Journal of Chest Surgery最新文献

{"title":"Prognostic Significance of Circulating Tumor Cells in Patients with Esophageal Cancer Who Attained Pathological Complete Response after Neoadjuvant Therapy.","authors":"Chia-Hsun Hsieh, Chuan Cheng, Yu-Wen Wen, Yin-Kai Chao","doi":"10.5090/jcs.25.055","DOIUrl":"https://doi.org/10.5090/jcs.25.055","url":null,"abstract":"<p><strong>Background: </strong>Pathological complete response (pCR) refers to the absence of residual tumor cells after neoadjuvant chemoradiotherapy (nCRT) and is associated with favorable outcomes. However, 25%-33% of such patients still experience disease recurrence. This study aimed to evaluate the prognostic value of circulating tumor cells (CTCs) for risk stratification in patients with esophageal carcinoma (EC) who achieved pCR following nCRT.</p><p><strong>Methods: </strong>We measured post-nCRT CTC counts in the peripheral blood of patients with EC who attained pCR after undergoing nCRT. The impact of CTC counts on survival was then analyzed, accounting for the potential confounding effects of established clinical and pathological risk factors.</p><p><strong>Results: </strong>The study included 24 patients, of whom 18 (75%) had detectable CTCs. The mean CTC concentration was 5.1 per mL of blood. Univariable Cox regression analysis showed that CTC count was the only independent predictor of disease-free survival (hazard ratio, 1.113; 95% confidence interval, 1.008-1.229; p=0.034). Receiver operating characteristic curve analysis determined an optimal cutoff value of 4.5 CTCs per mL. The 3-year disease-free survival rate was significantly higher in the low-CTC group (92.9%) than in the high-CTC group (50.0%, p=0.032).</p><p><strong>Conclusion: </strong>In patients with EC who achieve pCR following nCRT, CTC quantification may help identify those at increased risk of poor survival outcomes.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348942","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}

{"title":"Single-Lumen Tube Intubation with CO₂ Insufflation versus Double-Lumen Tube Intubation in Video-Assisted Transthoracic Esophagectomy for Esophageal Cancer: A Retrospective Comparative Study.","authors":"Hiep Van Pham, Tuan Anh Nguyen, Thang Manh Tran, Hoai To Nguyen","doi":"10.5090/jcs.25.061","DOIUrl":"https://doi.org/10.5090/jcs.25.061","url":null,"abstract":"<p><strong>Background: </strong>Video-assisted transthoracic esophagectomy (VATE) is typically performed with double-lumen tube intubation (DLTI) to facilitate 1-lung ventilation. Single-lumen tube intubation (SLTI) with CO₂ insufflation offers an alternative approach, enabling 2-lung ventilation with artificial pneumothorax, which may improve surgical exposure and reduce pulmonary complications. This study compared the efficacy and safety of SLTI with CO₂ insufflation versus DLTI in VATE.</p><p><strong>Methods: </strong>This retrospective study included 94 male patients who underwent VATE for esophageal cancer at 108 Military Central Hospital between November 2018 and September 2023. Patients were divided into 2 groups: SLTI with CO₂ insufflation (n=44) and DLTI (n=50). The assessed outcomes included lymph node yield, operative time, postoperative complications, intensive care unit (ICU) admission, and length of hospital stay.</p><p><strong>Results: </strong>The SLTI group had a significantly higher left recurrent laryngeal nerve lymph node yield (2.22±2.65 vs. 0.77±2.14, p=0.008) and a greater total lymph node harvest (23.91±9.22 vs. 19.00±11.75, p=0.02) than the DLTI group. Operative time was longer in the SLTI group for the thoracic phase (168.64±23.69 minutes vs. 142.12±24.17 minutes, p=0.04) and overall (311.82±43.67 minutes vs. 272.68±35.97 minutes, p=0.001). Postoperative complication rates and length of hospital stay did not differ significantly between groups, although ICU admission was more frequent with SLTI (84.1% vs. 56.0%, p=0.003).</p><p><strong>Conclusion: </strong>SLTI with CO₂ insufflation is a safe and feasible alternative to DLTI in VATE, enabling more extensive recurrent laryngeal lymph node dissection but requiring longer operative times.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348943","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}

