Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"A European survey on non-technical skills in robotic thoracic surgery for lung resections.","authors":"Ghada M M Shahin, Merel J Verhagen, Merlijn Hutteman, Jeroen Wink, Steven A Stamenkovic, Marion Durand, Jean-Marc Baste, Franca Melfi, Jerry Braun","doi":"10.1093/icvts/ivaf231","DOIUrl":"https://doi.org/10.1093/icvts/ivaf231","url":null,"abstract":"<p><strong>Objectives: </strong>In robotic surgery, interaction between team-members differs from that in open surgery, which impacts the team-members' tasks and responsibilities. Training for robot-assisted thoracic surgery (RATS) is primarily focused on technical skills. However, non-technical skills (NOTECHS) are equally important for safe and high-quality surgery. There is debate whether NOTECHS require adjustments to meet specific needs of RATS. The aim of this study is to evaluate how NOTECHS-domains are perceived, performed and trained in European robotic thoracic centers.</p><p><strong>Methods: </strong>A digital exploratory survey was distributed amongst 40 robotic thoracic surgeons in 33 European centers. The survey contained 40 questions concerning the setting, team, robotic platform, operating room set-up, briefing & debriefing (B&D), and NOTECHS.</p><p><strong>Results: </strong>Survey response rate was 85%. A training program for RATS is offered by 38%. There is a wide variety in team composition and set-up in the operating room. The B&D checklist is essentially the same as for open surgery. A conversion protocol is available for 85% of surgeons, but 11% is not aware of its contents. Among the four NOTECHS-domains, communication&teamwork is considered most important, followed by situational awareness. In some centers, team-training in NOTECHS is either lacking (36%) or provided only once (33%).</p><p><strong>Conclusions: </strong>Although the importance of NOTECHS in RATS is widely recognized among European robotic surgeons, focused and structured team-training in these skills is lacking. Furthermore, a conversion protocol is not always available or known. These findings offer room for improvement and encourage further research.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194007","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}

{"title":"Minimally invasive mitral valve repair for commissural prolapse: Safety, success, and long-term efficacy.","authors":"Clemens Engler, Leo Pölzl, Felix Nägele, Michael Graber, Jakob Hirsch, Ronja Lohmann, Johannes Holfeld, Julia Dumfarth, Johannes Spilka, Ludwig Müller, Michael Grimm, Daniel Höfer, Can Gollmann-Tepeköylü, Nikolaos Bonaros","doi":"10.1093/icvts/ivaf213","DOIUrl":"10.1093/icvts/ivaf213","url":null,"abstract":"<p><strong>Objectives: </strong>Commissural prolapse (CP) is a rare and complex mitral valve pathology which is complicated in preoperative diagnosis and repair. This study evaluated the safety, success, and long-term efficacy of minimally invasive mitral valve repair (MIMVR) for CP compared to posterior leaflet prolapse (PMLp).</p><p><strong>Methods: </strong>Between 2001 and 2022, 34 patients with CP and 590 with PMLp underwent MIMVR at our center. Operative, perioperative, and long-term follow-up data were retrospectively collected. Surgical success was defined as freedom from conversion to valve replacement, sternotomy, and residual mitral regurgitation (MR) > grade I. Long-term efficacy included MR recurrence, reoperation, and survival.</p><p><strong>Results: </strong>Median age was similar (CP: 64.0 years [53.2; 69.8] vs PMLp: 62.0 years [53.0; 69.0], p = 0.783). Barlow's disease was more frequent in PMLp (80.3% vs 32.4%, p < 0.001). Cross-clamp (127.0 min vs 105.0 min, p = 0.001) and bypass times (208.5 min vs 190.5 min, p = 0.031) were longer in CP. CP patients had longer hospital stays (10.0 days [8.0; 12.0] vs 8.0 days [7.0; 9.0], p < 0.001), but short-term outcomes, including 30-day mortality, stroke, and ECMO support, were comparable. At a median follow-up of 4.5 years (CP) and 2.4 years (PMLp, p = 0.001), rates of recurrent MR, reoperation, and survival were similar.</p><p><strong>Conclusions: </strong>MIMVR for CP is safe, successful, and durable with outcomes comparable to PMLp. Despite greater technical complexity and longer operative times, this approach provides reliable results for CP.