Yuhong Yang, Hang Zhao, Jiacong Liu, Xuhua Huang, Jiayue Ye, Jinming Xu, Wang Lv, Linhai Zhu, Jian Hu
{"title":"Two versus three to four cycles of neoadjuvant immunochemotherapy for stage IB-IIIB non-small cell lung cancer: a real-world study.","authors":"Yuhong Yang, Hang Zhao, Jiacong Liu, Xuhua Huang, Jiayue Ye, Jinming Xu, Wang Lv, Linhai Zhu, Jian Hu","doi":"10.21037/jtd-2024-2256","DOIUrl":"10.21037/jtd-2024-2256","url":null,"abstract":"<p><strong>Background: </strong>No consensus exists regarding the optimal number of cycles of neoadjuvant immunochemotherapy for patients with stage IB-IIIB non-small cell lung cancer (NSCLC). In this study, we compared the efficacy and safety of 2 cycles of neoadjuvant immunochemotherapy in stage IB-IIIB NSCLC with those of 3-4 cycles.</p><p><strong>Methods: </strong>All patients with IB-IIIB NSCLC who received preoperative immunochemotherapy at the Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, from 2019 to 2022 were consecutively included in this retrospective study. Subsequently, 1:1 propensity score matching (PSM) according to baseline characteristics was performed to compare the efficacy and safety between the 2-cycle group and the 3 to 4-cycle group. The follow-up period was required to be at least 1 year after surgery or when the patient decided to abandon treatment.</p><p><strong>Results: </strong>Of the 184 patients with stage IB-IIIB NSCLC included in the analysis, 61 received 2 cycles of neoadjuvant immunochemotherapy while 123 received 3-4 cycles. After a 1:1 PSM, there were no significant differences in baseline clinicopathological characteristics among the108 patients (54 pairs) who received 2 cycles or 3-4 cycles of neoadjuvant immunochemotherapy. The objective response rate (ORR) in the 3 to 4-cycle group was significantly higher than that in the 2-cycle group (83.3% <i>vs.</i> 63.0%; P=0.01). The incidence of grade 3-4 adverse events (AEs) in the 3 to 4-cycle group was similar to that of the 2-cycle group (13.0% <i>vs.</i> 9.3%; P=0.54). About 90.7% (49/54) of patients in the 2-cycle group and 46.3% (25/54) in the 3 to 4-cycle group eventually underwent surgery. The rate of major pathological response (MPR) in the 3 to 4-cycle group and 2-cycle group was 68.0% and 69.4% (P=0.90), respectively. The rate of pathological complete response (pCR) in the 3 to 4-cycle group and 2-cycle group was 36.0% and 38.8% (P=0.82), respectively. The median disease-free survival (DFS) in the 3 to 4-cycle group and 2-cycle group was not reached (P=0.80). The 1-year DFS rate and 2-year DFS rate in the 2-cycle group were 87.8% and 77.6%, respectively, while those in the 3 to 4-cycle group were 80.0% and 76.0%, respectively. The median overall survival (OS) in the 2-cycle group was 42.4 months, and it was not reached in the 3 to 4-cycle group (P=0.42). The 1-year OS rate and 2-year OS rate in the 2-cycle group were 93.9% and 87.8%, respectively, while those in the 3 to 4-cycle group were 88.0% and 80.0%, respectively.</p><p><strong>Conclusions: </strong>Three to four cycles of neoadjuvant immunochemotherapy can result in more tumor regression in IB-IIIB NSCLC. Extending the number of cycles to 3-4 cycles may be feasible and safe in IB-IIIB NSCLC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"1028-1041"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnostic utility of endobronchial ultrasound elastography for detecting benign and malignant lymph nodes: a retrospective study.","authors":"Xinyu Zhou, Yaqing Li","doi":"10.21037/jtd-24-1042","DOIUrl":"10.21037/jtd-24-1042","url":null,"abstract":"<p><strong>Background: </strong>The endobronchial ultrasound (EBUS) elastography is a diagnostic tool used for measuring the elasticity of intrathoracic lesions. It is still essential for discussions about how accurate elastography is at identifying benign and malignant mediastinal and hilar lymph nodes. The objective of this study was to investigate the diagnostic utility of EBUS elastography and to determine the variables affecting this procedure.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective study involving patients with suspected lung cancer who underwent EBUS elastography followed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) at Zhejiang Cancer Hospital between October 2021 and March 2023. The pathological results of EBUS-TBNA, validated through a six-month follow-up, served as the gold standard. Each lymph node had its ultrasonic elastography indices recorded, including the elastography grading score, blue color ratio (BCR), blue color score, and short axis diameter. The diagnostic efficacy of elastography was assessed using the receiver operating characteristic (ROC) curve, which differentiated between benign and malignant lymph nodes. To investigate the factors impacting the elastography indices, multivariate logistic regression was used with multiple serological markers, lymph node location, and pathology.