Interactive cardiovascular and thoracic surgery最新文献

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Malignant pleural mesothelioma in situ. 恶性胸膜间皮瘤原位。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-10-10 DOI: 10.1093/icvts/ivac255
Kohei Ando, Takao Morohoshi, Yukio Tsuura, Munetaka Masuda
{"title":"Malignant pleural mesothelioma in situ.","authors":"Kohei Ando,&nbsp;Takao Morohoshi,&nbsp;Yukio Tsuura,&nbsp;Munetaka Masuda","doi":"10.1093/icvts/ivac255","DOIUrl":"https://doi.org/10.1093/icvts/ivac255","url":null,"abstract":"<p><p>Although the diagnosis of malignant pleural mesothelioma at an in situ stage was traditionally challenging, it is now possible owing to advances in molecular biological methods such as P16 fluorescence in situ hybridization or BRCA1-associated protein 1 immunohistochemistry. Here, we report the first case, to our knowledge, of total parietal pleurectomy for mesothelioma in situ. Future follow-up and accumulation of cases are necessary to determine whether total parietal pleurectomy could be applied as a treatment for mesothelioma in situ or not.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"35 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/cf/ivac255.PMC9639806.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33493884","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}
引用次数: 1
Augmenting mitral valve repair evaluation with intraoperative left ventricle pressure measurements. 术中测量左心室压力评价增强二尖瓣修复。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-10-10 DOI: 10.1093/icvts/ivac242
Hugo Issa, Mimi Deng, Kenza Rahmouni, Vincent Chan
{"title":"Augmenting mitral valve repair evaluation with intraoperative left ventricle pressure measurements.","authors":"Hugo Issa,&nbsp;Mimi Deng,&nbsp;Kenza Rahmouni,&nbsp;Vincent Chan","doi":"10.1093/icvts/ivac242","DOIUrl":"https://doi.org/10.1093/icvts/ivac242","url":null,"abstract":"<p><p>Surgical mitral valve repair remains the gold standard treatment of mitral regurgitation due to degenerative disease. Surgery is performed on the quiescent heart; therefore, assessments of valve repair success can only be made following separation from cardiopulmonary bypass. Intra-ventricular pressure measurements are often made in percutaneous valve procedures but has yet been described at the time of surgical repair. As an example, the saline test, whereby normal saline is injected across the mitral valve from the left atrium into the left ventricle, on the arrested heart remains an integral component of surgical repair. However, the haemodynamics of the saline test have never been evaluated. We present a simple and novel technique to quantify the saline test by passing a 22-G catheter across the mitral leaflets during saline testing under maximal ventricle distension. The saline test may be less informative among patients in whom the maximum generated left ventricle diastolic pressure is low. These data may be of help to a surgeon interpreting intraoperative saline tests with the hope of a competent mitral valve. As well, it may provide support for intraventricular pressure monitoring at the time of mitral valve surgery.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40381252","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}
引用次数: 1
Acute Kidney Injury after High-Flow Regional Cerebral Perfusion in Neonatal and Infant Aortic Arch Repair. 新生儿和婴儿主动脉弓修复术中高流量区域脑灌注后的急性肾损伤。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-19 DOI: 10.1093/icvts/ivac247
Fumiaki Shikata, Kagami Miyaji, Satoshi Kohira, Hiroshi Goto, Torii Shinzo, Tadashi Kitamura, Toshiaki Mishima, Masaomi Fukuzumi, Shunichiro Fujioka, Akihiro Sasahara, Haruna Araki
{"title":"Acute Kidney Injury after High-Flow Regional Cerebral Perfusion in Neonatal and Infant Aortic Arch Repair.","authors":"Fumiaki Shikata, Kagami Miyaji, Satoshi Kohira, Hiroshi Goto, Torii Shinzo, Tadashi Kitamura, Toshiaki Mishima, Masaomi Fukuzumi, Shunichiro Fujioka, Akihiro Sasahara, Haruna Araki","doi":"10.1093/icvts/ivac247","DOIUrl":"10.1093/icvts/ivac247","url":null,"abstract":"<p><strong>Objectives: </strong>We applied high-flow regional cerebral perfusion (HFRCP) for aortic arch reconstruction in neonates and infants by monitoring regional oxygen saturation of the thigh (rSO2T) using near-infrared spectroscopy to maintain peripheral perfusion. This study was designed to investigate the optimal perfusion flow of HFRCP for renal protection.