General Thoracic and Cardiovascular Surgery最新文献

{"title":"Comparison of early recurrence in young-onset primary spontaneous pneumothorax following surgery using different covering methods.","authors":"Taiki Takasugi, Motoki Sakuraba, Wataru Arai","doi":"10.1007/s11748-024-02049-3","DOIUrl":"10.1007/s11748-024-02049-3","url":null,"abstract":"<p><strong>Objectives: </strong>The treatment of primary spontaneous pneumothorax not only involves bulla resection via video-assisted thoracic surgery but also covers the lesion. Ideal treatment should minimize adhesions and reduce the recurrence rate. This study aimed to explore different covering methods and compare the frequency of early recurrence for each covering method.</p><p><strong>Methods: </strong>We included 370 subjects with primary spontaneous pneumothorax < 25 years who were treated with video-assisted thoracic surgery from August 2012 to December 2022. Subjects were divided into three groups depending on how the treated lesions were covered. The P group included 162 subjects treated between April 2012 and June 2017 whose lesions were covered using polyglycolic acid sheets on the staple line of the bulla resection lesion. The O group included 93 subjects treated between July 2017 and July 2019 whose lesions were covered with oxidized regenerated cellulose over a polyglycolic acid sheet. The N group included 115 subjects treated between August 2019 and December 2022 whose lesions were covered with oxidized regenerated cellulose over a polyglycolic acid nano sheet.</p><p><strong>Results: </strong>Recurrence rates were 3.7%, 8.6%, and 6.0% in the P, O, and N groups, respectively; however, the differences were not statistically significant. The adhesions were milder in the N group than in the P and O groups.</p><p><strong>Conclusions: </strong>Although both covering methods were effective in preventing recurrence, further studies involving further treatment modifications and longer-term follow-ups are required.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"45-51"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418569","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":"Combined procedure using a double flap as a surgical option for coarctation of the aorta with delayed diagnosis.","authors":"Mitsuru Sato, Naoki Masaki, Sadahiro Sai","doi":"10.1007/s11748-024-02071-5","DOIUrl":"10.1007/s11748-024-02071-5","url":null,"abstract":"<p><p>Simple coarctation of the aorta is repaired in an infant by direct end-to-end anastomosis of the aorta or subclavian flap aortoplasty. However, some cases are not detected until late childhood. For school-age patients, greater consideration must be given to risks such as postoperative limb ischemia and the potentially harmful effects of any artificial material on future growth. Here, we describe our technique for these patients, in whom the value of direct anastomosis is uncertain, to minimize the amount of synthetic graft material used while achieving successful anatomical repair.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"66-69"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987766","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":"Evaluating air leakage from staple line reinforcements in anatomical pulmonary resection (AIRSTOP): a prospective randomized controlled trial protocol.","authors":"Jotaro Yusa, Kazuhisa Tanaka, Kohei Takahashi, Yuki Shiko, Takeshi Sugawara, Ichiro Yoshino, Hidemi Suzuki","doi":"10.1007/s11748-024-02111-0","DOIUrl":"https://doi.org/10.1007/s11748-024-02111-0","url":null,"abstract":"<p><strong>Background: </strong>Air leakage during pulmonary resection is a major complication in thoracic surgery. It frequently occurs at sites of adhesion dissection, due to lung manipulation, and along the staple lines of automatic suturing devices, particularly in cases of pulmonary fragility such as those of emphysema and interstitial pneumonia. Persistent postoperative air leakage prolongs chest tube indwelling and extends hospitalization time. Staplers with absorbable tissue reinforcements have been introduced for pulmonary resection to prevent intraoperative stapler-related air leakage. This phase II prospective, open-label, randomized, parallel-group trial aims to validate the efficacy of staplers with or without absorbable tissue reinforcements in controlling stapler-related air leakage during anatomical pulmonary resections.