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Dr. Alessandro Brunelli is currently working at the Division of Thoracic Surgery, Ospedali Riuniti Ancona, Ancona, Italy, which is the only specialized center of thoracic surgery in the Marche Region.
The Division of Thoracic Surgery is a 8-bed, dedicated thoracic surgery unit, with qualified personnel, dedicated to the care of thoracic surgical patients. The unit is staffed with 4 certified thoracic surgeons and 3 residents. Surgical diseases of airways, chest wall, lung, pleura, mediastinum are among the most frequently conditions managed in the unit.
Dr. Brunelli main interests focus on the Quality of Care evaluation and improvement, Data Capturing, and performance monitoring. He has developed, validated and published several Risk-adjusted outcome models that are currently used to track the internal performance of the Division on a quarterly basis during Quality Management Conferences .
Dr. Brunelli is currently member of the Database Committee, the Audit and Clinical Excellence ad hoc Committee, the Scientific Committee and the Annual Meeting Committee of the European Society of Thoracic Surgeons.
He is Author of approximately 70 articles in peer-reviewed impact factored scientific journals such as The Journal of Thoracic and Cardiovascular Surgery, The Annals of Thoracic Surgery, The European Journal of Thoracicand Cardiovascular Surgery, Chest, Thoracic Surgery Clinics, Respiration and others.
Peri-operative processes of Care have been standardized according to evidence-based guidelines. Fast-tracking policies and Quality of Life evaluation are applied rountinely to all patients.
The 2007 institutional surgical volume for major lung resections (lobectomy/pneumonectomy) has been 100 cases, with a 0% mortality rate (versus a predicted mortality of 4%), and a median hospital stay for lobectomy of 5 days. 60% of cases have been discharged home before the 6th postoperative day after a major lung resection (see Internal Audit link).
The other principle interest of Dr. Brunelli is the preoperative functional evaluation of the thoracic surgical patient. Dr. Brunelli is currently the Chair of a European Respiratory Society/European Society of Thoracic Surgeons joint task force appointed to develop guidelines for the selection of patients for lung resection (see task force Questionnaire link).
Before the operation all patients are evaluated with a complete work-up including a cardiologica examination, Pulmonary Function tests, Carbon Monoxide Lung Diffusion Capacity measurement, maximal stair climbing test, cycle-ergospirometry with measurement of VO2 and VCO2 during effort.
This throughout evaluation allowed to select the most appropriate treatments for patients with lung cancer and to optimize their peri-operative management, including planned admission to advanced care facilities.
Another main interest of Dr. Brunelli is the minimally invasive approach the the Chest. The unit adopted the uniportal VATS technique for operations on spontaneous pneumothorax, lung and mediastinal biopsies, and other diseases normally managed by VATS procedures. By using the uniportal approach, only one single incision of 2 cm is performed and the camera and other dedicated endoscopic instruments are introduced through the single port. This has lead to a reduction in postoperative acute and chronic pain, postoperative stay and long term paresthesia.
A program of VATS lobectomy has been also initiated in 2007 and will be implemented on a stepwise fashion.
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