</p><p><strong>Methods: </strong>From 2009 to 2021, 28 consecutive neonates and infants who underwent aortic arch reconstruction with HFRCP were enrolled. The median age of the patients was 27 days; the median body weight was 3.0 kg. In HFRCP, perfusion flow was targeted at approximately 80-100 mL/kg/min and then lowered corresponding to brain rSO2 levels and blood gas data. Isosorbide dinitrate and chlorpromazine were administered to enhance peripheral perfusion flow. Regional oxygen saturation of the forehead and thighs were monitored. The stage of acute kidney injury (AKI) was classified based on the Kidney Disease Improving Global Outcomes criteria.</p><p><strong>Results: </strong>No patients had neurological events and peritoneal dialysis after surgery. The incidence of AKI was 39.3% with only three patients having greater than stage 2 AKI. The maximum postoperative serum creatinine concentration was negatively associated with the lowest rSO2T during HFRCP. The rSO2T during HFRCP was a predictive factor for postoperative creatinine increase of ≧0.3 mg/dL. The area under receiver operating characteristic curve was 0.78 with the cutoff value of 48% for rSO2T.</p><p><strong>Conclusions: </strong>The rSO2T during HFRCP is a potential predictor of postoperative renal function. To prevent AKI, the rSO2T should be preserved more than 48% by increasing HFRCP flow.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/25/ivac247.PMC9950871.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360661","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}
引用次数: 0
Preoperative P-wave parameters and risk of atrial fibrillation after cardiac surgery: a meta-analysis of 20 201 patients. 心脏手术后术前p波参数与房颤风险:20201例患者的荟萃分析
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac220
Michal J Kawczynski, Sophie Van De Walle, Bart Maesen, Aaron Isaacs, Stef Zeemering, Ben Hermans, Kevin Vernooy, Jos G Maessen, Ulrich Schotten, Elham Bidar
{"title":"Preoperative P-wave parameters and risk of atrial fibrillation after cardiac surgery: a meta-analysis of 20 201 patients.","authors":"Michal J Kawczynski,&nbsp;Sophie Van De Walle,&nbsp;Bart Maesen,&nbsp;Aaron Isaacs,&nbsp;Stef Zeemering,&nbsp;Ben Hermans,&nbsp;Kevin Vernooy,&nbsp;Jos G Maessen,&nbsp;Ulrich Schotten,&nbsp;Elham Bidar","doi":"10.1093/icvts/ivac220","DOIUrl":"https://doi.org/10.1093/icvts/ivac220","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the role of P-wave parameters, as defined on preprocedural electrocardiography (ECG), in predicting atrial fibrillation after cardiac surgery [postoperative atrial fibrillation (POAF)].</p><p><strong>Methods: </strong>PubMed, Cochrane library and Embase were searched for studies reporting on P-wave parameters and risk of POAF. Meta-analysis of P-wave parameters reported by at least 5 different publications was performed. In case of receiver operator characteristics (ROC-curve) analysis in the original publications, an ROC meta-analysis was performed to summarize the sensitivity and specificity.</p><p><strong>Results: </strong>Thirty-two publications, with a total of 20 201 patients, contributed to the meta-analysis. Increased P-wave duration, measured on conventional 12-lead ECG (22 studies, Cohen's d = 0.4, 95% confidence interval: 0.3-0.5, P < 0.0001) and signal-averaged ECG (12 studies, Cohen's d = 0.8, 95% confidence interval: 0.5-1.2, P < 0.0001), was a predictor of POAF independently from left atrial size. ROC meta-analysis for signal-averaged ECG P-wave duration showed an overall sensitivity of 72% (95% confidence interval: 65-78%) and specificity of 68% (95% confidence interval: 58-77%). Summary ROC curve had a moderate discriminative power with an area under the curve of 0.76. There was substantial heterogeneity in the meta-analyses for P-wave dispersion and PR-interval.</p><p><strong>Conclusions: </strong>This meta-analysis shows that increased P-wave duration, measured on conventional 12-lead ECG and signal-averaged ECG, predicted POAF in patients undergoing cardiac surgery.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/11/ivac220.PMC9492265.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631177","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}
引用次数: 0
Is mood associated with perception of recovery? Preoperative depression versus postoperative delirium after cardiac surgery. 情绪是否与恢复知觉有关?心脏手术后术前抑郁与术后谵妄。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac229
Ari A Mennander
{"title":"Is mood associated with perception of recovery? Preoperative depression versus postoperative delirium after cardiac surgery.","authors":"Ari A Mennander","doi":"10.1093/icvts/ivac229","DOIUrl":"https://doi.org/10.1093/icvts/ivac229","url":null,"abstract":"<p><p>The author alone is responsible for the Invited Commentary, which does not necessarily reflect the policy of the Journal.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40336273","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}
