General Thoracic and Cardiovascular Surgery最新文献

{"title":"Anatomical feasibility of redo transcatheter aortic valve replacement based on post-TAVR CT imaging.","authors":"Tohru Takaseya, Ken-Ichiro Sasaki, Naoki Itaya, Masahiro Sasaki, Kensuke Oshita, Michiko Yokomizo, Yoshihiro Fukumoto, Eiki Tayama","doi":"10.1007/s11748-025-02183-6","DOIUrl":"https://doi.org/10.1007/s11748-025-02183-6","url":null,"abstract":"<p><strong>Objectives: </strong>One of the risks of redo transcatheter aortic valve replacement is coronary artery obstruction caused by the cusps of the first transcatheter aortic valve. We evaluated the feasibility of this procedure based on data from post-transcatheter aortic valve replacement computed tomography scans. We also evaluated whether redo transcatheter aortic valve replacement could be a standard lifetime management option for patients with severe aortic stenosis.</p><p><strong>Methods: </strong>The post-transcatheter aortic valve replacement computed tomography data of 143 patients who received balloon-expandable transcatheter aortic valves and 187 patients who received self-expanding transcatheter aortic valves were analyzed. The risk of coronary obstruction in redo transcatheter aortic valve replacement, defined by the transcatheter aortic valve commissure level above the coronary height and a transcatheter aortic valve-to-aorta distance of < 2.0 mm in each coronary sinus, was evaluated.</p><p><strong>Results: </strong>The mean age of the patients was 85.5 ± 5.1 years (35% male), and the mean body surface area was 1.43 ± 0.17 m². The percentage of patients at a high risk of coronary obstruction was significantly higher in the self-expanding valve group (71.1%) than in the balloon-expandable valve group (32.2%). In both the balloon-expandable and self-expanding valve groups, the group at a high risk of coronary obstruction had smaller aortic roots.</p><p><strong>Conclusions: </strong>Current transcatheter aortic valve devices may carry a higher risk of coronary obstruction in patients with small aortic roots. Careful patient selection and comprehensive pre-procedural assessment are necessary to reduce the risk for the patients' lifetime management.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689923","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 the ratio of surgical margin to nodule size in pulmonary metastasectomy for colorectal carcinoma.","authors":"Ali Ozdil, Gizem Kececi Ozgur, Esranur Akpunar, Ayse Gul Ergonul, Pinar Gursoy, Deniz Nart, Tevfik Ilker Akcam, Kutsal Turhan, Alpaslan Cakan, Ufuk Cagirici","doi":"10.1007/s11748-025-02185-4","DOIUrl":"https://doi.org/10.1007/s11748-025-02185-4","url":null,"abstract":"<p><strong>Objectives: </strong>Pulmonary metastasectomy (PM) is a survival-enhancing treatment in the multimodal management of metastatic colorectal cancer (CRC). Given the high recurrence rates, we hypothesized that the adequacy of the surgical margin relative to nodule size might have prognostic value. This study aimed to analyze clinical characteristics and identify prognostic factors for disease-free survival (DFS) and overall survival (OS) in patients who underwent PM for CRC.</p><p><strong>Methods: </strong>We retrospectively reviewed 105 patients who underwent PM for CRC metastases between January 2010 and December 2023. Survival outcomes were analyzed using Kaplan-Meier and Cox regression models. ROC analysis was used to determine the optimal cut-off value for the ratio of surgical margin (SM) to nodule size (NS).</p><p><strong>Results: </strong>The optimal cut-off value for SM/NS was 0.61 for DFS (sensitivity: 80.5%, specificity: 57%, (95% CI 0.67-0.86; p < 0.001) and 0.59 (95% CI 0.61-0.82; p < 0.001) with a sensitivity of 83.7% and specificity of 57.1% for OS. Univariate analysis showed that CEA level, disease-free interval (DFI), and NS were significantly associated with both DFS and OS. SM/NS was also significant for both outcomes (p < 0.001 and p = 0.001). Multivariate analysis confirmed that CEA, DFI, NS, and SM/NS were independent prognostic factors for DFS and OS (all p < 0.05).</p><p><strong>Conclusions: </strong>SM/NS ratio may be a reliable prognostic factor in PM for CRC. A ratio of ≤ 0.6 was associated with poorer survival outcomes and could be a more consistent indicator than nodule size or margin width alone.