General Thoracic and Cardiovascular Surgery最新文献_第4页

Robotic-assisted versus open resection of pulmonary sequestration: a retrospective cohort study. RATS surgery for pulmonary sequestration. 机器人辅助与开放式肺隔离切除术：一项回顾性队列研究。肺隔离的RATS手术。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-24 DOI: 10.1007/s11748-025-02172-9

Henrike Deissner, Alessio Campisi, Raffaella Griffo, Benedikt Niedermaier, Thomas Muley, Michael Allgäuer, Hauke Winter, Martin E Eichhorn

{"title":"Robotic-assisted versus open resection of pulmonary sequestration: a retrospective cohort study. RATS surgery for pulmonary sequestration.","authors":"Henrike Deissner, Alessio Campisi, Raffaella Griffo, Benedikt Niedermaier, Thomas Muley, Michael Allgäuer, Hauke Winter, Martin E Eichhorn","doi":"10.1007/s11748-025-02172-9","DOIUrl":"https://doi.org/10.1007/s11748-025-02172-9","url":null,"abstract":"Background: Pulmonary sequestration (PS) is a rare congenital lung malformation often requiring surgical resection due to recurrent infections or hemoptysis. Traditionally treated via open thoracotomy, recent advancements have made minimal-invasive approaches like robotic-assisted thoracoscopic surgery (RATS) increasingly viable. This study compares outcomes between RATS and open resection for PS in a high-volume center.Methods: In this retrospective cohort study, 23 adult patients who underwent surgical resection of PS between 2010 and 2023 were analyzed. Fifteen patients were treated via open thoracotomy (THKT), while eight underwent RATS using the DaVinci-X system. We compared preoperative findings, intraoperative variables, and postoperative outcomes.Results: The patients in the RATS group were younger (median age: 36 vs 47 years) and had a shorter median hospital stay (5 vs 10 days, p < 0.001) compared to the THKT group. The RATS group also experienced earlier chest drainage removal (3 vs. 4 days, p = 0.016). However, the median duration of surgery was longer for RATS (118 vs. 75 min, p = 0.018). A trend towards less postoperative complications was observed in the RATS group (33% vs. 0%).Conclusions: RATS provides a safe and effective alternative to open surgery for PS resection, with benefits including reduced hospital stay and earlier chest tube removal. Despite longer operative times, the minimally invasive approach may offer enhanced recovery and fewer complications. Continued accumulation of experience with RATS is likely to improve operative efficiency, making it a valuable option in the surgical management of pulmonary malformations.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474821","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

Reinterventions and medical costs after tetralogy of Fallot repair: a retrospective cohort study using health insurance claims in Japan. 法洛四联症修复后的再干预和医疗费用：日本健康保险索赔的回顾性队列研究。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-23 DOI: 10.1007/s11748-025-02174-7

Yasutaka Hirata, Shintaro Nemoto, Yusei Hamada, Akihiro Nakajima, Yasumi Nishiwaki, Kosuke Kikuchi

{"title":"Reinterventions and medical costs after tetralogy of Fallot repair: a retrospective cohort study using health insurance claims in Japan.","authors":"Yasutaka Hirata, Shintaro Nemoto, Yusei Hamada, Akihiro Nakajima, Yasumi Nishiwaki, Kosuke Kikuchi","doi":"10.1007/s11748-025-02174-7","DOIUrl":"https://doi.org/10.1007/s11748-025-02174-7","url":null,"abstract":"Background: Reinterventions after congenital heart disease surgery include not only reoperations but also medical catheter interventions, and the details of these treatment realities are often unclear. This study aimed to elucidate the medical and surgical reinterventions and associated medical costs after the tetralogy of Fallot (TOF) repair using Japanese health insurance claims data.Methods and results: We analyzed reinterventions and medical costs from insurance claims data of patients who underwent TOF repair between 2005 and 2021. Of 174 patients who underwent TOF repair, 23 (13.2%) received a total of 34 reinterventions. These included 23 percutaneous catheter interventions and 11 reoperations. The 5-year reintervention-free rate was 87.5% overall, 94.9% for surgeries with right ventricular outflow tract reconstruction (N = 130), and 65.6% for surgeries with peripheral pulmonary artery plasty (N = 44). The median (interquartile range) medical cost for patients without reintervention was ¥5.33 million (4.62-7.14 million) and the cost for the patients with reintervention was ¥ 10.59 million (7.73-13.97 million).Conclusion: Using Japanese insurance claims data, we analyzed the reoperation and catheter intervention after the TOF repair. The reintervention-free rate after TOF repair differed significantly by surgical procedure with a tendency for poorer postoperative prognosis, particularly in cases involving the peripheral pulmonary artery plasty. These analysis results may contribute to predicting outcomes after TOF repair for healthcare professionals.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474820","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

