General Thoracic and Cardiovascular Surgery最新文献

{"title":"Preoperative imaging assessment of neurogenic tumors at the thoracic apex to determine suitability for robotic surgery.","authors":"Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki","doi":"10.1007/s11748-025-02140-3","DOIUrl":"https://doi.org/10.1007/s11748-025-02140-3","url":null,"abstract":"<p><strong>Objective: </strong>To predict suitability for robotic surgery from preoperative images in patients with neurogenic tumors at the thoracic apex.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent robot-assisted thoracic surgery for tumors at the thoracic apex located cranial to the first rib. Patient characteristics, preoperative computed tomography findings, operative time, operative bleeding, rate of conversion to thoracotomy, and surgical outcomes were reviewed. We examined the image characteristics of converted cases and cases with an operative time exceeding 2 h.</p><p><strong>Results: </strong>Twenty-five patients underwent robot-assisted thoracic surgery for apical neurogenic tumors, and 64% of these tumors were schwannomas. Ninety-day mortality was 0%; however, postoperative neurological complications were common (Horner's syndrome: 56%, bronchial plexus disorder: 36%) even after enucleation. However, almost all symptoms disappeared within 1 year. Persistent nerve complications were observed in two patients (8%). Tumors < 3 cm did not interfere with vessel visualization and were resected within 2 h. Patients with an unconfirmed boundary with the vessels were considered for an anterior transcervical thoracic approach for safety reasons.</p><p><strong>Conclusions: </strong>Robot-assisted thoracic surgery for apical neurogenic tumors is feasible; however, postoperative neurological symptoms are common within 1 year after surgery. Thoracotomy should be considered for patients with tumors in contact with the subclavian vessels. Preparations for a transmanubrial approach may be necessary for such cases.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmanubrial approach for en bloc resection of oligometastatic extranodal extension positive lymph nodes with partial common carotid artery and trachea resection after esophagectomy.","authors":"Naoya Okada, Hiroaki Kato, Syuichi Naraoka, Takeshi Yokoyama, Yasushi Furuta, Yoshihiro Kinoshita","doi":"10.1007/s11748-025-02135-0","DOIUrl":"https://doi.org/10.1007/s11748-025-02135-0","url":null,"abstract":"<p><strong>Background and aims: </strong>The transmanubrial approach (TMA) provides excellent exposure of the cervical-thoracic border area, allowing for the resection of thoracic outlet structures while preserving the clavicle, avoiding muscle sacrifice, and maintaining full shoulder mobility.</p><p><strong>Methods: </strong>This report presents the first instance of TMA being utilized for oligometastatic, extranodal extension-positive lymph node dissection en bloc with partial resection of the common carotid artery and trachea following esophagectomy.</p><p><strong>Surgical technique: </strong>We describe the surgical technique with illustrated explanations.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of confounding risk factors for newly occurring atrial fibrillation after coronary artery bypass grafting.","authors":"Mesut Engin, Bişar Amaç","doi":"10.1007/s11748-025-02118-1","DOIUrl":"10.1007/s11748-025-02118-1","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"295-296"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for size change of aorta in patients with acute blunt traumatic aortic injury.","authors":"Soojin Lee, Seunghwan Song, Seon Hee Kim, Chang Won Kim, Hoon Kwon, Dongman Ryu, Na Hyeon Lee, Eunji Kim","doi":"10.1007/s11748-024-02054-6","DOIUrl":"10.1007/s11748-024-02054-6","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the changes in aorta size, the factors affecting size changes in patients with acute blunt traumatic aortic injury and to evaluate the adequacy of the current 120% thoracic endovascular aortic repair graft oversizing policy.