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674446","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":"Inhaled nitric oxide therapy is effective in improving right ventricular function in patients receiving ECPELLA support.","authors":"Yusuke Motoji, Tadashi Kitamura, Toshiaki Mishima, Masaomi Fukuzumi, Ryoichi Kondo, Yoshimi Tamura, Saya Ishikawa, Akio Sugimoto, Koki Aiso, Kagami Miyaji","doi":"10.1007/s11748-025-02181-8","DOIUrl":"https://doi.org/10.1007/s11748-025-02181-8","url":null,"abstract":"<p><strong>Objectives: </strong>ECPELLA, which uses veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and the Impella percutaneous ventricular assist device, is effective for patients with cardiogenic shock. However, patients with severe right heart dysfunction frequently have difficulty weaning off V-A ECMO. Inhaled nitric oxide (iNO) therapy may induce pulmonary artery pressure while improving right ventricular function. The goal of this study is to determine whether iNO improves right and left ventricular function in patients on ECPELLA.</p><p><strong>Methods: </strong>This retrospective study, conducted at a single-center, involved 44 ECPELLA-supported patients diagnosed with cardiac shock from January 2019 to August 2024. After applying exclusion criteria, 16 cases who received iNO therapy for right heart failure were analyzed (n = 16). Patients without evidence of right ventricular dysfunction or with incomplete data were excluded. iNO was initiated at 20 ppm when the pulmonary artery pulsatility index (PAPi) was < 1.0 during data collection, the ECMO flow rate was maintained at 2 L/min, and the pulmonary artery catheter measurements were taken before starting iNO and 24 h later.</p><p><strong>Results: </strong>The median age of the patients was 66 years, with an interquartile range of 59-72, and 11 of the patients (69%) were male. Acute myocardial infarction was the primary diagnosis in eight patients, followed by dilated cardiomyopathy in four, ischemic cardiomyopathy in two, arrhythmogenic right ventricular cardiomyopathy in one, and pulmonary embolism in one. The average duration of iNO therapy was 8 ± 6 days, with 12 patients (75%) successfully weaning off ECPELLA. The 30-day mortality rate was 38% (6/16), with an in-hospital mortality rate of 50% (8/16). Hemodynamic parameters improved significantly after receiving iNO therapy. The PAPi rose from 0.96 ± 0.54 to 1.94 ± 1.7, and the right ventricular fractional area change improved from 24 ± 7.6 to 32 ± 9.5%. In addition, cardiac power output increased from 0.33 ± 0.07 Watt (W) to 0.73 ± 0.21 W, while left ventricular ejection fraction improved from 19 ± 7.6 to 31 ± 16%. Impella flow increased significantly following iNO therapy, and V-A extracorporeal membrane oxygenation-assisted flow decreased. Patients with PAPi levels below 1.0 after iNO therapy had significantly lower ECMO weaning rates and higher 30-day mortality rates.</p><p><strong>Conclusions: </strong>iNO significantly enhanced both right and left ventricular function in patients undergoing ECPELLA. However, it was also indicated that severe right ventricular dysfunction, which did not respond to iNO, was linked to poor outcomes in patients supported by ECPELLA.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667550","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":"Correction: Uniportal video-assisted thoracoscopic surgery for lung cancer: the current opinions and future perspectives of thoracic surgeons in Japan.","authors":"Takuya Watanabe, Takefumi Doi, Hiromitsu Domen, Yoshinori Handa, Hitoshi Igai, Jun Suzuki, Akihiro Taira, Masayuki Tanahashi, Takashi Suda","doi":"10.1007/s11748-025-02180-9","DOIUrl":"https://doi.org/10.1007/s11748-025-02180-9","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658913","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":"Initial experience of mitral valve repair using the Physio Flex Annuloplasty Ring.","authors":"Kosaku Nishigawa, Shuhei Kawamoto, Kazuki Morooka, Motoharu Shimozawa, Fumiya Haba, Shunya Ono, Takeyuki Kanemura","doi":"10.1007/s11748-025-02182-7","DOIUrl":"https://doi.org/10.1007/s11748-025-02182-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the early clinical and echocardiographic outcomes of mitral valve (MV) repair using the Physio Flex Annuloplasty Ring for mitral regurgitation (MR) of various etiologies.