Introduction: The robotic-assisted (RATS) lobectomy learning curve is usually measured compared to an established videothoracoscopic (VATS) surgery program. The objective of our study is to compare the learning curves of both techniques. Methods: We performed an intention-to-treat analysis comparing the RATS vs. VATS lobectomies. Surgical time, conversions, complications, number of lymph nodes (LNs) and lymph node stations harvested, chest drainage duration, length of stay, readmissions, and 90-day mortality were compared between both groups. The learning curve was assessed using the CUSUM method. Results: RATS cases (30) and VATS cases (35) displayed no significant differences. The RATS learning curve was completed after 23 procedures while the VATS curve required 28 interventions. Complications appeared in four RATS procedures and in eight VATS patients. No differences in the number of LNs and harvested LN stations were reported. Four patients were readmitted in the RATS group, and eight in the VATS group. No 90-day postoperative mortality was observed in either group. The RATS group reported fewer chest tube days (3 (2–5) vs. 5 (4–5.8), p = 0.005) and hospital days (4 (3–6) vs. 5 (4–6), p = 0.023). Conclusions: The RATS curve appears shorter than the VATS curve. RATS lobectomies resulted in reduced chest tube duration and length of stay during the learning time period.

Background: Primary focal hyperhidrosis, characterized by excessive sweating primarily affecting the hands and axillae, can significantly impact quality of life. Bilateral thoracic sympathectomy is the gold standard treatment, providing permanent resolution of palmar hyperhidrosis. Most studies evaluating outcomes and patient satisfaction after sympathectomy focus on short- to medium-term follow-up, typically up to 5 years. This study aimed to assess anxiety, satisfaction, and sweat redistribution 20 years after bilateral endoscopic thoracic sympathectomy. Methods: Between January 2002 and December 2003, 106 patients with primary hyperhidrosis underwent bilateral endoscopic thoracic sympathectomy targeting ganglia T2–T3 at our center. The patients were contacted via telephone in 2023 and asked to complete the same survey they had filled out preoperatively and 12 months postoperatively. The survey evaluated sweat redistribution, anxiety, hyperhidrosis-related symptoms, and satisfaction. Anxiety, satisfaction, and perceived sweating were rated using a 5-point visual analog scale (VAS) ranging from 0 (unsatisfied/no symptoms) to 4 (very satisfied/severe symptoms). Results: Of the 106 eligible patients, 24 (22.6%) completed the survey. Most reported persistent anhidrosis (palmar or palmar–axillary) 20 years post-surgery. The survey results remained consistent with those at the 1-year follow-up. Significant sweat redistribution to the abdomen and back was observed. Patient satisfaction remained high, with no significant differences between the 1-year and 20-year assessments. Anxiety significantly decreased compared to preoperative levels (p < 0.001). Conclusions: Bilateral endoscopic thoracic sympathectomy is an effective long-term treatment for reducing excessive sweating. Patient satisfaction remains high over time, despite the persistence of compensatory sweating.

Surgical treatment of localized cancer has proven to be a significant option in terms of oncological and functional results. Currently there are three approaches: open surgery, laparoscopic and robotic surgery. The latter underwent a technological surveillance exercise, this is a management tool that helps to reduce the risk of the high direction decisions, it develops in a series of stages: planning, search and capture, analysis and organization, intelligence and communication. Through this exercise, it was determined the evolution of technologies for robotic surgery and which ones are currently on the market, the variety of possible procedures within this approach and oncology applications, the scientific production of countries, institutions and the reflection of this in patent development; the following serve as protocol for decisionmaking.

Background: Hematological indices such as the neutrophil-lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and systemic immune inflammation index (SII) have been proposed as markers of inflammatory disease and prognostic indicators in some tumors, but their role remains controversial. This study aims to evaluate the relationship between these indices and postoperative complications in patients undergoing robotic-assisted anatomic lung resection for oncological purposes. Methods: This retrospective, single-center study included patients who underwent anatomical lung resection from January 2022 to June 2023 using robotic-assisted surgery. The data collected included hematological variables, demographic information, body mass index (BMI) data, information about pulmonary function, medical history, postoperative outcomes, and survival data. Results: A total of 96 patients were included, with a median BMI of 26.10. The data distribution across demographic and clinical variables was homogeneous. Univariate and multivariate analyses revealed no significant association between preoperative or postoperative inflammatory indices and postoperative complications, persistent air leak (PAL), or 1-year mortality. Conclusions: This small, retrospective study with short-term follow-up found no significant relationship between inflammatory indices and postoperative outcomes. These findings suggest that SII and similar indices are not reliable predictors of complications, PAL, or mortality in patients undergoing robotic-assisted anatomic lung resection.

This clinical case shows the repercussions of acute exposure to cement dust in the respiratory tract and other mucous membranes. Following a cement dust pipe explosion, the patient endured a severe inhalation of dust. A combination of rigid bronchoscopy and a mechanical insufflation–exsufflation system was employed to remove cement debris from the airways. Respiratory physiotherapy sessions were implemented for effective secretion clearance, contributing to a successful short-term recovery. While this remains an isolated case, the unconventional techniques employed provide valuable insights for potential similar scenarios in the future.