JTCVS Techniques最新文献

{"title":"Septum-guided segmentectomy for deep early-stage non–small cell lung cancer: A novel, margin-independent, parenchyma-sparing concept","authors":"Qing Wang MD, PhD,&nbsp;Xinshu Wu MD,&nbsp;Zhexu Wen MD, PhD,&nbsp;Yang Liu MD,&nbsp;Jun Zhang MD,&nbsp;Feng Yao MD, PhD,&nbsp;Zhigang Li MD, PhD,&nbsp;Junfeng Geng MD","doi":"10.1016/j.xjtc.2026.102401","DOIUrl":"10.1016/j.xjtc.2026.102401","url":null,"abstract":"<div><h3>Objective</h3><div>The application of segmentectomy for deep-located tumors remains controversial as the result of margin concerns. This study evaluated septum-guided segmentectomy, which uses intersegmental septa and veins as anatomical boundaries to ensure precise dissection independent of fixed linear margin requirements.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 292 patients with deep-located cT1a-bN0M0 non–small cell lung cancer undergoing septum-guided segmentectomy (n = 130) or lobectomy (n = 162) via a minimally invasive approach (January 2019 to March 2025). To rigorously control for selection bias, propensity-score matching incorporating key physiological and anatomical confounders was performed, generating 88 well-balanced matched pairs (n = 176). Perioperative outcomes, locoregional recurrence, recurrence-free survival, and overall survival were evaluated.</div></div><div><h3>Results</h3><div>After propensity-score matching, baseline balance was achieved across key covariates. Survival analysis using stratified methods revealed no significant differences in recurrence-free survival or overall survival between the groups (<em>P</em>&gt; .05). Notably, despite a substantial proportion of patients in the segmentectomy group not fulfilling standard National Comprehensive Cancer Network margin criteria (&gt;20 mm or greater tumor size)—with a mean margin distance of 14.1 mm—no locoregional recurrence was observed during follow-up. R0 resection was achieved in all patients. Although segmentectomy involved longer operative times (<em>P</em>&lt; .001), perioperative complications and hospital stays were highly comparable between the 2 cohorts.</div></div><div><h3>Conclusions</h3><div>Septum-guided segmentectomy demonstrates preliminary oncologic safety and perioperative outcomes comparable with lobectomy for deep-located early-stage non–small cell lung cancer. By using the intersegmental septum as a reliable anatomical barrier, this concept establishes a precise surgical paradigm that safely reduces the reliance on fixed margin distances.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102401"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096800","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 Norwood procedure in hypoplastic left heart syndrome with dextrocardia and situs solitus: Challenges that can be accepted","authors":"Sameh M. Said MBBCh, MD, MBA,&nbsp;Ahmed Wahba MBBCh,&nbsp;Yasin Essa MD","doi":"10.1016/j.xjtc.2026.102559","DOIUrl":"10.1016/j.xjtc.2026.102559","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102559"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096366","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":"Repair of vertical vein stenosis in mixed total anomalous pulmonary venous return: An extra-cardiac approach avoiding posterior dissection","authors":"Rachel Johnstone MM,&nbsp;Jenna Smarzinski MD,&nbsp;Sahithi Bhavana MBBS,&nbsp;Robert Vande Kappelle MD,&nbsp;Wasim Khan MD,&nbsp;Brandon Smith MD,&nbsp;Robert Stewart MD,&nbsp;Tara Karamlou MD, MSc","doi":"10.1016/j.xjtc.2026.102560","DOIUrl":"10.1016/j.xjtc.2026.102560","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102560"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096661","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":"Long-term outcomes for repair of inferolateral left ventricular pseudoaneurysm via the endocardial exclusion patch technique","authors":"Aaron Guo MD,&nbsp;Theodore Dimitrov BS,&nbsp;Doug A. Gouchoe MD,&nbsp;Divyaam Satija MD,&nbsp;Ammu V. Alvarez MD,&nbsp;Matthew C. Henn MD,&nbsp;Juan Crestanello MD,&nbsp;Bryan A. Whitson MD, PhD","doi":"10.1016/j.xjtc.2026.102478","DOIUrl":"10.1016/j.xjtc.2026.102478","url":null,"abstract":"<div><h3>Objectives</h3><div>Left ventricular pseudoaneurysms are a rare complication of myocardial infarction, endocarditis, or iatrogenic injury. Urgent surgical intervention is necessary given the high risk of expansion or life-threatening rupture. Defects on the posterior, inferolateral wall of the ventricle can be particularly challenging to repair with standard epicardial approaches due to difficulty with obtaining adequate exposure and postrepair hemostasis.</div></div><div><h3>Methods</h3><div>We retrospectively identified adult patients at a quaternary referral center who underwent repair of left ventricular pseudoaneurysm via an endocardial exclusion patch between January 2017 to September 2024. Chart review was performed to obtain individual indications, operative technique, and postoperative outcomes.