Journal of Chest Surgery最新文献

{"title":"Commentary: The Emerging Role of Circulating Tumor Cells Beyond Pathological Complete Response in Esophageal Cancer.","authors":"Xu-Heng Chiang","doi":"10.5090/jcs.26.010","DOIUrl":"10.5090/jcs.26.010","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"59 2","pages":"78-80"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345383","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}

{"title":"Commentary: Revisiting the Question: Should We Avoid Valve Replacement in Children?","authors":"Jae Gun Kwak","doi":"10.5090/jcs.26.015","DOIUrl":"10.5090/jcs.26.015","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"59 2","pages":"98-99"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345373","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}

{"title":"A 26-Year Secret: An Unusual Culprit Behind Massive Hemoptysis: A Case Report.","authors":"Robin Benzigar Poovattil, Roman Dutta, Haritha Therse Joseph, Abhishek Mohan, Shyam Rengan, Rohit Rathi, Sabyasachi Bal","doi":"10.5090/jcs.25.026","DOIUrl":"10.5090/jcs.25.026","url":null,"abstract":"<p><p>Foreign body aspiration is frequently encountered in children but can also occur in adults, where it often remains undiagnosed for years. Forgotten foreign bodies within the bronchial tree may later manifest with either vague symptoms or life-threatening complications, such as massive hemoptysis. Contrast-enhanced computed tomography of the thorax is the preferred initial diagnostic modality and can suggest the presence of a foreign body. We present a case involving an adult who remained undiagnosed until adulthood, when he was ultimately found to have a foreign body embedded in the lung parenchyma.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"39-41"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972316","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}

{"title":"Beyond Chronological Age: Biological Resilience as the True Determinant in Abdominal Aortic Aneurysm Repair.","authors":"Khaled Ebrahim Al Ebrahim","doi":"10.5090/jcs.25.130","DOIUrl":"10.5090/jcs.25.130","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"42-43"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534442","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}

{"title":"A 19F Blake Drain versus a 28F Conventional Drain Following Video-Assisted Thoracoscopic Esophagectomy for Esophageal Cancer: A Comparative Retrospective Study.","authors":"Hiep Van Pham, Tuan Anh Nguyen, Thang Manh Tran","doi":"10.5090/jcs.25.060","DOIUrl":"10.5090/jcs.25.060","url":null,"abstract":"<p><strong>Background: </strong>Pleural drainage is essential for preventing and managing respiratory complications after video-assisted thoracoscopic esophagectomy (VATE). Conventional large-bore drains often cause significant pain. Small-bore drains (e.g., 19F Blake drains) may reduce discomfort; however, evidence regarding their use in VATE is limited. This study compared drainage effectiveness and pain between 19F Blake drains and conventional 28F drains after VATE for esophageal cancer.</p><p><strong>Methods: </strong>This retrospective study included 77 male patients with middle- or lower-third esophageal cancer who underwent VATE with laparoscopic retrosternal tunneling from November 2018 to November 2022. Fifty-five patients received a 28F conventional drain, and 22 received a 19F Blake drain. Outcomes included drainage duration and volume, pain levels (Visual Analog Scale [VAS]), postoperative pneumonia rates, and pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) on postoperative day 3.</p><p><strong>Results: </strong>The 19F group reported significantly lower pain scores on postoperative days 1-3 (VAS: 2.95-3.25 vs. 4.07-4.62, p<0.001). Drainage duration and pneumonia rates were similar between groups. The 19F group demonstrated a trend toward higher drainage volume and significantly better preservation of pulmonary function, with smaller declines in FVC (ΔFVC: 0.24±0.20 L vs. 0.63±0.17 L, p<0.001) and FEV1 (ΔFEV1: 0.38±0.25 L vs. 0.58±0.25 L, p=0.02).</p><p><strong>Conclusion: </strong>19F Blake drains provide similar drainage effectiveness to that of 28F drains, with reduced postoperative pain and better pulmonary function preservation. These findings support the use of 19F Blake drains to improve patient comfort and recovery following VATE.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"30-36"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972259","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}

{"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":"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":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348940","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}

{"title":"Commentary: As the Techniques of Esophagectomy Evolve, So Does the Drain.","authors":"Yi-Ting Yen","doi":"10.5090/jcs.25.172","DOIUrl":"10.5090/jcs.25.172","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"59 1","pages":"37-38"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890222","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}

{"title":"Nationwide Trends in Coronary Artery Bypass Grafting in the Republic of Korea, 2005-2022: A Comparison with International Data.","authors":"Min Ho Ju, Jun Ho Lee, Yun Jin Kim, Ho Jin Kim, Ho Young Hwang, Sang Yoon Yeom, Hee Jung Kim, Young-Nam Youn, Wook Sung Kim, Man-Jong Baek, Hyun Keun Chee","doi":"10.5090/jcs.25.101","DOIUrl":"10.5090/jcs.25.101","url":null,"abstract":"<p><p>Coronary artery bypass grafting (CABG) remains a key revascularization strategy for ischemic heart disease; however, nationwide trends in the Republic of Korea have not been thoroughly investigated. Using data from the Korean National Health Insurance Service, we analyzed adult patients who underwent isolated CABG between 2005 and 2022. We evaluated surgical volume, patient demographics, procedural strategies (off-pump vs. on-pump), and outcomes. International comparisons were conducted using national cardiac surgery registry data. A total of 51,923 CABG cases were identified. Annual surgical volume declined until 2013 but gradually increased thereafter, reaching 3,717 cases in 2022. Despite this recovery, Korea's per capita CABG rate remains among the lowest worldwide. In contrast, more than 60% of procedures were performed off-pump-the highest rate worldwide. Over time, the average patient age and prevalence of diabetes increased, whereas in-hospital mortality showed a modest decline. Compared with other countries, the Republic of Korea demonstrated a uniquely low procedural volume and a strong preference for off-pump CABG. This nationwide analysis highlights Korea's distinctive CABG practice patterns and provides valuable insights for optimizing future clinical and policy decisions in cardiac surgical care.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"7-16"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769285","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}