</p><p><strong>Results: </strong>Of the 168 patients, 322 lymph nodes were punctured, with 175 (54.3%) being malignant. The area under the ROC curve (AUC) for the combined index of elastography grading score and short-axis diameter was 0.702 [95% confidence interval (CI): 0.645-0.759]. While the pathology of the lymph nodes was found to influence the BCR, BCR was unable to distinguish between lymph nodes with benign conditions and those with small cell carcinoma.</p><p><strong>Conclusions: </strong>The use of elastography data alone may be inadequate for diagnosing metastatic lymph nodes. However, elastography can provide supplementary diagnostic information during EBUS-TBNA. Invasive EBUS-TBNA remains recommended as it aids in the identification of malignant lymph nodes when used in conjunction with pathological, radiological, and clinical findings.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"614-622"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Electronic patient-reported outcome-based symptom management, a new era in surgical patient management.","authors":"Borja Aguinagalde, Iker Lopez, Jon Ander Lizarbe","doi":"10.21037/jtd-24-1427","DOIUrl":"10.21037/jtd-24-1427","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"531-534"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"DeepSeek's impact on thoracic surgeons' work patterns-past, present and future.","authors":"Yutao Chen, Jianfei Shen, Dehua Ma","doi":"10.21037/jtd-2025b-04","DOIUrl":"10.21037/jtd-2025b-04","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"1114-1117"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Zhou, Di Ren, Yanhong Chen, Sha Wen, Yiwen Zhang, Fei Song, Mei Yang, Michael Eisenhut, James O'Rourke, Ying Li, Shuiqing Gui
{"title":"Presepsin, procalcitonin, interleukin-6, and high-sensitivity C-reactive protein for predicting bacterial DNAaemia among patients with sepsis.","authors":"Yan Zhou, Di Ren, Yanhong Chen, Sha Wen, Yiwen Zhang, Fei Song, Mei Yang, Michael Eisenhut, James O'Rourke, Ying Li, Shuiqing Gui","doi":"10.21037/jtd-24-1714","DOIUrl":"10.21037/jtd-24-1714","url":null,"abstract":"<p><strong>Background: </strong>Anti-infective therapy against pathogens is the key to treatment of sepsis. Metagenomic next-generation sequencing (mNGS) has higher sensitivity than blood culture. The aim of this study was to use mNGS to identify DNAaemia of pathogens and to assess the diagnostic accuracy of presepsin (PSEP), procalcitonin (PCT), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP) in differentiating between bacterial and nonbacterial infections in patients with sepsis.</p><p><strong>Methods: </strong>This retrospective study included patients with sepsis from November 2020 to September 2022 in the Shenzhen Second People's Hospital. Blood samples were sent for blood culture and mNGS when the patients were diagnosed with sepsis. Plasma PSEP, PCT, and IL-6 levels were measured using whole blood specimens that were collected and analyzed after a diagnosis of sepsis. Area under the receiver operating characteristic curve (AUC) was used to evaluate the accuracy of PSEP, PCT, IL-6, and hsCRP for prediction of bacterial DNAaemia detected by mNGS in patients with sepsis.</p><p><strong>Results: </strong>This study included 230 patients with sepsis. The bacterial DNAaemia rate was 53.0% [Gram-positive DNAaemia (GPD), Gram-negative DNAaemia (GND), and fungi DNAaemia rate was 18.2%, 37.8%, and 10.9%, respectively]. Among GND, <i>Klebsiella</i> was the most common, followed by <i>Escherichia coli</i>; meanwhile, the GPD were mainly <i>Enterococcus</i>, and <i>Aspergillus</i> was identified in 5 patients with sepsis. The PSEP median values were significantly higher in GND than in non-GND [GND: 1,291 pg/mL, interquartile range (IQR) 456-3,502 pg/mL; non-GND: 707 pg/mL, IQR 332-2,417 pg/mL; P=0.035]. There was no significant difference in PSEP values between GPD and non-GPD groups, or between fungi DNAaemia and non-fungi DNAaemia groups. Receiver operating characteristics analysis indicated that the best cutoff values for PSEP, PCT, IL-6, and hsCRP were 869 pg/mL, 1.14 ng/mL, 85.5 pg/mL, and hsCRP 96.2 mg/L, respectively. Logistic regression indicated that PSEP, PCT, IL-6, and hsCRP had significant predictive value for GND in patients with sepsis. The levels of PCT and IL-6 were different between patients with GPD and those with non-GPD. Only PCT levels differed significantly between fungal DNAaemia and nonfungal DNAaemia.