Background: Early post-operative airway management after laryngo-tracheal surgery is crucial. Acute respiratory failure due to glottis’ edema may occur, requiring reintubation. This can prolong ventilatory assistance, jeopardizing anastomosis. To date, only judicious steroid administration and fluid management are available to avoid more invasive procedures. High-flow oxygen therapy (HFOT) is a noninvasive O₂ support method providing humidification, warmed air, and Positive End-Expiratory Pressure (AIRVO2). No data about HFOT use to prevent early complications after laryngo-tracheal surgery are reported in the literature. Methods: Between September 2020 and September 2022, 107 consecutive patients who underwent laryngo-tracheal surgery received HFOT (Group A). Data and long-term results were compared with those of 80 patients operated between September 2018 and August 2020 (Group B), when HFOT was not available. All patients were operated in a single center. No pre- or post-operative settings changed, except for HFOT introduction. We analyzed and compared the risk for “delayed” reintubation (unexpected reintubation within the first 24–48 h after extubating/laryngeal mask removal) in the two groups. Results: No patients reported HFOT-related adverse events. The control group (B) presented “delayed” reintubation in 37% (p = 0.027), intensive care unit admission in 67% (p = 0.005) and longer hospital stay (p = 0.001) compared to the HFOT group (A). The minor complications’ rate was 3% in both group and overall mortality was 0%. Re-stenosis was described in 4.6% of the HFOT group, without a statistically significant difference (p = 0.7006). Conclusions: Our study is the first to investigate HFOT use in patients undergoing laryngo-tracheal surgery, potentially representing a consistent innovation in the peri-operative management of these patients. With the limitation of a retrospective series, we would suggest HFOT use for preventing post-operative reintubation rate, possibly reducing ICU admissions and hospital stays.

Background/Objectives: Neuroendocrine tumors (NETs) of the lung account for about 30% of NETs. In localized and locally advanced forms, radical surgical resection is the standard of care. Although considered indolent tumors, they appear to be susceptible to post-surgical recurrence, with rates differing between typical and atypical carcinoid. Although still debated, several clinicopathologic factors are potentially associated with recurrence. The aim of this retrospective/prospective observational study is to evaluate the predictive role of clinicopathological factors and radiomics features in patients with NET of the lung. Methods: From January 2021 to April 2024, 45 consecutive patients who underwent radical (R0) surgery for lung NET at the ENETS Center of Excellence of the Sant’Andrea Hospital were enrolled, all with at least 12 months of postoperative follow-up and availability of preoperative unenhanced chest CT. Clinicopathologic and radiomic factors were considered (107 radiomic features). Of the individual characteristics, the impact on recurrence was assessed by univariate logistic regression. Results: Among the 45 patients included, 4 patients (8.9%) experienced disease recurrence. Among the clinicopathological features, major age at diagnosis (p = 0.020), atypical carcinoid (p = 0.010), presence of functional syndrome (p = 0.002), advanced stage at diagnosis (p = 0.013), necrosis (p = 0.017) higher Ki-67 (p = 0.001), higher mitotic count (p = 0.006), and pathologic lymph node (p = 0.006) were associated with disease recurrence. Three radiomic features were found to predict recurrence: DependenceEntropy (p = 0.049), DependenceNonUniformityNormalized (p = 0.024), and Elongation (p = 0.039). In this preliminary analysis, multivariate analysis was not performed due to the small sample size. Conclusions: This study has shown that radiomics can be a valuable tool in predicting recurrence. Currently, to our knowledge, no other studies on the possible application of radiomics as prognostic factors in patients with lung NET have been published. These encouraging findings warrant further investigations with larger, multicenter cohorts to validate these results and implement them by constructing a predictive model of recurrence.