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12526119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180746","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":"Anatomical burden of prior percutaneous coronary intervention and long-term outcomes after coronary artery bypass grafting: An analysis spanning two decades.","authors":"Go Yamashita, Jiro Sakai, Takumi Takauchi, Shun Otani, Shoya Nakano, Ryo Fujimoto, Atsushi Sugaya, Shingo Hirao, Tatsuhiko Komiya","doi":"10.1093/icvts/ivaf237","DOIUrl":"10.1093/icvts/ivaf237","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine whether the anatomical burden of prior percutaneous coronary intervention(PCI) influences long-term outcomes after coronary artery bypass grafting, beyond the impact of intervention presence alone.</p><p><strong>Methods: </strong>This retrospective study analyzed consecutive patients undergoing coronary artery bypass grafting at a single institution between 2000 and 2024. The inclusion criteria comprised isolated, non-emergent surgery. Patient categorization was based on prior PCI-treated lesions: none, single, or multiple. The primary endpoint was long-term overall survival. The secondary endpoints included cardiac death, myocardial infarction, stroke, heart failure hospitalization, and repeat revascularization. Long-term outcomes were assessed using Kaplan-Meier analysis and Cox multivariable models, adjusting for 26 clinical factors.</p><p><strong>Results: </strong>Of 2,442 patients, 1,205 met the inclusion criteria (755 none, 227 single-lesion, 223 multiple-lesion intervention). Over a median follow-up of 12.0 (interquartile range, 11.3-12.9; maximum: 24.2) years, the multiple-lesion intervention group had higher rates of in-hospital acute kidney injury (34.1% vs. 21.1% vs. 24.2%, P = 0.003). Overall survival differed significantly between groups over the follow-up period (log-rank P = 0.004), with 15-year survival rates of 35.8%, 46.0%, and 48.0% for multiple-lesion, single-lesion, and no prior PCI groups, respectively. After adjustment, multiple-lesion intervention was associated with increased risks of cardiac death (adjusted subdistribution hazard ratio: 1.91), myocardial infarction (2.26), and repeat revascularization (1.92) compared with no prior intervention.</p><p><strong>Conclusions: </strong>Multiple-lesion PCI was associated with higher long-term risks of cardiac death, myocardial infarction, and repeat revascularization, while stroke risk was similar. Single-lesion PCI showed outcomes comparable to no prior PCI except for higher heart failure hospitalization. These findings require confirmation in larger, multicenter comparative studies to address residual confounding.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180648","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":"Outcomes of the modified Cabrol technique in aortic root replacement: Early and midterm experience.","authors":"Nayeem Nasher, Joshua Chen, Purab Kothari, Colin King, Jacqueline McGee, Vishal Shah, Saarah Khairi, Konstadinos Plestis","doi":"10.1093/icvts/ivaf235","DOIUrl":"10.1093/icvts/ivaf235","url":null,"abstract":"<p><strong>Objectives: </strong>The modified Cabrol technique has been associated with excellent graft patency. However, prior studies were limited to patients largely on long-term anticoagulation. We sought to analyze outcomes in patients primarily managed without mechanical prostheses.</p><p><strong>Methods: </strong>We retrospectively analyzed all patients who underwent aortic root replacement by a single surgeon from 2014 to 2024. Patients who underwent reimplantation of one or both coronary ostia using the modified Cabrol technique with separate interposition grafts were identified. Baseline characteristics and postoperative outcomes were reported. Predictors of mortality were analyzed using Cox proportional hazards, and overall survival was reported using Kaplan-Meier analysis.