引用次数: 0
Feasibility and long-term outcomes of surgery for primary thoracic synovial sarcoma. 原发性胸滑膜肉瘤手术治疗的可行性及远期疗效。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac238
Sara Pieropan, Olaf Mercier, Delphine Mitilian, Pauline Pradère, Dominique Fabre, Daniela Iolanda Ion, Olivier Mir, Barbara Galbardi, Vincent Thomas De Montpreville, Elie Fadel
{"title":"Feasibility and long-term outcomes of surgery for primary thoracic synovial sarcoma.","authors":"Sara Pieropan,&nbsp;Olaf Mercier,&nbsp;Delphine Mitilian,&nbsp;Pauline Pradère,&nbsp;Dominique Fabre,&nbsp;Daniela Iolanda Ion,&nbsp;Olivier Mir,&nbsp;Barbara Galbardi,&nbsp;Vincent Thomas De Montpreville,&nbsp;Elie Fadel","doi":"10.1093/icvts/ivac238","DOIUrl":"https://doi.org/10.1093/icvts/ivac238","url":null,"abstract":"<p><strong>Objectives: </strong>Primary thoracic synovial sarcoma (SS) is a rare, high-grade, malignancy. Involvement of vital organs is frequent and may decrease the benefits of surgical resection. We reviewed our practice at a highly experienced thoracic-surgery centre to assess early- and long-term outcomes after surgery.</p><p><strong>Methods: </strong>We conducted a retrospective, observational, single-centre study of patients undergoing curative-intent surgery for primary thoracic SS between 1 January 2000 and 31 January 2021 as part of a multidisciplinary management. We assessed demographics, medical history, histopathology and follow-up information.</p><p><strong>Results: </strong>We enrolled 20 patients (13 males) with a median age of 40 years old and a median tumour size of 11 cm. Neoadjuvant chemotherapy was administered to 13 patients. Surgery consisted in extrapleural pneumonectomy (n = 7), extrapleural lobectomy (n = 5), chest wall resection (n = 4) or tumour resection (n = 4). R0 resection was achieved in 16 (80%) patients. Adjuvant therapy was given to 13 patients. 6 patients developed postoperative complications. The median hospital stay was 11.5 days. Overall survival at 2 and 5 years was 51% and 22%, respectively; median overall survival was 25 months and median disease-free survival was 8.5 months. Relapses occurred in 15 patients. By univariate analysis, incomplete resection was the only significant predictor of survival (P = 0.01).</p><p><strong>Conclusions: </strong>Primary thoracic SS is an aggressive disease. Surgery included in a multimodal treatment may contribute to achieving a good outcome, providing that an R0 resection is obtained. Given the considerable technical challenges of surgery, patient selection and referral to an experienced centre are crucial to minimize morbidity and mortality.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/41/ivac238.PMC9492245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40352141","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}
引用次数: 0
Low copper levels measured in the aortic wall of New Zealand patients with non-syndromic ascending thoracic aortic aneurysm. 新西兰无综合征性胸升主动脉瘤患者主动脉壁铜含量低。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac235
Adam El-Gamel, Josephenine Mak, Steve Bird, Megan N C Grainger, Gregory M Jacobson
{"title":"Low copper levels measured in the aortic wall of New Zealand patients with non-syndromic ascending thoracic aortic aneurysm.","authors":"Adam El-Gamel,&nbsp;Josephenine Mak,&nbsp;Steve Bird,&nbsp;Megan N C Grainger,&nbsp;Gregory M Jacobson","doi":"10.1093/icvts/ivac235","DOIUrl":"https://doi.org/10.1093/icvts/ivac235","url":null,"abstract":"<p><strong>Objectives: </strong>Studies in animals have shown causal relationships between copper (Cu) deficiency and the development of thoracic aortic aneurysms (TAAs) [1, 2]. Cu deficiency is widespread in New Zealand (NZ) soils; the high soil pH from the use of lime fertilizers reduces the bioavailability of Cu for grazing animals and growing plants; this, in turn, reduces Cu availability in the NZ human food chain. Our study is a pilot study to explore associations between Cu and TAA. We measured Cu levels in aneurysmal aortic tissues in patients undergoing Bentall procedures and non-aneurysmal aortic tissue from coronary artery bypass graft patients.</p><p><strong>Methods: </strong>Aortic samples were collected from 2 groups of patients during elective open-heart surgery over 4 months between November 2017 and February 2018. The groups were a TAA group, patients with non-syndromic aortic aneurysm and without the bicuspid aortic valve or known infectious or inflammatory condition (ANEURYSM; n = 13), and a control coronary artery bypass graft group (CONTROL; n = 44). Standardized digested dry tissue weighed samples were analysed from both groups. Tissue extraction of trace elements was carried out using HCl-H2O2 digestion and a highly sensitive analytical technique, inductively coupled plasma mass spectrometry-used to measure elemental concentrations.