</p><p><strong>Methods: </strong>Overall, 120 patients will be randomized into two groups: one that will undergo conventional anatomical pulmonary resection and the other in which staplers with absorbable tissue reinforcements will be used. The primary endpoint will be intraoperative stapler-related air leakage. Data will be analyzed between 2024 and 2025.</p><p><strong>Discussion: </strong>This trial will validate the effectiveness and safety of staple line reinforcements in controlling intraoperative air leakage during anatomical pulmonary resections, potentially leading to optimized strategies for patients with conditions such as emphysema and interstitial pneumonia.</p><p><strong>Trial registration: </strong>This trial has been registered with the Japan Registry of Clinical Trials 1032220620 ( https://jrct.niph.go.jp/latest-detail/jRCTs031230224 ).</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893669","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":"Extracorporeal membrane oxygenation vs cardiopulmonary bypass in lung transplantation: an updated meta-analysis.","authors":"Rachid Eduardo Noleto da Nobrega Oliveira, Felipe S Passos, Bernardo Mulinari Pessoa","doi":"10.1007/s11748-024-02114-x","DOIUrl":"https://doi.org/10.1007/s11748-024-02114-x","url":null,"abstract":"<p><strong>Aim: </strong>This meta-analysis aimed to compare the outcomes of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB) in lung transplantation.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation. Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs). DerSimonian and Laird random-effects model was applied for all endpoints. I² statistics was used to assess heterogeneity.</p><p><strong>Results: </strong>Fourteen studies with a total of 1797 patients were included. ECMO was associated with significant reductions in hepatic dysfunction (OR 0.47, 95% CI 0.25-0.90), hemodialysis (OR 0.62, 95% CI 0.43-0.88), severe graft rejection (OR 0.43, 95% CI 0.23-0.78), one-year mortality (OR 0.70; 95% CI 0.51 to 0.98; p = 0.04; I² = 13%) and tracheostomy rates (OR 0.62, 95% CI 0.46-0.86). Additionally, ECMO reduced the length of hospital stay (MD - 5.69 days, 95% CI - 9.31 to - 2.08) and ICU stay (MD - 6.02 days, 95% CI - 8.32 to - 3.71). However, ECMO was associated with longer total ischemic time (MD 61.07 min, 95% CI 3.51 to 118.62). No significant differences were observed for stroke, thromboembolic events, atrial fibrillation, or 30-day and 3-year mortality.</p><p><strong>Conclusions: </strong>ECMO offers perioperative advantages in lung transplantation, reducing postoperative complications, one-year mortality, and recovery time compared to CPB. However, the longer total ischemic time with ECMO warrants further investigation into its long-term outcomes.</p><p><strong>Trial registry: </strong>International Prospective Register of Systematic Reviews; N°: CRD42024604049; URL: https://www.crd.york.ac.uk/prospero/ .</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871888","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":"Influence of HLA mismatch between donors and recipients on postoperative outcomes in cadaveric lung transplantation.","authors":"Hidenao Kayawake, Ichiro Sakanoue, Satona Tanaka, Yojiro Yutaka, Yoshihiro Nishino, Akira Matsumoto, Taiki Ryo, Taichi Matsubara, Daisuke Nakajima, Hiroshi Date","doi":"10.1007/s11748-024-02109-8","DOIUrl":"https://doi.org/10.1007/s11748-024-02109-8","url":null,"abstract":"<p><strong>Objectives: </strong>Generally, HLA matching between donors and recipients is not performed in lung transplantation (LTx). Therefore, whether HLA mismatch between donors and recipients (D/R mismatch) influences postoperative outcomes after LTx remains uncertain. In this study, we investigated the influence of D/R mismatch on postoperative outcomes after cadaveric LTx (CLT).</p><p><strong>Methods: </strong>A total of 140 CLT procedures were performed between 2012 and 2020. After excluding 5 recipients with preformed DSA and 1 recipient undergoing re-LTx, 134 recipients were enrolled in this retrospective study. The postoperative outcomes were compared between recipients with higher and lower D/R mismatches.</p><p><strong>Results: </strong>The median D/R mismatch (A/B/DR loci) was 4.0 (range, 1-6). When dividing these 134 recipients into two groups (H group [D/R mismatch ≥ 5, n = 57] and L group [D/R mismatch ≤ 4, n = 77]), there were no significant differences in the patient backgrounds. The lengths of hospital and intensive care unit stays were similar (p = 0.215 and p = 0.37, respectively). Although the overall survival was not significantly better in the H group than in the L group (p = 0.062), chronic lung allograft dysfunction-free survival was significantly better in the H group than in the L group (p = 0.027). Conversely, there was no significant difference in the cumulative incidence of de novo donor-specific anti-HLA antibodies (dnDSAs) between the two groups (p = 0.716).