General Thoracic and Cardiovascular Surgery最新文献

{"title":"Aortic floating thrombus in patients with COVID-19: a report of eight cases.","authors":"K Soumer, M Mallouki, N Azabou, H Horchani, S Nsiri, M Bousnina, A Jemel","doi":"10.1007/s11748-024-02072-4","DOIUrl":"10.1007/s11748-024-02072-4","url":null,"abstract":"<p><strong>Background: </strong>Thromboembolic events of COVID-19 are due to hyperinflammatory process associated with hypercoagulable state. The aim of the study was to determine characteristics and clinical outcomes of patients with COVID-19 who presented with aortic thrombus.</p><p><strong>Methods: </strong>We retrospectively conducted a single-center, descriptive study over a period of 1 year and 7 months, between June 2021 and December 2022, involving eight patients with documented SARS-CoV-2 infection associated with aortic thrombus revealed by acute limb ischemia.</p><p><strong>Results: </strong>The mean age of patients was 67 years with a median of 64, 5 ± 14. Of the eight included patients, six were men and two were women. Aortic thrombus was diagnosed in all cases. Six patients developed one episode of acute limb ischemia and one patient had recurrent upper and lower ischemia despite full anticoagulation whereas one patient had distal embolization with palpable pulses. In six patients, the thrombi were located in descending and abdominal aorta, while two patients presented with ascending aorta floating thrombus. Seven patients required urgent revascularization whereas medical treatment was recommended for one patient. The primary outcomes were successful in five cases, one patient had to be amputated above elbow, whereas two patients died due to a rapid deterioration of respiratory condition.</p><p><strong>Conclusion: </strong>Aortic thrombosis is a rare clinical presentation in SARS-CoV-2 infection but with potentially fatal embolic complication. Physicians should maintain a high degree of clinical suspicion to diagnose thromboembolic consequences of SARS-CoV-2 infection for timely management and avoiding morbidities like ischemic stroke and major amputations.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"164-170"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975492","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":"In vitro protamine addition for coagulation assessment using TEG 6s system during cardiopulmonary bypass: a pilot study.","authors":"Koichi Yoshinaga, Yusuke Iizuka, Yoshihiko Chiba, Yusuke Sasabuchi, Masamitsu Sanui","doi":"10.1007/s11748-024-02061-7","DOIUrl":"10.1007/s11748-024-02061-7","url":null,"abstract":"<p><strong>Objective: </strong>Systemic heparinization during cardiopulmonary bypass (CPB) can significantly affect thromboelastography (TEG). This study investigated the feasibility of adding protamine in vitro to allow assessment of coagulation status using the TEG 6s system during CPB.</p><p><strong>Methods: </strong>In this prospective observational study, 21 patients undergoing elective cardiac valve surgery were evaluated. During CPB, protamine was added in vitro to the heparinized blood of these patients at a concentration of 0.05 mg/mL and analyzed with the TEG 6s (Pre). The TEG parameters were compared to those analyzed after CPB withdrawal and systemic protamine administration (Post).</p><p><strong>Results: </strong>The citrated kaolin maximal amplitude (CK-MA) and the citrated functional fibrinogen maximal amplitude (CFF-MA) exhibited strong correlations between Pre and Post measurements (r = 0.790 and 0.974, respectively, P < 0.001 for both), despite significant mean differences (-2.23 mm for CK-MA and -0.68 mm for CFF-MA). Bland-Altman analysis showed a clinically acceptable agreement between Pre and Post measurement of CK-MA and CFF-MA (the percentage error was 10.6% and 12.2%, respectively). In contrast, the citrated kaolin reaction time (CK-R) showed no significant correlation between Pre and Post measurements (r = 0.328, P = 0.146), with a mean difference of 1.42 min (95% CI: -0.45 to 3.29).</p><p><strong>Conclusions: </strong>In vitro protamine addition allows assessment of coagulation status during CPB using the TEG 6s system. CK-MA and CFF-MA measured during CPB using this method revealed a strong correlation and agreement with post-CPB measurements, suggesting that our method potentially facilitates early prediction of post-CPB coagulation status and decision-making on transfusion strategies.</p><p><strong>Clinical trial registration: </strong>The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, registration number: UMIN000041097, date of registration: July 13, 2020, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046925 ) before the recruitment of participants.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"147-154"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626450","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":"Effects of temperature on transient neurologic dysfunction after total arch replacement.","authors":"Keitaro Nakanishi, Hiroshi Sato, Yutaka Iba, Ayaka Arihara, Shuhei Miura, Tsuyoshi Shibata, Jyunji Nakazawa, Tomohiro Nakajima, Takeo Hasegawa, Nobuyoshi Kawaharada","doi":"10.1007/s11748-024-02068-0","DOIUrl":"10.1007/s11748-024-02068-0","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between cooling status during aortic surgery with hypothermic circulatory arrest and postoperative neurologic dysfunction remains unknown. In the present study, we evaluated the effect of cooling status on transient neurologic dysfunction after total arch replacement.