</p><p><strong>Results: </strong>Cu concentration (mean ± SD) was significantly lower in ANEURYSM (3.34 ± 0.16 µg/g) when compared to the CONTROL group tissues (4.33 ± 0.20 µg/g) (dry weight; mean ± SD; Student's t-test, P < 0.05). Over 46% of the Aneurysm patients were Maori and live in a geographically Cu-deficient NZ territory.</p><p><strong>Conclusions: </strong>Cu deficiency may play a role in the development or progression of non-syndromic ascending aortic aneurysms in NZ. Maori patients are more at risk as they commonly live in rural NZ, dependent on locally grown nutritional sources. Further studies are required to confirm this exciting finding and to establish cause and effect relationship.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40348838","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}
引用次数: 0
Drainless thoracoscopic surgery should be avoided in primary spontaneous pneumothorax with pleural adhesion. 原发性自发性气胸合并胸膜粘连应避免无引流胸腔镜手术。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac237
Chieh-Kuo Lin, Ka-I Leong, Cheng-Hung How, Hu-Lin Christina Wang, Chao-Yu Liu
{"title":"Drainless thoracoscopic surgery should be avoided in primary spontaneous pneumothorax with pleural adhesion.","authors":"Chieh-Kuo Lin,&nbsp;Ka-I Leong,&nbsp;Cheng-Hung How,&nbsp;Hu-Lin Christina Wang,&nbsp;Chao-Yu Liu","doi":"10.1093/icvts/ivac237","DOIUrl":"https://doi.org/10.1093/icvts/ivac237","url":null,"abstract":"<p><strong>Objectives: </strong>Drainless thoracoscopic surgery, defined by omitting chest drain after surgery, has been demonstrated to be feasible in selected patients for pulmonary resection. However, drainless procedure for the treatment of primary spontaneous pneumothorax has raised concerns for its safety and thus has been less often reported. We aimed to share our preliminary experience regarding how to select patients with spontaneous pneumothorax for this procedure.</p><p><strong>Methods: </strong>A retrospective study recruiting 303 consecutive patients with the diagnosis of spontaneous pneumothorax undergoing thoracoscopic surgery in our centre from August 2016 to June 2020 was done. After careful selection, the chest drain was omitted in selected patients who underwent non-intubated uniportal thoracoscopic surgery. Patients' clinical characteristics and perioperative outcomes were analysed.</p><p><strong>Results: </strong>A total of 34 patients underwent drainless thoracoscopic surgery for the treatment of spontaneous pneumothorax. Pleural adhesion was noted in 9 patients during surgery, and all of them (100%) developed residual pneumothorax, among which intercostal drainage was required in 2 (22.2%) patients and ipsilateral pneumothorax recurred 3 years after surgery in 1 (11.1%) patient. Among the remaining 25 without pleural adhesion, 17 (68.0%) developed minor residual pneumothorax (P = 0.006), which all resolved spontaneously within 1-2 weeks, with no complications or recurrence during postoperative follow-up for at least 2 years.</p><p><strong>Conclusions: </strong>Drainless thoracoscopic surgery for the treatment of primary spontaneous pneumothorax is feasible but can be risky without careful patient selection. In our experience, the drainless procedure should be avoided in patients with identifiable pleural adhesion noted during surgery.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40352503","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}
引用次数: 1
Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules. 术中锥形束ct引导下肺小结节定位的有效性和安全性。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac236
Taisuke Kaiho, Hidemi Suzuki, Atsushi Hata, Takamasa Ito, Kazuhisa Tanaka, Yuichi Sakairi, Hideyuki Kato, Yuki Shiko, Yohei Kawasaki, Ichiro Yoshino
