General Thoracic and Cardiovascular Surgery最新文献_第2页

Efficacy of total arch replacement with frozen elephant trunk for type B aortic dissection involving left subclavian artery-adjacent entry: a strategy for anatomically challenging cases. 冷冻象鼻全弓置换治疗左锁骨下动脉邻近入口B型主动脉夹层的疗效：一种解剖学上具有挑战性的病例策略。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2025-11-03 DOI: 10.1007/s11748-025-02219-x

Norimasa Haijima, Mikihiko Kudo, Satoru Murata, Takuya Ono, Hideyuki Shimizu

{"title":"Efficacy of total arch replacement with frozen elephant trunk for type B aortic dissection involving left subclavian artery-adjacent entry: a strategy for anatomically challenging cases.","authors":"Norimasa Haijima, Mikihiko Kudo, Satoru Murata, Takuya Ono, Hideyuki Shimizu","doi":"10.1007/s11748-025-02219-x","DOIUrl":"10.1007/s11748-025-02219-x","url":null,"abstract":"Objective: To evaluate the feasibility and safety of total arch replacement with a frozen elephant trunk in patients with Stanford type B aortic dissection and an entry ≤ 10 mm distal to the left subclavian artery.Methods: We retrospectively reviewed 40 consecutive patients who underwent either total arch replacement with a frozen elephant trunk (n = 30) or thoracic endovascular aortic repair (n = 10). The primary outcome was late all-cause mortality. Secondary outcomes included major complications, planned additional endovascular repair after total arch replacement with a frozen elephant trunk, false lumen thrombosis, and aortic remodeling.Results: In the thoracic endovascular aortic repair group, procedure-related complications occurred, including retrograde type A dissection and one death from aortic rupture. In the total arch replacement with a frozen elephant trunk group, all deaths were unrelated to the index procedure. Planned additional endovascular repair was more frequently performed after total arch replacement with a frozen elephant trunk.Conclusions: Total arch replacement with a frozen elephant trunk is safe for anatomically challenging type B aortic dissection with an entry near the left subclavian artery and represents a viable treatment option in this setting.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"476-482"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437802","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}

引用次数: 0

Comment on "Prognostic impact of lung diffusion capacity in patients with early-stage lung cancer achieving 5-year postoperative recurrence-free survival: propensity score matching analysis". 评论“肺弥散能力对早期肺癌患者术后5年无复发生存的预后影响：倾向评分匹配分析”。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2026-02-08 DOI: 10.1007/s11748-026-02263-1

Muhammad Nouman Javed, Mahnoor Fatima Awan, Noor Fatima, Muhammad Huzaifa Sabir

引用次数: 0

CT-based evaluation of thoracic anatomy in AS vs AR patients undergoing MIAVR. 行MIAVR的AS与AR患者胸部解剖的ct评价。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2025-11-21 DOI: 10.1007/s11748-025-02223-1

Yuto Yasumoto, Yoshitsugu Nakamura, Kasumi Tamagawa, Yuka Higuma, Kusumi Niitsuma, Miho Kuroda, Satoshi Okugi, Yujiro Hayashi, Taisuke Nakayama, Yujiro Ito

{"title":"CT-based evaluation of thoracic anatomy in AS vs AR patients undergoing MIAVR.","authors":"Yuto Yasumoto, Yoshitsugu Nakamura, Kasumi Tamagawa, Yuka Higuma, Kusumi Niitsuma, Miho Kuroda, Satoshi Okugi, Yujiro Hayashi, Taisuke Nakayama, Yujiro Ito","doi":"10.1007/s11748-025-02223-1","DOIUrl":"10.1007/s11748-025-02223-1","url":null,"abstract":"Objective: In this study, the difference in anatomical variables was considered between Aortic stenosis (AS) and Aortic regurgitation (AR) groups by preoperative computed tomography (CT) in minimally invasive cardiac surgery for aortic valve replacement (MIAVR).Methods: Patients who underwent AVR between 2012 and 2021 at our center were retrospectively analyzed in two groups, AS and AR. The final 278 samples possessed detailed clinical information of the patients. The six items were measured in preoperative CT and compared in significant difference in number.Results: No significant differences were found in the patients' characteristics between the AS and AR groups except for age, sex and body surface area. The number of younger and male patients was higher in the AR group than in the AS group (P < 0.01), including a larger body surface area (P < 0.01). The AR group had larger rightward laterality aorta and third ICS (AS vs AR - 3.9 ± 8.9 vs 0.6 ± 8.9 mm, P < 0.01; 14.2 ± 1.3 vs 15 ± 1.6 cm, P < 0.01, respectively).Conclusions: Preoperative CT revealed thoracic anatomical differences between AS and AR patients undergoing MIAVR. Although no direct correlation with cross-clamp time was observed except for AP distance in both AR and AS, surgeons should be aware that these anatomical features-particularly the rightward aorta and deeper and more caudally positioned AV in AR patients to make surgical decision making, surgical planning. CT-based evaluation is a valuable tool for guiding approach strategy and patient selection in MIAVR.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"490-497"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563570","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}