</p><p><strong>Methods: </strong>We studied patients who underwent elective total arch replacement with hypothermic circulatory arrest and antegrade selective cerebral perfusion from December 2011 to January 2021. Changes in tympanic temperature trends recorded during surgery were plotted. Several parameters, including the nadir temperature, cooling speed, and degree of cooling (cooling area, or the area under the curve of inverted temperature trends from cooling to rewarming as calculated by the integral method), were analyzed. The relationships between these variables and transient neurologic dysfunction were evaluated.</p><p><strong>Results: </strong>Transient neurologic dysfunction was observed in 33 (14.5%) of the 228 included patients. In the transient neurologic dysfunction group, the cooling area was larger (2417.3 vs. 1920.8 °C min; P < 0.001) and the cooling speed was higher (0.68 vs. 0.51 °C/min; P < 0.001) than in the non-transient neurologic dysfunction group. A multivariate logistic model revealed that both the cooling area (odds ratio = 1.13 per 100 °C min; P < 0.001) and cooling speed (odds ratio = 3.69 per °C/min; P = 0.041) were independent risk factors for transient neurologic dysfunction.</p><p><strong>Conclusions: </strong>Both the cooling area, which indicates the degree of cooling, and cooling speed had significant relationships with transient neurologic dysfunction after total arch replacement. Together, these findings indicate that overcooling and rapid cooling may contribute to brain injury.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"155-163"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893243","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":"Comparison of postoperative pain between robotic and uniportal video-assisted thoracic surgery for anatomic lung resection in patients with stage I lung cancer.","authors":"Keita Tokuishi, Jun-Ichi Wakahara, Yuichiro Ueda, So Miyahara, Hiroyasu Nakashima, Yoshiko Masuda, Ryuichi Waseda, Takeshi Shiraishi, Toshihiko Sato","doi":"10.1007/s11748-025-02129-y","DOIUrl":"https://doi.org/10.1007/s11748-025-02129-y","url":null,"abstract":"<p><strong>Objective: </strong>Uniportal video-assisted thoracoscopic surgery (U-VATS) and robot-assisted thoracoscopic surgery (RATS) are widely used, minimally invasive procedures. The present study aimed to compare postoperative pain following U-VATS and RATS anatomical lung resection in patients with clinical stage I lung cancer.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the data from 133 patients with clinical stage I lung cancer who underwent U-VATS (n = 63), four-arm RATS (n = 70) lobectomy, or segmentectomy between August 2020 and August 2023. Early postoperative outcomes, pain scores through postoperative day 7, and duration of postoperative analgesic use 60 days after surgery were compared using propensity score-matched analysis.</p><p><strong>Results: </strong>In the propensity score-matched analysis, the U-VATS group had a shorter operative time than the RATS group (160 vs. 202 min, respectively; P < 0.001). However, no significant differences were observed in blood loss, chest tube duration, complications, post operative stay length, or number of dissected lymph nodes and stations. The U-VATS group exhibited significantly lower pain scores than the RATS group throughout the entire postoperative period, particularly on postoperative days 1, 2, 3, 4, 5, and 7(P = 0.006, 0.044, 0.032, 0.041, 0.007, and 0.024, respectively). The number of patients who used analgesics for at least 2 months was lower in the U-VATS group than in the RATS group (4 [8.2%] vs. 17 [34.0%], respectively; P = 0.002).</p><p><strong>Conclusion: </strong>U-VATS anatomical lung resection in patients with clinical stage I lung cancer has less postoperative pain than RATS.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515449","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":"Trends in serum KL-6 levels following lung transplantation for interstitial lung diseases.","authors":"Kazuhisa Matsumoto, Akihiro Ohsumi, Tomohiro Handa, Daisuke Nakajima, Satona Tanaka, Satoshi Hamada, Kohei Ikezoe, Kiminobu Tanizawa, Toyohiro Hirai, Hiroshi Date","doi":"10.1007/s11748-025-02117-2","DOIUrl":"https://doi.org/10.1007/s11748-025-02117-2","url":null,"abstract":"<p><strong>Objective: </strong>To assess the changes in Krebs von den Lungen-6 (KL-6) levels pre- and post-lung transplantation for interstitial lung disease and to determine the connection between changes in KL-6 levels and chronic lung allograft dysfunction.</p><p><strong>Methods: </strong>Eighty-two lung transplantation procedures were performed in interstitial lung disease patients between January 2008 and December 2019. We compared changes in KL-6 levels before and after transplantation in two groups: unilateral and bilateral lung transplant groups. Additionally, KL-6 levels just before or at the onset of chronic lung allograft dysfunction were compared to the lowest post-transplant levels.