General Thoracic and Cardiovascular Surgery最新文献

{"title":"Acupuncture-related pneumothorax: a 14-case single-center series and a review of the literature.","authors":"Yohei Kameda, Taketsugu Yamamoto, Suzue Yoshizawa, Shoma Tanaka, Tomohiro Arai, Nozomi Urata, Takamitsu Maehara, Aya Saito","doi":"10.1007/s11748-026-02397-2","DOIUrl":"10.1007/s11748-026-02397-2","url":null,"abstract":"<p><strong>Background: </strong>Acupuncture is widely practiced and generally considered safe, yet pneumothorax remains a potentially serious adverse event. The clinical characteristics and optimal management of acupuncture‑related pneumothorax have not been fully clarified.</p><p><strong>Methods: </strong>We retrospectively reviewed patients diagnosed with acupuncture‑related pneumothorax at our institution between 2006 and 2026. Clinical characteristics, management strategies, and outcomes were analyzed. A focused literature review was also conducted using PubMed.</p><p><strong>Results: </strong>Fourteen patients were identified (median age, 48 years; range 30-73; 10 females). Pneumothorax occurred on the right side in 5 patients, on the left in 7, and bilaterally in 2. Most cases were classified as small pneumothorax according to the British Thoracic Society criteria. Six patients were managed conservatively, six underwent ambulatory drainage, and two required chest tube drainage with hospitalization. One patient presented with hemothorax. No recurrence was observed during follow‑up. A literature review identified 11 previously reported cases, including severe and fatal presentations.</p><p><strong>Conclusion: </strong>Most cases of acupuncture‑related pneumothorax were mild and successfully managed with conservative or ambulatory treatment. However, severe complications can occur, underscoring the need for clinician awareness and prompt recognition of this potentially serious adverse event.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919448","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":"Perioperative considerations and single-case feasibility claims in subcostal single-port robotic resection of a posterior mediastinal tumor in an infant.","authors":"Priyanka Ochani, Ayushman Ochani, Konain Fatima","doi":"10.1007/s11748-026-02399-0","DOIUrl":"10.1007/s11748-026-02399-0","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919424","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":"Robot-assisted thoracoscopic fissureless fissure-last approach versus conventional interlobar method for left lower lobectomy in lung cancer: a comparative study of short-term outcomes.","authors":"Tatsuya Miyamoto, Shinji Matsui, Wakako Fujiwara, Yoshiteru Kidokoro, Yasuaki Kubouchi, Ken Miwa, Hiroshige Nakamura, Yugo Tanaka","doi":"10.1007/s11748-026-02396-3","DOIUrl":"https://doi.org/10.1007/s11748-026-02396-3","url":null,"abstract":"<p><strong>Objectives: </strong>Incomplete interlobar fissure complicates lobectomy and raises the risk of prolonged postoperative air leak. Although the fissureless fissure-last approach can reduce air leak in thoracoscopic surgery, its applicability in robot-assisted thoracoscopic surgery for left lower lobectomy remains uncertain. This study evaluated the feasibility of the fissureless fissure-last approach by comparing perioperative outcomes with those of the conventional interlobar approach.</p><p><strong>Methods: </strong>This single-center retrospective study included 53 patients with primary lung cancer who underwent robot-assisted left lower lobectomy between November 2019 and November 2024. They were divided into a fissureless fissure-last group (n = 13) and a conventional interlobar group (n = 40), and perioperative outcomes were compared.</p><p><strong>Results: </strong>Patient characteristics did not differ significantly between the groups. The severe incomplete interlobar fissure proportion was significantly higher (77% vs. 10%, p < 0.001) and operative time significantly longer (190 vs. 152 min, p = 0.011) in the fissureless fissure-last group. No conversions to thoracotomy or major intraoperative complications occurred in either group. Duration of chest drain, postoperative hospital stay, and postoperative complications were comparable between the groups. The incidence of prolonged postoperative air leak was 0% (0/13) in the fissureless fissure-last group and 5% (2/40) in the conventional interlobar group; however, the difference was not statistically significant.</p><p><strong>Conclusions: </strong>The fissureless fissure-last approach in robot-assisted left lower lobectomy appears to be a safe and feasible alternative for selected patients with severe incomplete interlobar fissure.