Effects of trimetazidine on cardiac function and ventricular remodeling in patients with ischemic cardiomyopathy: a systematic review and meta-analysis. 曲美他嗪对缺血性心肌病患者心功能和心室重构的影响：系统回顾和荟萃分析。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-17 DOI: 10.1007/s11748-025-02171-w

Wenjing Shi, Juan Cui, Chunyan Chen

{"title":"Effects of trimetazidine on cardiac function and ventricular remodeling in patients with ischemic cardiomyopathy: a systematic review and meta-analysis.","authors":"Wenjing Shi, Juan Cui, Chunyan Chen","doi":"10.1007/s11748-025-02171-w","DOIUrl":"https://doi.org/10.1007/s11748-025-02171-w","url":null,"abstract":"Background: Ischemic cardiomyopathy (ICM) is a late manifestation of coronary artery disease, marked by significant deterioration of cardiac pump function and abnormal ventricular remodeling. Current therapies have limitations, driving the search for novel approaches, especially targeting myocardial metabolism, as a key research focus.Objective: This study aims to systematically evaluate the effects of Trimetazidine (TMZ) on improving cardiac function and delaying ventricular remodeling in patients with ICM.Methods: Relevant literature was retrieved from five databases: PubMed, Embase, Web of Science, Cochrane Central, and CNKI, covering all studies published to date. A meta-analysis was conducted to assess the impact of trimetazidine on LVEF, E/A ratio, wall motion index, LVEDD, and LVESD, using standardized mean differences (SMD) as the effect measure and calculating the 95% CI.Results: A total of 9 studies involving 1037 patients were included. The meta-analysis results showed that the LVEF in the trimetazidine treatment group was significantly higher than that in the control group (SMD = 0.64, 95% CI: [0.30, 0.97], p < 0.0001). The E/A ratio and wall motion index also showed improvement (SMD = 0.20, 95% CI: [0.03, 0.36]; SMD = - 0.54, 95% CI: [- 0.78, - 0.29]). However, the effects of trimetazidine on LVEDD and LVESD were not significant (SMD = - 0.36, 95% CI [- 1.09, 0.36]; SMD = - 0.03, 95% CI [- 1.12, 1.07]).Conclusion: TMZ can effectively improve cardiac function in patients with ischemic cardiomyopathy, but its impact on ventricular remodeling is limited. Future research should further explore its application in the treatment of ICM.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316597","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

Trends of aortic valve-preserving surgery in japan: an updated five-year nationwide survey. 日本主动脉瓣保留手术的趋势：一项最新的五年全国调查。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-15 DOI: 10.1007/s11748-025-02170-x

Satoshi Arimura, Takashi Kunihara, Yutaka Okita, Shuichiro Takanashi, Tatsuhiko Komiya, Hitoshi Yaku, Hitoshi Okabayashi, Hirofumi Takemura, Hirokuni Arai, Masaru Sawazaki, Yoshiro Matsui, Norihiko Shiiya

