Diego Gonzalez-Rivas

Shanghai Pulmonary Hospital · Thoracic surgery department and lung tranplantation

Pure Uniportal Robotic-Assisted Thoracic Surgery (U-RATS) is the robotic thoracic surgery performed through a single intercostal incision, without rib spreading, using the robotic camera, robotic dissecting instruments, and robotic staplers. Compared to multiport, U-RATS simplifies the management of possible intraoperative bleeding, mainly due to r...

Background Innovations in surgical instruments have made single-port surgery more widely accepted and lead to a reduced demand for surgical assistants. As COVID-19 has ravaged the world, maintaining minimum medical staffing requirements and proper social distancing have become major topics of interest. We sought to evaluate the feasibility of apply...

Objectives: The paediatric tracheobronchial inflammatory myofibroblastic tumour is a rare disease. Whether limited surgical resection is a feasible surgical approach for these patients remains controversial. The objectives of this study were to report the long-term prognosis after limited surgical resections on paediatric tracheobronchial IMT and...

OBJECTIVES Thymic epithelial tumours (TETs) are relatively rare indolent malignancies in the mediastinum. Lymph node metastasis (LNM) is an important prognostic indicator for TETs; however, the pattern of LNM involved in TETs has yet to be elucidated. METHODS Patients diagnosed with histologically confirmed thymoma (A–B3), thymic carcinomas and th...

Video-Assisted Thoracic Surgery (VATS) is already practised worldwide, in almost every condition addressed by open thoracic surgery. As part of minimally invasive thoracic surgery (MITS), VATS offers to patients and to healthcare providers excellent results and great satisfactions. Learning and performing VATS use different pathways in trainees and...

An introduction of tubeless anesthesia for thoracic surgery in different aspects including airway management, pathophysiologic alteration, monitoring, types of anesthesia drugs, and potential complications.

Colorectal cancer is one of the most commonly diagnosed cancers among men and women in the United States. Though colon and rectum cancer are often referred to as colorectal cancer, they are actually distinct disease entities. It is well known that the most common metastatic site for CRC patients is liver, followed by lung. Although lung metastases...

Lung cancer is a leading cause of cancer-related death worldwide, with a very poor overall five-year survival rate. The intrinsic limitations associated with the conventional diagnosis and therapeutic strategies used for lung cancer have motivated the development of nanotechnology and nanomedicine approaches, in order to improve early diagnosis rat...

Minimally invasive surgery (MIS) is gradually becoming the standard of care for the surgical treatment of nonsmall cell lung cancer (NSCLC). Compared with the multiple incision approach, including conventional multiportal video-assisted thoracoscopic surgery (mVATS) and multiportal robotic-assisted thoracoscopic surgery (mRATS), uniportal video-ass...

Patient-derived tumor xenografts (PDXs) are a powerful tool for drug discovery and screening in cancer. However, current studies have led to little understanding of genotype mismatches in PDXs, leading to massive economic losses. Here, we established PDX models from 53 lung cancer patients with a genotype matching rate of 79.2% (42/53). Furthermore...

Background: Standardized and transparent reporting of surgical technique is the cornerstone of effective dissemination, implementation and improvement. However, current reporting of surgical techniques is inadequate. The existing guidelines potentially applied to guide surgical technique reporting are with a minimal highlight of the surgical techni...

Background: The reporting of surgical techniques is of mixed quality, with most at a very minimal level. Reporting guidelines that could be applied to guide surgical technique reporting vary in methodology for development, discipline coverage, dimension coverage and detail requested. However, a scoping review that could indicate the gaps and effor...

En las dos últimas décadas la evolución de la cirugía mínimamente invasiva del tórax ha transmutado de un abordaje de tres puertos, siguiendo dos puertos hasta llegar a puerto único, conocido también como VATS Uniportal, procurando un confort mucho mejor para el paciente y resultados quirúr-gicos similares. Objetivos. Presentar la técnica quirúrgic...

Objectives: Uniportal (U-VATS) pneumonectomy in lung cancer patients remains disputed in terms of oncological outcomes, and has not been compared to open approaches previously. We evaluated U-VATS versus open pneumonectomy at a high-volume centre. Methods: Patients undergoing pneumonectomy for lung cancer between 2014 and 2018 were retrospective...

Background: The study aims to identify prognostic factors of overall survival (OS) in patients who had pneumonectomy, in order to develop a practical dynamic nomogram model. Methods: A total of 2,255 patients with non-small cell lung cancer (NSCLC) who underwent pneumonectomy were identified from 2010-2015 in the Surveillance, Epidemiology, and...

Objective Spontaneous ventilation video-assisted thoracic surgery (SV-VATS) is reported to have superior or equal efficacy on postoperative recovery to mechanical ventilation VATS (MV-VATS). However, perioperative safety of the SV-VATS blebectomy is not entirely demonstrated. Methods We performed a non-inferiority, randomized controlled trial (NCT...

Background: Sleeve lobectomy has been reported to be a safe procedure after neoadjuvant chemotherapy. We aim to evaluate the oncological and surgical outcomes of neoadjuvant chemoimmunotherapy (IO+C) for local advanced non-small cell lung cancer (NSCLC) patients who underwent sleeve lobectomy. Methods: NSCLC patients that underwent sleeve lobect...

