General Thoracic and Cardiovascular Surgery最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>ESP block did not demonstrate superior postoperative analgesic efficacy compared to systemic lidocaine in patients undergoing major thoracotomy.</p>","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}

{"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":"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":"385-404"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","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":"Comparison between OK-432 and Talc for pleurodesis in patients with persistent pulmonary air leak: a Japanese nationwide retrospective database study.","authors":"Jumpei Taniguchi, Shotaro Aso, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga","doi":"10.1007/s11748-024-02088-w","DOIUrl":"10.1007/s11748-024-02088-w","url":null,"abstract":"<p><strong>Objectives: </strong>OK-432 (Picibanil^®) and talc are used in patients with persistent pulmonary air leaks. However, it is unclear which of these two agents is more effective.</p><p><strong>Methods: </strong>This retrospective study used data from the Japanese Diagnosis Procedure Combination inpatient database. Patients with pneumothorax who underwent chemical pleurodesis between July 2010 and March 2022 were included in this study. The patients were categorized into two groups: the OK-432 and talc groups. The primary outcome measure was treatment failure, defined as a composite of requirement for additional surgical procedures, bronchoscopic interventions, or chemical pleurodesis. The secondary outcome measures were in-hospital mortality, length of hospital stay, 30-day readmission, and incidence of interstitial lung diseases after hospitalization. To compare the outcomes between the groups, 1:4 propensity score matching was conducted.</p><p><strong>Results: </strong>Among the 4179 eligible patients, 3551 and 628 patients underwent chemical pleurodesis using OK-432 and talc, respectively. Propensity score matching yielded 2508 and 627 patients who underwent chemical pleurodesis using OK-432 and talc within seven days of admission, respectively. The frequency of treatment failure in the talc group (37.5% vs. 31.4%; P = 0.006) was lower than that in the OK-432 group with no significant differences in other outcomes.</p><p><strong>Conclusions: </strong>Medical professionals can consider talc as the initial pleurodesis agent for patients with persistent air leaks.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"428-435"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344889","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":"Design and evaluation of valve interventions using ex vivo biomechanical modeling: the Stanford experience.","authors":"Gabe Weininger, Stefan Elde, Yuanjia Zhu, Y Joseph Woo","doi":"10.1007/s11748-025-02127-0","DOIUrl":"10.1007/s11748-025-02127-0","url":null,"abstract":"<p><p>The increase in prevalence of valvular heart disease coupled with an aging population has placed increased emphasis on durable valvular repair strategies. Despite many advances in valvular therapies, there has been little rigorous biomechanical evaluation and validation of existing repair strategies. Our research group engineered a novel 3D-printed, ex vivo heart simulator, which has allowed us to refine and innovate numerous surgical repair strategies with hemodynamic and biomechanical feedback in real time on explanted animal heart valves. Data obtained from this novel simulator have directly influenced clinical practice at our institution. It has also proven to be an outstanding platform for valvular device development. Herein, we will review our experience with ex vivo biomechanical simulation, subdivided into work on aortic valve pathology, mitral valve pathology, and novel devices.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"375-384"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of minimally invasive thoracoscopic surgery for pulmonary mycosis complicated with hematopoietic malignancy.","authors":"Reo Ohtsuka, Sakashi Fujimori, Souichiro Suzuki, Takahiro Karasaki, Shinichiro Kikunaga, Kazuki Ito, Yosuke Hamada, Shusei Mihara, Otoya Watanabe, Hisashi Yamamoto","doi":"10.1007/s11748-024-02092-0","DOIUrl":"10.1007/s11748-024-02092-0","url":null,"abstract":"<p><strong>Objective: </strong>Patients with hematopoietic malignancies (HM) are often immunocompromised and, therefore, susceptible to developing invasive fungal infections, including pulmonary mycosis. Surgical resection is indicated for localized pulmonary mycosis refractory to antifungal agents. This study investigated the feasibility and outcomes of minimally invasive surgery for pulmonary mycosis patients complicated with HM.</p><p><strong>Methods: </strong>We retrospectively reviewed 56 cases of surgically treated pulmonary mycosis among the 3994 lung resections performed in our department between 2011 and 2020, focusing on the 19 cases under treatment for HM.