Background/Objectives: The aim of this study was to analyze whether the implementation of artificial intelligence (AI), specifically the Natural Language Processing (NLP) branch developed by OpenAI, could help a thoracic multidisciplinary tumor board (MTB) make decisions if provided with all of the patient data presented to the committee and supported by accepted clinical practice guidelines. Methods: This is a retrospective comparative study. The inclusion criteria were defined as all patients who presented at the thoracic MTB with a suspicious or first diagnosis of non-small-cell lung cancer between January 2023 and June 2023. Intervention: GPT 3.5 turbo chat was used, providing the clinical case summary presented in committee proceedings and the latest SEPAR lung cancer treatment guidelines. The application was asked to issue one of the following recommendations: follow-up, surgery, chemotherapy, radiotherapy, or chemoradiotherapy. Statistical analysis: A concordance analysis was performed by measuring the Kappa coefficient to evaluate the consistency between the results of the AI and the committee’s decision. Results: Fifty-two patients were included in the study. The AI had an overall concordance of 76%, with a Kappa index of 0.59 and a consistency and replicability of 92.3% for the patients in whom it recommended surgery (after repeating the cases four times). Conclusions: AI is an interesting tool which could help in decision making in MTBs.

There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1–3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60–70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival.

Background: Lung resection using video-assisted thoracoscopic surgery (VATS) improves surgical accuracy and postoperative recovery. Unfortunately, moderate-to-severe acute postoperative pain is still inherent to the procedure, and a technique of choice has not been established for the appropriate control of pain. In this study, we aimed to compare the efficacy and safety of intrathecal morphine (ITM) with that of intercostal levobupivacaine (ICL). Methods: We conducted a single-center, prospective, randomized, observer-blinded, controlled trial among 181 adult patients undergoing VATS (ISRCTN12771155). Participants were randomized to receive ITM or ICL. Primary outcomes were the intensity of pain, assessed by a numeric rating scale (NRS) over the first 48 h after surgery, and the amount of intravenous morphine used. Secondary outcomes included the incidence of adverse effects, length of hospital stay, mortality, and chronic post-surgical pain at 6 and 12 months after surgery. Results: There are no statistically significant differences between ITM and ICL groups in pain intensity and evolution at rest. In cough-related pain, differences in pain trajectories over time are observed. Upon admission to the PACU, cough-related pain was higher in the ITM group, but the trend reversed after 6 h. There are no significant differences in adverse effects. The rate of chronic pain was low and did not differ significantly between groups. Conclusions: ITM can be considered an adequate and satisfactory regional technique for the control of acute postoperative pain in VATS, compatible with the multimodal rehabilitation and early discharge protocols used in these types of surgeries.

Electronic patient-reported outcome-based symptom management, a new era in surgical patient management