Journal of Chest Surgery最新文献

{"title":"Commentary: Revisiting the Radiation Dose in Neoadjuvant Therapy for Esophageal Cancer: Insights from a High-Dose Strategy.","authors":"Kwon Joong Na","doi":"10.5090/jcs.25.134","DOIUrl":"10.5090/jcs.25.134","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"58 6","pages":"252-254"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439170","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 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":"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":"255-263"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081865","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":"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":"239-251"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125797","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":"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":"10.5090/jcs.25.112","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"286-287"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348941","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: Prognostic Implications of <i>EGFR</i> Exon 20 Insertions in Resected Non-Small Cell Lung Cancer.","authors":"Geun Dong Lee","doi":"10.5090/jcs.25.139","DOIUrl":"10.5090/jcs.25.139","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"58 6","pages":"237-238"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439238","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":"Left Ventricular Assist Device Use as a Bridge to Heart Transplantation in Restrictive Cardiomyopathy: A Series of 2 Cases.","authors":"Arif Okay Karslıoğlu, Endri Balla, Atilla Sezgin","doi":"10.5090/jcs.25.012","DOIUrl":"10.5090/jcs.25.012","url":null,"abstract":"<p><p>Restrictive cardiomyopathy (RCM) is associated with a high mortality rate among patients awaiting heart transplantation, largely due to the challenges inherent in mechanical circulatory support device implantation and the limited effectiveness of pharmacologic therapies. The small size of the left ventricular cavity in RCM patients can cause significant complications, such as inflow cannula obstruction, impaired diastolic filling, and an increased risk of suction events. Here, we present 2 cases, each rare individually, both of which posed unique surgical challenges. Our aim was to evaluate the preoperative conditions, clinical characteristics, surgical approaches, and early outcomes in 2 RCM patients: one who received a left ventricular assist device (LVAD) as a bridge to heart transplantation, and the other as a bridge to candidacy. For the first patient, LVAD implantation with mitral valve resection was performed under emergency conditions due to the presence of a left atrial thrombus; subsequent heart transplantation was later achieved. For the second patient, LVAD implantation with mitral valve replacement was conducted as a bridge to candidacy in the setting of high pulmonary vascular resistance.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"281-285"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817728","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":"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":"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":"217-226"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125812","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":"Concomitant Ablation of Atrial Fibrillation in Redo Heart Valve Surgery.","authors":"Yoonjin Kang, Dong Jae Han, Jae Woong Choi, Ho Young Hwang, Kyung Hwan Kim, Hong Rae Kim, Joon Bum Kim, Jin Kyoung Kim, Ho Jin Kim, Jae Suk Yoo, Sung-Ho Jung, Jae Won Lee","doi":"10.5090/jcs.25.045","DOIUrl":"10.5090/jcs.25.045","url":null,"abstract":"<p><strong>Background: </strong>Although there is general agreement on performing concomitant ablation of atrial fibrillation (AF) during left-sided heart valve surgery in low-risk patients due to its proven long-term clinical benefits, its role in reoperative cases remains debated because of perceived high risks.</p><p><strong>Methods: </strong>This study included 338 consecutive patients with AF who underwent redo surgery for left-sided valve disease between 2000 and 2015 at 2 tertiary referral centers. Among them, 143 patients underwent concomitant surgical ablation for AF (ablation group), while 195 did not (no-ablation group). To evaluate comparative long-term clinical outcomes between the 2 groups, inverse probability of treatment weighting was applied.</p><p><strong>Results: </strong>Early mortality rates were 3.5% (4/143) in the ablation group and 9.2% (18/195) in the no-ablation group (p=0.064). At 5 years, the cumulative incidence of AF recurrence was 12.3%±0.1% in the ablation group and 85.2%±0.1% in the no-ablation group (p<0.001). During follow-up (median, 103 months), the ablation group demonstrated significantly lower risks of death (adjusted hazard ratio [aHR], 0.495; 95% confidence interval [CI], 0.312-0.784; p=0.003) and thromboembolic events (aHR, 0.212; 95% CI, 0.058-0.771; p=0.019) compared with the no-ablation group.</p><p><strong>Conclusions: </strong>Concomitant AF ablation during redo valve surgery was associated with improved rhythm outcomes, survival, and freedom from thromboembolic events, supporting its consideration as a reasonable option even in this high-risk group.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"58 6","pages":"272-280"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439212","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":"Changes in General Thoracic Surgery Volume during the Medical-Political Conflict in South Korea by Institutional Type and Surgical Complexity: An Analysis of National Health Insurance Claims.","authors":"Yeong Min Lee, Geun Dong Lee, Sung-Hoon Kim","doi":"10.5090/jcs.25.093","DOIUrl":"10.5090/jcs.25.093","url":null,"abstract":"<p><strong>Background: </strong>In February 2024, South Korea experienced a major healthcare disruption following the mass resignation of approximately 86% of resident physicians in protest of a government-led medical reform. In response, the government introduced a policy that centralized high-complexity operations in tertiary hospitals and redirected low-complexity procedures to general hospitals and clinics. However, the nationwide impact of this policy on surgical distribution and volume remains unclear.</p><p><strong>Methods: </strong>A retrospective analysis was performed using nationwide claims data from the Korean National Health Insurance Service, accessed via the Health Insurance Review and Assessment Service (HIRA). General thoracic surgery volumes from February to July 2023 (pre-crisis) were compared to the same period in 2024 (post-crisis) across tertiary hospitals (n=47), general hospitals (n=331), and smaller hospitals/clinics (n=37,888). Surgical complexity was categorized using relative value units (RVUs), which reflect procedural intensity and resource requirements.</p><p><strong>Results: </strong>Overall thoracic surgery volume declined by 15% during the crisis. Tertiary hospitals reported a 22% reduction in procedures, while general hospitals and clinics recorded increases of 9% and 92%, respectively. High-complexity operations (≥30,000 RVUs) at tertiary hospitals fell by 22%, with only partial compensation by general hospitals. Low-complexity procedures (<30,000 RVUs) also decreased at tertiary hospitals but were not adequately redistributed.</p><p><strong>Conclusion: </strong>The 2024 healthcare crisis caused significant disruption to surgical capacity in South Korea. Although some redistribution occurred, the government's reallocation strategy did not fully achieve its intended goals. Recovery of pre-crisis surgical capacity, especially for high-complexity procedures, remains incomplete.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"58 6","pages":"264-271"},"PeriodicalIF":1.5,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439181","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":"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}