The emergence of epidemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in December 2019 in Wuhan, China causing Coronavirus Disease 2019 (COVID-19) and its rapid expansion around the world, leading to a global pandemic of dimensions not observed at least since the “Spanish influenza” pandemic in 1917-18, has had great consequences a...

Surgery still offers the best option for patients with early stage non-small cell lung cancer that can tolerate surgery. With the increase in screening programs, more patients are diagnosed at early stages of cancer. Sadly, not all of them are fit for surgery, but with minimally invasive approaches, large number of those patients can be offered sur...

Training is one of the main surgical aims a thoracic surgeon is looking for. Training in video-assisted thoracoscopic anatomical lung resection has been one of the cornerstones in the world of thoracic surgery training in the last decade. The shift from open to thoracoscopic lobectomy is a challenge that always required expert advice and hands-on s...

OBJECTIVES The goal of this study was to compare the feasibility and safety of uniportal thoracoscopic segmentectomy (UTS) with that of multiportal thoracoscopic segmentectomy (MTS). METHODS From January 2014 to December 2015, a total of 1056 patients who underwent thoracoscopic segmentectomy were identified, including 375 and 681 who had simple a...

Pathology arising from the intrathoracic portion of the trachea (distal trachea), the carina and the main bronchi is usually neoplastic and is mainly treated with surgery. Resection of the intrathoracic portion of the trachea, the carina and the main bronchi for neoplastic lesions does not necessitate lung resection and is traditionally being condu...

The use of video-assisted thoracic surgery (VATS) as an approach for early-stage lung cancer treatment has revealed benefits compared to open surgery by minimizing trauma to the patients. This trend has brought the evolution of VATS to less and less invasive methods, eventually leading to the development of Uniportal VATS (UniVATS) technique. This...

Objectives To compare short- and long-term outcomes between sleeve lobectomy and pneumonectomy for lung cancer in a single center during a 15 years period. Methods 1981 patients who underwent either a sleeve lobectomy (964, 48.7%) or a pneumonectomy (1017, 51.3%) from January 2003 to December 2017 at the Shanghai Pulmonary Hospital, were matched a...

Objectives: Important benefits in uniportal video-assisted thoracoscopic surgery (VATS) for lung cancer have recently been achieved. However, the use of this technique for complex sleeve procedures is limited. We describe the technical aspects of and patient outcomes following carinal resections using uniportal VATS. Methods: Since 2015, 16 slee...

Objectives To compare short- and long-term outcomes between sleeve lobectomy and pneumonectomy for lung cancer in a single center during a 15 years period. Methods 1981 patients who underwent either a sleeve lobectomy (964, 48.7%) or a pneumonectomy (1017, 51.3%) from January 2003 to December 2017 at the Shanghai Pulmonary Hospital, were matched a...

Surgical scientific literature contains relatively little information regarding the surgical outcomes of anatomic sublobar resections performed with the uniportal video-assisted thoracoscopic surgery (U-VATS) technique. This paper attempts to evaluate the role of U-VATS segmentectomies in the landscape of a minimally invasive approach to the treatm...

Background: Since 2004, uniportal video-assisted thoracic surgery (VATS) approach was progressively widespread and also applied in the treatment of thymoma, with promising results. We report the first series of patients who undergone uniportal VATS thymectomy using a homemade glove-port with carbon dioxide (CO2) insufflation. The aim of this articl...

Open in new tabDownload slide Open in new tabDownload slide Summary Uniportal video-assisted thoracoscopic surgery may be the approach for any thoracic procedure, from minor resections to complex reconstructive surgery. However, anatomical lobectomy represents its most common and clinically proven usage. A wide variety of information about unipor...

Background: Tumor immune infiltration is closely associated with clinical outcome in lung cancer. We aimed to develop an immune signature to improve the prognostic predictions of lung adenocarcinoma (LUAD). Methods: We applied "Cell type Identification by Estimating Relative Subsets of RNA Transcripts" method to quantify the fraction of 22 leuko...

Background The superiority of robot‐assisted thoracic surgery (RATS) over video‐assisted thoracic surgery (VATS) and thoracotomy remains controversial for lung cancer. Methods A network meta‐analysis (NMA) and pairwise meta‐analysis (PMA) were performed to evaluate the perioperative outcomes using 5 databases. Results Thirty‐two studies involving...

The competency in video-assisted thoracoscopic (VATS) lobectomy is expected to be achieved after surgeons practiced 30 to 50 cases according to previous reports. Does single port video-assisted thoracoscopic (SPVATS) lobectomy have a steeper learning curve and being harder to perform correctly, leading to long development times and high defect rate...

Objectives The aim of this study was to investigate the adequacy of bronchial sleeve lobectomy by video-assisted thoracoscopic surgery (VATS) in perioperative outcomes and its oncological efficacy by comparing to that by thoracotomy in a balanced population. Methods 363 patients who received bronchial sleeve lobectomy for NSCLC from January 2013 t...

Open in new tabDownload slide Open in new tabDownload slide Double sleeve, bronchial and vascular reconstructions are challenging procedures indicated for centrally located tumours to avoid pneumonectomy. Traditionally, these resections have been performed by thoracotomy, but thanks to advances in imaging systems, better surgical instruments and t...