OncoReview

Is there a place for robotic surgery in modern thoracic oncosurgery?

Michal Grabysa — 2025-05-28

Robotic-assisted thoracic surgery (RATS) has transformed the management of thoracic oncologic diseases, including lung cancer, mediastinal tumors, and esophageal cancer, by offering precision, reduced invasiveness, and enhanced visualization compared to open thoracotomy and video-assisted thoracoscopic surgery (VATS). This review evaluates RATS’ current role and future potential, analyzing oncologic efficacy, clinical outcomes, and economic implications. RATS demonstrates shorter hospital stays, lower complication rates and survival rates equivalent to traditional methods.

Despite challenges such as high costs and steep learning curves, technological advancements – artificial intelligence (AI), single-port systems, and haptic feedback – promise to expand its utility.

Drawing on literature from 2015 to 2025, this paper affirms RATS’ vital place in modern thoracic surgery, particularly in thoracic oncology, with its role poised to grow as economic and training barriers are overcome. The future of RATS depends on innovation and accessibility, which could lead to changes in the standards of care in the coming years.

Management Of A Case Of Left Atrial Myxoma Presenting With Right Ventricular Dysfunction And Pulmonary Artery Hypertension

Saylee Madnoorkar — 2025-05-28

Left atrial myxomas are rare primary cardiac tumors, accounting for approximately 0.5% of all cardiac tumors per million individuals annually. Although histologically benign, their strategic location and potential for obstructive or embolic complications often render them clinically significant. These tumors predominantly arise from the interatrial septum and may present with a constellation of non-specific systemic and cardiorespiratory indications, mimicking various cardiac or pulmonary pathologies. A middle-aged subject with progressive dyspnea, fatigue, and signs of cardiorespiratory compromise was studied in this case study. Initial laboratory investigations revealed elevated renal parameters suggestive of end-organ involvement or hypoperfusion. Further evaluation with two-dimensional echocardiography (2D ECHO) revealed the presence of a large left atrial mass, consistent with a myxoma, prolapsing through the mitral valve during diastole. Associated findings included severe pulmonary artery hypertension (PAH) and right ventricular (RV ) dysfunction. The left ventricular ejection fraction (EF) was preserved at 55%, indicating isolated right-sided compromise. The patient was hemodynamically stabilized using appropriate medical management prior to surgical intervention. Optimization involved correction of fluid balance, management of renal function, and supportive treatment for RV dysfunction and PAH. Once stable, the case experienced successful surgical excision of the tumor via median sternotomy and cardiopulmonary bypass. Histopathological examination established the identification of atrial myxoma. The postoperative recovery was predominantly unremarkable, with gradual improvement in cardiopulmonary function and normalization of renal parameters. This case highlights the importance of early recognition and comprehensive evaluation of cardiac tumors, particularly myxomas, which can have life-threatening consequences if not promptly diagnosed and managed.

Management of hydrocephalus after cerebellar pilocytic astrocytoma in a pediatric patient: case report and literature review

Daniel Encarnación-Santos — 2025-05-28

Background: Pilocytic astrocytoma (PA) is the most common brain malignancy in children. PA is a distinct histological and biological subgroup of gliomas that have a slow growth rate. Most PAs are located infratentorial and in the median cerebral structures such as the optic nerve, brain stem, and hypothalamus. Hydrocephalus is a common finding in patients with PA.
Case presentation: In this report, we describe a case of a patient treated surgically for PA who developed a common complication – hydrocephalus. Pre-operative dilatation of the lateral ventricles with transependymal cerebrospinal fluid flow along with her young age were defined as the risk factors. She required numerous interventions and the findings along with treatment modalities are discussed in detail.
Conclusions: Cases with pre-existing risk factors for post-operative hydrocephalus should be evaluated prophylactic cerebrospinal fluid diversion surgery. If a more conservative approach is employed, the patients’ neurological status and ventricle size should be closely monitored. Pediatric patients are negatively affected with repetitive surgeries in terms of physical and mental health. Thus, in order to avoid additional interventions, pre-operative planning of all available options should be discussed with the family.