General Thoracic and Cardiovascular Surgery最新文献

{"title":"Long-term results of the frozen elephant trunk technique in primary chronic type B aortic dissection.","authors":"Hisato Ito, Saki Bessho, Yu Shomura, Noriyuki Kato, Shinji Kanemitsu, Toru Mizumoto, Koji Hirano, Yasumi Maze, Toshiya Tokui, Motoshi Takao","doi":"10.1007/s11748-024-02043-9","DOIUrl":"10.1007/s11748-024-02043-9","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to analyze long-term results of the total aortic arch replacement with the frozen elephant trunk technique for primary chronic type B aortic dissection.</p><p><strong>Methods: </strong>Among 322 patients who had the frozen elephant trunk technique, 43 (13.4%) patients (median age, 64.0 years) with primary chronic type B aortic dissection were analyzed. The patients underwent surgery at a median of 27.0 months after the onset of aortic dissection. The false lumen was patent in 30 (69.8%) patients preoperatively.</p><p><strong>Results: </strong>Two patients suffered paraplegia and another died of cerebral infarction. Complete thrombosis of the peri-stent false lumen was achieved in 36 (83.7%) patients. Overall survival, freedom from aortic events, and freedom from aortic reintervention were 83.5%, 37.2%, and 42.2% at 5 years, respectively. Survival rates of the patients with or without aortic events were 75.0% and 95.8% at 5 years (Log-rank, p = 0.22). Late aortic events occurred in 19 (44.2%) patients including distal stent graft-induced new entry, type Ib endoleak, and false lumen dilation. The ratio of the stent graft diameter to the preoperative short axis diameter of the true lumen (hazard ratio, 1.90; 95% confidence interval, 1.01-3.59), and the maximal diameter of a postdissection aneurysm (1.07; 1.01-1.12) were the significant multivariate risk predictors of late aortic events.</p><p><strong>Conclusions: </strong>Late aortic events occurr fairly frequently, and new strategies need to be explored to enhance the effectiveness of this procedure in the future.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"770-778"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184068","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":"A balanced mitral leaflet and large ring strategy avoids systolic anterior motion in Barlow's disease.","authors":"Tomomi Nakajima, Bryan J Mathis, Yuji Hiramatsu, Phan Van Nguyen","doi":"10.1007/s11748-024-02040-y","DOIUrl":"10.1007/s11748-024-02040-y","url":null,"abstract":"<p><strong>Objectives: </strong>Mitral valve repair for Barlow's disease offers good outcomes but excessive and myxomatous valvular tissue is associated with systolic anterior motion. Although valvular disease might progress after repair and cause long-term systolic anterior motion, few reports focus on this aspect. Herein, we will review our 16-year experience with mitral valve repair for Barlow's disease and systolic anterior motion incidence.</p><p><strong>Methods: </strong>We retrospectively reviewed surgical outcomes of 92 cases of mitral valve repair using a balanced leaflet/large ring strategy plus median sternotomy for Barlow's disease (median age 45.1 ± 12.7 years old [19-72], 37 females) from 2004 to 2019. Concomitant surgeries, except for tricuspid valve or anti-arrhythmic surgeries, were excluded.</p><p><strong>Results: </strong>The follow-up period was 5.8 ± 4.4 years with no deaths. Patients had mitral regurgitation of grade 3/4 (15 cases) or 4/4 (77 cases) due to anterior leaflet (3 cases), posterior leaflet (75 cases), or bileaflet (14 cases) prolapse, with chord elongation (39 cases), chord rupture (22 cases), or a combination of both (14 cases). All cases required ring annuloplasty (median size of 33.0 ± 5.4 mm) combined with leaflet resection (91 cases), chord intervention (12 cases), or indentation closure (2 cases). No case had short- or long-term SAM. The freedom-from-mitral-regurgitation (of greater than grade 2/4) rate was 94.1% over 5 years and 76.0% over 10 years without reoperation.</p><p><strong>Conclusions: </strong>Our two-pronged strategy for mitral valve repair in Barlow's disease avoids systolic anterior motion over the long-term, with good outcomes.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"763-769"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237392","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 outcome in patients with lung adenocarcinoma with mucin.","authors":"Keiko Ueda, Yo Kawaguchi, Yasushi Itoh, Daigo Ishihara, Hiroki Saito, Takuya Shiratori, Keigo Okamoto, Yoko Kataoka, Mayumi Ohshio, Yasuhiko Ohshio, Jun Hanaoka","doi":"10.1007/s11748-024-02103-0","DOIUrl":"https://doi.org/10.1007/s11748-024-02103-0","url":null,"abstract":"<p><strong>Objective: </strong>Mucin-producing adenocarcinoma is a less common variant of lung adenocarcinoma. Adenocarcinoma cells with mucin can spread through the airspace via mucus-mediated extension, leading to their implantation in distant normal lungs. Consequently, post-operative intrapulmonary recurrence frequently occurs. Mucin-producing adenocarcinomas include not only invasive mucinous adenocarcinoma but also papillary, acinar, and other subtypes. Despite increasing reports on surgical outcomes for invasive mucinous adenocarcinomas, the outcomes for total mucin-producing adenocarcinoma remain unclear.