{"title":"Trends of aortic valve-preserving surgery in japan: an updated five-year nationwide survey.","authors":"Satoshi Arimura, Takashi Kunihara, Yutaka Okita, Shuichiro Takanashi, Tatsuhiko Komiya, Hitoshi Yaku, Hitoshi Okabayashi, Hirofumi Takemura, Hirokuni Arai, Masaru Sawazaki, Yoshiro Matsui, Norihiko Shiiya","doi":"10.1007/s11748-025-02170-x","DOIUrl":"https://doi.org/10.1007/s11748-025-02170-x","url":null,"abstract":"Objective: We evaluated trends and outcomes of aortic valve-preserving surgery (AVPS) in Japan, particularly with regard to aortic regurgitation (AR), in comparison with data from 2014.Methods: We conducted a nationwide survey across 244 hospitals in Japan, focusing on aortic valve and aortic root surgeries performed in 2019. The breakdown of procedures, including isolated aortic valvuloplasty (AVP) and valve-sparing root replacement (VSRR), in AR patients was examined, and compared with the results from 2014.Results: In 2019, the isolated AVP rate for AR was 5.5%, down from 7.5% in 2014. The VSRR rate among aortic root surgeries remained (33.1%). Within VSRR procedures, aortic valve reimplantation (reimplantation) accounted for 62.7% of cases, aortic root remodeling (remodeling) for 32.0%, and other root replacement techniques for 5.3%. AVPS was performed in 102 hospitals, with 10 institutions accounting for 42.2% of all cases. One-year reoperation rates for AVP, reimplantation, remodeling, and other root replacement were 8.0%, 1.8%, 6.0%, and 14.3%, respectively. Short-term (up to 4 years) aortic valve-related reoperation rates for AVP, reimplantation, and remodeling were 9.7%, 6.1%, and 9.5%, respectively. Use of a pericardial patch emerged as an independent risk factor for reoperation following AVPS (P = 0.022; odds ratio 3.382; 95% confidence interval 1.195-9.570).Conclusions: The rate of AVP performed for AR in Japan decreased significantly from 2014 to 2019, while the rate of VSRR for root procedures remained stable. Use of a pericardial patch was identified as an independent risk factor for aortic valve-related reoperation following initial repair.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301837","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

Mid-term results of the floating stitch for systolic anterior motion in hypertrophic obstructive cardiomyopathy. 浮动针对肥厚性梗阻性心肌病收缩期前运动的中期评价。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-12 DOI: 10.1007/s11748-025-02167-6

Tomonari Uemura, Akihiko Usui, Yoshiyuki Tokuda, Yuji Narita, Masato Mutsuga

{"title":"Mid-term results of the floating stitch for systolic anterior motion in hypertrophic obstructive cardiomyopathy.","authors":"Tomonari Uemura, Akihiko Usui, Yoshiyuki Tokuda, Yuji Narita, Masato Mutsuga","doi":"10.1007/s11748-025-02167-6","DOIUrl":"https://doi.org/10.1007/s11748-025-02167-6","url":null,"abstract":"Objective: Systolic anterior motion (SAM) is an important factor for hypertrophic obstructive cardiomyopathy (HOCM) patients with a hypertrophic interventricular septum. We developed the 'floating stitch technique' to relieve SAM and have used it since 2017. The mid-term results of the floating stitch technique are reported.Methods: Ten consecutive HOCM patients (5 male, mean age 65.6 years) who underwent septal myectomy and the floating stitch technique from 2017 to 2022 were included. All patients underwent preoperative, pre-discharge, and annual follow-up echocardiographic evaluations. The median postoperative observation period was 3.5 (range 1.2-6.6) years.Results: There were no cases of cutting or elongation of the floating stitch during the follow-up period. The median mitral valve area (MVA) was 2.9 [interquartile range (IQR) 2.6-3.1] cm2 before surgery, 2.6 (IQR 2.2-2.7) cm2 before discharge, and 2.6 (IQR 2.2-2.8) cm2 at the latest follow-up. There were no cases of mitral stenosis clinically. All cases showed a significant decrease in the left ventricular outflow tract pressure gradient after surgery, but one case required re-operation due to recurrent obstruction at the mid-cardiac position. SAM did not recur in any cases, and all patients were in NYHA class 1 at the latest follow-up.Conclusions: The floating stitch technique showed an excellent SAM-suppression effect and durability. MVA decreased about 10% following the floating stitch technique, but sufficient area was secured without functional mitral stenosis. The combination of septal myectomy and floating stitch technique is a simple and reproducible procedure for HOCM, especially with severe SAM.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283531","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

