Kyobu geka. The Japanese journal of thoracic surgery最新文献_第2页

[Implantable Left Ventricular Assist Device]. 植入式左心室辅助装置。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Masato Mutsuga

{"title":"[Implantable Left Ventricular Assist Device].","authors":"Masato Mutsuga","doi":"","DOIUrl":"","url":null,"abstract":"Drug-resistant severe heart failure significantly impairs cardiac pump function, affecting both prognosis and quality of life (QOL). When conventional treatments are ineffective, a ventricular assist device (VAD) can support heart function. Heart transplantation remains the ultimate treatment, but donor shortages and eligibility constraints limit access. The left ventricular assist device (LVAD) is a crucial option, serving as a bridge to transplantation (BTT) or a permanent destination therapy (DT) for ineligible patients. In Japan, DT was covered by insurance in 2021, expanding from 7 to 19 facilities by 2023. Key differences between BTT and DT include the removal of the age limit (65 years) and reduced caregiver requirements. LVAD technology has advanced, with miniaturization improving implantation feasibility and reducing surgical burden. Pump designs have evolved from pulsatile to continuous-flow types, with axial and centrifugal models enhancing efficiency. Innovations in biocompatibility and wireless power transmission aim to reduce complications and improve long-term outcomes. BiVACOR, a fully implantable total artificial heart using magnetic levitation, was first clinically tested in 2024. While currently limited to temporary use before transplantation, further advancements may lead to broader applications, enhancing patient survival and QOL.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 10","pages":"838-842"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149775","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

[Surgical Skills Training Device]. 【外科技能训练装置】。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Rihito Tamaki, Kohei Abe

{"title":"[Surgical Skills Training Device].","authors":"Rihito Tamaki, Kohei Abe","doi":"","DOIUrl":"","url":null,"abstract":"Currently, board certification for cardiovascular surgeons in Japan mandates a minimum of 30 hours of off the job training (OJT). However, starting in June 2024, training hours will be doubled when conducted under the auspices of the Japanese Societies of Thoracic, Cardiovascular, and Vascular Surgery, and increased by 1.5 times when using animal tissue, simulators, or three dimensional (3D) printing models. The growing adoption of minimally invasive techniques has led to a decline in traditional median sternotomy procedures, thereby reducing direct operative experience for young surgeons and underscoring the need for innovative training methods. Simulation tools in cardiovascular surgery span a wide range in both fidelity-the extent to which a model replicates real anatomical conditions-and cost. Options vary from low-cost, low-fidelity homemade models using everyday materials to high-fidelity systems employing porcine hearts or cadaveric tissues. Recent innovations include smartphone-based applications, such as the e-Suture app, which provides objective evaluations of needle handling, and online training platforms that have enabled remote coronary artery anastomosis training during the coronavirus disease (COVID)-19 pandemic. Moreover, high-fidelity simulators using 3D printing technology and robotic surgery training devices have broadened the scope of available educational resources. Ultimately, it is most important for trainees to be aware of the need to transfer their skills to clinical practice when undergoing training.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 10","pages":"793-798"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149633","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

[Subclavian-aortic Bypass Grafting for Aortic Coarctation in Adults:Report of a Case]. [锁骨下主动脉旁路移植术治疗成人主动脉缩窄1例]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Toshihiko Nishi, Takenori Yamazaki

引用次数: 0

[Two-stage Repair of Kommerell Diverticulum with Right Aortic Arch and Aberrant Left Subclavian Artery:Report of a Case]. [右主动脉弓伴左锁骨下动脉异常的Kommerell憩室两期修复1例]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Takeshi Sakaguchi, Ryo Hirayama, Mai Matsukawa, Kenta Uekihara, Syuichi Urashita, Tomoya Miyamoto, Takenori Kojima, Ryusuke Suzuki

引用次数: 0

[Intraoperative Monitoring of Cerebral and Spinal Cord Perfusion in Thoracic and Thoracoabdominal Aortic Surgery]. 【胸胸腹主动脉手术术中脑脊髓灌注监测】。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Soichiro Henmi, Kenji Okada