引用次数: 0

Surgical outcomes and prognoses of patients with clinical stage I lung cancer and interstitial lung disease. 临床I期肺癌和间质性肺疾病患者的手术结果和预后

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2025-12-29 DOI: 10.1007/s11748-025-02240-0

Hidenao Kayawake, Momoko Soda, Masakazu Takayama, Yuhei Yokoyama, Tetsu Yamada, Ryo Tachikawa, Keisuke Tomii, Hiroshi Hamakawa, Yutaka Takahashi

{"title":"Surgical outcomes and prognoses of patients with clinical stage I lung cancer and interstitial lung disease.","authors":"Hidenao Kayawake, Momoko Soda, Masakazu Takayama, Yuhei Yokoyama, Tetsu Yamada, Ryo Tachikawa, Keisuke Tomii, Hiroshi Hamakawa, Yutaka Takahashi","doi":"10.1007/s11748-025-02240-0","DOIUrl":"10.1007/s11748-025-02240-0","url":null,"abstract":"Objective: Studies have reported poor surgical outcomes in patients with lung cancer and interstitial lung disease. Therefore, we retrospectively analyzed the perioperative and long-term outcomes of this patient population.Methods: Between 2004 and 2021, we enrolled 103 patients with interstitial lung disease and clinical stage I lung cancer (8th edition of the TNM classification) without a history of lung cancer treatment within 5 years before surgery and undergoing complete resection from our institution.Results: The median patient age was 74 years (range: 60-89 years), and 90 patients were male. The most common surgical procedures were lobectomy (n = 85), followed by partial resection (n = 13), segmentectomy (n = 4), and pneumonectomy (n = 1). The median observation period was 1102 days. Concerning perioperative outcomes, 90-day postoperative mortality was 7 (6.8%) and complications (≥ Grade 3 according to the Clavien-Dindo classification) were observed in 30 patients (29.1%). Regarding long-term outcomes, lung cancer recurrence was observed in 38 patients. Fifty-six patients died during the observation period, but only 20 (35.7%) died of lung cancer recurrence. Pathological upstaging was observed in 51 patients (49.5%). The 5-year overall survival and recurrence-free survival rates were 48.6% and 41.8%, respectively.Conclusions: A relatively high 90-day mortality rate was observed. Deaths from causes other than lung cancer recurrence were observed more frequently than those from lung cancer recurrence. Hence, when selecting treatment strategies for early lung cancer combined with interstitial lung disease, the risks of acute exacerbation and progression of interstitial lung disease should be considered.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"549-556"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849449","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}

引用次数: 0

Transesophageal echocardiographic assessment of left atrial and left ventricular venting: pitfalls and troubleshooting in over 300 cases. 经食管超声心动图评价左心房和左心室通风口：300多例的陷阱和排除方法。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2025-11-15 DOI: 10.1007/s11748-025-02222-2

Kazumasa Orihashi

{"title":"Transesophageal echocardiographic assessment of left atrial and left ventricular venting: pitfalls and troubleshooting in over 300 cases.","authors":"Kazumasa Orihashi","doi":"10.1007/s11748-025-02222-2","DOIUrl":"10.1007/s11748-025-02222-2","url":null,"abstract":"Objectives: Left atrial (LA) and left ventricular (LV) venting during open-heart surgery is essential for myocardial protection, maintaining a bloodless field, and facilitating air removal. However, catheter malposition and inadequate venting are not uncommon because of limited visibility. Although transesophageal echocardiography (TEE) can assist in catheter monitoring, TEE-guided management strategies remain underreported. This study aimed to characterize catheter-related issues and describe effective troubleshooting approaches.Methods: We retrospectively analyzed intraoperative TEE findings in 304 patients who underwent open-heart surgery at Kochi University Hospital, including 200 with LV venting and 104 with LA venting. TEE records of catheter-related events and corrective maneuvers were reviewed, and challenges in TEE assessment were identified.Results: No catheter-related injuries were observed. In the LV group, TEE identified failure of ventricular entry (n = 5), impingement on papillary muscles or the apex (n = 18), and catheter-induced mitral regurgitation (n = 11). Residual air was frequently localized distant from the catheter tip. In the LA group, misplacement into pulmonary veins (n = 9) or the left atrial appendage (LAA) (n = 2) was noted. Venting was ineffective in cases of acute LV distension during antegrade cardioplegia or due to Thebesian venous return. In some cases, deep catheter placement resulted in incomplete drainage of the right-sided LA.Conclusions: Both LA and LV venting have distinct pitfalls. TEE facilitates identification and correction of catheter-related problems, but structured training in TEE assessment is essential to optimize outcomes.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"483-489"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523134","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}

