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Kyobu geka. The Japanese journal of thoracic surgery最新文献

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[Contrivance to Use Ultrasonic Scalpel for Laparoscopic Surgery during Internal Thoracic Artery Harvest]. [在胸内动脉采集过程中使用超声刀进行腹腔镜手术的装置]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Tsukasa Ohno, Shunei Saito, Ryohei Otsuka, Yuta Okumura, Ken Miyahara, Akio Matsuura
{"title":"[Contrivance to Use Ultrasonic Scalpel for Laparoscopic Surgery during Internal Thoracic Artery Harvest].","authors":"Tsukasa Ohno, Shunei Saito, Ryohei Otsuka, Yuta Okumura, Ken Miyahara, Akio Matsuura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>From April 2024, manufacturing of short-shaft ultrasonic scalpels( SNGHK) has ceased. A scalpel for laparoscopic surgery (HDH05) remains available;however, its long shaft is unsuitable for internal thoracic artery harvesting through a median sternotomy. We contrived to make the latter device easier to handle using a method that requires no specialized parts. Three tubes( a 22 Fr polyvinyl chloride catheter and two extracorporeal circuit tubes, 6 mm and 10 mm in diameter;all about 18 cm long) are prepared and incised vertically. The tubes are installed around the shaft from the handpiece side. The enlarged diameter of the shaft then permits the scalpel tip to be held closer to the surgical area, allowing delicate procedures to be carried out more securely.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1071-1073"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Thoracic Endovascular Aortic Repair for Re-entry of Distal Anastomosis Following Ascending Replacement for Acute Aortic Dissection:Report of a Case]. [胸腔内血管主动脉修复术用于急性主动脉夹层升支置换术后远端吻合口的再次进入：一例病例报告]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Hisaya Mori, Hisato Takagi
{"title":"[Thoracic Endovascular Aortic Repair for Re-entry of Distal Anastomosis Following Ascending Replacement for Acute Aortic Dissection:Report of a Case].","authors":"Hisaya Mori, Hisato Takagi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 61-year-old female underwent ascending aortic replacement (resecting the primary entry in the ascending aorta) for Stanford type A acute aortic dissection 1 year and 8 months before. Her postoperative course was uneventful, and the patient was discharged on 17 days later. Follow-up recent computed tomography (CT) scans, however, revealed dissecting aortic aneurysm of the distal aortic arch due to a new entry at the distal anastomosis of the ascending replacement. Thoracic endovascular aor-tic repair( placing a short stent graft, 52-mm Valiant Navion, into the ascending aorta) was successfully performed to occlude the new entry. Post-procedural CT scans indicated retrograde flow into the false lumen of the aortic arch via a re-entry of the left subclavian artery, and endovascular repair to exclude the re-entry is now planned.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1111-1115"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Prophylactic Negative Pressure Wound Therapy for Patients at High Risk of Surgical Site Infection in Cardiovascular Surgery]. [心血管外科手术中手术部位感染高风险患者的预防性负压伤口疗法]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Shuji Nagatomi, Yuka Ito, Fumiya Ono, Ryo Imada, Yushi Yamashita, Naoki Tateishi, Yoshikazu Kawazu, Tamahiro Kinjo
{"title":"[Prophylactic Negative Pressure Wound Therapy for Patients at High Risk of Surgical Site Infection in Cardiovascular Surgery].","authors":"Shuji Nagatomi, Yuka Ito, Fumiya Ono, Ryo Imada, Yushi Yamashita, Naoki Tateishi, Yoshikazu Kawazu, Tamahiro Kinjo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Deep sternal wound infection after cardiovascular surgery is one of the most devasting complications in both a short and long term. The addition of prophylactic negative pressure wound therapy( pNPWT) to standard surgical site infection( SSI) prophylaxis could be promising approach for the reduction of this problem.</p><p><strong>Methods: </strong>We evaluated 117 consecutive patients who underwent median sternotomy for cardiovascular surgery at our institution from July 2021 to December 2021. pNPWT with Prevena system was used for patients at high risk of SSI. The incidence of SSI was considered.</p><p><strong>Results: </strong>There were 50 patients in pNPWT group and 67 in the usual management group. The estimated risk of SSI was significantly higher in the pNPWT group (2.9±2.3% vs 1.7±1.3%, p<0.05), but there was no significant difference in the incidence of SSI.</p><p><strong>Conclusion: </strong>Prophylactic negative wound therapy in cardiovascular surgery may reduce the incidence of SSI to normal levels in a group of patients at high risk of SSI.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1085-1089"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Transposition of the Left Subclavian Artery Before a Thoracic Endovascular Aortic Repair for Type B Aortic Dissection]. [B型主动脉夹层胸腔内血管主动脉修补术前左锁骨下动脉转位]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Tomohiro Odate, Takashi Miura, Shogo Yokose, Koji Hashizume