</p><p><strong>Design and methods: </strong>This retrospective review study was conducted using the prospectively collected medical records of 45 patients (mean age: 53.5 years, male: 39 patients) with blunt traumatic aortic injury treated at a level 1 trauma center between 2012 and 2021. Aortic diameter was measured by computed tomography angiographic images at four different levels [ascending aorta (A), isthmus (B), descending thoracic aorta (C), and infrarenal aorta (D)] on arrival and follow-up (median time interval, 13 days). Associated factors including patient characteristics and hemodynamic parameters on arrival and follow-up were collected to determine their influence on changes in the aorta.</p><p><strong>Results: </strong>The mean diameter of all four aortic levels increased on follow-up computed tomography compared to initial computed tomography (A: + 11.77%, B: + 10.19%, C: + 7.71%, D: + 12.04%). Patient age and injury severity score influenced changes in the diameter of the ascending aorta (P < 0.05). Patient age and blunt traumatic aortic injury grade were significantly associated with changes in the infrarenal aortic diameter (P < 0.05). Three cases of type 1 endoleak were observed at follow-up but all were spontaneously resolved without further intervention at next computed tomography follow-up.</p><p><strong>Conclusions: </strong>In patients with acute blunt traumatic aortic injury, aortic diameter is significantly smaller by about 10% under shock and is not considered a basis for oversizing the currently implemented 120% thoracic endovascular aortic repair graft sizing. However, in young patients under the age of 40, the change is significantly large and subsequent computed tomography follow-up is required.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"209-217"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-pump versus on-pump coronary artery bypass grafting in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.","authors":"Anelise Poluboiarinov Cappellaro, Luiz F Costa de Almeida, Manoela Lenzi Pinto, Marcelo Albuquerque Barbosa Martins, Augusto Graziani E Sousa, Júlia Gonçalves Gadelha, Ana Carolina Putini Vieira, Luís Fernando Rosati Rocha, Myat Soe Thet","doi":"10.1007/s11748-025-02116-3","DOIUrl":"10.1007/s11748-025-02116-3","url":null,"abstract":"<p><strong>Introduction: </strong>Off-pump coronary artery bypass graft surgery (OPCAB) has been suggested as superior to on-pump coronary artery bypass graft surgery (ONCAB) in certain high-risk subgroups, but its benefit in patients with chronic obstructive pulmonary disease (COPD) remains controversial. This meta-analysis aimed to evaluate OPCAB versus ONCAB outcomes in COPD patients.</p><p><strong>Methods: </strong>We followed PRISMA guidelines and searched PubMed, Embase, and the Cochrane Library in August 2024 for studies comparing OPCAB and ONCAB in COPD patients. Statistical analysis was conducted using Review Manager 5.4.1 and Rstudio with a fixed or random effects model.</p><p><strong>Results: </strong>Six studies with a total of 1,687 patients were included, of which 1,062 (62.95%) underwent OPCAB. The mean patient age was 63.6 years. OPCAB did not significantly affect all-cause mortality compared to ONCAB (OR 1.14; 95% CI 0.65-1.99). There were no significant differences in reintubation (OR 0.81; 95% CI 0.53-1.23), prolonged ventilation (OR 0.54; 95% CI 0.24-1.22), post-operative atrial fibrillation (OR 0.90; 95% CI 0.70-1.15), or ARDS (OR 0.43; 95% CI 0.14-1.33). However, ventilation time was significantly shorter in the OPCAB group (MD - 5.30 h; 95% CI - 7.22 to - 3.38).</p><p><strong>Conclusion: </strong>OPCAB is associated with reduced ventilation time in COPD patients though it shows no significant difference in all-cause mortality or other post-operative complications compared to ONCAB.