Journal of Chest Surgery最新文献_第9页

The Prognostic Value of Oligo-Recurrence Following Esophagectomy for Esophageal Cancer. 食管切除术后低执行率对癌症的预后价值。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-09-12 DOI: 10.5090/jcs.23.050

Minsang Kang, Woojung Kim, Chang Hyun Kang, Kwon Joong Na, Samina Park, Hyun Joo Lee, In Kyu Park, Young Tae Kim

{"title":"The Prognostic Value of Oligo-Recurrence Following Esophagectomy for Esophageal Cancer.","authors":"Minsang Kang, Woojung Kim, Chang Hyun Kang, Kwon Joong Na, Samina Park, Hyun Joo Lee, In Kyu Park, Young Tae Kim","doi":"10.5090/jcs.23.050","DOIUrl":"10.5090/jcs.23.050","url":null,"abstract":"Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer.Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated.Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05).Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212093","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}

引用次数: 2

Bilateral Cardiac Sympathetic Denervation as a Safe Therapeutic Option for Ventricular Arrhythmias. 双侧心交感神经去支配是治疗室性心律失常的安全选择。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-08-14 DOI: 10.5090/jcs.23.055

Soo Jung Park, Deok Heon Lee, Youngok Lee, Hanna Jung, Yongkeun Cho

{"title":"Bilateral Cardiac Sympathetic Denervation as a Safe Therapeutic Option for Ventricular Arrhythmias.","authors":"Soo Jung Park, Deok Heon Lee, Youngok Lee, Hanna Jung, Yongkeun Cho","doi":"10.5090/jcs.23.055","DOIUrl":"10.5090/jcs.23.055","url":null,"abstract":"Background: The recurrence of ventricular arrhythmias (VAs) in patients who have already undergone treatment with antiarrhythmic medication, catheter ablation, and the insertion of implantable cardioverter defibrillators is not uncommon. Recent studies have shown that bilateral cardiac sympathetic denervation (BCSD) effectively treats VAs. However, only a limited number of studies have confirmed the safety of BCSD as a viable therapeutic option for VAs.Methods: This single-center study included 10 patients, who had a median age of 54 years (interquartile range [IQR], 45-65 years) and a median ejection fraction of 58.5% (IQR, 56.2%-60.8%), with VAs who underwent video-assisted BCSD. BCSD was executed as a single-stage surgery for 8 patients, while the remaining 2 patients initially underwent left cardiac sympathetic denervation followed by right cardiac sympathetic denervation. We evaluated postoperative complications, the duration of hospital stays, and VA-related symptoms before and after surgery.Results: The median hospital stay after surgery was 2 days (IQR, 2-3 days). The median surgical time for BCSD was 113 minutes (IQR, 104-126 minutes). No significant complications occurred during hospitalization or after discharge. During the median follow-up period of 13.5 months (IQR, 10.5-28.0 months) from surgery, no VA-related symptoms were observed in 70% of patients.Conclusion: The benefits of a short postoperative hospitalization and negligible complications make BCSD a safe, alternative therapeutic option for patients suffering from refractory VAs.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044368","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}

引用次数: 0

Outcomes after Mechanical Aortic Valve Replacement in Children with Congenital Heart Disease. 先天性心脏病患儿机械主动脉瓣置换术后的疗效。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-09-12 DOI: 10.5090/jcs.23.071

Joon Young Kim, Won Chul Cho, Dong-Hee Kim, Eun Seok Choi, Bo Sang Kwon, Tae-Jin Yun, Chun Soo Park