引用次数: 0

Clinical nodal positive disease is associated with greater surgical complexity in salvage lung resection after tyrosine kinase inhibitor therapy. 临床淋巴结阳性疾病与酪氨酸激酶抑制剂治疗后补救性肺切除术的手术复杂性相关。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2026-02-19 DOI: 10.1007/s11748-026-02270-2

Shigeki Suzuki, Takahiro Suzuki, Yu Okubo, Kyohei Masai, Kaoru Kaseda, Keisuke Asakura

引用次数: 0

Minimally invasive cardiac surgeries in 2022: annual report by Japanese Society of Minimally Invasive Cardiac Surgery. 2022年微创心脏手术：日本微创心脏外科学会年度报告。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2025-12-19 DOI: 10.1007/s11748-025-02225-z

Tomoki Shimokawa, Hiraku Kumamaru, Noboru Motomura, Hiroyuki Nishi, Hiroyuki Nakajima, Hiroyuki Kamiya, Kazuma Okamoto, Soh Hosoba, Yoshikatsu Saiki, Takashi Miura, Minoru Tabata, Akira Shiose, Taichi Sakaguchi

{"title":"Minimally invasive cardiac surgeries in 2022: annual report by Japanese Society of Minimally Invasive Cardiac Surgery.","authors":"Tomoki Shimokawa, Hiraku Kumamaru, Noboru Motomura, Hiroyuki Nishi, Hiroyuki Nakajima, Hiroyuki Kamiya, Kazuma Okamoto, Soh Hosoba, Yoshikatsu Saiki, Takashi Miura, Minoru Tabata, Akira Shiose, Taichi Sakaguchi","doi":"10.1007/s11748-025-02225-z","DOIUrl":"10.1007/s11748-025-02225-z","url":null,"abstract":"Purpose: Up-to-date national data on minimally invasive cardiac surgery (MICS) are essential for quality control but remain limited. This report summarizes 2022 outcomes of right- or left-minithoracotomy, thoracoscopic/port-assisted, and robotic-assisted MICS in Japan, based on the Japan Cardiovascular Surgery Database (JCVSD).Methods: Data were collected from patients undergoing mitral valve repair/replacement (MV repair, n = 2525; MVR, n = 279), aortic valve replacement (AVR, n = 1114), coronary artery bypass grafting (CABG, n = 450), atrial septal defect closure (ASD, n = 212), and cardiac tumor resection (n = 113) using MICS approaches. Perioperative data included 30-day and in-hospital mortality, conversion rates, and major morbidities.Results: For MV repair, the 30-day and in-hospital mortality rates were 0.3% and 0.2% in isolated cases (n = 1461) and 0.4% and 0.6% overall, respectively. Mortality rates for MVR were 2.5% and 4.2% in isolated cases (n = 120) and 2.9% and 4.3% overall, respectively. Mortality rates for AVR were 0.6% and 1.0% in isolated cases (n = 981) and 0.9% and 1.3% overall, respectively. Mortality rates for CABG were 1.6% and 1.8%, respectively. Mortality rates were 0% for both ASD closure and tumor resection. Across the groups, conversion to full sternotomy ranged from 0% to 1.8%.Conclusion: The 2022 nationwide MICS data demonstrate consistently low mortality and morbidity across all procedure types. As MICS adoption grows, these updated JCVSD findings will serve as vital benchmarks for ongoing quality improvement in Japan.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"510-517"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793825","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}

引用次数: 0

Methodological and ethical considerations in temporary chest closure for severe chest trauma: a letter to the editor. 严重胸外伤临时闭胸术的方法学和伦理考虑：致编辑的一封信。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-05-01 Epub Date: 2026-02-11 DOI: 10.1007/s11748-026-02266-y