{"title":"On-Pump Coronary Artery Bypass Grafting Remains the Cornerstone: Reflections on the Future of Coronary Revascularization.","authors":"Khaled Ebrahim Al Ebrahim","doi":"10.5090/jcs.25.112","DOIUrl":"https://doi.org/10.5090/jcs.25.112","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348941","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}

{"title":"Complete Revascularization in Coronary Artery Bypass Grafting: Separating the Wheat from the Chaff.","authors":"Ho Young Hwang","doi":"10.5090/jcs.25.097","DOIUrl":"https://doi.org/10.5090/jcs.25.097","url":null,"abstract":"<p><p>Coronary artery bypass grafting (CABG) has been established as the most effective treatment for patients with multi-vessel coronary artery disease. To maximize outcomes by restoring perfusion to the largest possible myocardial territory, complete revascularization (CR) has long been a key objective of CABG. Because the anatomic severity of coronary artery stenosis on coronary angiography has been the main criterion for selecting target vessels for several decades, the definition of CR has traditionally been based on angiographic anatomy. Numerous studies have examined the impact of anatomic CR on outcomes after CABG; however, the results remain controversial. At the same time, there has been increasing interest in ischemia-inducing coronary artery stenosis assessed by functional studies such as dobutamine-stress echocardiography, nuclear imaging tests, fractional flow reserve, and quantitative flow ratio. This has raised the importance of defining CR based on functional ischemia rather than anatomic stenosis. Nevertheless, only a few studies have reported the impact of functional CR on CABG outcomes. Therefore, this narrative review summarizes the various definitions of CR in CABG, highlights its benefits and shortcomings, and introduces the available literature evaluating the effects of anatomic and functional CR on long-term clinical outcomes.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348940","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}

{"title":"A Giant Traumatic Pneumatocele Manifesting as Hemoptysis in an Adolescent: A Case Report.","authors":"Chansop Hwang, Beatrice Chia-Hui Shih, Duk Hwan Moon, Sungsoo Lee","doi":"10.5090/jcs.25.034","DOIUrl":"https://doi.org/10.5090/jcs.25.034","url":null,"abstract":"<p><p>Traumatic pneumatocele (TP) is a rare, benign pulmonary lesion that primarily affects children and young adults following blunt chest trauma. We present the case of a 16-year-old male judo athlete who developed persistent hemoptysis. Imaging identified a large hydropneumothorax. During video-assisted thoracoscopic surgery, a cystic lesion was discovered in the left lower lobe, and intraoperative bronchofibroscopy revealed a minor bronchopleural fistula. A wedge resection was performed, resulting in an uncomplicated recovery; the patient was discharged on postoperative day 2. This case underscores the rarity of complicated TP necessitating surgical intervention and highlights the importance of considering TP in young patients with blunt chest trauma.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138744","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}