</div></div><div><h3>Results</h3><div>A total of 6 patients were identified. Three (50%) patients had undergone previous cardiac operations, including coronary bypass (n = 1), mitral valve replacement (n = 1), or both (n = 1). Etiologies of the pseudoaneurysms were ischemic (n = 3), infectious (n = 2), or mixed (n = 1). Concomitant mitral valve and/or coronary artery intervention was performed in 5 (86%) cases. There was 100% obliteration of the pseudoaneurysm sac on follow-up imaging and 100% survival to most recent follow-up (median, 1035 days).</div></div><div><h3>Conclusions</h3><div>An endocardial patch exclusion technique is technically feasible with safe and durable outcomes; potential benefits of this approach include minimizing dissection in reoperative fields, avoidance of previous coronary bypass grafts, and improved hemostasis with no exposed epicardial suture lines.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102478"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096782","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":"Establishment of a feasible surgical strategy for aortoesophageal fistula","authors":"Katsuhiro Yamanaka MD, PhD,&nbsp;Kenji Okada MD, PhD,&nbsp;Kazunori Sakaguchi MD,&nbsp;Tasuku Okada MD,&nbsp;Hironaga Shiraki MD,&nbsp;Ryo Kawabata MD,&nbsp;Jun Karaki MD,&nbsp;Yasufumi Koterazawa MD, PhD,&nbsp;Noriko Oyama MD, PhD,&nbsp;Soichiro Henmi MD, PhD,&nbsp;Hironobu Goto MD, PhD,&nbsp;Hiroaki Takahashi MD, PhD,&nbsp;Yutaka Okita MD, PhD","doi":"10.1016/j.xjtc.2026.102502","DOIUrl":"10.1016/j.xjtc.2026.102502","url":null,"abstract":"<div><h3>Objectives</h3><div>Aortoesophageal fistula (AEF) represents one of the most challenging and devastating complications in aortic surgery. This study aimed to evaluate the feasibility, technical considerations, and clinical outcomes of our standardized multidisciplinary strategy for AEF, which has been consistently applied since 2008.</div></div><div><h3>Methods</h3><div>This retrospective study included 21 patients with AEF who underwent open surgery from January 2008 to September 2025. The primary end point was freedom from infection-related death, reflecting the central role of infection control in AEF management. Secondary end points included hospital mortality, overall survival, and the esophageal reconstruction rate.</div></div><div><h3>Results</h3><div>The mean age was 69.3 ± 11.2 years. Hospital mortality after open surgery was 26.9%. The 10-year overall survival and freedom from infection-related death were 38.4 ± 13.2% and 89.7 ± 6.8%, respectively. After implementation of our current standardized strategy in 2008, no recurrent infections were observed, and 10 patients successfully completed reconstruction.</div></div><div><h3>Conclusions</h3><div>Although hospital mortality remains substantial, long-term outcomes were favorable. The current multidisciplinary surgical strategy was associated with improved infection-related outcomes, with no recurrent infections observed.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102502"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096786","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":"Graft-valve dehiscence as the mechanism of remodeling failure in connective tissue disorders: The case for reimplantation","authors":"Sixtine Godin MD,&nbsp;Ali Irshad MD,&nbsp;Veronica Lorenz MD,&nbsp;Mohamed Shoeib MD,&nbsp;Gaby Aphram MD,&nbsp;Matteo Pettinari MD, PhD,&nbsp;Stefano Mastrobuoni MD,&nbsp;Gebrine El Khoury MD,&nbsp;Laurent de Kerchove MD, PhD","doi":"10.1016/j.xjtc.2026.102573","DOIUrl":"10.1016/j.xjtc.2026.102573","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102573"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096789","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":"First-in-human totally robotic left ventricular assist device implantation through a right minithoracotomy","authors":"Yi-Chun Kuo MSN,&nbsp;Chu-Lin Hsiao RN,&nbsp;Ling-Yi Wei MD,&nbsp;Hsun-Yi Fu MD,&nbsp;Jeng-Wei Chen MD,&nbsp;Hsi-Yu Yu MD, PhD,&nbsp;Nai-Hsin Chi MD, PhD","doi":"10.1016/j.xjtc.2026.102578","DOIUrl":"10.1016/j.xjtc.2026.102578","url":null,"abstract":"<div><span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (331KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102578"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096798","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":"Fluorescence-guided bronchoscopic localization with a novel silicone marker: An ex vivo human proof-of-concept study","authors":"Masaya Tamura MD,&nbsp;Takashi Sakai MD,&nbsp;Naoki Furukawa MD,&nbsp;Yujiro Bunno MD,&nbsp;Marino Yamamoto MD,&nbsp;Ryohei Miyazaki MD,&nbsp;Hironobu Okada MD,&nbsp;Takayuki Sato MD","doi":"10.1016/j.xjtc.2026.102564","DOIUrl":"10.1016/j.xjtc.2026.102564","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the technical feasibility and potential clinical applicability of a novel fluorescence-guided bronchoscopic localization strategy using a solid fluorescent silicone rubber marker for intraoperative localization of small peripheral pulmonary nodules.