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"201-208"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic and cardiovascular surgeries in Japan during 2022 : Annual report by the Japanese Association for Thoracic Surgery.","authors":"Naoki Yoshimura, Yukio Sato, Hiroya Takeuchi, Tomonobu Abe, Toyofumi Fengshi Yoshikawa, Yasutaka Hirata, Michiko Ishida, Hisashi Iwata, Takashi Kamei, Nobuyoshi Kawaharada, Shunsuke Kawamoto, Kohji Kohno, Hiraku Kumamaru, Kenji Minatoya, Noboru Motomura, Rie Nakahara, Morihito Okada, Hisashi Saji, Aya Saito, Masanori Tsuchida, Kenji Suzuki, Hirofumi Takemura, Tsuyoshi Taketani, Yasushi Toh, Wataru Tatsuishi, Hiroyuki Yamamoto, Takushi Yasuda, Masayuki Watanabe, Goro Matsumiya, Yoshiki Sawa, Hideyuki Shimizu, Masayuki Chida","doi":"10.1007/s11748-024-02106-x","DOIUrl":"10.1007/s11748-024-02106-x","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"254-294"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-lung transplant outcomes of connective tissue disease-related interstitial lung diseases compared with idiopathic interstitial pneumonia: a single-center experience in Japan.","authors":"Miho Yamaguchi, Takafumi Yamaya, Mitsuaki Kawashima, Chihiro Konoeda, Hidenori Kage, Masaaki Sato","doi":"10.1007/s11748-024-02073-3","DOIUrl":"10.1007/s11748-024-02073-3","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the outcomes of lung transplantation for connective tissue disease-related interstitial lung disease (CTD-ILD) conducted at our institution, compared with those for idiopathic interstitial pneumonias (IIPs).</p><p><strong>Methods: </strong>We retrospectively reviewed patients with CTD-ILD and IIPs who underwent lung transplantation at our hospital from July 2015 to October 2023. We compared patients' backgrounds, early complications within 28 days post-transplant (CTCAE grade 3 or higher), postoperative courses, and prognoses between the two groups.</p><p><strong>Results: </strong>The CTD-ILD group (n = 19) and the IIPs group (n = 56) were compared. The CTD-ILD group had significantly higher preoperative use of corticosteroids and antifibrotic agents, mean pulmonary arterial pressure, anti-human leukocyte antigen antibody positivity, and donor age (p < 0.05). In addition, the CTD-ILD group had significantly longer operation times (579.0 vs 442.5 min), longer stays in the intensive care unit (17.0 vs 9.0 days) and hospital (58.0 vs 44.0 days); required more tracheostomies (57.9 vs 25.0%); and experienced more respiratory (52.6 vs 25.0%) and gastrointestinal (42.1 vs 8.9%) complications (p < 0.05). However, there were no significant differences in overall survival, nor chronic lung allograft dysfunction (CLAD)-free survival between the two groups.</p><p><strong>Conclusion: </strong>Perioperative complications, notably respiratory and gastrointestinal complications, were prevalent after lung transplantation among CTD-ILD patients. Despite this, long-term survival rates were comparable to those observed in IIP cases.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"227-234"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal size of Frozenix for true thoracic aneurysms: is downsizing an option?","authors":"Jun Hayashi, Shingo Nakai, Kimihiro Kobayashi, Yoshinori Kuroda, Eiichi Ohba, Masahiro Mizumoto, Atsushi Yamashita, Tomonori Ochiai, Tetsuro Uchida","doi":"10.1007/s11748-024-02074-2","DOIUrl":"10.1007/s11748-024-02074-2","url":null,"abstract":"<p><strong>Objective: </strong>During total arch replacement (TAR) using frozen elephant trunk (FET) technique with Frozenix for true thoracic aortic aneurysm (tTAA), oversized FET tends to be chosen similar to the endovascular devise selection. However, the oversized FET is considered a risk factor for intimal injury. The appropriate size selection of FET remains insufficiently understood.</p><p><strong>Methods: </strong>Between October 2014 and March 2022, a total of 49 patients underwent TAR using Frozenix for tTAA. Out of 49 patients, four patients planned to staged surgery were excluded, 19 patients were operated on with an undersized Frozenix compared with the descending aorta (undersized FET group) and in 26 patients an equal or oversized Frozenix was used (oversized FET group). Clinical outcomes and postoperative diameter changes were investigated.</p><p><strong>Results: </strong>In-hospital mortality was 0%. The mean diameter of Frozenix and the descending aorta was 30.7 mm and 28.8 mm, respectively, in the oversized FET group, and 26.7 mm and 30.1 mm in the undersized FET group. Postoperative computed tomography (CT) demonstrated no endoleaks not only in the oversized FET group but also in the undersized FET group. CT also revealed that undersized FET had expanded more than the original diameter in all cases except for two, with an average of 2.47 ± 1.53 mm. Additionally, the descending aorta covered with Frozenix shrank in 10 patients (53%). Postoperative adverse aortic events were not observed.