</p><p><strong>Methods: </strong>We retrospectively analyzed 185 patients who underwent MV repair using Physio Flex Annuloplasty Ring between July 2020 and October 2024. Degenerative MR was the most common type (n = 94), followed by functional MR (n = 79). Severe and moderate MR were observed in 126 and 59 patients, respectively.</p><p><strong>Results: </strong>Artificial chordal reconstruction, leaflet resection, and folding plasty were performed in 61 (33.0%), 21 (11.4%), and 13 (7.0%) patients, respectively, whereas ring annuloplasty alone was performed in 64 (34.6%) patients. The median ring size was 30 mm (interquartile range, 30-32mm). The operative mortality rate was 2.2%. Postoperatively, no/trivial and mild MR were observed in 162 (87.6%) and 18 (9.7%) patients, respectively. Left ventricular end-diastolic and end-systolic diameters significantly decreased from 51 ± 8 mm to 47 ± 7 mm and from 34 ± 9 mm to 32 ± 8 mm, respectively (P < 0.001). The right ventricular systolic pressure also decreased (33 ± 13 mmHg to 29 ± 10 mmHg; P < 0.001). Functional mitral stenosis (mean transmitral pressure gradient of ≥ 5 mmHg) occurred in 13 patients.</p><p><strong>Conclusion: </strong>MV repair using the Physio Flex Annuloplasty Ring provides effective MR control and satisfactory early outcomes, with an acceptable incidence of functional mitral stenosis.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658914","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":"Liver transplant volume association with presence of heart and lung transplant programs: analysis of SRTR metrics.","authors":"Sanath Patil, Faizaan Siddique, Daler Rahimov, Keshava Rajagopal, John W Entwistle, Adam Bodzin, Vakhtang Tchantchaleishvili","doi":"10.1007/s11748-025-02178-3","DOIUrl":"https://doi.org/10.1007/s11748-025-02178-3","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to understand how centers transplanting liver only (L0), centers transplanting heart and liver (LH), and centers transplanting liver, heart, and lung (LHL) differ regarding volume, waitlist and post-transplant outcomes.</p><p><strong>Methods: </strong>Data were collected from the Scientific Registry of Transplant Recipients (SRTR) in July 2023. SRTR star ratings were categorized into five tiers, with one being the lowest tier and five the highest tier.</p><p><strong>Results: </strong>Median liver transplant volumes were 35 [IQR: 14-51] for L0 centers, 45 [10-75] for LH centers, and 101 [69-131] for LHL centers (p < 0.001). Liver waitlist survival (p = 0.13), waitlist duration (p = 0.31) and 1-year survival ratings (p = 0.32) were comparable across all 3 categories. Annual transplant volume was associated with a higher SRTR waitlist duration rating (p < 0.001) but not with 1-year post-transplant survival (p = 0.51).</p><p><strong>Conclusion: </strong>The presence of a heart transplant and lung transplant programs in liver transplant centers is associated with higher liver transplant volumes, translating to higher waitlist duration tier ratings for liver recipients, but not to improved 1-year post-transplant survival.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600125","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":"Analysis of risk factors for postoperative infections following the Nuss procedure for pectus excavatum.","authors":"Atsushi Higashio, Yoshiki Morotomi, Yumi Mizoue, Kenichi Saga, Masakatsu Takeda, Mari Sonoda, Tamaki Iwade, Kosuke Endo, Hiroaki Fukuzawa, Masahito Sato","doi":"10.1007/s11748-025-02177-4","DOIUrl":"https://doi.org/10.1007/s11748-025-02177-4","url":null,"abstract":"<p><strong>Objective: </strong>The Nuss procedure is widely applied for the treatment of pectus excavatum (PE); however, postoperative infection remains a significant concern. Herein, we evaluated the postoperative outcomes and risk factors for postoperative infections following the Nuss procedure.