Current challenges in thoracic surgery最新文献_第10页

Novel thoracoscopic lymph node dissection techniques for left upper lobectomy with a fused fissure 新型胸腔镜下左上肺叶融合裂切除术淋巴结清扫技术

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.21037/CCTS-2019-FILSC-04-M04

Y. Matsuura, J. Ichinose, M. Nakao, S. Okumura, M. Mun

{"title":"Novel thoracoscopic lymph node dissection techniques for left upper lobectomy with a fused fissure","authors":"Y. Matsuura, J. Ichinose, M. Nakao, S. Okumura, M. Mun","doi":"10.21037/CCTS-2019-FILSC-04-M04","DOIUrl":"https://doi.org/10.21037/CCTS-2019-FILSC-04-M04","url":null,"abstract":": Currently, lobectomy with systematic lymph node dissection (LND) is the standard surgical procedure for early stage, non-small cell lung cancer (NSCLC). Several issues may arise when performing a lobectomy such as a fused fissure, especially during thoracoscopic surgery. In this case, performing hilar LND in a conventional manner may be difficult. Since both hilar and mediastinal LND are essential procedures during surgery for NSCLC, it is crucial to achieve both safe lobectomy and precise systematic LND in fused fissure cases. To address this difficult situation, we have developed the following three novel thoracoscopic techniques that focus on LND: (I) the “anterior fissure first technique”, (II) the “#4L-posterior first technique”, and (III) the “anterior #7 dissection technique”. First, the anterior fissure first technique enables the operator to view the entire hilar lymph node, similar to a situation with a complete fissure, and allows the hilar LND to proceed in a conventional manner. Second, when using the #4L-posterior first technique, the left lower paratracheal (#4L) LND is straightforward since the left recurrent laryngeal nerve (RLN) has already been dissected, and only the anterior area of #4L remains to be dissected. Finally, during the anterior #7 dissection technique, when performing the subcarinal (#7) LND, we do not dissect between the dorsal side of the trachea and esophagus. Consequently, the bronchial artery (BA) is preserved and postoperative ischemic change in the bronchial stumps is prevented. We believe that our techniques are oncologically appropriate and enable the safe and straightforward execution of precise thoracoscopic lobectomy and systematic LND, even in cases of fused fissures.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68326214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Narrative review of the role of bronchoscopy in airway complications after lung transplantation 支气管镜检查在肺移植术后气道并发症中的作用综述

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.21037/ccts-20-167

Alfredo Jalilie

引用次数: 0

Multiple pulmonary nodules: a management dilemma 多发性肺结节:一个管理难题

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.21037/ccts-21-37

Suha Kaaki, T. D’amico

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A narrative review of lung cancer screening implementation: increasing utilization of evidence-based practice 癌症筛查实施的叙述性回顾：循证实践的日益利用

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.21037/CCTS-2020-LCS-03

J. A. Miller, R. V. Haren

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Narrative review of radiomics for classifying pulmonary nodules and potential impact on lung cancer screening 肺结节分类的放射组学叙述性综述及其对癌症筛查的潜在影响

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.21037/CCTS-2020-LCS-05

M. Stephens

{"title":"Narrative review of radiomics for classifying pulmonary nodules and potential impact on lung cancer screening","authors":"M. Stephens","doi":"10.21037/CCTS-2020-LCS-05","DOIUrl":"https://doi.org/10.21037/CCTS-2020-LCS-05","url":null,"abstract":"Lung cancer screening has proven to be a useful tool for identifying early stage lung cancers, however, the overall accuracy can sometimes lead to false positive and negatives that have potential adverse effects on patient outcomes. Advancement in computational methods have allowed for quantification of pulmonary nodule imaging features, referred to as radiomics, which have the potential to increase lung cancer screening accuracy and improve patient management. The initial part of this review covers common radiomic features and the challenges in deriving them. The second part of this review systematically evaluates literature relating to radiomics and lung cancer finding articles in areas that might have the potential to change management in lung cancer screening. Pertinent literature included initial nodule classification as benign or malignant, classifying subsolid nodules as invasive or noninvasive, and prediction of tumor recurrence after surgical resection. The reviewed articles evaluating use of radiomics are mostly limited due to small sample sizes and lack of a validation cohort. These studies show potential for radiomic features to improve pulmonary nodule classification and change the way patients are managed, however, comparison between studies is limited due to variabilities in the way these features are derived. To make these features useful will require further research and standardization of the workflows that derive these features.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47574737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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A case of destroyed lung caused by a chronic lymphocytic leukemia with mass effect 慢性淋巴细胞白血病伴团块效应致肺破坏1例

