Journal and News Scan

This study evaluated the SHURUI single-port (SP) robotic system for uniportal robotic-assisted thoracic surgery (RATS) in lung cancer patients. Unlike conventional multi-incision systems, the SHURUI SP utilizes a single, highly flexible robotic arm, aiming to improve maneuverability and minimize incision size, which is especially beneficial for patients with limited thoracic space. In a phase I/II trial, 35 patients (median age 58) underwent lobectomy or segmentectomy. All surgeries were completed successfully, with no need to switch to other surgical methods or make additional incisions. The median operative time was 155 minutes, with minimal blood loss and no transfusions required. The 30-day complication rate was low at 11.43 percent, with no major issues or readmissions, and patients were typically discharged after four days. Compared to the multiple fully jointed arms required for the da Vinci single-port, the SHURUI SP provides a potential single-port alternative. 

This study investigated the long-term outcomes of hardware removal (HR) in patients who had previously undergone surgical fixation for blunt chest trauma, with a median of 11.5 rib fractures stabilized per patient. A retrospective review spanning 2017 to 2023 was performed, with follow-up assessments conducted approximately 28 months after HR. The study focused on improvements in mobility, self-care, daily activities, mental health, and symptoms such as chest pain and tightness. Among 28 patients, HR was primarily performed due to persistent pain, discomfort, chest tightness, hardware dislocation, or infection, usually around 18 months after the initial surgery. Surgeons employed a muscle-sparing technique through the previous incision, with or without excision. Patients experiencing chest tightness and infections reported the greatest symptom relief, with 75 percent showing improvement, followed by those with hardware dislocation. All patients in these groups expressed full satisfaction and a willingness to undergo HR again if needed. 

This study analyzed pregnancy outcomes in female lung transplant (LuT) recipients, focusing on modifiable factors that could improve outcomes. Using data from the Transplant Pregnancy Registry International (TPRI), the study included 53 women who reported 72 pregnancies after LuT between 1991 and 2021. Most transplants were performed due to cystic fibrosis or pulmonary hypertension. Notably, only 36 percent of participants used contraception post-transplant, and 54 percent of the pregnancies were unplanned. The live birth rate was 62 percent; however, 60 percent of babies were premature and of low birth weight. Birth defects were reported in 16 percent of cases, but none were linked to mycophenolic acid usage. 
 
Unplanned pregnancies were associated with lower maternal survival and poorer newborn outcomes, including lower gestational age and birth weight. In contrast, planned pregnancies resulted in healthier babies and better maternal survival. These findings highlight that effective pregnancy planning is the most important modifiable factor for improving outcomes for both mothers and their children after lung transplantation. 

This article investigated the role of different definitions of warm ischemia time during donation after circulatory death (DCD) heart transplants and the development of severe primary graft dysfunction (PGD). The authors found that prolonged donor hypoxia before normothermic regional perfusion (NRP)—specifically, more than 23 minutes in patients with a functional warm ischemic time defined by oxygen saturation below 80 percent—was associated with significantly higher rates of severe PGD. Interestingly, the authors also identified a linear association suggesting that elevated PGD rates correlated with increased ischemia time. Other outcomes, such as overall mortality and length of hospital stay, were not significantly different.