</p><p><strong>Methods: </strong>We clinically and pathologically evaluated 511 patients who underwent curative resection for lung adenocarcinoma at our institution. The patients were divided into adenocarcinoma with mucin and without mucin groups. Based on pathological findings, the adenocarcinoma with mucin was further classified into intracellular, extracellular, and mucus extension types. Additionally, the CT value of the tumor mass was analyzed using SYNAPSE VINCENT software.</p><p><strong>Results: </strong>The 5 year overall survival after surgery was 81.5% and 75.9% for patients with adenocarcinoma with versus without mucin (P = 0.774), respectively. The 5 year intrapulmonary recurrence rate in patients with adenocarcinoma with mucin was 29.2%, significantly higher than 12.9% for patients without mucin. Mucus extension was a strong indicator (hazard ratio: 3.03) of intrapulmonary recurrence after surgery. According to SYNAPSE VINCENT analysis, a high volume rate of - 400 HU indicated mucus extension.</p><p><strong>Conclusion: </strong>Our results demonstrated that intrapulmonary recurrence occurs approximately 2.3 times more often in adenocarcinoma with mucin than in adenocarcinoma without mucin. Mucus extension is a significant risk factor for intrapulmonary recurrence, and surgeons can predict it using SYNAPSE VINCENT analysis.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638678","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":"Determining optimal pretreatment in cardiac surgery: an experimental study.","authors":"Masahiro Fujii, Hiromasa Yamashita, Yasuhiro Kawase, Ryuzo Bessho, Yosuke Ishii","doi":"10.1007/s11748-024-02102-1","DOIUrl":"https://doi.org/10.1007/s11748-024-02102-1","url":null,"abstract":"<p><strong>Objectives: </strong>Heart failure patients with reduced ejection fraction are currently treated with four drug combinations: angiotensin receptor/neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors, resulting in improved survival outcomes. Herein, we examined whether myocardial protection by esaxerenone or sacubitril/valsartan may present a counter-effect to the harm caused by cardioplegic arrest.</p><p><strong>Methods: </strong>Male Wistar rats fed a normal diet were orally administered esaxerenone (3 mg/kg; Esax) or sacubitril/valsartan (68 mg/kg; SaV) once a day for 2 weeks from 6 weeks of age. Age-matched, untreated male Wistar rats served as controls (Control). Isolated rat hearts were aerobically Langendorff-perfused and subjected to 2 min of St Thomas' Hospital 2 cardioplegia (STH2) infusion and 28 min of normothermic global ischemia followed by 60 min of reperfusion. The recovery of function was measured during 60 min of reperfusion. Additionally, troponin T levels were measured after reperfusion as myocardial injury.</p><p><strong>Results: </strong>The final recovery of left ventricular developed pressure (presented as the percentage of preischemic value) in the Control, Esax, and SaV groups was 50.7 ± 6.2%, 68.5 ± 7.4%*, and 69.3 ± 14.3%*, respectively (*p < 0.05 vs. Control). Troponin T (ng per gram wet weight) levels in the Control, Esax, and SaV groups were 166.8 ± 78.1, 77.0 ± 14.6*, and 74.2 ± 36.6*, respectively (*p < 0.05 vs. Control).</p><p><strong>Conclusion: </strong>Oral administration of esaxerenone or sacubitril/valsartan to rats 2 weeks prior to surgery enhanced the myocardial protection afforded by STH2 and may attenuate the myocardial injury caused by hyperkalemic cardioplegic arrest.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618136","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":"Mitochondrial respiratory pathways in immature rat heart tissue using different cardioplegic solutions.","authors":"Arslan Mamedov, Eglė Rumbinaitė, Sebastian Romann, Dovydas Verikas, Povilas Jakuška, Serik Aitaliyev, Rimantas Benetis, Edgaras Stankevičius","doi":"10.1007/s11748-024-02097-9","DOIUrl":"10.1007/s11748-024-02097-9","url":null,"abstract":"<p><strong>Introduction: </strong>Minor defects in the mitochondrial ATP-generating system and post-cardioplegia oxidative phosphorylation can negatively impact cardiac function in immature hearts. This study aimed to examine the mitochondrial respiratory pathway using three different cardioplegic solutions (Custodiol HTK, St. Thomas, and Del Nido) during moderate (1 h) and long (3 h) ischemic periods.