</p><p><strong>Conclusions: </strong>Bacterial-DNAaemia was detected in half of the patients with sepsis. PSEP, PCT, IL-6, and hsCRP demonstrated significant predictive value for GND, PCT and IL-6 levels demonstrated significant predictive value for GPD. Meanwhile, only PCT demonstrated significant predictive value for fungal DNAaemia.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"991-1001"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of pleurodesis for lung cancer patients with interstitial lung disease.","authors":"Hirokazu Iso, Akihiko Miyanaga, Yozo Sato, Yukari Shirakura, Kaoruko Shinbu, Tomoyasu Inoue, Atsuhiro Nagano, Kazuhito Misawa, Takehiro Tozuka, Akari Murata, Katsuyuki Higa, Susumu Takeuchi, Masaru Matsumoto, Koichiro Kamio, Kazuo Kasahara, Masahiro Seike","doi":"10.21037/jtd-24-1541","DOIUrl":"10.21037/jtd-24-1541","url":null,"abstract":"<p><strong>Background: </strong>Managing malignant pleural effusion (MPE) with pleurodesis is essential for symptom relief and minimizing the need for repeated thoracentesis. Interstitial lung disease (ILD) is one of the most common complications associated with advanced lung cancer. However, the efficacy and safety of pleurodesis for MPE secondary to lung cancer with ILD remains unclear. This study aimed to evaluate the efficacy and safety of pleurodesis in this population.</p><p><strong>Methods: </strong>This study was a single-center retrospective analysis. The cases of pleurodesis in patients with MPE secondary to lung cancer complicated with ILD at Nippon Medical School Hospital (Tokyo, Japan) between January 2010 and December 2022 were included.</p><p><strong>Results: </strong>Of the 26 lung cancer patients with ILD who underwent pleurodesis were analyzed. Fourteen patients received talc and 12 patients received minocycline, respectively. Talc was used in 10 out of 14 patients with drug-induced ILD and radiation-induced lung injury (RILI). In contrast, minocycline was used in 10 out of 12 patients with idiopathic interstitial pneumonias (IIPs). One month after pleurodesis, the efficacy for pleural adhesions was 64.3% and 50.0% in the talc and minocycline groups. The presence of a partially expanded lung before pleurodesis was a predictive factor for failure [odds ratio: 7.00, 95% confidence interval (CI): 1.20-40.83, P=0.04]. When excluding the patients presenting partially expanded lung, the efficacy rate was 77.8% and 71.4% in the talc and minocycline groups. One case of grade 5 acute respiratory distress syndrome (ARDS) was observed in each group. All cases developing ARDS had been treated with systemic prednisolone against ILDs presenting ground glass opacity and consolidation within 6 months before pleurodesis.</p><p><strong>Conclusions: </strong>Pleurodesis is considered to be one of the treatment options against MPE in patients with ILD. However, two cases of ARDS were observed; thus, clinicians should carefully consider the indication of pleurodesis in the patients who had the recent onset of ILD and were treated with systemic prednisolone.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"687-694"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The APPLE's core question-upfront osimertinib versus the sequential approach for <i>EGFR</i> mutated non-small cell lung cancer.","authors":"Joe Q Wei, Alexander Yuile, Aaron C Tan","doi":"10.21037/jtd-24-1785","DOIUrl":"10.21037/jtd-24-1785","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"524-527"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The rise of DeepSeek: technology calls for the \"catfish effect\".","authors":"Jinlin Wu","doi":"10.21037/jtd-2025b-02","DOIUrl":"10.21037/jtd-2025b-02","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"1106-1108"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sue In Choi, Won Jai Jung, Yujin Jeong, Sanghoon Park, Byung-Keun Kim, Sang Yeub Lee, Hyonggin An, Eun Joo Lee