{"title":"Outcomes after Mechanical Aortic Valve Replacement in Children with Congenital Heart Disease.","authors":"Joon Young Kim, Won Chul Cho, Dong-Hee Kim, Eun Seok Choi, Bo Sang Kwon, Tae-Jin Yun, Chun Soo Park","doi":"10.5090/jcs.23.071","DOIUrl":"10.5090/jcs.23.071","url":null,"abstract":"Background: The optimal choice of valve substitute for aortic valve replacement (AVR) in pediatric patients remains a matter of debate. This study investigated the outcomes following AVR using mechanical prostheses in children.Methods: Forty-four patients younger than 15 years who underwent mechanical AVR from March 1990 through March 2023 were included. The outcomes of interest were death or transplantation, hemorrhagic or thromboembolic events, and reoperation after mechanical AVR. Adverse events included any death, transplant, aortic valve reoperation, and major thromboembolic or hemorrhagic event.Results: The median age and weight at AVR were 139 months and 32 kg, respectively. The median follow-up duration was 56 months. The most commonly used valve size was 21 mm (14 [31.8%]). There were 2 in-hospital deaths, 1 in-hospital transplant, and 1 late death. The overall survival rates at 1 and 10 years post-AVR were 92.9% and 90.0%, respectively. Aortic valve reoperation was required in 4 patients at a median of 70 months post-AVR. No major hemorrhagic or thromboembolic events occurred. The 5- and 10-year adverse event-free survival rates were 81.8% and 72.2%, respectively. In univariable analysis, younger age, longer cardiopulmonary bypass time, and smaller valve size were associated with adverse events. The cut-off values for age and prosthetic valve size to minimize the risk of adverse events were 71 months and 20 mm, respectively.Conclusion: Mechanical AVR could be performed safely in children. Younger age, longer cardiopulmonary bypass time and smaller valve size were associated with adverse events. Thromboembolic or hemorrhagic complications might rarely occur.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212085","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}

引用次数: 0

Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report. 慢性平胸不连的手术切除显示败血症性Pseudarthrosis：一例报告。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-09-12 DOI: 10.5090/jcs.23.041

Robin Deville, Justin Issard, Anna Vayssette, Jalal Assouad

引用次数: 0

A 20-Year Update on the Practice of Thoracic Surgery in Canada: A Survey of the Canadian Association of Thoracic Surgeons. 加拿大胸外科实践的20年更新：加拿大胸外科医师协会的调查。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-10-11 DOI: 10.5090/jcs.23.093

Sami Aftab Abdul, Frances Wright, Christian Finley, Sebastien Gilbert, Andrew J E Seely, Sudhir Sundaresan, Patrick J Villeneuve, Donna E Maziak

{"title":"A 20-Year Update on the Practice of Thoracic Surgery in Canada: A Survey of the Canadian Association of Thoracic Surgeons.","authors":"Sami Aftab Abdul, Frances Wright, Christian Finley, Sebastien Gilbert, Andrew J E Seely, Sudhir Sundaresan, Patrick J Villeneuve, Donna E Maziak","doi":"10.5090/jcs.23.093","DOIUrl":"10.5090/jcs.23.093","url":null,"abstract":"Background: This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada.Methods: An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer.Results: Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%-34% reported an on-call ratio of 1:4-1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps.Conclusion: This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41214766","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}

引用次数: 0

Comparable Outcomes of Bicuspid Aortic Valves for Rapid-Deployment Aortic Valve Replacement. 双叶主动脉瓣用于快速展开主动脉瓣置换术的可比较结果。

Journal of Chest Surgery Pub Date : 2023-11-05 DOI: 10.5090/jcs.23.070

Somin Im, Kyung Hwan Kim, Suk Ho Sohn, Yoonjin Kang, Ji Seong Kim, Jae Woong Choi

{"title":"Comparable Outcomes of Bicuspid Aortic Valves for Rapid-Deployment Aortic Valve Replacement.","authors":"Somin Im, Kyung Hwan Kim, Suk Ho Sohn, Yoonjin Kang, Ji Seong Kim, Jae Woong Choi","doi":"10.5090/jcs.23.070","DOIUrl":"10.5090/jcs.23.070","url":null,"abstract":"Background: Edwards Intuity is recognized as a relatively contraindicated bioprosthesis for bicuspid aortic valve disease. This study compared the early echocardiographic and clinical outcomes of rapid-deployment aortic valve replacement for bicuspid versus tricuspid aortic valves.Methods: Of 278 patients who underwent rapid-deployment aortic valve replacement using Intuity at Seoul National University Hospital, 252 patients were enrolled after excluding those with pure aortic regurgitation, prosthetic valve failure, endocarditis, and quadricuspid valves. The bicuspid and tricuspid groups included 147 and 105 patients, respectively. Early outcomes and the incidence of paravalvular leak were compared between the groups. A subgroup analysis compared the outcomes for type 0 versus type 1 or 2 bicuspid valves.Results: The bicuspid group had more male and younger patients. Comorbidities, including diabetes mellitus, hypertension, chronic kidney disease, and coronary artery disease, were less prevalent in the bicuspid group. Early echocardiographic evaluations demonstrated that the incidence of ≥mild paravalvular leak did not differ significantly between the groups (5.5% vs. 1.0% in the bicuspid vs. tricuspid groups, p=0.09), and the early clinical outcomes were also comparable between the groups. In the subgroup analysis between type 0 and type 1 or 2 bicuspid valves, the incidence of mild or greater paravalvular leak (2.4% vs. 6.7% in type 0 vs. type 1 or 2, p=0.34) and clinical outcomes were comparable.Conclusion: Rapid-deployment aortic valve replacement for bicuspid aortic valves demonstrated comparable early echocardiographic and clinical outcomes to those for tricuspid aortic valves, and the outcomes were also satisfactory for type 0 bicuspid aortic valves.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427503","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}

