CHEST Guidelines-Doing-More-and-Doing-Better-in-Robotic-Thoracic-Su (2)

Doing-More-and-Doing-Better-in-Robotic-Thoracic-Su (2)

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The document discusses two separate medical topics: antibiotic adherence in children with respiratory infections and the adoption of robotic surgery for pulmonary procedures.<br /><br />In the first section, the focus is on protracted bacterial bronchitis (PBB) in children. The authors highlight the importance of monitoring antibiotic adherence and the role of biofilms in children's airways, which may hinder treatment effectiveness. There is concern that biofilms can block antibiotics and immune responses, and subinhibitory concentrations of antibiotics can enhance biofilm formation. Though higher doses and prolonged antibiotic courses might reduce biofilms and recurrent PBB, clinical evidence is lacking. Emphasis is placed on parental education about adherence to prevent bacterial resistance and treatment failures. Additionally, studies are suggested to better understand PBB and related conditions.<br /><br />The second section addresses the outcomes of robotic lobectomies, a surgical procedure for lung cancer. A study by Tchouta et al. found that high-volume centers performed these surgeries with better outcomes, such as shorter hospital stays and lower mortality rates, compared to low-volume centers. Concerns are raised about many robotic surgeries being conducted at hospitals without sufficient experience, potentially skewing results. While robotic surgery offers several advantages, such as reduced cost and improved outcomes in some single-center studies, it is highlighted as an expensive procedure due to equipment costs. Increased competition in the robotic surgery market is expected to reduce costs. The letter from Novellis et al. stresses the need for surgeons to attain a certain proficiency level, typically around 20 procedures, to maximize the effectiveness of robotic surgeries. <br /><br />Overall, the document underscores the need for adherence to antibiotic regimens, calls for more research into optimal antibiotic strategies, and discussions around the cost-efficiency and proficiency demands of robotic surgery in clinical practice.

Keywords

antibiotic adherence

protracted bacterial bronchitis

biofilms

pediatric respiratory infections

parental education

robotic lobectomy

lung cancer surgery

surgical proficiency

healthcare costs

clinical outcomes