-up date was October 2019. Median (min-max) survival was calculated to compar...

Introduction Lobar lung transplantation (LLTx) allows the use of oversized grafts for small recipients. In this technically demanding and not widely adopted procedure, prolonged air leak, kinking of vascular anastomoses and remaining dead space are frequent complications. We describe our experience in treatening the rarely reported bronchial stump...

BACKGROUND We aimed to analyse the nodal spread of our non-small cell lung cancer pN2 cohort according to tumour location, the possible implications of an unusual spreading pattern, and other factors influencing postoperative survival after anatomical lung resection. METHODS In this retrospective observational study, clinical data was collected...

Background: Cadaveric lobar lung transplantation (L-LTx) is developed to overcome donor–recipient size mismatch. Controversial short- and long-term outcomes following L-LTx have been reported compared to full-sized lung transplantation (F-LTx). This study reports long-term outcomes after L-LTx. Methods: We reviewed patients undergoing lung transpla...

OBJECTIVES Lung volume reduction (LVR) is an efficient and approved treatment for selected emphysema patients. There is some evidence that repeated LVR surgery (LVRS) might be beneficial, but there are no current data on LVRS after unsuccessful bronchoscopic LVR (BLVR) with endobronchial valves (EBVs). We hypothesize good outcome of LVRS after BLVR...

Background. Treatment of stage IIIA lung cancer remains controversial because it includes a very heterogeneous group of patients. The purpose of our study was to compare survival between stage IIIA subsets and to externally validate our results with another center’s database. Methods. Patients with completely resected stage IIIA/B lung cancer were...

Background: The key issues for performing lung volume reduction surgery (LVRS) is the identification of the target zones. Recently introduced three-dimensional computed tomography rendering methods are used to identify the morphological distribution and its severity of lung emphysema by densitometry. We demonstrate a new software for emphysema ima...

Myasthenia gravis is a rare but archetypic autoimmune disease that is characterized by the autoantibody-mediated disruption of the neuromuscular junction leading to a skeletal muscle weakness. Immunomodulatory treatment options for Myasthenia gravis patients are largely unspecific, include suppression of the entire immune compartment and are often...

Purpose Although malignancy is considered a common complication after lung transplantation, profound studies about incidence, characterization, risk assessment and morbidity and mortality are scarce. Therefore we analyze all recipients at our center. Methods All 521 lung transplant recipients at our center between 1992 and 2018 were retrospectivel...

Purpose The Charlson-Deyo-Comorbidity-Index is a popular age independent score to predict long term survival. It incorporates 17 weighted comorbidity conditions and is established in a variety of clinical fields. However, the feasibility for lung transplantation is not yet tested. We therefore validate this score for primary graft dysfunction (PGD)...

OBJECTIVES No significant data are available to assess whether complex sleeve lobectomy (complex-SL) can be considered comparable to conventional lobectomy (CL) in terms of surgical outcome. The purpose of this study was to compare surgical and oncological outcomes of complex-SL with CL in patients with lung cancer. METHODS Between 2000 and 2015, a...

Background Primary pulmonary sarcoma (PPS) is a rare malignant lung neoplasm, and there is very little medical evidence about treatment of PPS. The aim of this study is to clarify the clinical characteristics and therapeutic outcome of patients who underwent surgical resection for PPS. Methods We retrospectively reviewed the records of patients who...

Objectives: No significant data is available to assess whether extended sleeve lobectomy (extended-SL) can be considered comparable to conventional lobectomy (CL) in terms of surgical outcome. The purpose of this study was to compare surgical and oncological outcomes of extended-SL with CL in patients with lung cancer. Methods: Between 2000 and 201...

Surgery is still an inherent part of the treatment of non-small cell lung cancer. This article summarizes various aspects of the surgical treatment of early and locally advanced stages of lung cancer. Minimally invasive techniques for lung cancer resection - video-or robotic-assisted - are today standard for early stages. Perioperative mortality is...

Fusions of the EWSR1 gene with partners from the CREB gene family have been identified in several histologic entities, mostly mesenchymal tumors of variable clinical malignant potential, including angiomatoid fibrous histiocytomas (AFH), clear cell sarcomas (CCS), clear cell sarcoma‐like tumors of the gastrointestinal tract (CCSLTGT), primary pulmo...

Objectives: We hypothesize a significant correlation between parameters of preoperative dynamic magnetic resonance imaging (MRI) and postoperative outcomes measured by pulmonary function tests. Methods: Dynamic MRI of the lungs was prospectively performed during 2 breath cycles 1 day before and 3 months after surgery, herein termed as pre- and p...

The aim of lung volume reduction surgery (LVRS) for patients suffering from severe emphysema is to improve lung function and palliate dyspnea. Careful patient selection in a multidisciplinary approach in a high-volume center is mandatory for a successful outcome. Pulmonary complications including air leak and pneumonia as well as cardiac complicati...

Background: Radiotherapy is recommended as primary local therapy for inoperable patients with non-small cell lung cancer (NSCLC). We hypothesized that selected patients with advanced emphysema could be candidates for surgery and improved functional outcome might result in addition to low mortality and morbidity and successful cancer control when s...

Lung volume reduction surgery (LVRS) for symptomatic patients with advanced emphysema was proven to be successful in a large randomized multi-center trial (NETT) and in several large single center series. This evidence primarily concerns patients with heterogeneous, upper-lobe predominant emphysema and low exercise tolerance within certain selectio...

Purpose: Utilization of donation after circulatory death (DCD) donors has the potential to decrease donor shortage in lung transplantation (LTx). This study reviews the long-term outcome of LTx from DCD donors. Methods: We included all consecutive DCD (Maastricht Category III) and all donations after brain death (DBD) donor lung transplants at o...

