Harvard Catalyst Profiles

Hypothesis: The adoption of a standardized technique to dissect the N1 intrapulmonary stations 12, 13 and 14 from the lobectomy specimen will significantly increase the total number of stations and LN dissected which will improve the pathologic staging accuracy of patients with NSCLC undergoing upfront surgery. Primary Objective: To compare the number of stations and lymph nodes sampled when adopting a standardized technique compared to the conventional (prior) technique. Determine the number of cases upstaged to N1 with the intrapulmonary lymph node dissection compared to the conventional technique. General description of the study This is a multi-institutional prospective study where a subset of lobectomy specimens’ resection will undergo systematic lymph node dissection either by the patient’s treating thoracic surgeon and/or by a member of the pathology team in the institution’s frozen section room. Regardless of who does the dissection, the material provided to the prosectors aims to clarify and standardize the way intrapulmonary lymph node dissection is performed. All study team members will receive a Lung Lobectomy Lymph Node Dissection Quality Improvement Manual with videos, images, and a protocol for a standardized lymph node dissection. This will include a series of blunt peribronchial dissections starting from the hilum to the periphery, with special attention to points of airway bifurcation where intrapulmonary lymph nodes aggregate This is a great opportunity to join a prospective trial in lung cancer involving both surgeons and pathologist.

Hypothesis: Prophylactic use of endoluminal vacuumtherapywill reduce the incidence of anastomotic leaks in patients undergoing elective esophagectomy. Primary objective: To assess the incidence of postoperative anastomotic leak inpatients with prophylacticuse of esophageal endoluminal vacuum therapy compared to those without General Description of Study Design This is a controlled trial. Patients would be randomly assigned to either a control group (receiving standard surgery without endoluminal vacuum therapy which consist of esophagectomy, partial gastrectomy and lymphadenectomy) or an intervention group (receiving prophylactic endoluminal vacuum therapy).