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905895","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":"Association between preoperative pan-immune-inflammation value and postoperative atrial fibrillation after scheduled video-assisted thoracoscopic lobectomy.","authors":"Myungjin Ko, Ji Yeon Kwon, Hyun-Seong Lee, Byeongcheol Lee, Ji Hye Lee","doi":"10.1007/s11748-026-02389-2","DOIUrl":"https://doi.org/10.1007/s11748-026-02389-2","url":null,"abstract":"<p><strong>Objective(s): </strong>This study aimed to evaluate the association between preoperative pan-immune-inflammation value (PIV) and postoperative atrial fibrillation (POAF) after scheduled video-assisted thoracoscopic surgery (VATS) lobectomy. In addition, we assessed other complete blood count (CBC)-derived inflammatory indices and performed sensitivity analyses according to the interval between laboratory testing and surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients scheduled for VATS lobectomy between January 2015 and November 2025. Patients with preexisting atrial fibrillation or other arrhythmias, active infection, hematologic or immunologic disease, intraoperative change in the extent of resection, additional concomitant surgery, or insufficient medical records were excluded. The primary outcome was POAF. Preoperative PIV and other CBC-derived inflammatory indices were compared between patients with and without POAF. Multivariable logistic regression was performed using log-transformed preoperative PIV, adjusted for age, conversion to thoracotomy, and estimated blood loss. Sensitivity and exploratory analyses were also conducted.</p><p><strong>Results: </strong>Among 475 patients, POAF occurred in 42 patients (8.8%). Patients with POAF were older, had greater estimated blood loss, and had longer postoperative hospital stay. Preoperative PIV did not differ significantly between groups. In multivariable analysis, log-transformed preoperative PIV was not independently associated with POAF. The discriminative ability of PIV for POAF was poor, with an area under the receiver operating characteristic curve of 0.560. Findings remained unchanged in sensitivity and exploratory analyses.</p><p><strong>Conclusions: </strong>This study did not detect a significant association between preoperative PIV and POAF after scheduled VATS lobectomy. Given the limited number of POAF events, a modest association cannot be excluded.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887218","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 preoperative nutritional status on longitudinal changes in pulmonary function and prognosis after lung cancer surgery.","authors":"Kentaro Miura, Daisuke Nakamura, Sachie Koike, Shuji Mishima, Yukihiro Terada, Shunichiro Matsuoka, Hirotaka Kumeda, Takashi Eguchi, Kazutoshi Hamanaka, Kimihiro Shimizu","doi":"10.1007/s11748-026-02384-7","DOIUrl":"https://doi.org/10.1007/s11748-026-02384-7","url":null,"abstract":"<p><strong>Objective: </strong>Preoperative nutritional status is a known prognostic factor in lung cancer surgery. However, its effect on postoperative pulmonary function over time remains unclear. This study evaluated the association between preoperative nutritional status and longitudinal respiratory changes andoutcomes after curative resection.</p><p><strong>Methods: </strong>Patients who underwent resection for non-small cell lung cancer between January 2020 and December 2024 were prospectively analyzed. Patients were classified by prognostic nutritional index (PNI) into normal (PNI ≥ 50) and malnutrition (PNI < 50) groups. Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), and diffusing capacity of the lung for carbon monoxide (%DLco), was assessed preoperatively and at 6 and 12 months postoperatively. Changes were compared between lobectomy and sublobar resection by nutritional status. Overall survival (OS) and recurrence-free survival (RFS) were analyzed.</p><p><strong>Results: </strong>Of 551 surgical patients, 294 were included. Low PNI was associated with significantly worse OS and RFS (P < 0.001 and P = 0.005, respectively). Patients with low PNI undergoing lobectomy showed poorer survival outcomes in unadjusted analyses, although interaction analysis demonstrated no significant modification of the prognostic impact of PNI by surgical procedure. Among patients undergoing lobectomy, postoperative FVC recovery differed according to nutritional status (p=0.016), whereas no significant differences were observed in FEV1.0 or %DLco.</p><p><strong>Conclusions: </strong>Low preoperative PNI was associated with poorer survival and may be associated with postoperative pulmonary functional recovery after lung resection. Preoperative nutritional status may warrant consideration alongside established clinical and oncological factors when planning surgical treatment.