</p><p><strong>Conclusions: </strong>No significant difference in dnDSA development was observed between patients with higher and lower D/R HLA mismatches. Given the favorable outcomes in the high HLA mismatch group, CLTs can be performed safely in recipients with high D/R HLA mismatches.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800298","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":"Transient neurologic dysfunction after aortic arch surgery.","authors":"Mesut Engin, Abdurrahman Demirel, Ahmet Kağan As, Şenol Yavuz","doi":"10.1007/s11748-024-02110-1","DOIUrl":"https://doi.org/10.1007/s11748-024-02110-1","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784908","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":"Preoperative neutrophil-to-lymphocyte ratio predicts recurrence of esophageal squamous cell carcinoma after neoadjuvant triplet chemotherapy.","authors":"Kentaro Kubo, Shota Igaue, Daichi Utsunomiya, Yuto Kubo, Kyohei Kanematsu, Daisuke Kurita, Koshiro Ishiyama, Junya Oguma, Koichi Goto, Hiroyuki Daiko","doi":"10.1007/s11748-024-02053-7","DOIUrl":"10.1007/s11748-024-02053-7","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy followed by esophagectomy is the standard treatment for resectable advanced esophageal squamous cell carcinoma (ESCC) in Japan. Triplet chemotherapy is the standard neoadjuvant regimen. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) are well-known prognostic factors for esophageal cancer. However, their usefulness in patients with resectable advanced disease undergoing esophagectomy after neoadjuvant triplet chemotherapy is unknown.</p><p><strong>Method: </strong>We examined 144 ESCC patients who underwent neoadjuvant triplet chemotherapy followed by esophagectomy between January 2015 and December 2020 to investigate the relationship between inflammatory markers and recurrence-free survival (RFS). Optimal marker cutoff values for RFS were determined using receiver operating characteristic curve analysis. Patients were divided into high and low NLR groups (NLR cutoff, 3.0).</p><p><strong>Results: </strong>NLR was high in 61 patients and low in 83. Univariate analyses demonstrated that low NLR was significantly associated with worse RFS (p = 0.049). Multivariate analyses demonstrated that high NLR was an independent predictor of RFS (odds ratio, 1.911; 95% confidence interval, 1.098-3.327; p = 0.022). RFS significantly differed between the low and high NLR groups. RFS did not significantly differ between the patients when stratified according to the other inflammatory markers.</p><p><strong>Conclusion: </strong>Preoperative NLR is an easily obtained and useful predictor of RFS in patients with resectable advanced ESCC treated with neoadjuvant triplet chemotherapy followed by esophagectomy.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"802-809"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444079","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 pulmonary function of patients with lung cancer and interstitial lung abnormalities.","authors":"Norifumi Tsubokawa, Takahiro Mimae, Takeshi Mimura, Atsushi Kagimoto, Atsushi Kamigaichi, Nobutaka Kawamoto, Yoshihiro Miyata, Morihito Okada","doi":"10.1007/s11748-024-02037-7","DOIUrl":"10.1007/s11748-024-02037-7","url":null,"abstract":"<p><strong>Objective: </strong>We investigated the impact of radiological interstitial lung abnormalities on the postoperative pulmonary functions of patients with non-small cell lung cancer.</p><p><strong>Methods: </strong>A total of 1191 patients with clinical stage IA non-small cell lung cancer who underwent lung resections and pulmonary function tests ≥ 6 months postoperatively were retrospectively reviewed. Postoperative pulmonary function reduction rates were compared between patients with and without interstitial lung abnormalities and according to the radiological interstitial lung abnormality classifications. Surgical procedures were divided into wedge resection, 1-2 segment resection, and 3-5 segment resection groups.