</p><p><strong>Results: </strong>In total, 28 female and 49 male patients (median age: 54 years; range 22-64; 42 and 35 patients underwent unilateral and bilateral lung transplantations, respectively) were enrolled. The post-transplant observation period ranged from 8 to 163 (median: 64.2) months. KL-6 levels decreased in 76 patients (98.7%). Notably, the KL-6 level was lower in the bilateral lung transplantation group than in the unilateral lung transplantation group. Moreover, KL-6 levels were higher just before or at the onset of chronic lung allograft dysfunction than the lowest post-transplant levels. These levels were significantly higher than the highest post-transplant levels observed in the non-chronic lung allograft dysfunction group.</p><p><strong>Conclusions: </strong>Our findings suggest that KL-6 levels decrease in interstitial lung disease patients following lung transplantation, with a greater reduction in KL-6 levels observed in bilateral lung transplantation compared to unilateral lung transplantation. Elevated serum KL-6 levels were associated with chronic lung allograft dysfunction, highlighting its utility as a diagnostic biomarker.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482786","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":"Postoperative outcomes of cardiovascular surgery managed by nurse practitioners.","authors":"Masato Saitoh, Takuma Yamasaki, Tomoaki Tanabe, Shuichi Tochigi, Daiki Hirayama, Kiyotaka Aoyama, Imun Tei","doi":"10.1007/s11748-025-02132-3","DOIUrl":"https://doi.org/10.1007/s11748-025-02132-3","url":null,"abstract":"<p><strong>Objective: </strong>The significant workload of cardiovascular surgeons in Japan has led to a growing interest in implementing nurse practitioners as a means to address this issue. This study seeks to evaluate the postoperative outcomes of cardiovascular surgeries in which nurse practitioners were involved at our institution.</p><p><strong>Methods: </strong>This study utilized a retrospective observational study design. This study included patients who underwent scheduled cardiovascular surgeries at our hospital between April 1, 2019, and March 31, 2024. Patients were divided into two groups for postoperative care management: the DR group (physician only) and the NP group (co-management by physician and nurse practitioner). The primary end point was the 30-day mortality. We compared the two groups.</p><p><strong>Results: </strong>A total of 394 patients were classified into two groups: DR group (n = 101) and NP group (n = 293). There was no significant difference in the 30-day mortality between the two groups. The NP group had significantly shorter hospital stay (NP 20.6 ± 11.1 vs. DR 24.0 ± 11.8; p = 0.01; effect size = 0.299), postoperative length of stay (NP 14.5 ± 8.9 vs. DR 18.0 ± 10.4; p = 0.001; effect size = 0.376), ICU stay (NP 5.2 ± 3.5 vs. DR 6.3 ± 4.5; p = 0.014; effect size = 0.284), and time until 50-m walking (NP 3.8 ± 3.5 vs. DR 5.1 ± 5.1; p = 0.004; effect size = 0.342). There were no significant differences in the incidence of postoperative complications between the two groups.</p><p><strong>Conclusions: </strong>Nurse practitioners have the potential to provide safe care equivalent to that of physicians, and it may contribute to reduced hospital stays and improved postoperative recovery in patients.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482653","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":"Aortic wall degeneration late after ascending aortic wrapping.","authors":"Haruna Araki, Tadashi Kitamura, Shinzo Torii, Toshiaki Mishima, Masaomi Fukuzumi, Kagami Miyaji","doi":"10.1007/s11748-025-02133-2","DOIUrl":"https://doi.org/10.1007/s11748-025-02133-2","url":null,"abstract":"<p><p>Little is currently known about the pathological changes after aortic wrapping. This study investigated long-term outcomes including pathological findings after ascending aortic wrapping. Of the 30 patients who underwent aortic wrapping from 2004 to 2012, redo surgery was later performed in six patients. All the patients underwent ascending aorta replacement because of safety issues associated with aortic cross clamping due to adhesion. Pathologically, the tunica media had been lost and replaced by foreign body granulation. The wrapped aorta manifested severe erosion late after surgery. The wrapped aorta will likely be replaced in a redo surgery.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482651","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":"Guidelines for preoperative pulmonary function assessment in patients with lung cancer who will undergo surgery (The Japanese Association for Chest Surgery).","authors":"Yasuhisa Ohde, Kazuhiro Ueda, Jiro Okami, Hajime Saito, Toshihiko Sato, Eiji Yatsuyanagi, Masanori Tsuchida, Takahiro Mimae, Hiroyuki Adachi, Tomoyuki Hishida, Hisashi Saji, Ichiro Yoshino","doi":"10.1007/s11748-025-02120-7","DOIUrl":"https://doi.org/10.1007/s11748-025-02120-7","url":null,"abstract":"<p><p>This article translates the guidelines for preoperative pulmonary function assessment in patients with lung cancer who will undergo surgery, established by the Japanese Association of Chest Surgery on May 17, 2021, from Japanese to English. The last version of these guidelines was created on April 5, 2011. Over the past decade, changes in clinical practice have