Journal of Chest Surgery最新文献

{"title":"Low-Dose Computed Tomography Lung Cancer Screening for Individuals Who Have Never Smoked: A Review of Recent Updates in Taiwan and the United States.","authors":"Sun Nou Chung, Riley Hurr, Hao-Wen Chen, Tzu-Ning Kao, Mong-Wei Lin, Chi-Fu Jeffrey Yang","doi":"10.5090/jcs.25.017","DOIUrl":"10.5090/jcs.25.017","url":null,"abstract":"<p><p>Low-dose computed tomography (LDCT) screening is widely recognized as an effective tool for the early detection of lung cancer. However, its efficacy among individuals without a history of smoking continues to attract interest. Currently, nearly all lung cancer screening guidelines provide recommendations exclusively for individuals who currently smoke or have a history of smoking. Emerging research indicates that LDCT screening may also benefit individuals who have never smoked but are genetically predisposed to lung cancer or have been exposed to certain environmental risk factors. This underscores the need to consider expanding LDCT screening eligibility criteria to include carefully selected never-smokers at high risk, potentially preventing lung cancer-related deaths.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"175-184"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795708","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":"Robotic Thymectomy Using the Single-Port Robotic System via the Subxiphoid Approach.","authors":"Jun Hee Lee, Byung Mo Gu, Hyun Koo Kim","doi":"10.5090/jcs.25.041","DOIUrl":"10.5090/jcs.25.041","url":null,"abstract":"<p><p>Technological advances have led to significant progress in minimally invasive surgery in the field of general thoracic surgery. Thymectomy, which has traditionally been performed via an open approach through a median sternotomy, is now entering a new era because of the advantages offered by robot-assisted thoracic surgery. Robotic thymectomy using the single-port robotic system via the subxiphoid approach has recently been introduced. This innovative technique offers several potential benefits, including reduced postoperative pain, faster recovery, and improved cosmetic outcomes. However, it can be technically challenging during the early phase, especially for less experienced robotic surgeons. In this study, we present our surgical technique in detail, providing tips and highlighting potential pitfalls to aid in overcoming these technical challenges.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"167-174"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795709","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":"Bilateral Elastofibroma Dorsi in a Symptomatic Male Patient: Is Surgical Resection Justified? A Case Report.","authors":"Ahmed Gamal Elkhouly, Faisal Hamad, Al Anoud Al Saud, Mohammed Saleh Ishaq","doi":"10.5090/jcs.25.005","DOIUrl":"10.5090/jcs.25.005","url":null,"abstract":"<p><p>Elastofibroma dorsi (ED) is a rare, benign, slowly growing soft tissue neoplasm characterized by abnormal elastic fiber proliferation. There is a marked female predominance; bilateral presentation occurs in only 10% of cases. ED is usually located in the infra-scapular area, adherent to the posterior chest wall and ribs. Although many theories have been proposed regarding its pathogenesis, the exact cause remains uncertain. Preoperative diagnosis is established based on clinical picture and radiological imaging. We present a case of a 49-year-old man with bilateral ED who complained of back pain and limited shoulder movement, and who underwent simultaneous bilateral surgical removal; histopathological examination confirmed the diagnosis.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"205-208"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056801","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":"Robot-Assisted Transcervical Esophagectomy for Thoracic Esophageal Carcinoma.","authors":"Takeo Fujita","doi":"10.5090/jcs.25.031","DOIUrl":"10.5090/jcs.25.031","url":null,"abstract":"<p><p>Surgical approaches for thoracic esophageal cancer have evolved from invasive open procedures to minimally invasive techniques such as thoracoscopic and robot-assisted surgery. While robotic surgery offers improved precision and visualization, it still relies on single-lung ventilation and may not significantly reduce postoperative complications. Recently, transcervical esophagectomy (TCE) using a mediastinoscope has emerged as a promising alternative, enabling esophageal resection and lymphadenectomy via the neck without thoracic incisions. However, challenges such as recurrent laryngeal nerve palsy and limited reproducibility persist. Robot-assisted TCE addresses these issues by improving precision and reducing interference in the narrow mediastinum. Early studies, including the authors' pilot work, have shown encouraging results. Despite its potential, comprehensive data on the short-term outcomes and safety of this technique remain limited. This study aims to introduce robot-assisted TCE for patients with thoracic esophageal carcinoma and compare its clinical benefits with those of transthoracic robot-assisted esophagectomy, thereby clarifying its role in the evolving field of esophageal cancer surgery.