</p><p><strong>Results: </strong>All patients underwent 3-port video-assisted thoracoscopic surgery, including one patient converted to open surgery. The 30 day mortality rate was zero. The overall survival rate 1 year after surgery was 63.2%. No relapse of mycosis was observed, and the majority of the cause of death was the progression of HM. The rate of major postoperative complications was comparable between the patients with HM (3/19) and without HM (5/37), despite the patients with HM having a higher frequency of immunocompromised status than those without HM. Most patients who underwent surgery before hematopoietic stem cell transplantation (HSCT) had leukocytopenia, while all patients who underwent surgery after HSCT received immunosuppressants. Mucormycosis was observed in 13 out of 19 patients (68%) with HM, and it was significantly associated with preoperative pancytopenia and usage of immunosuppressants.</p><p><strong>Conclusion: </strong>Minimally invasive surgery was feasible for pulmonary mycosis complicated with HM despite the high frequency of immunosuppression. These findings will deepen our understanding of pulmonary mycosis associated with HM and may improve perioperative patient care.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"436-442"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498610","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":"Safety and validity of selective cerebrospinal fluid drainage in open and endovascular aortic repair.","authors":"Yuko Ohashi, Naoki Washiyama, Daisuke Takahashi, Kazumasa Tsuda, Masahiro Hirano, Norihiko Shiiya","doi":"10.1007/s11748-024-02085-z","DOIUrl":"10.1007/s11748-024-02085-z","url":null,"abstract":"<p><strong>Objectives: </strong>Although cerebrospinal fluid drainage has been shown to reduce the risk of ischemic spinal cord injury, serious complications have also been reported. We have been using it selectively in a pressure- and volume-regulated method and aimed to evaluate its safety, and its validity in elective thoracic endovascular aortic repair in a propensity-matched cohort.</p><p><strong>Methods: </strong>Among the 450 patients who underwent open surgery (n = 169) or thoracic endovascular aortic repair (n = 281) on the descending or thoracoabdominal aorta, 147 underwent cerebrospinal fluid drainage, which was prophylactic in 135 and therapeutic in 12. Prophylactic drainage was performed in elective open surgery under distal aortic perfusion (n = 67) or in selected patients undergoing thoracic endovascular aortic repair (n = 68).</p><p><strong>Results: </strong>Drainage-related complications were observed in 13 (9.6%), one of which was graded severe (0.74%). In patients undergoing prophylactic drainage, spinal cord injury was detected in 2/135 (1.5%). In patients without prophylactic drainage, 15/315 (4.8%) developed spinal cord injury. Therapeutic drainage was performed in 12 of these 15 patients, 10 of whom remained paralytic in varying degree. In the inverse probability weighted analysis of the patients undergoing elective thoracic endovascular aortic repair, the incidence of spinal cord injury was lower with prophylactic drainage (p = 0.028).</p><p><strong>Conclusions: </strong>Pressure- and volume-regulated spinal drainage rarely causes serious complications. Its prophylactic use seems beneficial in selected patients, including those undergoing thoracic endovascular aortic repair with high risk for spinal cord injury.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"411-419"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344891","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":"Impact of the expanded indication of robot-assisted thoracic surgery for mediastinal tumors.","authors":"Taketo Kato, Hiroki Watanabe, Yuta Kawasumi, Yuka Kadomatsu, Harushi Ueno, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.1007/s11748-024-02093-z","DOIUrl":"10.1007/s11748-024-02093-z","url":null,"abstract":"<p><strong>Objective: </strong>Following the introduction of robot-assisted thoracoscopic surgery (RATS) as a health insurance-covered treatment in Japan, we investigated the current status and impact of the expansion of the indications for RATS for mediastinal tumors.</p><p><strong>Methods: </strong>Between 2018 and 2022, 209 cases of total mediastinal tumor resection were performed in our hospital. The study period was divided into the first half (January 2018 to June 2020) and the second half (July 2020 to December 2022), and perioperative parameters were compared between the two groups.</p><p><strong>Results: </strong>Ninety-six surgical procedures were performed in the first half and 113 in the second half. The percentage of RATS approach was significantly higher in the second half compared with the first half (P < 0.001). Indications for RATS in the second half compared with the first half were significantly increased in patients with stage II (P < 0.001) and stage III (P = 0.026) thymomas, tumor diameter ≥ 50 mm (P < 0.011), and patients undergoing extended thymectomy for myasthenia gravis (P < 0.009). In respect of short-term postoperative parameters, the estimated intraoperative blood loss (P < 0.035), postoperative drain duration (P < 0.037), and postoperative hospital stay (P < 0.011) were significantly lower in the second half than in the first half.