引用次数: 0

Enoxaparin as an Anticoagulant in a Multipara with a Mechanical Mitral Valve: A Case Report. 依诺肝素作为一种抗凝剂治疗多发性机械二尖瓣：一例报告。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-07-31 DOI: 10.5090/jcs.23.031

Yo Seb Lee, Jun Seok Kim

{"title":"Enoxaparin as an Anticoagulant in a Multipara with a Mechanical Mitral Valve: A Case Report.","authors":"Yo Seb Lee, Jun Seok Kim","doi":"10.5090/jcs.23.031","DOIUrl":"10.5090/jcs.23.031","url":null,"abstract":"Patients who have undergone mechanical valve replacement require anticoagulation therapy with warfarin to prevent thromboembolism. However, administering warfarin to pregnant patients increases their risk of warfarin embryopathy or central nervous system disorders. Consequently, safer alternatives, such as heparin or low-molecular-weight heparin injection, are substituted for warfarin. However, limited research has been conducted on this subject, with no large-scale studies and particularly few investigations involving multiparous patients. A patient who had previously undergone mechanical mitral valve replacement for atrial septal defect and mitral stenosis received anticoagulant therapy with enoxaparin during 2 pregnancies. Upon confirmation of pregnancy, warfarin was replaced with subcutaneously injected enoxaparin with a dosage of 1 mg/kg at 12-hour intervals. The enoxaparin dosage was controlled using an anti-factor Xa assay, with a target range of 0.3-0.7 IU/mL. Intravenous heparin injections were administered starting 3 days prior to the expected delivery date and were continued until delivery, after which warfarin was resumed. No complications were observed during the deliveries.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888742","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}

引用次数: 0

Valve-Sparing Neo-Aortic Root Replacement for Neo-Aortic Root Dilatation 20 Years after Arterial Switch Operation for Transposition of the Great Arteries: A Case Report. 大动脉转位动脉转换术后20年新主动脉根部扩张的瓣膜保留新主动脉根部置换术：一例报告。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-08-14 DOI: 10.5090/jcs.23.051

Sangjun Lee, Chan Hyeong Kim, Jae Hong Lee, Jae Gun Kwak

引用次数: 0

Minimally Invasive Procedure versus Conventional Redo Sternotomy for Mitral Valve Surgery in Patients with Previous Cardiac Surgery: A Systematic Review and Meta-Analysis. 既往心脏手术患者二尖瓣手术的微创手术与传统重做立体术：系统综述和荟萃分析。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-10-11 DOI: 10.5090/jcs.23.038

Muhammad Ali Tariq, Minhail Khalid Malik, Qazi Shurjeel Uddin, Zahabia Altaf, Mariam Zafar

{"title":"Minimally Invasive Procedure versus Conventional Redo Sternotomy for Mitral Valve Surgery in Patients with Previous Cardiac Surgery: A Systematic Review and Meta-Analysis.","authors":"Muhammad Ali Tariq, Minhail Khalid Malik, Qazi Shurjeel Uddin, Zahabia Altaf, Mariam Zafar","doi":"10.5090/jcs.23.038","DOIUrl":"10.5090/jcs.23.038","url":null,"abstract":"Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population.Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model.Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05).Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41214768","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}

引用次数: 0

A Knife Penetrating the Right Ventricle, Interventricular Septum, and 2 Valves: A Case Report. 一把刀穿透右心室、室间隔和2个瓣膜：一例报告。

Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-08-14 DOI: 10.5090/jcs.23.066

Megan Minji Chun, Stephanie Nguyen, Isao Anzai, Hiroo Takayama

引用次数: 0