</p><p><strong>Methods: </strong>A total of 41 male Wistar albino rats were utilized in this study. Five experiments were conducted without the use of any cardioplegic solution (CP0 group). To assess both moderate and prolonged ischemic periods, six experiments were carried out in each of the following groups: CP1 group (St. Thomas solution), CP2 group (Custodiol HTK solution), and CP3 group (Del Nido solution).</p><p><strong>Results: </strong>After 1 h, the highest mitochondrial respiration rate was observed in the CP3 group and the lowest in the CP1 group (p = 0.006). After adding ADP substrate, the highest mitochondrial ATP-production-coupled respiration was recorded in the CP3 group, which was similar to the control group CP0. After 3 h, while evaluating the ratio between mitochondrial respiration ATP-production coupled and basal respiration, significant differences were found between CP1 group and CP3 group (p = 0.035), as well as between the CP1 and CP0 groups (p = 0.045). Additionally, by assessing the condition of the outer mitochondrial membrane using the Cyt C effect (Cyt/Phos [ADP]), significant differences were observed between the CP1 and CP3 group (p = 0.004), as well as between CP1 and CP0 groups (p = 0.003).</p><p><strong>Conclusion: </strong>Del Nido cardioplegic solution provided optimal mitochondrial protection under moderate and long myocardial ischemia conditions.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581378","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":"An effective plication technique for diaphragmatic eventration under thoracoscopy with laparoscopic image display.","authors":"Takashi Sakai, Suguru Shirai, Hitoshi Dejima, Yoshikane Yamauchi, Yuichi Saito, Yukinori Sakao","doi":"10.1007/s11748-024-02064-4","DOIUrl":"10.1007/s11748-024-02064-4","url":null,"abstract":"<p><p>Diaphragmatic eventration causes respiratory distress with the development of severe diaphragmatic compression of lung volume. While non-surgical treatment, such as physical therapy and pulmonary rehabilitation, is adequate for mild cases, surgical intervention is critical for severe diaphragmatic eventration. A 45-year-old man with respiratory fatigue was diagnosed with left diaphragmatic eventration and underwent surgery with diaphragmatic plication with double-row stapling under a video-assisted approach. Thoracoscopy with laparoscopic image display avoided visceral tissue involvement, and the double-stapling technique prevented diaphragmatic rupture and lowered the diaphragmatic level. The procedure improved the patient's respiratory function by reducing respiratory fatigue. This procedure is safe and effective for the thin and vulnerable diaphragmatic muscle.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"752-753"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855329","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":"The effect of spironolactone in reducing the risk of postoperative atrial fibrillation in patients undergoing coronary artery bypass graft surgery: randomized single-blind placebo-controlled study.","authors":"Ava Farzaneh, Mehdi Moradi, Gholamreza Safarpoor, Armin Karamian","doi":"10.1007/s11748-024-02101-2","DOIUrl":"10.1007/s11748-024-02101-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF), one of the most common cardiac arrhythmias following coronary artery bypass graft (CABG) surgery is associated with unfavorable outcomes.</p><p><strong>Objectives: </strong>This study investigated the effect of spironolactone administered two weeks before surgery on the incidence of POAF in patients undergoing CABG.</p><p><strong>Methods: </strong>This randomized single-blind placebo-controlled study was conducted on 130 CABG patients. All patients were randomly divided into intervention and control groups including 65 cases for each group. In the intervention group, patients received 50 mg of spironolactone orally daily for 2 weeks before surgery, and in the control group patients received placebo daily from 2 weeks before surgery. All patients were continuously monitored for the occurrence of POAF for two weeks postoperatively.</p><p><strong>Results: </strong>The mean age of the patients in the intervention and control groups was 61.7 ± 5.4 and 60 ± 6.7 years, respectively. The incidence of POAF in the intervention and control groups was 7.7% and 20%, respectively (Odds Ratio = 0.33, P = 0.042). All demographic and clinical variables were similar in patients with and without POAF (all P > 0.05).</p><p><strong>Conclusions: </strong>Our findings revealed that in comparison to placebo, the use of spironolactone is associated with reduced incidence of POAF in CABG candidates.