</p><p><strong>Methods: </strong>This study comprised a retrospective review of 112 cases of PE treated via the Nuss procedure between January 2019 and March 2024. Postoperative infection control measures, including thorough disinfection of the surgical field and perioperative intravenous administration of cefazolin, were ensured in all cases. Patient characteristics, surgical outcomes, and postoperative complications were analyzed, and risk factors for postoperative infection were assessed via multivariate analysis.</p><p><strong>Results: </strong>Postoperative complications were observed in 17 cases (15.2%), including 6 (5.4%) with infection. Atopic dermatitis (AD) was significantly more common in the infection group (4/6, 66.7%) than in the non-infection group (8/106, 7.6%, p < 0.01). Multivariate analysis further identified the use of topical steroid medications for AD as the only independent risk factor for postoperative infection (Odds Ratio: 51.0, 95% CI: 7.12-366.0). Notably, two infections occurred beyond the typical 90-day surveillance period.</p><p><strong>Conclusions: </strong>AD is a significant risk factor for postoperative infection following the Nuss procedure, particularly when managed with topical steroid medications. These results suggest that patients with AD undergoing this procedure require meticulous preoperative management, rigorous infection control measures, and extended follow-up owing to the continued risk of infection throughout the bar placement period.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591000","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":"A new strategy for open surgery of giant aortoiliac aneurysms with preservation of the hypogastric artery.","authors":"Dragan Piljic, Nail Sehic, Jus Ksela, Mario Lescan","doi":"10.1007/s11748-025-02179-2","DOIUrl":"https://doi.org/10.1007/s11748-025-02179-2","url":null,"abstract":"<p><strong>Purpose: </strong>We present a new approach for open surgical repair of giant aortoiliac (AI) aneurysms that prioritizes preservation of the hypogastric artery (HA). In cases where the aneurysm extends to the iliac bifurcation and involves both HAs, traditional open repair techniques often require an aortobifemoral bypass with HA exclusion, posing challenges for maintaining pelvic perfusion.</p><p><strong>Methods: </strong>A retrospective analysis of 10 patients treated between 07/2021 and 07/2023 was conducted. The aneurysms extended to both HA in all cases. Patients were followed up at 30-day and in 6-month intervals thereafter. A total of 10 HA revascularization procedures were performed in 10 patients undergoing open surgical AI aneurysms repair (9 men and 1 woman; median age 68 [65; 70] years). Six-mm polyester grafts were used for aortic tube graft to HA bypass in 10 cases.</p><p><strong>Results: </strong>Successful open surgical repair of giant AI aneurysms, including those involving the iliac bifurcation, was achieved in all cases. There was one case of perioperative myocardial infarction with pulmonary edema. No instances of gluteal claudication, colon ischemia, or perineal ischemia were observed. Eight patients reported no change in sexual function, while one patient experienced a reduction in erectile function. One patient died in the ICU 2 weeks postoperatively. During a follow-up period of 6-18 months, graft patency was maintained in nine patients.</p><p><strong>Conclusion: </strong>An additional branch to the HA can reliably maintain pelvic circulation in the short to intermediate term, helping to prevent ischemia in patients requiring extended open surgical repair that involves both HAs.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583588","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":"Impact of GAP score on surgical prognosis of non-small-cell lung cancer with usual interstitial pneumonia.","authors":"Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Hisashi Tomita, Shuko Nojiri, Kenji Suzuki","doi":"10.1007/s11748-024-02096-w","DOIUrl":"10.1007/s11748-024-02096-w","url":null,"abstract":"<p><strong>Objective: </strong>Post-surgical survival outcomes in patients with non-small-cell lung cancer (NSCLC) and idiopathic pulmonary fibrosis (IPF) are expected to be worse than those in patients with other idiopathic interstitial pneumonias (IIPs). However, these remain unclear regarding patients with NSCLC and IPF histologically diagnosed as usual interstitial pneumonia [IPF(UIP)]. We aimed to assess the surgical and survival outcomes and identify prognostic factors in patients with NSCLC and IPF(UIP).