</p><p><strong>Conclusions: </strong>RATS has recently been expanded for mediastinal tumors with improved short-term outcomes in our hospital after health insurance was applied in Japan. In the future, it will be necessary to discuss the further expansion of its indications by taking into account safety and long-term outcomes.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"443-449"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521559","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":"Effect of taurine on vascular dysfunction in an in vitro ischemia-reperfusion model of rat thoracic aorta.","authors":"Ariyan Teimoori, Halit Güner Orhan, Elif Demirtaş, Nargiz Zeynalova, Oğuzhan Ekin Efe, Selda Emre Aydıngöz","doi":"10.1007/s11748-024-02089-9","DOIUrl":"10.1007/s11748-024-02089-9","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to evaluate the protective effect of taurine on endothelial dysfunction in a vascular ischemia-reperfusion (IR) model.</p><p><strong>Methods: </strong>Thoracic aortas of 9 male Sprague-Dawley rats (350-500 g) were cut into rings and randomized into control (n = 7), IR (n = 8), IR + taurine 1 mM (n = 7), IR + taurine 10 mM (n = 8), IR + taurine 30 mM (n = 8), and IR + taurine 100 mM (n = 5) groups. Aortic rings in the IR group were stored in 0.9% saline at 4 °C for 24 h, placed in Krebs-Henseleit solution gassed with 95%O₂ + 5%CO₂ at 37 °C, and exposed to sodium hypochlorite (200 μM) for 30 min. Responses to KCl (80 mM), phenylephrine (10^-10-10^-4 M), acetylcholine (10^-10-10^-4 M), and sodium nitroprusside (SNP, 10^-11-10^-5 M) were recorded. E_max (maximum response) and pD₂ (negative logarithm of concentration producing half-maximum response) were calculated.</p><p><strong>Results: </strong>IR decreased KCl contraction (control 1047 ± 176 mg, IR 682 ± 128 mg, p = 0.0007), which was reversed by 30 and 100 mM taurine (960 ± 313 mg, p = 0.02 and 1066 ± 488 mg, p = 0.02, respectively). IR impaired phenylephrine, acetylcholine, and SNP responses (p < 0.0001). Taurine did not affect IR-impaired phenylephrine contractions. IR decreased both pD₂ (control, 7.1 ± 0.1; IR, 6.0 ± 0.2; p < 0.01) and E_max (control, 83.5 ± 2.7%; IR, 26.8 ± 2.5%; p < 0.0001) of acetylcholine relaxation, both of which were reversed by 100 mM taurine (pD_2, 7.2 ± 0.1; p < 0.001; E_max, 45.4 ± 2.6%; p < 0.0001). For SNP relaxation, IR decreased pD₂ (control 8.2 ± 0.1, IR 7.7 ± 0.1, p < 0.01), which was reversed by 100 mM taurine (8.5 ± 0.1, p < 0.0001).</p><p><strong>Conclusion: </strong>Taurine protects endothelial function after IR injury. Further studies should explore the mechanism of this effect and the potential of adding taurine to vascular graft storage solutions.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"420-427"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344890","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":"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":"450-452"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","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":"Vagus nerve/recurrent laryngeal nerve ratio: proposal of a new parameter predicting left vocal cord palsy using intraoperative nerve monitoring during esophagectomy.","authors":"Hiroyasu Ishikawa, Youichi Kumagai, Toru Ishiguro, Tetsuya Ito, Toshifumi Saito, Norimichi Chiyonobu, Noriyasu Chika, Takehiro Shiraishi, Takatoshi Matsuyama, Hideyuki Ishida","doi":"10.1007/s11748-025-02162-x","DOIUrl":"https://doi.org/10.1007/s11748-025-02162-x","url":null,"abstract":"<p><strong>Aim: </strong>Intraoperative nerve monitoring (IONM) during esophageal cancer surgery can help to identify and preserve the recurrent laryngeal nerve (RLN). To devise a useful parameter for prediction of left vocal cord palsy (VCP), we measured the electromyographic (EMG) amplitude of the left RLN and vagus nerve (VN) using intermittent IONM.</p><p><strong>Methods: </strong>We studied 35 consecutive patients who underwent esophagectomy with lymph node dissection around the left RLN. After lymph node dissection, the left RLN and left VN were stimulated, and the EMG amplitude was measured using IONM. The VN/RLN ratio (V/R ratio) was calculated, and the presence of left VCP, diagnosed by laryngoscopy on the first postoperative day, was compared among the patients.</p><p><strong>Results: </strong>Ten of the 35 patients (28.6%) had left VCP. In the VCP and non-VCP groups, the left VN amplitude was 190.0 (0-1111) µV and 520.0 (120-1200) µV (P = 0.006), and the VR ratio was 0.26 (0-0.75) and 0.71 (0.24-1.0) (P < 0.001), respectively. Receiver operating characteristic curve analysis using the left VN amplitude and V/R ratio showed an area under the curve (AUC) of 0.80 with a cutoff of 354 µV, and an AUC 0.90 with a cutoff of 0.50, respectively(P = 0.05). When left VN amplitudes of < 100 μV, < 354 μV, and a V/R ratio of ≤ 0.50 were defined as left VCP, the accuracy was 80.0%, 74.2%, and 88.6%, respectively.</p><p><strong>Conclusions: </strong>Using intermittent IONM, the V/R ratio with a cutoff value of 0.50 has the potential to be a more useful parameter for prediction of VCP after esophagectomy than EMG amplitude during VN stimulation.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173530","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}