{"title":"The Current Consensus on Salvage Surgery after Targeted Therapy for Advanced EGFR-Mutant Non-Small Cell Lung Cancer.","authors":"Yu-Wei Liu, Po-Chih Chang, Jadzia Tin-Tsen Chou, Shah-Hwa Chou","doi":"10.5090/jcs.25.047","DOIUrl":"10.5090/jcs.25.047","url":null,"abstract":"<p><p>Salvage surgery is an emerging option for carefully selected patients with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) whose disease remains controlled on tyrosine kinase inhibitor (TKI) therapy. Fourteen retrospective series report median progression-free survival (PFS) of 14-52 months and overall survival (OS) often exceeding 3 years, suggesting better disease control than continued TKI therapy alone. Although PFS generally improves, some cohorts show no OS advantage, probably because effective post-progression treatments dilute survival differences. Non-surgical local consolidative therapies remain essential for oligometastatic disease; nevertheless, resection yields intact specimens for comprehensive pathologic and molecular analysis. Access to tissue permits earlier identification of resistance mechanisms-most commonly the T790M mutation-more accurate prognostication, and more precise systemic-therapy selection. Comprehensive sampling can also identify histologic transformation and compound mutations that precede radiologic progression. Adverse prognostic factors include older age, high preoperative carcinoembryonic antigen levels, advanced pathological T stage, programmed death-ligand 1 ≥1%, and spread through air spaces. Salvage surgery is feasible and effective in carefully selected patients, especially those with oligoresidual disease and favorable tumor biology. Patient selection should integrate performance status, anatomic extent, histopathology, and genomic profile through multidisciplinary discussions. Despite regional differences (e.g., higher EGFR-mutation prevalence and wider adoption of minimally invasive approaches in East Asia) oncologic outcomes are comparable when selection criteria are applied consistently. Prospective trials are warranted to validate these retrospective observations, refine selection algorithms, establish optimal timing, and clarify how surgery can best be integrated with next-generation targeted agents and immunotherapies.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"17-29"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795685","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}

{"title":"Epidermal Growth Factor Receptor Exon 20 Insertion in Early Resected Non-Small Cell Lung Cancer: A Retrospective, Single-Center Study in Taiwan.","authors":"Ying Shian Chen, Hsu-Kai Huang, Ying-Yi Chen, Yen-Shou Kuo, Kuan Hsun Lin, Cheng-Jung Lin, Tsai-Wang Huang","doi":"10.5090/jcs.25.027","DOIUrl":"10.5090/jcs.25.027","url":null,"abstract":"<p><strong>Background: </strong><i>EGFR</i> exon 20 insertions account for 1% to 10% of <i>EGFR</i> mutations in non-small-cell lung cancer (NSCLC) and are known to confer resistance to traditional tyrosine kinase inhibitors. However, the prognostic significance of these mutations in early-stage resected NSCLC remains unclear. This study assesses outcomes in patients with resected NSCLC harboring <i>EGFR</i> exon 20 insertions, comparing them to patients with common <i>EGFR</i> mutations and those with wild-type <i>EGFR</i>.</p><p><strong>Methods: </strong>We retrospectively reviewed 3,235 patients who underwent resection for NSCLC at Tri-Service Hospital between 2008 and 2021. After excluding cases lacking <i>EGFR</i> testing, incomplete data, or advanced-stage disease, 44 patients with exon 20 insertions were matched to 602 patients with common <i>EGFR</i> mutations and 729 with wild-type <i>EGFR</i>. Clinical characteristics, disease-free survival (DFS), and overall survival (OS) were analyzed using the Kaplan-Meier method, with statistical comparisons performed using the log-rank test. Cox proportional hazards models were used to identify independent prognostic factors.</p><p><strong>Results: </strong>Patients with exon 20 insertions were younger and more frequently presented with stage IA disease. The 5-year DFS was 79% in the exon 20 insertion group, compared to 81% in the common mutation group and 83.9% in the wild-type group. The 5-year OS was 78.5% for exon 20, 91.9% for common mutations, and 91% for wild-type. While no significant differences in DFS or OS were observed between groups, the exon 20 insertion group had a higher incidence of secondary cancers. Multivariable analysis indicated that exon 20 insertion was independently associated with worse OS, but not with DFS.</p><p><strong>Conclusion: </strong><i>EGFR</i> exon 20 insertions do not significantly shorten DFS, but are associated with inferior OS in early-stage resected NSCLC. Given the limited treatment options, the role of adjuvant therapy warrants further investigation.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"227-236"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972284","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}