{"title":"Efficacy and safety of intraoperative cone-beam CT-guided localization of small pulmonary nodules.","authors":"Taisuke Kaiho,&nbsp;Hidemi Suzuki,&nbsp;Atsushi Hata,&nbsp;Takamasa Ito,&nbsp;Kazuhisa Tanaka,&nbsp;Yuichi Sakairi,&nbsp;Hideyuki Kato,&nbsp;Yuki Shiko,&nbsp;Yohei Kawasaki,&nbsp;Ichiro Yoshino","doi":"10.1093/icvts/ivac236","DOIUrl":"https://doi.org/10.1093/icvts/ivac236","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of intraoperative cone-beam computed tomography-guided video-assisted thoracoscopic surgery wedge resection of impalpable small pulmonary nodules.</p><p><strong>Methods: </strong>This was a single-centre phase 2 trial conducted between April 2018 and March 2019. Peripheral small pulmonary nodules, defined as either ground-glass opacity-dominant (>50%) nodules measuring ≤3 cm in diameter (ground-glass opacity-dominant type) or nodules measuring ≤2 cm in diameter located deeper than the nodule diameter from the visceral pleura (deep solid type), were eligible for resection using a cone-beam computed tomography-guided thoracoscopic manner. The primary end-point was macroscopic complete resection, and secondary end-points were: nodule extraction rate, operation time, localization time, marking accuracy, microscopic complete resection and safety.</p><p><strong>Results: </strong>Twenty-two nodules, in 9 men and 11 women with a mean age of 64.3 years, were visualized and resected. The nodules were located in the right upper, middle and lower lobes in 3, 1 and 5 patients, respectively, and in the left upper and lower lobes in 5 and 8 patients, respectively. Seven nodules were ground-glass opacity-dominant types, and 15 were deep solid types. Cone-beam computed tomography could clearly image all nodules. The mean time for localization was 17.4 min. The mean operation time was 110.7 min. Macroscopic complete resection was accomplished in 21 nodules (95.5%). Microscopic complete resection was achieved in all nodules (100%). Postoperative air leakage and bleeding were observed in 1 patient (5%).</p><p><strong>Conclusions: </strong>Cone-beam computed tomography might be a safe and useful guide for video-assisted thoracoscopic surgery wedge resection of impalpable peripheral pulmonary nodules.</p><p><strong>Date and number of irb approval: </strong>15 November 2017, 381.</p><p><strong>Clinical trial registration number: </strong>UMIN 000030388.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356087","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}
引用次数: 0
Segmentectomy versus lobectomy for inner-located small-sized early non-small-cell lung cancer. 内位小体积早期非小细胞肺癌的节段切除术与肺叶切除术。
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-09-09 DOI: 10.1093/icvts/ivac218
Shinya Tane, Yoshitaka Kitamura, Kenji Kimura, Nahoko Shimizu, Gaku Matsumoto, Kazuya Uchino, Wataru Nishio
{"title":"Segmentectomy versus lobectomy for inner-located small-sized early non-small-cell lung cancer.","authors":"Shinya Tane,&nbsp;Yoshitaka Kitamura,&nbsp;Kenji Kimura,&nbsp;Nahoko Shimizu,&nbsp;Gaku Matsumoto,&nbsp;Kazuya Uchino,&nbsp;Wataru Nishio","doi":"10.1093/icvts/ivac218","DOIUrl":"https://doi.org/10.1093/icvts/ivac218","url":null,"abstract":"<p><strong>Objectives: </strong>Although segmentectomy is an acceptable alternative to lobectomy for peripheral small-sized non-small-cell lung cancer, the effectiveness of segmentectomy for inner lesions remains unknown. The aim of this study was to examine the feasibility of segmentectomy in comparison with lobectomy for inner lesions.</p><p><strong>Methods: </strong>We retrospectively analysed 570 patients with small (≤2 cm) cN0 non-small-cell lung cancer who underwent segmentectomy or lobectomy between January 2007 and March 2021. We focused on patients with lesions located in the inner two-thirds, which were determined using three-dimensional computed tomography (n = 227). After propensity score matching analysis based on sex, age, pulmonary function, serum carcinoembryonic antigen level, radiographic tumour findings and tumour location, we compared the surgical and oncological outcomes in patients who underwent segmentectomy (n = 66) and lobectomy (n = 66).</p><p><strong>Results: </strong>Postoperative mortality or morbidity did not differ significantly between the 2 groups. The 5-year recurrence-free and overall survival rates in the segmentectomy and lobectomy groups were 93.6% vs 84.1% and 95.8% vs 87.9%, respectively. The differences between 2 groups were not significant (P = 0.62 and P = 0.23, respectively). The 2 groups also showed no differences in loco-regional recurrence. Multivariable Cox regression analysis revealed that segmentectomy had a comparable impact on recurrence-free survival (hazard ratio, 0.61; 95% confidence interval, 0.17-2.03; P = 0.43).</p><p><strong>Conclusions: </strong>Segmentectomy for inner-located small-sized non-small-cell lung tumours could be an acceptable treatment in comparison with lobectomy.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/1d/ivac218.PMC9468593.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40709628","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}
引用次数: 5
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