occurred that do not align with the current guidelines, prompting a revision in conjunction with the introduction of new evidence this time. This guideline was developed with reference to the internationally adopted GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system. Extraction of evidence, systematic review, and quality assessment are entrusted to each guideline review committee and the Pulmonary Function Assessment Working Group. Committee members are also responsible for determining the selection of evidence and the extraction period, with a particular emphasis on adopting items considered to be of special importance. The recommended assessment and management is categorized into a general overview, pulmonary function assessment, cardiopulmonary exercise test, pulmonary function assessment for lung cancer with interstitial pneumonia, preoperative smoking cessation, and pulmonary rehabilitation. These are described by the strength of recommendation, the strength of evidence, and the consensus rate.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448879","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":"WTAP-mediated m6A modification on BASP1 mRNA contributes to ferroptosis in AAA.","authors":"Zexiang Tian, Wei Li, Jian Wang, Shuzhen Li","doi":"10.1007/s11748-025-02130-5","DOIUrl":"https://doi.org/10.1007/s11748-025-02130-5","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm (AAA) is a common aneurysm that is often associated with atherosclerosis and can lead to artery rupture and death. Brain abundant membrane attached signal protein 1 (BASP1) is related to a variety of pathophysiological processes, but its role in AAA has not been reported.</p><p><strong>Methods: </strong>Real-time quantitative polymerase chain reaction (qRT-PCR) and western blot were used to detect the expressions of BASP1 and Wilms' tumor 1-associated protein (WTAP). Angiotensin-II (Ang-II) was employed for inducing AAA models in vitro to explore the effects and mechanism of BASP1 in AAA. Cell viability, apoptosis, oxidative stress level, and Fe²⁺ level were measured by the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium bromide (MTT), flow cytometry, and various kits, respectively. In terms of mechanism, the methylated RNA immunoprecipitation (MeRIP)-qPCR, the dual luciferase reporter assay, and the cytochrome experiments were utilized to evaluate the relationship between BASP1 and WTAP.</p><p><strong>Results: </strong>A highly expressed level of BASP1 was observed in aortic tissues of AAA patients and Ang-II could induce AAA models by treating vascular smooth muscle cells (VSMCs). In cellular function, BASP1 knockdown impaired AAA and ferroptosis resulted from Ang-II. Mechanically, WTAP mediated the N6-methyladenosine (m6A) modification and mRNA stability of BASP1. Meanwhile, WTAP was highly expressed in AAA tissues of patients and the effects of WTAP silence in AAA and ferroptosis were diminished by up-regulated BASP1.</p><p><strong>Conclusion: </strong>WTAP promotes cell viability and inhibits apoptosis and ferroptosis resulted from Ang-II in VSMCs by mediating the m6A level of BASP1.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448881","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":"Guidelines for the treatment of empyema (The Japanese Association for Chest Surgery).","authors":"Yuji Shiraishi, Mitsugu Omasa, Shinichi Yamashita, Yoon Hyung-Eun, Masayuki Tanahashi, Takeshi Fukami, Shinichi Tokyooka, Yasuhisa Ode, Tatsuro Okamoto, Takashi Shiraishi, Yasushi Shintani, Yasuhiro Hida, Sumiko Maeda, Isao Matsumoto, Yuichi Sakairi, Mariko Fukui, Katsuhiro Okuda, Masanori Tsuchida, Akira Iyoda, Hisashi Saji, Ichiro Yoshino","doi":"10.1007/s11748-025-02119-0","DOIUrl":"https://doi.org/10.1007/s11748-025-02119-0","url":null,"abstract":"<p><p>This article translates the guidelines for the treatment of empyema established by the Japanese Association of Chest Surgery in 2023 from Japanese to English. These guidelines were developed by the Working Group on Guidelines for the Treatment of Empyema of our society, involving the establishment of clinical questions, conducting systematic reviews in accordance with the MINDS (Medical Information Distribution Service) Manual for Guideline Development 2020 version 3.0 and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system, and determining the levels of recommendations. Furthermore, external evaluators provided assessments. Subsequently, the guidelines were finalized after receiving public comments from the members of the society. Even in the current era of advanced antibiotic therapy, empyema remains difficult to treat. However, the specific guideline for the treatment of empyema lacks in our country. Each institution is conducting clinical practices in its own way. Therefore, aiming to standardize the treatment of empyema, we have developed a practice guideline of empyema treatment. The pathophysiology of empyema is diverse, so empyema is classified into acute, chronic, and postoperative empyema. The recommended surgical treatment for each type of empyema is described, being categorized by the strength of recommendation, strength of evidence, and consensus rate.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448880","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}