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887182","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":"Pre-emptive combined serratus anterior plane block and early recovery after minimally ınvasive direct coronary artery bypass: a retrospective cohort study.","authors":"Tuğçe Gazioğlu Kişi, Bahar Uslu Bayhan","doi":"10.1007/s11748-026-02392-7","DOIUrl":"https://doi.org/10.1007/s11748-026-02392-7","url":null,"abstract":"<p><strong>Objective: </strong>Minimally invasive direct coronary artery bypass (MIDCAB) via left anterior thoracotomy causes substantial early pain requiring opioids. The serratus anterior plane block (SAPB) is opioid-sparing, but data on a pre-emptive combined approach are limited. We evaluated its association with opioid administration and early recovery.</p><p><strong>Methods: </strong>Adults undergoing MIDCAB (January-December 2025) were retrospectively grouped by pre-emptive combined SAPB versus standard systemic analgesia. The primary outcome was 24-h postoperative intravenous morphine administration. Secondary outcomes were total morphine-equivalent administration including rescue tramadol, visual analogue scale pain scores, rescue analgesia, time to extubation, intensive care unit (ICU) and hospital stay, and opioid-related adverse events.</p><p><strong>Results: </strong>Sixty-four patients were analyzed (SAPB, n = 33; control, n = 31). Twenty-four-hour intravenous morphine administration was lower with SAPB (9.15 ± 2.56 vs 12.71 ± 3.71 mg, p < 0.001), as was total morphine-equivalent administration (9.72 ± 3.14 vs 19.11 ± 5.80 mg, p < 0.001). Pain scores were lower at 12 h (1 [0-2] vs 4 [3-5]) and 24 h (0 [0-1] vs 3 [2-4]) (both p < 0.001), rescue analgesia was less frequent (6.1% vs 74.2%, p < 0.001), and extubation was earlier (4 [4, 5] vs 8 [6-10] hours, p < 0.001). ICU stay showed a non-significant trend (p = 0.052) and hospital stay was similar (p = 0.414). Opioid-related adverse events did not differ significantly (9.1% vs 29.0%, p = 0.057).</p><p><strong>Conclusions: </strong>Pre-emptive combined SAPB was associated with lower opioid administration, better pain control, and earlier extubation after MIDCAB.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879913","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":"Single-use bronchoscopes for pleural cavity access: cadaveric feasibility study.","authors":"Hiroki Imabayashi, Yuki Sata, Terunaga Inage, Kazuhisa Tanaka, Takane Suzuki, Hidemi Suzuki","doi":"10.1007/s11748-026-02309-4","DOIUrl":"10.1007/s11748-026-02309-4","url":null,"abstract":"<p><p>We conducted a cadaveric feasibility study of two intrapleural applications of single-use bronchoscopes. In Approach 1, a 2.7 mm bronchoscope was used as a visual stylet inside a 20-Fr trocar catheter to confirm pleural entry and drain-tip position. In Approach 2, a 5.0 mm bronchoscope was used as a flexible thoracoscope for limited pleural inspection, aspiration, and direct-vision forceps biopsy; a sprayed-instillation maneuver was performed only to confirm technical deliverability. Approach 1 was attempted and feasible in six hemithoraces of three Thiel-embalmed cadavers. Approach 2 was attempted and feasible in four hemithoraces; it was not attempted in two hemithoraces due to time constraints and a large persistent air leak after Approach (1) No negative-to-positive conversion (new persistent air leak) was observed after Approach (2) These techniques may offer complementary approaches to conventional methods for observing the intrathoracic space and therefore warrant stepwise clinical validation.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"913-916"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867860","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":"A non-invasive and simple method to assess incomplete aortic cross-clamping during cardiovascular surgery with cardiopulmonary bypass.","authors":"Kenta Minami, Arudo Hiraoka, Tomoya Oshita, Ryosuke Muraki, Masahisa Arimichi","doi":"10.1007/s11748-026-02341-4","DOIUrl":"10.1007/s11748-026-02341-4","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"909-912"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307047","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":"Bypass graft design assisted by virtual reality simulation in multi-vessel coronary artery bypass grafting.","authors":"Toshifumi Hiraoka, Katsuhiko Imai, Shinya Takahashi","doi":"10.1007/s11748-026-02278-8","DOIUrl":"10.1007/s11748-026-02278-8","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"847-853"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354650","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":"Imaging risk factors for development of type A acute aortic dissection.","authors":"Mesut Engin, Cihan Aydın, Ufuk Aydın, Yusuf Ata","doi":"10.1007/s11748-026-02318-3","DOIUrl":"10.1007/s11748-026-02318-3","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"924-925"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987276","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}