</p><p><strong>Conclusions: </strong>Undersized Frozenix tightly fit the descending aorta and resulted in complete sealing without endoleaks. Oversized FET is not strictly necessary considering the size-related adverse complications.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"218-226"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing identification of early-stage lung adenocarcinomas through solid component analysis of three-dimensional computed tomography images.","authors":"Sanae Kuroda, Megumi Nishikubo, Nanase Haga, Yuki Nishioka, Nahoko Shimizu, Wataru Nishio","doi":"10.1007/s11748-024-02076-0","DOIUrl":"10.1007/s11748-024-02076-0","url":null,"abstract":"<p><strong>Objectives: </strong>As the role of segmentectomy expands in managing early-stage lung adenocarcinoma, precise preoperative assessments of tumor invasiveness via computed tomography become crucial. This study aimed to evaluate the effectiveness of solid component analysis of three-dimensional (3D) computed tomography images and establish segmentectomy criteria for early-stage lung adenocarcinomas.</p><p><strong>Methods: </strong>This retrospective study included 101 cases with adenocarcinoma diagnoses, with patients undergoing segmentectomy for clinical stage 0 or IA between 2012 and 2017. The solid component volume (3D-volume) and solid component ratio (3D-ratio) of tumors were calculated using 3D computed tomography. Additionally, based on two-dimensional (2D) computed tomography, the solid component diameter (2D-diameter) and solid component ratio (2D-ratio) were calculated. The area under the receiver-operating characteristic curve (AUC) was calculated for each method, facilitating predictions of mortality and recurrence within 5 years. The AUC of each measurement was compared with those of invasive component diameter (path-diameter) and invasive component ratio (path-ratio) obtained through pathology analysis.</p><p><strong>Results: </strong>The predictive performance of 3D-volume did not differ significantly from that of path-diameter, whereas 2D-diameter exhibited less predictive accuracy (AUC: 3D-volume, 2D-diameter, and path-diameter: 0.772, 0.624, and 0.747, respectively; 3D-volume vs. path-diameter: p = 0.697; 2D-diameter vs. path-diameter: p = 0.048). Results were similar for the solid component ratio (AUC: 3D-ratio, 2D-ratio, path-ratio: 0.707, 0.534, and 0.698, respectively; 3D-ratio vs. path-ratio: p = 0.882; 2D-ratio vs. path-ratio: p = 0.038).</p><p><strong>Conclusion: </strong>Solid component analysis using 3D computed tomography offers advantages in prognostic prediction for early-stage lung adenocarcinomas.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"235-244"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and evaluation of valve interventions using ex vivo biomechanical modeling: the Stanford experience.","authors":"Gabe Weininger, Stefan Elde, Yuanjia Zhu, Y Joseph Woo","doi":"10.1007/s11748-025-02127-0","DOIUrl":"https://doi.org/10.1007/s11748-025-02127-0","url":null,"abstract":"<p><p>The increase in prevalence of valvular heart disease coupled with an aging population has placed increased emphasis on durable valvular repair strategies. Despite many advances in valvular therapies, there has been little rigorous biomechanical evaluation and validation of existing repair strategies. Our research group engineered a novel 3D-printed, ex vivo heart simulator, which has allowed us to refine and innovate numerous surgical repair strategies with hemodynamic and biomechanical feedback in real time on explanted animal heart valves. Data obtained from this novel simulator have directly influenced clinical practice at our institution. It has also proven to be an outstanding platform for valvular device development. Herein, we will review our experience with ex vivo biomechanical simulation, subdivided into work on aortic valve pathology, mitral valve pathology, and novel devices.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}