{"title":"[Transposition of the Left Subclavian Artery Before a Thoracic Endovascular Aortic Repair for Type B Aortic Dissection].","authors":"Tomohiro Odate, Takashi Miura, Shogo Yokose, Koji Hashizume","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We encountered a patient who had undergone a transposition procedure, which encompassed the performance of subclavian-common carotid arterial end-to-side anastomosis before a thoracic endovascular aortic repair (TEVAR) when carrying out Stanford type B aortic dissection. A 50-year-old man was admitted to our hospital with a diagnosis of chronic Stanford type B aortic dissection that tended to expand. Transposition was performed in advance of zone 2 TEVAR. Lymphorrhea was observed under the skin following surgery. A decreasing tendency for lymphorrhea was confirmed at six months following the operation. Coil embolization was performed after the occurrence of a type I leak following TEVAR;the leak was repaired successfully during the procedure. No ischemic symptoms in the upper left limb or any cerebral complications were observed, demonstrating the safety of the transposition method. The transposition method can be the first choice for revascularization of the left subclavian artery because it requires only one incision, no anticoagulant drugs, and is expected to maintain patency for a long period.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1074-1077"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Complete Tracheal Rupture of the Neck due to Blunt Trauma]. [钝器外伤导致颈部气管完全破裂]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Saki Yamamoto, Chieko Kitamura, Yusuke Kita, Ryo Kobayashi
{"title":"[Complete Tracheal Rupture of the Neck due to Blunt Trauma].","authors":"Saki Yamamoto, Chieko Kitamura, Yusuke Kita, Ryo Kobayashi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A foreign national male in his 30s presented to our hospital after falling overboard. He appeared to have had a rope around his neck during the fall;however, no witnesses observed this. The patient was agitated in the emergency room and was walking around incessantly. He exhibited a cervical cord scar and hoarseness at the beginning of the examination and developed dyspnea and bloody phlegm 40 minutes after arrival. Sudden respiratory deterioration occurred, and oral intubation was performed under sedation with 30 mg midazolam. Chest computed tomography( CT) revealed bilateral pneumothorax and complete transection of the cervical trachea, with tube deviation into the mediastinum. After bilateral drainage of the thoracic cavity, a tracheostomy was performed in the emergency room. The patient underwent tracheoplasty in the operating room 4 hours after arrival. He was extubated on postoperative day( POD) 10;however, bilateral recurrent nerve palsy persisted. The patient was discharged on POD 16.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1090-1096"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Metastatic Lung Tumor with Bronchial Cast Shadow in Which Intraoperative Bronchoscopy Was Useful During Robotic Surgery]. [带有支气管阴影的转移性肺肿瘤在机器人手术中的术中支气管镜检查很有用]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Motoka Omata, Shota Mitsuboshi, Hiroaki Shidei, Akira Ogihara, Hiroe Aoshima, Tamami Isaka, Takako Matsumoto, Masato Kanzaki
{"title":"[Metastatic Lung Tumor with Bronchial Cast Shadow in Which Intraoperative Bronchoscopy Was Useful During Robotic Surgery].","authors":"Motoka Omata, Shota Mitsuboshi, Hiroaki Shidei, Akira Ogihara, Hiroe Aoshima, Tamami Isaka, Takako Matsumoto, Masato Kanzaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A man in his 60s, who had undergone surgery for rectal cancer, liver metastases, and lung metastasis, had a past history of myocardial infarction and ventricular fibrillation with reduced cardiac functions. He was referred to our department because of a pulmonary nodule shadow in the S2 right upper lobe and a bronchial cast shadow along the B2 bronchus. Robot-assisted thoracoscopic right S2 segmentectomy was performed and intraoperative bronchoscopy revealed a polyp-like tumor within B2a. Then, B2a and B2b were resected and the tumor was removed into the surgical field. It was confirmed that there was no residue using a bronchoscope, and the bronchus was cut on the proximal side of B2 using an automatic suturing device. The final pathological diagnosis was rectal cancer with lung metastasis, and the endobronchial tumor showed necrotic tissue and bronchial stumps were negative.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1080-1084"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Rupture without Bleeding Secondary to Endotension After Thoracic Endovasular Aneurysm Repair:Report of a Case]. [胸腔内动脉瘤修补术后继发于内张力的无出血破裂：病例报告]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Baku Takahashi, Hiroyuki Morokuma, Keiji Kamohara
{"title":"[Rupture without Bleeding Secondary to Endotension After Thoracic Endovasular Aneurysm Repair:Report of a Case].","authors":"Baku Takahashi, Hiroyuki Morokuma, Keiji Kamohara","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a rare case of rupture without bleeding secondary to endotension after thoracic endovascular aneurysm repair. An 82-year-old woman had undergone multiple thoracic endovascular aortic repairs for a distal arch aneurysm. Due to the aneurysm enlargement, stent graft was eventually placed from the ascending aorta to just above the celiac artery after axillo-axillo-common carotid artery bypass. Postoperative computed tomography (CT) revealed no endoleak (EL). However, arch aneurysm sac continued to expand without ELs. Furthermore, thoracoabdominal aneurysm was enlarged. She was referred to our hospital because of severe chest pain while we considered open repair. CT demonstrated aneurysm enlargement and massive hematoma, suggesting rupture. Therefore, an open repair was performed by thoracotomy. Interestingly, we found that there was no EL, indicating endotension-induced aneurysm rupture. Her aorta was partially replaced with vascular prosthesis. Second intervention should be performed to prevent critical complications if the aneurysm is expanding even without obvious EL.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1107-1110"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Thymic Carcinoma with Massive Pericardial Effusion:Report of a Case]. [胸腺癌伴大量心包积液：一例报告]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Kenjiro Komori, Hiroyoshi Tsubochi, Shunsuke Endo
