This study aimed to conduct a systematic review and meta‐analysis comparing video‐assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) in the context of pulmonary metastasectomy. Three databases were assessed. The primary outcome was overall survival. The secondary outcomes were recurrence‐free survival, ipsilateral recurrence, and hospital length of stay (LOS). Hazard ratios (HRs), odds ratios (ORs), and mean difference (MD) with 95% confidence intervals (CIs) were calculated. Reconstruction of time‐to‐event data and sensitivity analyses were performed for the primary endpoint. After screening, 11 studies were included encompassing 2159 patients undergoing lung metastasectomy (VATS: 827; OT: 1332). Compared to OT, patients who underwent VATS had higher overall survival rates (HR 0.75; 95% CI 0.67–0.85; p < 0.01), no significant difference in recurrence‐free survival (HR 1.07; 95% CI 0.88–1.29; p = 0.48), shorter hospital LOS (MD −1.99 days; 95% CI −2.59 to −1.39; p < 0.01), and no significant difference in ipsilateral recurrence rates (OR 0.86; 95% CI 0.52–1.42; p = 0.56). For patients undergoing pulmonary metastasectomy, VATS strategy is associated with higher survival rates and reduced hospital LOS when compared with OT. Moreover, metastasis recurrence does not seem to be associated with long‐term mortality in this population.

Lung transplantation is a crucial treatment for end-stage lung diseases. However, postoperative pain management remains a significant challenge. Therefore, this study aims to examine the implications of adoption cryoanalgesia on lung transplantation pain control protocol. Three databases were searched for studies comparing cryoanalgesia versus standard of care analgesia in patients after lung transplantation. The primary outcome was opioid consumption throughout the entire hospitalization, at postoperative day (POD) 7 and at POD 14 addressed with Morphine Milligram Equivalents (MME). The secondary outcomes were maximum reported pain score at POD 7, hospital length of stay (LOS) and time until extubation. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated for continuous outcomes. A total of 5 studies encompassing 485 patients undergoing lung transplantation were included, of whom 228 underwent cryoanalgesia. Compared to standard of care, cryoanalgesia demonstrated significant reduction in opioid consumption at POD 7 (MD: −96.79 MME, 95% CI −183.40 to −10.18, p=0.03), at POD 14 (MD −225,26 MME; 95% CI −366.58 to −83.94; p<0.01) and throughout the entire hospitalization (MD: −307.76 MME, 95% CI −461.72 to −153.79, p<0.01). In addition, there was a significant reduction in pain scores in the cryoanalgesia group (MD: −1.10 points, 95% CI −1.77 to −0.43, p<0.01). However, no significant differences were found regarding hospital LOS or time until extubation. This meta-analysis indicates that cryoanalgesia effectively reduces opioid requirements and pain levels in lung transplant patients.

The use of extracorporeal membrane oxygenation (ECMO) during lung transplantation has progressively expanded and, in many centers, replaced conventional cardiopulmonary bypass. However, it remains unclear whether central or peripheral veno-arterial (VA) ECMO provides superior postoperative outcomes. This study aimed to compare central VA-ECMO (cVA-ECMO) and peripheral VA-ECMO (pVA-ECMO) during lung transplantation, with a focus on survival, primary graft dysfunction grade 3 (PGD3), postoperative ECMO support, and postoperative morbidity. Three databases were assessed through November 2025. Five retrospective observational studies including 866 patients were included. Overall survival was analyzed using reconstructed individual patient data derived from Kaplan–Meier curves. Random-effects models were applied for all pooled analyses. There was no significant difference in overall survival (HR 1.224, p=0.13) and in PGD3 at 72 h incidence (OR 1.55; p=0.26) between cVA-ECMO and pVA-ECMO. However, pVA-ECMO was associated with a higher requirement for postoperative ECMO use (OR 6.05; p=0.04), longer duration of extracorporeal support (MD +1.61 days; p=0.01), prolonged mechanical ventilation (MD +2.73 days; p<0.01), and longer intensive care unit length of stay (MD +4.05 days; p<0.01). The risk of limb ischemia requiring invasive treatment was significantly higher with pVA-ECMO (OR 4.94; p=0.001). Although survival and PGD3 incidence were comparable, pVA-ECMO was associated with greater postoperative morbidity and vascular complications. These findings should be interpreted with caution, and cannulation strategy should be individualized according to patient risk profile, surgical context, and center-specific expertise rather than favoring one approach uniformly.