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.26663/CTS.2021.0007

K. Ceylan, Canberk Heskiloğlu, F. Cansun, S. Kaya, A. Yener

{"title":"A case of destroyed lung caused by a chronic lymphocytic leukemia with mass effect","authors":"K. Ceylan, Canberk Heskiloğlu, F. Cansun, S. Kaya, A. Yener","doi":"10.26663/CTS.2021.0007","DOIUrl":"https://doi.org/10.26663/CTS.2021.0007","url":null,"abstract":"Tuberculosis and bronchiectasis are the most common causes of the destroyed lung. Mediastinal masses, which cause bronchial compression, can also cause bronchiectasis. Chronic lymphocytic leukemia (CLL) is the most common subtype of leukemia, and it can rarely cause bronchiectasis and destroyed lungs by causing a mass effect in the mediastinum. A 50-year-old female patient with a history of tuberculosis in her childhood admitted to our clinic with dyspnea, cough, and chest pain. During the clinical examinations, a solid mass with approximately 46x33 mm in size was observed in the posterior mediastinum, compressing the left main bronchus and the entire left lung was destroyed. Since the patient had no definite diagnosis and was symptomatic, a surgical treatment was planned, and left pneumonectomy was performed together with mediastinal mass excision. As a result of the extracted specimen histopathology, bronchiectasis was present, and the mediastinal mass was consistent with chronic lymphocytic leukemia. The patient did not experience any postoperative complications and was referred to the oncology clinic for follow-up and treatment. Herein, we aimed to present a case with chronic lymphocytic leukemia mass in the posterior mediastinum compressing the left main bronchus, which caused bronchiectasis and destroyed lung with the literature’s accompaniment.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83956952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skin reaction after pectus surgery 胸廓手术后的皮肤反应

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.26663/cts.2021.0017

H. Yildiran

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An inappropriate localization of a zoonotic disease: infraclavicular, infrapectoral hydatic cycst 人畜共患疾病的不恰当定位:锁骨下、胸骨下水循环

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.26663/cts.2021.0023

F. Cansun, Canberk Heskiloğlu

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Lung transplant anastomotic airway complications and bronchoscopic management 肺移植吻合口气道并发症及支气管镜处理

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.21037/ccts-20-163

Christopher Di Felice, S. Sethi

引用次数: 0

Comparison of thoracotomy and videothoracoscopy for intrathoracic bronchogenic cysts 开胸与胸腔镜治疗胸内支气管源性囊肿的比较

Current challenges in thoracic surgery Pub Date : 2021-01-01 DOI: 10.26663/cts.2021.00011

K. Ceylan, Hüseyin Mestan, S. Kaya, A. Yener

{"title":"Comparison of thoracotomy and videothoracoscopy for intrathoracic bronchogenic cysts","authors":"K. Ceylan, Hüseyin Mestan, S. Kaya, A. Yener","doi":"10.26663/cts.2021.00011","DOIUrl":"https://doi.org/10.26663/cts.2021.00011","url":null,"abstract":"Background: Bronchogenic cyst is a generally benign and rare congenital anomaly. The mediastinum and lung parenchyma are the most common sites the cysts occur. This study aimed to compare the effectiveness of thoracoscopy and thoracotomy for the treatment of bronchogenic cysts. Materials and Methods: Twenty-one patients were operated on in Dr. Suat Seren Thoracic Surgery Clinic between 2004 and 2019 with the diagnosis of bronchogenic cyst. Patients were divided into two groups according to the surgery method as video-assisted thoracoscopic surgery (VATS) or thoracotomy. Demographic and operative features, radiological findings, and complications were retrospectively analyzed. Results: Patients underwent either VATS (10 patients) or thoracotomy (11 patients). Sixteen patients underwent simple cyst excision, whereas parenchymal resection was performed for five patients. The mean Visual Analogue Scale (VAS) value was 3.5 ± 1.1 for the VATS group and 6.5 ± 1 for the thoracotomy group. Duration of hospital stay and chest drainage was 4.2 ± 1.7 and 3.2 ± 1.7 days, respectively, in the VATS group, while in the thoracotomy group, it was 7.1 ± 4.5 and 6.1 ± 4.5 days. The time of hospitalization stay, duration of chest drainage, operative time, and VAS values were found statistically significantly lower in the VATS group. Conclusions: Both VATS and thoracotomy are preferred surgical methods in bronchogenic cyst surgery. VATS is superior to thoracotomy in terms of shorter hospital stay, chest drainage duration, operative time, and lower postoperative pain level. Minimally invasive methods can be chosen safely for the treatment of bronchogenic cyst in appropriate cases.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75325005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0