Rabia Raheem, Munazza Raheem

引用次数: 0

Women in Japanese cardiovascular surgery: 21-year trends (2004-2025), current status and future perspectives. 日本接受心血管手术的女性：21年趋势（2004-2025）、现状和未来展望

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-04-30 DOI: 10.1007/s11748-026-02306-7

Osamu Ishida, Shotaro Yoshida, Koji Tsutsumi

{"title":"Women in Japanese cardiovascular surgery: 21-year trends (2004-2025), current status and future perspectives.","authors":"Osamu Ishida, Shotaro Yoshida, Koji Tsutsumi","doi":"10.1007/s11748-026-02306-7","DOIUrl":"https://doi.org/10.1007/s11748-026-02306-7","url":null,"abstract":"Background: Despite the increasing number of female medical graduates in Japan, women remain underrepresented in cardiovascular surgery.Methods: Using complete registry data from the Japanese Board of Cardiovascular Surgery (2004-2025), we examined annual proportions of female board-certified cardiovascular surgeons and newly certified surgeons. Linear regression was performed to assess trends and extrapolate future proportions. International benchmarking utilized published data from the United States, Europe, and global surveys.Results: The proportion of female board-certified cardiovascular surgeons increased from 0.7% in 2004 to 4.8% in 2025 (annual increase 0.202 percentage points; 95% CI 0.18-0.23; R2 = 0.973; P < 0.001). Among newly certified surgeons, the proportion was more variable, reaching 9.0% in 2025. Linear extrapolation projected the overall proportion to reach 5.6% in 2030 (95% prediction interval 5.0-6.1%) and 7.6% in 2040 (95% prediction interval 7.0-8.2%). The current Japanese proportion of 4.8% is approximately half the global average of 8.0% (from the 2024 EACTS global workforce analysis based on CTSNet data across 146 countries) and 42-47% of the United States (11.5%) and Europe (10.3%) in the same report.Conclusions: Over two decades, female representation in Japanese cardiovascular surgery has risen steadily to 4.8%, driven by increasing female new certifications. Japan's current level corresponds to Western proportions from the mid-2000s, reflecting a persistent international disparity. The recent physician work-style reform and ongoing efforts to improve retention may influence future trends, but longitudinal data are needed to evaluate their impact.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768475","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}

引用次数: 0

Gastroparesis following anatomical resection for lung cancer: clinical characteristics and implications. 肺癌解剖切除后胃轻瘫：临床特点及意义。

IF 1.3 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2026-04-29 DOI: 10.1007/s11748-026-02305-8

Hiromu Keira, Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki

{"title":"Gastroparesis following anatomical resection for lung cancer: clinical characteristics and implications.","authors":"Hiromu Keira, Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki","doi":"10.1007/s11748-026-02305-8","DOIUrl":"https://doi.org/10.1007/s11748-026-02305-8","url":null,"abstract":"Objective: Gastroparesis is a rare complication of thoracic surgery, defined as delayed gastric emptying without mechanical obstruction. Gastroparesis may worsen outcomes; however, data after lung resection are scarce. We aimed to determine the incidence, perioperative factors, and course of postoperative gastroparesis after anatomical lung resection for lung cancer.Methods: We retrospectively reviewed records of 1623 adult patients who underwent anatomical lung resection (2018-2022). Gastroparesis was defined as postoperative upper gastrointestinal symptoms with radiographic gastric dilatation without mechanical obstruction. Univariate comparisons were performed using the Wilcoxon rank-sum or Fisher's exact tests. Because of the infrequency of events, an exploratory multivariate analysis was conducted using Firth-penalized logistic regression with pre-specified covariates (clinical stage, lesion laterality, and extent of lymph node dissection).Results: Eight patients developed postoperative gastroparesis (0.49%, 8/1623). Affected patients tended to have left-sided and clinically advanced disease, and a longer operative time (median 210 vs. 147 min), greater blood loss (median 90 vs. 10 mL), and longer hospital stay (median 26 vs. 8 days). Onset occurred on postoperative days 2-6. All patients recovered with conservative management, without surgery. In Firth regression, left-sided resection and advanced stage increased odds of gastroparesis (adjusted odds ratio 3.67, 95% confidence interval 0.93-20.04; p = 0.064 and 3.17, 0.78-16.17; p = 0.108), respectively, whereas extent of lymph node dissection was not associated (1.44, 0.24-15.16; p = 0.706).Conclusions: Postoperative gastroparesis, although rare, was associated with prolonged hospitalization. Early recognition and supportive management are warranted, particularly after complex procedures.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768502","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}

引用次数: 0