Background: Lung volume reduction surgery (LVRS) has been proven to be a successful procedure and can be performed with low mortality when defined selection criteria are met. We hypothesized good outcome and low mortality after LVRS for selected patients with severe hyperinflation and nonhomogeneous morphology even when diffusion capacity of the l...

Objectives: Lung volume reduction surgery (LVRS) and lung transplantation (LTx) are the treatments of choice in selected patients with end-stage emphysema. Recently, the history of LVRS has been questioned due to reduced post-transplant survival. We aim to address this question by reviewing our experience, which is the largest single-centre series...

Objective: As large registries show an increased risk for lung transplant recipients aged 60 years or more, few single centers report favorable outcomes for carefully selected older recipients without providing essential details. The purpose of our study was to determine variables that influence survival in the elderly. Methods: All adult bilate...

OBJECTIVES: The objective of this retrospective study was to assess perioperative outcomes, overall survival and freedom from recurrence after induction chemotherapy followed by extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D) in patients with mesothelioma in a propensity score matched analysis. METHODS: Between September 1999 an...

Background: Due to an increased life expectancy in a healthy aging population and a progressive incidence of lung cancer, curative pulmonary resections can be performed even in octogenarians. The present study aims to investigate whether surgery is justified in patients reaching the age of 80 years and older who undergo resection for non-small cell...

Die interventionelle Bronchologie ist eine verhältnismässig junge Subspezialisierung der Pneumologie und Thoraxchirurgie. Die Bronchoskopie hat sich in der Vergangenheit vor allem auf die Diagnostik von pulmonalen Infektionen und Malignomen beschränkt. Durch ein ständig wachsendes Armamentarium an therapeutischen Möglichkeiten wachsen jedoch die In...

Background and objectives: There is a paucity of data concerning the impact of the sedation technique used for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) on diagnostic accuracy. The aim of this retrospective study was to compare the diagnostic accuracy of EBUS-TBNA in deep and moderate sedations, and to investigat...

Background: Thymic epithelial tumors (TET) are rare neoplasms with inconsistent treatment strategies. When researching for molecular pathways to find new therapies, the correlation between specific molecular markers and outcome has only rarely been investigated. The aim of this study was to investigate the correlation between survival, metastatic...

Background: One-lung ventilation during thoracic surgery is associated with hypoxia-reoxygenation injury in the deflated and subsequently reventilated lung. Numerous studies have reported volatile anesthesia-induced attenuation of inflammatory responses in such scenarios. If the effect also extends to clinical outcome is yet undetermined. We hypot...

Lung transplantation (LTx) is an accepted therapy in children with end-stage lung diseases. Pediatric-specific experience is considered important in pediatric LTx. We present our institutional experience and its outcome since the year 2000, asking whether different treatment strategies produce comparable outcomes in pediatric lung transplant recipi...

Inflammatory myofibroblastic tumor of the lung is a rare pulmonary lesion of intermediate biologic potential. Approximately half of all inflammatory myofibroblastic tumors show a rearrangement of the anaplastic lymphoma kinase (ALK) gene locus with potentially aberrant kinase expression. We present a 25-year-old man with recurrent exertional hemopt...

Objectives: To analyse the relapse pattern and influence of second-line treatment after recurrence of malignant pleural mesothelioma (MPM) in patients who had previously undergone multimodality treatment. Methods: Between September 1999 and December 2013, 136 patients underwent macroscopic complete resection (MCR) by extrapleural pneumonectomy a...

Treatment of malignant pleural mesothelioma (MPM) remains a clinical challenge. The aim of this study was to identify selection factorsfor allocation of MPM patients to multimodal therapy based on survival data from 12 years of experience. Eligible patients had MPM of all histological subtypes with clinical stage T1-3 N0-2 M0. Induction chemotherap...

Objectives: The main purpose of lung transplantation is improved quality of life and long-term survival. The effect of recipient comorbidities in lung transplant recipients is not yet well investigated and studies about the independent impact of the accumulation of comorbidities in a single recipient are completely lacking. Methods: All 315 consecu...

Extracorporeal life support (ECLS) as a bridge to lung transplantation (LuTx) is a promising option for patients with end-stage lung disease on the transplant waiting list. We investigated the outcome of patients bridged to lung transplantation on ECLS technologies, mainly extracorporeal membrane oxygenation (ECMO). Between January 2007 and October...

Cardiovascular disease is a major cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Preliminary studies have shown that both airflow obstruction as well as systemic inflammation may contribute to endothelial dysfunction in COPD. Lung volume reduction surgery (LVRS) is a treatment option in selected COPD...

Overall, emphysema (EMP) is the most common indication for lung transplantation. The majority of patients present with chronic obstructive pulmonary disease (COPD) and less frequently with alpha-1 antitrypsin deficiency (A1ATD). We analysed the results of lung transplants performed for EMP in order to identify the impact of age on short- and long-t...

• Nach Ausschöpfen der konservativen/medikamentösen Therapiemassnahmen bei fortgeschrittenem Lungenemphysem kann in vielen Fällen eine chirurgische oder bronchoskopische Behandlung angeboten werden. • Durch die chirurgische oder bronchoskopische Emphysembehandlung können eine Verbesserung der Dyspnoe, Zunahme der Leistungsfähigkeit und Verbesserung...

Lung volume reduction surgery (LVRS) improves dyspnoea, quality of life and may even prolong survival in carefully selected patients with end-stage emphysema. The benefit may be sustained for several years and vanishes with the natural progression of the disease. Data on repeated surgical treatment of emphysema are scarce. The aim of this study was...

Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Purpose: Smoking prevention in schoolchildren with the aim to inform and prevent smoking initiation has been widely studied and has shown variable results. Interventions provided by physicians in a hospital setting have been rarely reported. Here we show the feasibility and gain...