Marfan syndrome (MFS) and Loeys–Dietz syndrome (LDS) are hereditary connective tissue diseases, both characterized by aortic root and vessel involvement with an increased risk of aneurysms and dissections. Despite advances in surgical techniques and improved postoperative follow-up, the impact of surgery on long-term outcomes in these patient groups is still unknown. We performed a systematic review and a meta-analysis to compare the postoperative long-term events. The main outcome was long-term survival. Additional outcomes were freedom from dissection and reoperation. After reconstruction of time-to-event data for the individual survival analysis, pooled Kaplan–Meier curves for the endpoints were generated. A total of 1,794 studies were identified, of which 5 were included in the analysis, encompassing 1,005 patients (MFS: 778; LDS: 227). With MFS as the reference group, there was no significant difference in long-term survival between both groups, based on age (hazard ratio [HR]: 0.919; 95% confidence interval [CI]: 0.58–1.45; p=0.717) or postoperative follow-up (HR: 0.997; 95% CI: 0.45–2.19; p=0.995). However, LDS was associated with higher risk of dissection (HR: 0.331; 95% CI: 0.21–0.53; p<0.005) and reoperation (HR: 0.603; 95% CI: 0.40–0.90; p=0.014), reflecting unadjusted comparisons reconstructed from Kaplan–Meier curves. Although long-term survival is similar between MFS and LDS patients, those with LDS face a significantly higher risk of aortic dissection and reoperation. This elevated risk may be partly explained by the intrinsic genotypic heterogeneity of the LDS population. However, our pooled analysis could not fully adjust for this heterogeneity, underscoring the need for vigilant lifelong imaging surveillance and individualized surgical thresholds in LDS.

The left internal mammary artery (LIMA) remains the preferred conduit for coronary artery bypass grafting (CABG). However, diabetic patients face an increased risk of deep sternal wound infection (DSWI), particularly after pedicled LIMA harvesting, which may impair sternal perfusion. Skeletonized harvesting preserves sternal vascularity and may reduce infection risk, but current evidence remains limited and inconsistent. Three different databases were assessed. The primary outcome was the occurrence of DSWI. Secondary outcomes were hospital length of stay (LOS), cardiopulmonary bypass (CPB) time, blood transfusion rates, and aortic cross-clamp time. A random effects model was performed. Three retrospective studies involving 400 diabetic patients were included, of whom 190 underwent skeletonized and 210 pedicled LIMA harvesting. Skeletonized harvesting was associated with significantly reduced risk of DSWI (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.07–0.88; p = 0.031). CPB (mean difference [MD]: 3.03 minutes; 95% CI: 1.18–4.88; p = 0.001) and aortic cross-clamp times (MD: 3.06 minutes; 95% CI: 2.03–4.10; p < 0.001) were slightly longer in the skeletonized group. No significant differences were observed in hospital LOS (p = 0.159) or blood transfusion requirements (p = 0.959). Skeletonized LIMA harvesting is associated with lower odds of DSWI in diabetic patients undergoing CABG, despite modestly longer operative times.

To describe tomographic findings in a high-risk lung cancer population in resource-limited Brazilian areas, quantify pulmonary nodules and lung cancer frequency, analyze challenges in lung cancer screening within the Brazilian public health system, assess lung function in individuals with moderate or severe emphysema, and evaluate the role of community health agents in recruiting high-risk populations. This is a prospective, single-arm, longitudinal observational study involving individuals aged 50–80 years, current or former smokers with a smoking history of at least 20 pack-years, undergoing low-dose computed tomography (LDCT) with a 12-month follow-up. Screening results are classified according to Lung-RADS v2022 standards, with those rated as 3 or 4 undergoing further diagnostic assessments. The study aims to demonstrate the feasibility and effectiveness of lung cancer screening in socially vulnerable populations within resource-limited settings, providing essential insights to reduce mortality and improve health outcomes. The findings will assist the development of policies on lung cancer screening in the public health system. The study’s dissemination plan includes a website, social media, and participation in scientific conferences.