</div></div><div><h3>Methods</h3><div>An ex vivo human lung model was established using 4 freshly resected human pulmonary lobes. A radiopaque fluorescent silicone rubber marker (LuxSeed) was deployed bronchoscopically into peripheral bronchi without fluoroscopic or navigation guidance. Transpleural fluorescence was evaluated using a commercially available near-infrared thoracoscopic imaging system. Fluorescence detectability was assessed according to lung parenchymal thickness under noncompression and temporary compression conditions, and fluorescence intensity was quantified by signal-to-background ratio analysis.</div></div><div><h3>Results</h3><div>Successful deployment was achieved in all 4 resected pulmonary lobes. Fluorescence was consistently detected through lung parenchyma up to 12-mm thick without compression. Although fluorescence was not visible at depths of 15 and 20 mm under static conditions, temporary lung compression restored fluorescence detectability. Quantitative image analysis demonstrated improved signal-to-background ratios with compression, consistent with visual assessment. The marker was readily visualized using a standard near-infrared thoracoscopic imaging platform without dedicated localization equipment.</div></div><div><h3>Conclusions</h3><div>This proof-of-concept study demonstrates the feasibility of a novel fluorescence-guided bronchoscopic localization technology using a solid fluorescent silicone rubber marker. Compatibility with existing near-infrared thoracoscopic imaging systems and improved detectability during routine lung compression support future clinical evaluation in minimally invasive thoracic surgery.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102564"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096799","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":"Intraoperative recall of surgeon-defined 3-dimensional planning during robotic pulmonary resection: A feasibility study","authors":"Naoya Kawakita MD, PhD,&nbsp;Tomohiro Toko MD,&nbsp;Shiori Matsui MD,&nbsp;Kazumasa Nanjo MD,&nbsp;Kiyoshige Yamamoto MD,&nbsp;Emi Takehara MD,&nbsp;Taihei Takeuchi MD,&nbsp;Keisuke Fujimoto MD,&nbsp;Atsushi Morishita MD,&nbsp;Hiroaki Toba MD, PhD,&nbsp;Hiromitsu Takizawa MD, PhD","doi":"10.1016/j.xjtc.2026.102570","DOIUrl":"10.1016/j.xjtc.2026.102570","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility, usability, and user acceptance of integrating preoperative patient-specific 3-dimensional planning into an intraoperative stereoscopic robotic workflow during pulmonary resection.</div></div><div><h3>Methods</h3><div>We conducted a prospective single-center pilot study of patients scheduled to undergo robot-assisted pulmonary lobectomy or anatomical segmentectomy. Patient-specific pulmonary anatomical models were generated preoperatively and displayed intraoperatively on the robotic surgeon's console using an i-Lung 3-dimensional simulator. Planned transection references for the vascular and bronchial structures were defined using cut rings and recalled during surgery. Questionnaire responses from surgeons and assistants were prospectively collected after each procedure. The outcomes were summarized using descriptive statistics, and no formal hypothesis testing was performed.</div></div><div><h3>Results</h3><div>Sixteen consecutive patients were enrolled; 1 procedure was aborted because of unexpected pleural dissemination. The remaining 15 patients were analyzed. The system was successfully introduced in all 15 procedures, with no conversions, procedure interruptions, technical failures, system crashes, or image display interruptions attributable to the system. All surgeon responses indicated anatomical consistency, no rendering delay interfering with surgery, and no significant visual discomfort. Surgeon-rated depth perception and usefulness of console-based anatomical confirmation were rated 5 in 13 responses and 4 in 2 responses. Interactive functions and future-use items were rated 5 in all surgeon responses. Assistant responses also favored shared stereoscopic visualization.</div></div><div><h3>Conclusions</h3><div>The i-Lung 3-dimensional simulator enabled feasible integration of preoperative patient-specific 3-dimensional planning into the intraoperative stereoscopic robotic console environment. Further studies with objective endpoints are warranted.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"39 ","pages":"Article 102570"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096805","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":"Superior approach for pulmonary venous restenosis postcardiac-type total anomalous pulmonary venous connection repair in a 6-month-old infant","authors":"Kai Luo PhD,&nbsp;Yanjun Pan PhD,&nbsp;Xiaomin He PhD,&nbsp;Xinrong Liu PhD,&nbsp;Jinghao Zheng PhD,&nbsp;Zhongqun Zhu PhD,&nbsp;Huiwen Chen PhD","doi":"10.1016/j.xjtc.2026.102412","DOIUrl":"10.1016/j.xjtc.2026.102412","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102412"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634727","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}