{"title":"Surgical Resection after Chemoradiotherapy with a Higher Radiation Dose in Locally Advanced Esophageal Cancer: A Retrospective Study from Taiwan.","authors":"Chia Liu, Ling-I Chien, Yi-Ping Hung, Tzu-Yu Lai, Chien-Sheng Huang, Han-Shui Hsu, Ming-Huang Chen, Pin-I Huang, Po-Kuei Hsu","doi":"10.5090/jcs.25.040","DOIUrl":"10.5090/jcs.25.040","url":null,"abstract":"<p><strong>Background: </strong>Chemoradiotherapy is the standard treatment for esophageal cancer, but the optimal radiation dose remains undetermined. A dose of 50.4 Gy is commonly used in both neoadjuvant and definitive settings. This study evaluates the outcomes of using 50.4 Gy in neoadjuvant chemoradiotherapy (nCRT).</p><p><strong>Methods: </strong>Patients with esophageal cancer who underwent nCRT with 50.4 Gy radiation followed by surgery between 2010 and 2023 were retrospectively analyzed. They were categorized as achieving pathological complete response (pCR patients) or not (non-pCR patients). Oncological outcomes, including overall survival (OS) and recurrence-free survival (RFS), were assessed.</p><p><strong>Results: </strong>Among 258 patients treated with nCRT, 96.5% completed the treatment protocol, and 74.4% (n=192) proceeded to surgery. These 192 patients formed the analysis cohort. The overall complication rate was 70.3%, with 19.3% classified as major complications. The 30-day and 90-day postoperative mortality rates were both 0.5%. The pCR rate was 45%. Patients with pCR had a 3-year OS rate of 72.7% and a median survival of 125 months, whereas non-pCR patients had a 3-year OS rate of 49.6% and a median survival of 35 months (p=0.002). Additionally, pCR patients had a 3-year RFS rate of 62.0% and a median RFS of 68 months, compared to 33.6% and 20 months, respectively, for non-pCR patients (p<0.001).</p><p><strong>Conclusion: </strong>This study reports the outcomes of using 50.4 Gy in nCRT for locally advanced esophageal cancer. The findings affirm the efficacy of 50.4 Gy neoadjuvant chemoradiotherapy in achieving favorable long-term outcomes, particularly among patients with complete pathological response.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125797","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}

{"title":"Minimally Invasive versus Complete Sternotomy for Reimplantation Valve-Sparing Aortic Root Replacement: A Systematic Review and Meta-Analysis.","authors":"Kristine Santos, Mislav Planinc","doi":"10.5090/jcs.25.029","DOIUrl":"https://doi.org/10.5090/jcs.25.029","url":null,"abstract":"<p><p>Despite growing interest, comparative data on the minimally invasive David procedure (MI-DP) versus the traditional complete sternotomy approach (CS-DP) remain scarce, largely due to the inherent complexity of the operation. The present meta-analysis compared the perioperative outcomes of MI-DP and CS-DP. We systematically searched MEDLINE, Scopus, and the Cochrane Library for studies comparing MI-DP and CS-DP. Pooled odds ratios and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using RevMan ver. 8.13.0 (The Cochrane Collaboration). A subgroup analysis of exclusively propensity-matched data was also performed. Seven studies comprising 1,124 patients were included, with 394 (35%) in the MI-DP group. MI-DP was associated with reduced blood loss (MD, -123.1 mL; 95% CI, -150.1 to -96.1 mL; p<0.0001), intensive care unit (ICU) stay (MD, -0.5 days; 95% CI, -0.6 to -0.4 days; p<0.00001), and hospital stay (MD, -2.8 days; 95% CI, -4.9 to -0.7 days; p=0.01), albeit with a longer cross-clamp time (MD, 13.3 minutes; 95% CI, 2.8 to 23.9 minutes; p=0.01). Thirty-day mortality and complications, including neurological deficits and reoperation for bleeding, were similar between groups. The subgroup analysis restricted to propensity-matched data confirmed these benefits and revealed additional reductions in mechanical ventilation time (MD, -6.3 hours; 95% CI, -7.2 to -5.4 hours; p<0.00001) and red blood cell transfusion requirements (MD, -85.6 mL; 95% CI, -114.6 to -56.5 mL; p<0.00001). MI-DP offers reduced ventilation time, blood loss, and ICU and hospital stays without compromising safety. However, our findings should be interpreted cautiously pending validation by future prospective studies (PROSPERO CRD42025631006).</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125812","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}