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"209-213"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817697","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: Why Open Surgical Repair Still Matters-The Importance of Protocol-Driven Management for Ruptured Abdominal Aortic Aneurysm.","authors":"Myeong Su Kim, Suk-Won Song","doi":"10.5090/jcs.25.072","DOIUrl":"10.5090/jcs.25.072","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"193-195"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795707","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":"Analysis of Mortality-Related Factors in Patients Aged >80 Years Treated for Abdominal Aortic Aneurysms.","authors":"Juan Kim, Sung Woon Chung, Jongwon Kim, Miju Bae, Chung Won Lee, Up Huh","doi":"10.5090/jcs.25.003","DOIUrl":"10.5090/jcs.25.003","url":null,"abstract":"<p><strong>Background: </strong>With an aging population, the number of patients over 80 undergoing abdominal aortic aneurysm (AAA) repair is increasing. This study examines factors associated with mortality in these patients.</p><p><strong>Methods: </strong>A retrospective cohort study involving 66 patients aged >80 who underwent AAA repair between January 2010 and December 2022 was conducted. Baseline characteristics, treatment methods (open surgical repair [OSR] or endovascular aneurysm repair [EVAR]), post-treatment mortality, complications, and reinterventions were analyzed.</p><p><strong>Results: </strong>The mean age of patients was 82.74±2.64 years, with men comprising 74.2%. The OSR group had significantly younger patients than the EVAR group (81.92 years vs. 83.28 years, p=0.04). Rupture prevalence was significantly higher in the OSR group (27% vs. 7.5%, p=0.03). No significant difference was found in 30-day mortality rates between the OSR and EVAR groups (11.5% vs. 10%, p=0.85). Univariate logistic regression identified emergency surgery (odds ratio [OR], 6.18; p=0.04), post-treatment pneumonia (OR, 7.47; 95% confidence interval [CI], 1.00-55.70; p=0.05), and vasopressor use (OR, 44.57; p<0.01) as significant factors associated with 30-day mortality. Cox proportional hazard regression revealed age (hazard ratio [HR], 1.19; p=0.02), preoperative bedridden state (HR, 22.24; p<0.01), sacrifice of both internal iliac arteries (HR, 5.26; p=0.04), and postoperative vasopressor use (HR, 30.04; p<0.01) as significant predictors of overall mortality.</p><p><strong>Conclusion: </strong>In patients aged >80 years, aneurysm rupture and emergency operation significantly increased 30-day mortality following AAA repair. Preoperative bedridden status, management of internal iliac arteries, and postoperative vasopressor use were significant predictors of overall mortality. When determining surgical indications and predicting outcomes, careful attention should be given to factors influencing mortality throughout the entire surgical process.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"196-204"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795706","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":"Why Open Surgical Repair Remains Essential: Insights into the Suitability of Endovascular Aneurysm Repair in Ruptured Abdominal Aortic Aneurysms from a Tertiary Referral Center in South Korea.","authors":"Sang Yoon Kim, Dong Kyu Yoon, Jae Hang Lee, Hyoung Woo Chang, Kay-Hyun Park","doi":"10.5090/jcs.24.116","DOIUrl":"10.5090/jcs.24.116","url":null,"abstract":"<p><strong>Background: </strong>Several studies have demonstrated that emergency endovascular aneurysm repair (eEVAR) has become the standard treatment for ruptured abdominal aortic aneurysm (rAAA) compared to open surgical repair (OSR). This study investigated the feasibility of eEVAR in rAAA patients and analyzed the outcomes of OSR.</p><p><strong>Methods: </strong>At our institution, all patients (n=58) presenting with rAAA underwent OSR. We conducted a retrospective review of surgically treated rAAA patients between February 2006 and March 2021. Patients with impending rupture or isolated iliac aneurysm rupture were excluded.