Prognosis, imaging characteristics, and clinicopathological features of heavy smokers with clinical stage I lung adenocarcinoma: a multicenter study. 重度吸烟者合并临床I期肺腺癌的预后、影像学特征和临床病理特征：一项多中心研究

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-10 DOI: 10.1007/s11748-025-02166-7

Ikki Takada, Yoshihisa Shimada, Takahiro Mimae, Yujin Kudo, Takuya Nagashima, Yoshihiro Miyata, Hiroyuki Ito, Morihito Okada, Norihiko Ikeda

{"title":"Prognosis, imaging characteristics, and clinicopathological features of heavy smokers with clinical stage I lung adenocarcinoma: a multicenter study.","authors":"Ikki Takada, Yoshihisa Shimada, Takahiro Mimae, Yujin Kudo, Takuya Nagashima, Yoshihiro Miyata, Hiroyuki Ito, Morihito Okada, Norihiko Ikeda","doi":"10.1007/s11748-025-02166-7","DOIUrl":"https://doi.org/10.1007/s11748-025-02166-7","url":null,"abstract":"Objective: This study aimed to elucidate the relationship between smoking extent and prognosis, imaging characteristics, and clinicopathological factors in patients with clinical stage I lung adenocarcinoma (c-stage I LDA).Methods: We evaluated 2,285 patients who underwent surgical resection for c-stage I LDA between 2010 and 2018. Patients were classified into three groups based on the Brinkman Index (BI): never smokers (BI = 0), light smokers (0 < BI ≤ 600), and heavy smokers (BI > 600). Clinicopathological features and prognosis were analyzed according to smoking extent.Results: Significant differences in overall survival (OS) were observed across the smoking groups. Heavy smokers exhibited more invasive imaging characteristics, including a larger solid proportion and a higher maximum standardized uptake value (SUVmax), compared to never and light smokers. In multivariable analyses, heavy smoking was significantly associated with poorer OS (hazard ratio [HR] 2.071, p < 0.001). In addition, older age (HR 1.111, p < 0 .001) and the presence of vascular invasion (HR 2.312, p < 0.001) were also associated with worse OS among heavy smokers.Conclusion: Smoking extent was independently associated with poorer survival, larger solid tumor size, and higher SUVmax in patients with c-stage I LDA. Age and vascular invasion emerged as strong prognostic factors, particularly among heavy smokers.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257818","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

Preoperative assessment of pleural adhesions using computed tomography scan and positron emission tomography in patients with lung cancer. 肺癌患者术前胸膜粘连的计算机断层扫描和正电子发射断层扫描评估。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-09 DOI: 10.1007/s11748-025-02169-4

Kengo Yasuda, Masaya Yamasaki, Toho Wada, Wakako Fujiwara, Tatsuya Miyamoto, Shinji Matsui, Yasuaki Kubouchi, Yugo Tanaka