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562710","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":"Serum C-reactive protein and procalcitonin levels in patients with pneumonia and anastomotic leakage in the postoperative period after esophagectomy.","authors":"Hirotaka Ishida, Toshiaki Fukutomi, Yusuke Taniyama, Chiaki Sato, Hiroshi Okamoto, Yohei Ozawa, Ryohei Ando, Yasuharu Shinozaki, Michiaki Unno, Takashi Kamei","doi":"10.1007/s11748-024-02065-3","DOIUrl":"10.1007/s11748-024-02065-3","url":null,"abstract":"<p><strong>Objective: </strong>Despite being a less-invasive procedure, esophagectomy can cause severe infectious complications, such as pneumonia and anastomotic leakage. Herein, we aimed to clarify the inflammatory characteristics of pneumonia/anastomotic leakage after esophagectomy by assessing the difference between the postoperative trends of serum C-reactive protein (CRP) and procalcitonin (PCT) levels in patients with pneumonia/anastomotic leakage using the values on the consecutive postoperative day (POD).</p><p><strong>Methods: </strong>This study included 439 patients who underwent minimally invasive esophagectomy. Serum CRP and PCT levels were measured on PODs 1-7, 10, and 14. Pneumonia and anastomotic leakage were defined as Clavien-Dindo grades ≥ 2.</p><p><strong>Results: </strong>Pneumonia and anastomotic leakage occurred in 96 and 51 patients, respectively. The CRP and PCT levels peaked on POD 3 (11.6 ± 6.8 mg/dL) and POD 2 (0.69 ± 2.9 ng/mL), respectively. Between PODs 3 and 14, CRP levels were significantly higher in patients with pneumonia and anastomotic leakage than in those without complications (P < 0.001). Between PODs 3 and 14, PCT levels were significantly higher in patients with pneumonia; however, on most PODs, there were no significant differences in PCT levels between patients with and without anastomotic leakage.</p><p><strong>Conclusion: </strong>Inflammatory reactions caused by pneumonia may be more intense than those caused by anastomotic leakage after esophagectomy. Postoperative trends in serum CRP and PCT levels may vary depending on the complication type. Pneumonia and anastomotic leakage after esophagectomy can be potentially distinguished by the postoperative trend of PCT values before detailed examinations, such as computed tomography and endoscopy.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"746-751"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787790","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-28","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":"Long-term pulmonary repair in rat lungs after sublobar resection: electrocautery versus stapler methods.","authors":"Shunichiro Matsuoka, Daisuke Hara, Daisuke Nakamura, Hirotaka Kumeda, Kentaro Miura, Mai Iwaya, Takashi Eguchi, Kazutoshi Hamanaka, Takeshi Uehara, Kimihiro Shimizu","doi":"10.1007/s11748-024-02098-8","DOIUrl":"https://doi.org/10.1007/s11748-024-02098-8","url":null,"abstract":"<p><strong>Objective: </strong>We investigated and compared the long-term (6-month) histologic changes in a rat model of sublobar resection created using electrocautery or stapler techniques.</p><p><strong>Methods: </strong>Nine-week-old male rats were anesthetized and intubated; thoracotomy with sublobar resection was performed in the right middle lobe using electrocautery or stapler techniques. Histological examination was performed at 2, 4, 8, 12, and 24 weeks post-surgery to assess long-term effects on lung tissue repair and morphologic changes. Lung expansion and alveolar epithelial cell proliferation were evaluated by measuring the mean linear intercept and counting the number of alveolar type I and II cells.</p><p><strong>Results: </strong>The electrocautery group showed signs of lung self-repair at the resected area over time, with inflammatory cell infiltration followed by growth of vessels and bronchioles. Mesothelial cells covered the resected area by 2 weeks; elastic fibers gradually connected from both sides by 24 weeks. Lung expansion, measured by mean linear intercept, was initially small below the electrocautery resection area at 2 weeks but recovered from 4 to 24 weeks. The stapler group showed persistently small mean linear intercept over time. In the electrocautery group, the number of alveolar type II cells was higher just below the resection than in other areas from 2 to 24 weeks, followed by alveolar type I cells (4 to 24 weeks). The stapler group showed a transient alveolar type II cell increase at 2 weeks.</p><p><strong>Conclusions: </strong>Compared to the stapler technique, electrocautery may provide advantages for postoperative lung repair by promoting lung expansion and alveolar epithelial cell proliferation.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521560","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}