{"title":"COVID-19 infection and pulmonary sarcoidosis: a systematic review and meta-analysis of morbidity, severity and mortality.","authors":"Sue In Choi, Won Jai Jung, Yujin Jeong, Sanghoon Park, Byung-Keun Kim, Sang Yeub Lee, Hyonggin An, Eun Joo Lee","doi":"10.21037/jtd-24-1620","DOIUrl":"10.21037/jtd-24-1620","url":null,"abstract":"<p><strong>Background: </strong>The pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) influenced millions of lives, not only healthy subjects but also patients with various comorbidities. Of those, interstitial lung disease (ILD) is known to be specifically vulnerable to SARS-CoV-2, sometimes leading to a lethal outcome. Sarcoidosis, one of the ILDs, has been suggested to be more susceptible to COVID-19, but the results of previous studies are in disagreement.</p><p><strong>Methods: </strong>We performed a meta-analysis, attempting to explain the correlation between COVID-19 and sarcoidosis. Electronic databases were searched and selected for analysis under pre-established criteria. Risk ratio (RR) for incidence and odds ratio (OR) for severity, i.e., intensive care unit (ICU) admission and death, were calculated with (95%) confidence interval (CI) using R Statistical Software (version 4.3.1).</p><p><strong>Results: </strong>The RR of COVID-19 incidence on sarcoidosis patients was 5.86 (95% CI: 8.02-11.91). Admission of sarcoidosis patients to the ICU who were infected with SARS-CoV-2 was 2.48 (95% CI: 2.04-3.01). Death of sarcoidosis by COVID-19 was also significantly higher compared with healthy controls (OR =1.95, 95% CI: 1.58-2.41). Both morbidity and mortality due to COVID-19 was significantly higher in the sarcoidosis patients.</p><p><strong>Conclusions: </strong>Sarcoidosis patients are undeniably prone to SARS-CoV-2 infection, with increased severity, morbidity and greater mortality of COVID-19. Vaccination against SARS-CoV-2 for sarcoidosis therefore is beneficial, and may be a compulsory measure. Further studies regarding other factors are needed for a better understanding of the correlation between sarcoidosis and COVID-19.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"744-752"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative safety of simultaneous pulmonary resection and off-pump coronary artery bypass grafting: a retrospective analysis from a single institution.","authors":"Feng Chen, Shaobo Gao, Wenchao Xia, Meng Wang, Wei Zhang, Yijun Xu","doi":"10.21037/jtd-24-1369","DOIUrl":"10.21037/jtd-24-1369","url":null,"abstract":"<p><strong>Background: </strong>As an increasing number of patients with both lung cancer and coronary artery disease (CAD) are being discovered, doctors face great challenges in treating this group. Off-pump coronary artery bypass grafting (CABG) combined with simultaneous radical surgery for lung cancer has become an option at some institutions. In this study, we aimed to explore postoperative complications, hospitalization duration and expenses, and surgical safety among patients who underwent simultaneous pulmonary resection and off-pump CABG, in order to provide a new treatment approach for lung cancer patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>This study collected 85 patients who underwent lung resection and off-pump CABG at Tianjin Chest Hospital from 2020 to 2023. According to different methods of lung surgery, it is divided into two groups: lobectomy combined with off-pump CABG and wedge resection combined with off-pump CABG. These two groups were compared with 78 patients who only received off-pump CABG in terms of hospitalization time and cost, perioperative safety, and surgical complications, in order to evaluate the feasibility of lung resection combined with off-pump CABG.</p><p><strong>Results: </strong>From the perspective of cardiac function, simultaneous pulmonary resection (lobectomy or wedge resection) and off-pump CABG did not affect postoperative cardiac function compared with off-pump CABG alone [left ventricle (LV): P=0.19; pulmonary artery systolic pressure (PASP): P=0.93; left ventricular ejection fraction (LVEF): P=0.89]. From the perspective of postoperative complications, the combined operation did not increase the incidence of respiratory-related complications (P=0.87) or cardiovascular-related complications (P=0.72) and secondary surgical events (P=0.19), but it did increase the incidence of surgery-related complications (such as chylothorax and air leakage), 15.4%:2.6%, which was manageable. In terms of perioperative safety, intraoperative blood loss during the combined operation was manageable (580 mL:450 mL) and did not significantly prolong the operation time (P>0.05).</p><p><strong>Conclusions: </strong>Off-pump CABG combined with pulmonary resection is safe during the perioperative period, and the incidence of postoperative complications is manageable, thus reducing overall hospitalization costs. However, combined surgery poses certain technical difficulties and should be performed at experienced institutions.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"650-660"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}