{"title":"Preoperative assessment of pleural adhesions using computed tomography scan and positron emission tomography in patients with lung cancer.","authors":"Kengo Yasuda, Masaya Yamasaki, Toho Wada, Wakako Fujiwara, Tatsuya Miyamoto, Shinji Matsui, Yasuaki Kubouchi, Yugo Tanaka","doi":"10.1007/s11748-025-02169-4","DOIUrl":"https://doi.org/10.1007/s11748-025-02169-4","url":null,"abstract":"Objectives: The presence of pleural adhesions during lung cancer surgery can obstruct the surgical field and inhibit maneuverability, thereby potentially complicating the procedure. The current study examined the potential predictive factors of pleural adhesions using standard preoperative examinations for lung cancer surgery without additional assessments.Methods: This study included 542 patients with primary lung cancer who underwent chest computed tomography scan and positron emission tomography before undergoing surgery between January 2021 and September 2024. To assess differences in lung expansion between inspiration and natural breathing, the ratio of lung computed tomography scan measurements obtained during maximal inspiration-to-lung positron emission tomography measurements during spontaneous breathing was calculated. The ratios were compared between patients with pleural adhesions and those without.Results: In total, 56 patients were classified under the adhesion group and 486 under the non-adhesion group. If the ratio of the distance from the lung base to the interlobar fissure, measured on coronal computed tomography scan and positron emission tomography, was ≤ 1.390, and the angle of the lung base, measured on sagittal computed tomography scan, was ≥ 40°, the incidence of pleural adhesions was significantly higher (24.0% vs. 4.7%; p < 0.01).Conclusion: Standard preoperative examinations could be effective in predicting pleural adhesion.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247444","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

Unilateral upper lung field pulmonary fibrosis after primary lung cancer surgery as a late complication to be recognized. 单侧肺上野肺纤维化作为原发性肺癌手术后的晚期并发症有待认识。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-06 DOI: 10.1007/s11748-025-02164-9

Hironori Ishibashi, Mariko Hanafusa, Ayaka Asakawa, Yuya Ishikawa, Ryo Wakejima, Shota Horibe, Kenichi Okubo

{"title":"Unilateral upper lung field pulmonary fibrosis after primary lung cancer surgery as a late complication to be recognized.","authors":"Hironori Ishibashi, Mariko Hanafusa, Ayaka Asakawa, Yuya Ishikawa, Ryo Wakejima, Shota Horibe, Kenichi Okubo","doi":"10.1007/s11748-025-02164-9","DOIUrl":"https://doi.org/10.1007/s11748-025-02164-9","url":null,"abstract":"Objective: Unilateral upper lung field pulmonary fibrosis (UPF) is a possible complication on the operated side after lung cancer surgery. However, its incidence and associated perioperative factors remain unclear. This study investigated the clinical characteristics of patients with unilateral UPF after primary lung cancer surgery.Methods: We reviewed the records of all consecutive patients with lung cancer who underwent complete resection at the Institute of Science, Tokyo, between July 2010 and December 2021. We estimated the cumulative incidence and sub-hazard ratios using competing risk regression models.Results: A total of 979 patients were included in this analysis. The median follow-up period up to the last follow-up was 59.2 months (interquartile range 37.0-84.6 months). With 39 (4.0%) cases of postoperative unilateral UPF, the median follow-up time until the diagnosis of unilateral UPF was 25.5 months (interquartile range 12.9-45.3 months), and the 3-, 5-, and 10-year cumulative incidences of unilateral UPF were 2.7%, 4.0%, and 5.4%, respectively. The 5-year overall survival rate was 87.3%; however, 30 of the 39 patients (76.9%) with unilateral UPF experienced subsequent complications related to unilateral UPF, such as progressive respiratory distress, progressive body weight loss, and pneumonia. Age > 75 years, male sex, low body mass index (< 20 kg/m2), ischemic heart disease, history of pneumonia, emphysema, pulmonary apical cap, and right lower lobe tumors are possible risk factors for unilateral UPF.Conclusions: Unilateral UPF is an unrecognized late complication of lung cancer surgery that should be carefully monitored in patients with risk factors.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233814","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

Reconstruction of resected unilateral phrenic nerve using autologous intercostal nerve during malignant mediastinal tumor resection. 纵隔恶性肿瘤切除术中自体肋间神经重建单侧膈神经。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-03 DOI: 10.1007/s11748-025-02163-w

Hiroshi Yabuki, Sakiko Kumata, Jiro Abe, Shingo Miyabe, Fumiko Tomiyama, Masafumi Noda