{"title":"[Intraoperative Monitoring of Cerebral and Spinal Cord Perfusion in Thoracic and Thoracoabdominal Aortic Surgery].","authors":"Soichiro Henmi, Kenji Okada","doi":"","DOIUrl":"","url":null,"abstract":"Neurological complications during thoracic and thoracoabdominal aortic surgery remain significant issues affecting both postoperative quality of life and long-term survival. Inadequate cerebral and spinal cord perfusion, as well as embolic events, are major contributors to such outcomes. Near-infrared spectroscopy (NIRS)-based regional cerebral oxygen saturation (rSO2) monitoring allows continuous, non-invasive assessment of cerebral perfusion and has become a routine adjunct in high-risk procedures. Factors such as mean arterial pressure, arterial carbon dioxide tension (PaCO2), hemoglobin levels, and cardiac output all significantly influence rSO2 values. For spinal cord protection, motor evoked potential (MEP) monitoring provides a real-time assessment of the corticospinal tract integrity. Its utility is particularly prominent in thoracoabdominal aortic aneurysm repairs where spinal ischemia poses a risk of paraplegia. Prompt intraoperative responses-such as increasing blood pressure, cerebrospinal fluid drainage, or intercostal artery reconstruction-can be initiated based on MEP changes. At our institution, over 300 cases have been managed with MEP guidance, yielding favorable neurological outcomes. Integration of NIRS and MEP enables early detection of ischemia and timely interventions, thereby reducing neurological complications. Continued refinement and standardization of these modalities, in conjunction with other physiological and imaging assessments, are essential to further improve surgical outcomes.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 10","pages":"781-786"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149821","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

[Robotic Bronchoscopy:Current Status and Future Perspectives]. [机器人支气管镜：现状与未来展望]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Takahiro Nakajima

引用次数: 0

[Left Upper Sleeve Lobectomy for Endobronchial Tuberculosis that Caused the Stenosis of the Left Main Bronchus and the Complete Obstruction of the Left Upper Bronchus]. 【左上袖肺叶切除术治疗引起左主支气管狭窄和左上支气管完全阻塞的支气管内结核】。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Toru Kawakami, Hayato Nanami, Kiyomi Shimoda, Miyako Hiramatsu, Yuji Shiraishi, Takashi Arai

{"title":"[Left Upper Sleeve Lobectomy for Endobronchial Tuberculosis that Caused the Stenosis of the Left Main Bronchus and the Complete Obstruction of the Left Upper Bronchus].","authors":"Toru Kawakami, Hayato Nanami, Kiyomi Shimoda, Miyako Hiramatsu, Yuji Shiraishi, Takashi Arai","doi":"","DOIUrl":"","url":null,"abstract":"A 44-year-old female had a history of the treatment of pulmonary tuberculosis at the age of 17 and was diagnosed with the stenosis of the left main bronchus at the age of 18. Twenty-five years after the completion of pulmonary tuberculosis treatment, she suffered from severe dyspnea and wheeze. Her symptoms were due to endobronchial tuberculosis;the left main bronchus was stenotic and the left upper bronchus was completely obstructed, causing atelectasis of left upper lobe. Despite two years of medical treatment, her symptoms did not improve and she was referred to our hospital. She underwent bronchoscopic balloon dilatation twice, and her bronchial stenosis was alleviated. However, she still had a severe dyspnea due to bronchial malacia. We decided to perform a left upper sleeve lobectomy. Her symptoms were dramatically resolved after the surgical operation. Treatment of endobronchial tuberculosis remains challenging and there is no established treatment strategy. From the view of minimally invasive treatment, bronchoscopic intervention should be the treatment of choice. However, surgical treatment should be considered for the patients who did not improve with bronchoscopic intervention or who had re-stenosis after it.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 9","pages":"651-657"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149653","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

[Esophageal Surgery with Artificial Intelligence]. [人工智能食道手术]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Masashi Takeuchi, Yuko Kitagawa

引用次数: 0

[Robotic Mediastinal Tumor Surgery Using da Vinci Single-port( SP) Surgical System]. [使用达芬奇单孔（SP）手术系统的纵隔肿瘤机器人手术]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Yasushi Hoshikawa, Hisato Ishizawa

{"title":"[Robotic Mediastinal Tumor Surgery Using da Vinci Single-port( SP) Surgical System].","authors":"Yasushi Hoshikawa, Hisato Ishizawa","doi":"","DOIUrl":"","url":null,"abstract":"The da Vinci single-port (SP) surgical system is a new system in which a camera and three robotic forceps are inserted into the body through a single small wound for surgical manipulation. This paper outlines the basic techniques and tips for mediastinal tumor surgery using the da Vinci SP, especially the subxiphoid single-port approach. In addition, we will discuss the subcostal approach single-port middle or posterior mediastinal tumor surgery. The subxiphoid approach with the da Vinci SP requires specific tips and precautions, such as avoiding interference between the camera and forceps, forceps and another forceps, forceps and wound margin, and arm and pubic bone or lower extremity, but it is possible to perform thymectomy with good operability and minimal risk. Thymectomy using the da Vinci SP allows for unilateral pleural preservation and surgery that is almost equivalent to an extended thymectomy. Similarly, middle and posterior mediastinal tumor surgery via the subcostal approach with this system requires specific tips and precautions to avoid chylothorax and diaphragmatic hernia, as well as pain management measures such as modified-thoraco-abdominal nerves through perichondrial approach (m-TAPA) block.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 10","pages":"849-855"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149550","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

[Respirator in New Technology for Respiratory Medicine]. 呼吸医学新技术中的呼吸器。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-09-01

Yasushi Matsuda

引用次数: 0