</p><p><strong>Methods: </strong>This retrospective cohort study included patients with pathological stage I-III NSCLC and UIP. Prognostic factors and their association with lung cancer deaths (LCDs) and non-LCDs (NLCDs) were investigated.</p><p><strong>Results: </strong>The overall survival of patients with UIP was significantly poorer than that of others with IIPs. The main causes of death were lung cancer (36%) and respiratory disease (44%). Multivariate analyses revealed the pathological stage of NSCLC ≥ II (hazard ratio [HR], 2.196; p = 0.009) and GAP stage ≥ II (HR, 2.821; p = 0.016) to be significant prognostic factors. NLCD incidence was significantly high in patients with GAP stage ≥ II. Recurrence occurred in 26 patients (36.1%); the period from recurrence to death was shorter in patients with IPF(UIP) than in patients without IPF(UIP).</p><p><strong>Conclusions: </strong>Patients with NSCLC and IPF(UIP) had poor prognosis after surgery. However, the prognosis varied greatly depending on the GAP stage. Considering the difficulty in managing post-surgical recurrence and high incidence of LCDs in patients with IPF(UIP), pursuing a radical resection is recommended in patients with GAP stage I. For patients with GAP stage ≥ II, comprehensive management of UIP is also necessary.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"487-496"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498606","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":"Surgical outcome in patients with lung adenocarcinoma with mucin.","authors":"Keiko Ueda, Yo Kawaguchi, Yasushi Itoh, Daigo Ishihara, Hiroki Saito, Takuya Shiratori, Keigo Okamoto, Yoko Kataoka, Mayumi Ohshio, Yasuhiko Ohshio, Jun Hanaoka","doi":"10.1007/s11748-024-02103-0","DOIUrl":"10.1007/s11748-024-02103-0","url":null,"abstract":"<p><strong>Objective: </strong>Mucin-producing adenocarcinoma is a less common variant of lung adenocarcinoma. Adenocarcinoma cells with mucin can spread through the airspace via mucus-mediated extension, leading to their implantation in distant normal lungs. Consequently, post-operative intrapulmonary recurrence frequently occurs. Mucin-producing adenocarcinomas include not only invasive mucinous adenocarcinoma but also papillary, acinar, and other subtypes. Despite increasing reports on surgical outcomes for invasive mucinous adenocarcinomas, the outcomes for total mucin-producing adenocarcinoma remain unclear.</p><p><strong>Methods: </strong>We clinically and pathologically evaluated 511 patients who underwent curative resection for lung adenocarcinoma at our institution. The patients were divided into adenocarcinoma with mucin and without mucin groups. Based on pathological findings, the adenocarcinoma with mucin was further classified into intracellular, extracellular, and mucus extension types. Additionally, the CT value of the tumor mass was analyzed using SYNAPSE VINCENT software.</p><p><strong>Results: </strong>The 5 year overall survival after surgery was 81.5% and 75.9% for patients with adenocarcinoma with versus without mucin (P = 0.774), respectively. The 5 year intrapulmonary recurrence rate in patients with adenocarcinoma with mucin was 29.2%, significantly higher than 12.9% for patients without mucin. Mucus extension was a strong indicator (hazard ratio: 3.03) of intrapulmonary recurrence after surgery. According to SYNAPSE VINCENT analysis, a high volume rate of - 400 HU indicated mucus extension.</p><p><strong>Conclusion: </strong>Our results demonstrated that intrapulmonary recurrence occurs approximately 2.3 times more often in adenocarcinoma with mucin than in adenocarcinoma without mucin. Mucus extension is a significant risk factor for intrapulmonary recurrence, and surgeons can predict it using SYNAPSE VINCENT analysis.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"514-521"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638678","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}