{"title":"Simultaneous Detection of Primary Pulmonary Paraganglioma and a Mediastinal Mass: A Case Report.","authors":"Argün Kış, Eren Zenci, Emel Kılıçarslan","doi":"10.5090/jcs.25.046","DOIUrl":"https://doi.org/10.5090/jcs.25.046","url":null,"abstract":"<p><p>Primary pulmonary paraganglioma (PPP) is an extremely rare neuroendocrine tumor. We present the case of a 71-year-old woman referred for dyspnea who was incidentally diagnosed with both a mediastinal mass and a pulmonary nodule. Chest computed tomography revealed an anterior mediastinal mass and a right-sided paracardiac pulmonary nodule. The mediastinal mass was excised via median sternotomy, and the pulmonary lesion was removed by wedge resection. Histopathological analysis identified the pulmonary lesion as a moderately differentiated paraganglioma, while the mediastinal mass consisted of ectopic thyroid tissue. Although the lesions were discovered simultaneously, their histopathological features were entirely unrelated, indicating a coincidental coexistence. Nevertheless, thorough histopathological examination is essential to exclude syndromic or metastatic associations. PPP should be considered in the differential diagnosis of pulmonary tumors, and surgical resection remains the mainstay of diagnosis and treatment.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081884","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}

{"title":"The Impact of Chemoradiotherapy on Nutritional Status and Quality of Life in Esophageal Cancer Patients during the COVID-19 Pandemic: A Retrospective Study in Taiwan.","authors":"Chien-Hung Chiu, Ming-Ru Yu, Shu-Chun Huang, Pin-Li Chou, Ya-Tzu Tsao, Ching-Tzu Huang, Hsin-Hsin Lin, Yin-Kai Chao, Yu-Ling Chang","doi":"10.5090/jcs.25.048","DOIUrl":"https://doi.org/10.5090/jcs.25.048","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare and worsened quality of life (QOL). Advanced esophageal cancer is often accompanied by malnutrition and poor QOL; chemoradiotherapy (CRT) remains the mainstay of treatment. We evaluated nutrition and QOL pre- and post-CRT immediately before and during the pandemic.</p><p><strong>Methods: </strong>Patients with esophageal cancer who underwent neoadjuvant or definitive CRT between April 2019 and December 2020 were enrolled. Disease severity, treatment timing, and outcomes were compared for cohorts treated pre-COVID-19 and during COVID-19. Nutritional status was measured with the Patient-Generated Subjective Global Assessment (PG-SGA). QOL was measured with the Mandarin Chinese version of the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the esophageal site-specific module (QLQ-OES18). In the pandemic cohort, pre-/post-CRT paired analyses were performed.</p><p><strong>Results: </strong>Eighty-four patients were enrolled. The median diagnosis to treatment interval lengthened during COVID-19 (17.8 days vs. 24.2 days, p=0.04). Among the patients treated during the COVID-19 pandemic, nutritional status improved significantly following CRT (p=0.003). In the EORTC QLQ-C30, post-CRT scores for global health status (p<0.01) and emotional functioning (p<0.01) showed significant improvement. Additionally, symptom scores, including fatigue (p=0.02) and nausea and vomiting (p=0.02), decreased. However, financial difficulties worsened after CRT (p=0.02). In the EORTC QLQ-OES18, post-CRT symptom scores for eating (p<0.01), reflux (p=0.03), and pain (p<0.01) showed significant improvement.</p><p><strong>Conclusion: </strong>Despite COVID-19-related delays, CRT enhanced nutrition, global health, and symptom control in esophageal cancer, although financial burdens increased. Integrating socioeconomic support with oncologic care is vital during health crises.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081865","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}

{"title":"Correction: Mechanical versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 to 70 Years.","authors":"Youngkwan Song, Ki Tae Kim, Soo Jin Park, Hong Rae Kim, Jae Suk Yoo, Pil Je Kang, Sung-Ho Jung, Cheol Hyun Chung, Joon Bum Kim, Ho Jin Kim","doi":"10.5090/jcs.23.143e","DOIUrl":"10.5090/jcs.23.143e","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"58 5","pages":"214-215"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}