</p><p><strong>Results: </strong>No significant differences in postoperative pulmonary function reduction rates 6 months after wedge resection were observed between the interstitial lung abnormality [n = 202] and non-interstitial lung abnormality groups [n = 989] [vital capacity [VC]: 6.82% vs. 5.00%; forced expiratory volume in 1 s [FEV1]: 7.05% vs. 7.14%]. After anatomical resection, these values were significantly lower in the interstitial lung abnormality group than in the non-interstitial lung abnormality group [VC: 1-2 segments, 12.50% vs. 9.93%; 3-5 segments, 17.42% vs. 14.23%; FEV1: 1-2 segments: 13.36% vs. 10.27%; 3-5 segments: 17.36% vs. 14.39%]. No significant differences in postoperative pulmonary function reduction rates according to the radiological interstitial lung abnormality classifications were observed.</p><p><strong>Conclusions: </strong>The presence of interstitial lung abnormalities had a minimal effect on postoperative pulmonary functions after wedge resections; however, pulmonary functions significantly worsened after segmentectomy or lobectomy, regardless of the radiological interstitial lung abnormality classification in early-stage non-small cell lung cancer.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"786-795"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891777","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":"Lessons from short chest drain management for primary spontaneous pneumothorax.","authors":"Atsushi Kagimoto, Atsushi Kamigaichi, Masayuki Ishida, Takeshi Mimura","doi":"10.1007/s11748-024-02039-5","DOIUrl":"10.1007/s11748-024-02039-5","url":null,"abstract":"<p><strong>Objectives: </strong>Video-assisted thoracic surgery (VATS) bullectomy is the mainstay treatment for primary spontaneous pneumothorax (PSP) but we encounter patients with pain due to chest tube. This study investigated the postoperative outcomes of shortened silicone drain as a chest tube after VATS bullectomy to reduce pain.</p><p><strong>Methods: </strong>The current study included patients aged < 30 years who underwent VATS bullectomy for PSP. Patients with normal intrathoracic lengths of the silicone drain placed in a loop at the apex toward the diaphragm were categorized as Group L, whereas those with the silicone drain shortened to approximately 10 cm and placed toward the apex were classified as Group S. Postoperative pain evaluated using a numerical rating scale (NRS) and other perioperative outcomes were compared between the groups.</p><p><strong>Results: </strong>Altogether, 43 patients were included, with 22 in Group L and 21 in Group S, respectively. The NRS before chest tube removal was significantly lower in Group S (mean, 2.1) than in Group L (4.4; p = 0.001). In Group L, 4 patients (p = 0.017) required early chest tube removal than expected due to severe pain whereas none in Group S required this intervention; additionally, more patients needed additional analgesics than in Group S (p = 0.003).</p><p><strong>Conclusion: </strong>In VATS bullectomy for PSP, the pain intensity could be reduced by shortening the intrathoracic length of the silicone drain, compared to a longer intrathoracic length of the silicon drain. Our findings contribute to the establishment of optimal postoperative management of general thoracic surgery.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"796-801"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911744","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":"First case of major lung resection using the hinotori™ surgical robot system.","authors":"Takashi Suda, Mizuki Morota, Takahiro Negi, Daisuke Tochii, Sachiko Tochii","doi":"10.1007/s11748-024-02082-2","DOIUrl":"10.1007/s11748-024-02082-2","url":null,"abstract":"<p><p>We performed the first case of major lung resection using the hinotori™ surgical robot system, which is a new surgical support robot system developed in Japan. A left lower lobectomy and subcarinal lymph node dissection were performed. The operation time was 3 h and 5 min, the cockpit time (console time) was 2 h and 5 min, and the blood loss was 40 g. Although the hinotori™ surgical robot system requires further improvements to be used for lung cancer surgery, even in its current state, there is no difference in operability compared to the da Vinci robot, and it is possible to perform the same surgery. Further evaluation with additional cases is required in future.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"810-813"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307504","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}