</p><p><strong>Results: </strong>Anatomic measurements based on preoperative computed tomography indicated that 28 patients (48.3%) could have been candidates for eEVAR. Reasons for unsuitability included: (1) proximal neck length <10 mm (n=21, 51.7%); (2) proximal neck angulation >60° (n=11, 19.0%); (3) iliac artery diameter <5 mm (n=6, 10.3%); and (4) proximal neck diameter >32 mm (n=3, 5.2%). The 30-day mortality rate for OSR was 17.2% (n=10). The 1-year and 5-year survival rates were 53.4%±6.5% and 33.4%±6.3%, respectively. Multivariable logistic regression analysis revealed that a high preoperative serum lactate level (>5 mmol/L) and the presence of bowel ischemia were significant risk factors for 30-day mortality (odds ratio [OR], 11.95; 95% confidence interval [CI], 1.53-93.08; p<0.018; and OR, 15.28; 95% CI, 1.60-146.18; p<0.018, respectively).</p><p><strong>Conclusion: </strong>More than half of rAAA patients were not candidates for eEVAR due to various anatomical reasons. OSR demonstrated favorable short- and long-term outcomes and remains a viable standard treatment for rAAA.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"185-192"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217128","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":"Double Lung Transplantation Using Bilateral Anterior Thoracotomies with Video-Assistance: Techniques, Advantages, and Considerations.","authors":"Samina Park","doi":"10.5090/jcs.24.115","DOIUrl":"10.5090/jcs.24.115","url":null,"abstract":"<p><p>Lung transplantation remains the only curative option for patients with end-stage, medically refractory respiratory failure. Traditionally, the clamshell incision has been the primary surgical approach, as it provides extensive access to the mediastinum and bilateral pleural cavities. However, it is also associated with notable drawbacks, such as an increased risk of sternal nonunion and wound complications, which can impede postoperative recovery. This article introduces an alternative approach-double lung transplantation using video-assisted bilateral anterior thoracotomy. We present a detailed step-by-step surgical guide, offer practical tips, and highlight the advantages of this method over the conventional clamshell incision.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"160-163"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543704","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 Sarcopenia on Early Postoperative Complications in Patients Undergoing Decortication due to Empyema: A Retrospective Study in Turkey.","authors":"Tolga Semerkant, Arif Ates, Tuğçe Semerkant, Ferdane Melike Duran, Mustafa Gültekin, Hıdır Esme","doi":"10.5090/jcs.24.086","DOIUrl":"10.5090/jcs.24.086","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a progressive skeletal muscle disorder characterized by the loss of muscle mass and function. Computed tomography (CT) scans are a reliable method for diagnosing sarcopenia, as they allow for the measurement of muscle density using Hounsfield units (HU). In this study, we conducted a retrospective investigation into the prevalence of sarcopenia and its impact on postoperative complications in patients who underwent decortication for empyema.</p><p><strong>Methods: </strong>Between September 2020 and August 2023, we measured the average HU values of the bilateral paravertebral muscles at the T12 thoracic vertebra level using CT. This study included 145 patients who underwent thoracotomy and decortication for empyema at the Thoracic Surgery Clinic of Konya City Hospital. Based on their HU values, patients were categorized into 2 groups: the sarcopenia group (group S) and the control group (group C). Our objectives were to determine the prevalence of sarcopenia in these patients, evaluate its influence on early postoperative complications, and explore its potential role as a risk factor for postoperative complications.</p><p><strong>Results: </strong>Sarcopenia was identified in 49 (33.7%) of the patients who underwent thoracotomy and decortication for empyema. In group S, the rates of postoperative surgical site infection and pneumonia were significantly higher. Regression analysis revealed that sarcopenia was an independent risk factor for both postoperative pneumonia and surgical site infection. Additionally, the length of stay in the intensive care unit and the hospital was significantly longer in group S than in group C.</p><p><strong>Conclusion: </strong>In patients who underwent thoracotomy for empyema, sarcopenia independently increases the risk of postoperative pneumonia and surgical site infections.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"148-156"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626241","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: Real-World Insights into Adjuvant Immunotherapy after Esophagectomy.","authors":"Min Hee Hong","doi":"10.5090/jcs.25.065","DOIUrl":"10.5090/jcs.25.065","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":"58 4","pages":"146-147"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529971","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}