{"title":"Reconstruction of resected unilateral phrenic nerve using autologous intercostal nerve during malignant mediastinal tumor resection.","authors":"Hiroshi Yabuki, Sakiko Kumata, Jiro Abe, Shingo Miyabe, Fumiko Tomiyama, Masafumi Noda","doi":"10.1007/s11748-025-02163-w","DOIUrl":"https://doi.org/10.1007/s11748-025-02163-w","url":null,"abstract":"In some patients, complete resection of malignant tumors requires phrenic nerve resection; however, this can cause postoperative phrenic nerve paralysis, leading to reduced respiratory function and limited performance of daily activities. We encountered two patients in whom the phrenic nerve was resected during surgery for a malignant anterior mediastinal tumor and subsequently reconstructed using autologous intercostal nerves to preserve the diaphragm function. Although neither patient had preoperative phrenic nerve paralysis, the phrenic nerve required resection to totally remove the encasing tumor. The third and fifth intercostal nerves were harvested and used for reconstruction because the extent of phrenic nerve resection was too long for direct suturing. Postoperative chest radiographs confirmed the preserved diaphragm function during inspiration and expiration. In patients in whom long phrenic nerve sections are resected, the use of the intercostal nerve for reconstruction may preserve phrenic nerve function.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208239","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

The erector spinae plane block is not superior to perioperative systemic lidocaine infusion for postoperative analgesia management after thoracotomy: a randomized double-blind study. 竖脊肌平面阻滞并不优于围术期全身利多卡因输注用于开胸术后镇痛管理：一项随机双盲研究。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-03 DOI: 10.1007/s11748-025-02165-8

Tugberk Küçün, Elif Oral Ahiskalioglu, Ahmet Murat Yayik, Muhammed Enes Aydin, Neslihan Küçün, Ali Bilal Ulas, Ali Ahiskalioglu

{"title":"The erector spinae plane block is not superior to perioperative systemic lidocaine infusion for postoperative analgesia management after thoracotomy: a randomized double-blind study.","authors":"Tugberk Küçün, Elif Oral Ahiskalioglu, Ahmet Murat Yayik, Muhammed Enes Aydin, Neslihan Küçün, Ali Bilal Ulas, Ali Ahiskalioglu","doi":"10.1007/s11748-025-02165-8","DOIUrl":"https://doi.org/10.1007/s11748-025-02165-8","url":null,"abstract":"Background: The effect of erector spinae plane block and systemic lidocaine infusion for major thoracotomy is still unclear. Therefore, we aimed to compare ESPB, systemic lidocaine and standard analgesia in patients who undergoing major thoracotomy.Methods: Patients with ASA I-III, aged between 18 and 65 years scheduled for major thoracotomy were enrolled. Patients were randomly assigned to receive an intravenous (IV) infusion of placebo combined with ESP block using placebo (group P), ESP block with 0.25% bupivacaine combined with IV placebo (group ESPB), or IV-lidocaine combined with ESP-block using placebo (group L). The primary outcome was postoperative (24 h) total opioid consumption. The secondary outcomes were VAS scores, rescue analgesia, and intraoperative remifentanil consumption.Results: Resting VAS scores were significantly lower in both groups ESPB and L compared to group P during the first four postoperative hours. Similarly, dynamic VAS scores were lower in group ESPB and group L compared to group P during the first two postoperative hours (p < 0.05). ESP block was not found to be superior to systemic lidocaine in reducing morphine requirements during the first 24 h (30.25 ± 5.1 vs. 28.7 ± 3.1 respectively, p = 0.567). Additionally, the difference in morphine consumption between group P and either ESP-block or systemic lidocaine groups was minimal, amounting to only 3-4.5 mg. However, the requirement for rescue analgesia was significantly lower in both groups ESPB and L compared to group P (p < 0.05). There was no difference between groups ESPB and L in terms of rescue analgesia requirement.Conclusion: ESP block did not demonstrate superior postoperative analgesic efficacy compared to systemic lidocaine in patients undergoing major thoracotomy.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208240","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