{"title":"[Thymic Carcinoma with Massive Pericardial Effusion:Report of a Case].","authors":"Kenjiro Komori, Hiroyoshi Tsubochi, Shunsuke Endo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 70-years-old man visited our hospital with complaints of palpitations and shortness of breath from five days ago. Chest computed tomography( CT) revealed a solid tumor with 74 mm in diameter at the right anterior mediastinum and massive pericardial effusion. No malignant cells were noted in the pericardial effusion collected by pericardiocentesis. Based on the CT findings we judged the tumor completely extirpated. Pathologic diagnosis of the tumor was thymic carcinoma and microscopically no tumor exposure to pericardial cavity was found. Thymic carcinoma with massive pericardial effusion is extremely rare and only two cases were reported which can be resected.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1125-1129"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[System Changes to Carry Out Working-style Reforms at Department of Cardiovascular Surgery of the Local University Hospital]. [地方大学医院心血管外科进行工作方式改革的制度变革]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Hiromasa Nakamura, Atsuyuki Mitsuisi, Keisuke Yoshida, Naoki Edo, Ren Saito, Kazumasa Orihashi, Yujiro Miura
{"title":"[System Changes to Carry Out Working-style Reforms at Department of Cardiovascular Surgery of the Local University Hospital].","authors":"Hiromasa Nakamura, Atsuyuki Mitsuisi, Keisuke Yoshida, Naoki Edo, Ren Saito, Kazumasa Orihashi, Yujiro Miura","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The \"work style reform\" started in April 2024. Our hospital has actively begun implementing task shifts. This study aimed to investigate changes in the surgical outcomes and work hours of cardiovascular surgeons resulting from the introduction of task shifting.</p><p><strong>Patients and methods: </strong>A comparative study was conducted between January 2020 and December 2022, when task shifting was actively introduced, on cardiac surgery outcomes in patients aged 75 years and older, and perioperative risk scores( EuroSCOREⅡ, JapanSCORE2). Changes in the working status of the cardiovascular surgeons were also examined.</p><p><strong>Results: </strong>In total, 95 patients aged≥75 years who underwent cardiac surgery were enrolled. Euro-SCOREⅡ was 3.9% and the mortality rate by JapanSCORE2 was 3.7%, respectively. One case of 30-day mortality and four hospital deaths occurred. The median intensive care unit( ICU) and postoperative hospital stays were 3.0 and 24 days. Given the introduction of semiclosed ICU, medical work office assistants, and nurse practitioners, the hospital stay of cardiac surgeons decreased from 207 to 185 hours, and overtime work decreased from 64 to 41 hours.</p><p><strong>Conclusion: </strong>Our efforts toward \"work style reform\" can currently reduce overtime without degrading surgical outcomes. However, there is still room for improvement, and further reforms are necessary.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1065-1070"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Coronary Artery Perforation Treated with Coronary Artery Bypass Grafting and Coil Embolization:Report of a Case]. [用冠状动脉旁路移植术和线圈栓塞治疗冠状动脉穿孔：一个病例的报告]。
Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-12-01
Ryo Nangoya, Toshio Baba, Atsutaka Aratame
{"title":"[Coronary Artery Perforation Treated with Coronary Artery Bypass Grafting and Coil Embolization:Report of a Case].","authors":"Ryo Nangoya, Toshio Baba, Atsutaka Aratame","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recent years, percutaneous coronary intervention( PCI) has become mainstream for the treatment of coronary artery disease, and complications associated with this procedure are increasing accordingly. Coronary perforation, a complication of PCI, is rare but may lead to cardiac tamponade. Once cardiac tamponade occurs, the mortality rate increases. An 88-year-old man underwent coronary angiography that showed perfect right coronary occlusion. Coronary perforation occurred after the deployment of a drug-eluting stent( DES). We could not stop the bleeding despite covered stent implantation. We performed hybrid surgery, coronary artery bypass grafting (CABG) and coil embolization. The patient progressed uneventfully and was discharged on postoperative day 59. The combination of coil embolization and CABG may be an alternative strategy for treating coronary perforation.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"77 13","pages":"1116-1119"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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