</p><p><strong>Results: </strong>We identified 91 patients who underwent the modified Cabrol technique. The median age was 62 [interquartile range, 52-71] years, and 91.2% (83/91) were male. Patients presented urgently or emergently in 38.5% (35/91) of cases, and for acute dissection in 23.1% (21/91) of cases, and endocarditis in 15.4% (14/91). Patients required redo sternotomy in 50% of cases. A mechanical composite valve graft was used in only 7.7% (7/91) of patients. The incidence of long-term myocardial infarction was 4.4% (4/91). Survival at 1 and 5 years was 93% and 89% respectively. There was no significant association with the utilization of Cabrol graft and long-term mortality (Hazard Ratio 1.74, 95% CI 0.76-4.01, p-value 0.219).</p><p><strong>Conclusions: </strong>Patients undergoing the modified Cabrol technique had an acceptable risk of mortality in short- and midterm follow-up. The modified Cabrol technique is a valuable tool in an aortic surgeon's arsenal and should be used selectively.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179982","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":"Patient-Surgeon Communication in Thoracic Surgery: Insights from a European Multi-Country Survey on the Perioperative Experience.","authors":"Jonathan Pineda, Obieda Atiyani, Nicolas Moreno, Nuria Novoa, Sergio Bolufer Nadal, Peter Zsoldos, Karel Pfeuty, Mahmoud Ismail, Peter Licht, Mario Nosotti, Majed Refai, Elizabeth Belcher, Melanie Jenkins, Marcin Zielinski, Róbert Baláž, Ivan Kuhajda, Debra Montague, Miro Janik, József Furák, Ann-Marie Baird, Gianluca Casali, Cecilia Pompili","doi":"10.1093/icvts/ivaf228","DOIUrl":"https://doi.org/10.1093/icvts/ivaf228","url":null,"abstract":"<p><strong>Objectives: </strong>Many advancements have occurred in surgery from the technical side with increasingly sophisticated minimally invasive surgical options to the patient care side with the advent of ERAS and patient-related outcomes research. Patient-related outcomes research has allowed providers to focus on what is most important to a patient when it comes to quality of life, however, an ill-defined disconnect persists between the desires of patients and the perspectives of surgeons on what the patient values the most.</p><p><strong>Methods: </strong>A rigorously designed multi-country European survey of 9 carefully curated questions meant to mimic the perioperative journey for both the patient and surgeon distributed through an online link or paper version who recently underwent thoracic surgery and to surgeons involved with thoracic surgical care to explore the possible disconnect of perceptions of care throughout the perioperative journey.</p><p><strong>Results: </strong>A total of 444 participants (230 patients and 214 surgeons) from different parts of Europe responded to the survey. Noted discrepancies were found throughout the preoperative, intraoperative and post-operative phases when it came to perception of information given and understood, what was communicated, and how care was implemented.</p><p><strong>Conclusions: </strong>This study identifies critical gaps in the communication and perception of surgical care between patients and surgeons, emphasizing the need for the implementation of shared decision-making, and increasing awareness of enhanced holistic support throughout the perioperative journey.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152047","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}

{"title":"Intraoperative diaphragmatic plication during initial surgery with phrenic nerve resection.","authors":"Tomomi Isono, Mitsunori Ohta, Ryu Kanzaki, Jiro Okami, Yasunobu Funakoshi, Seiji Taniguchi, Yoshihisa Kadota, Kensuke Kojima, Toshiteru Tokunaga, Satoshi Kawanaka, Yukiyasu Takeuchi, Hidenori Kusumoto, Hiroyuki Shiono, Hideoki Yokouchi, Teruo Iwasaki, Naoki Ikeda, Naoko Ose, Yasushi Shintani","doi":"10.1093/icvts/ivaf233","DOIUrl":"https://doi.org/10.1093/icvts/ivaf233","url":null,"abstract":"<p><strong>Objectives: </strong>Diaphragmatic palsy can result in respiratory failure, potentially alleviated by diaphragmatic plication. Nevertheless, the benefits of preventive plication during phrenic nerve resection remain uncertain. This study evaluated whether preventive plication during primary surgery involving phrenic nerve resection alleviate paradoxical diaphragmatic movement and pulmonary function loss.</p><p><strong>Methods: </strong>Among 24,527 surgeries for lung cancer or mediastinal tumors at 11 institutions, 142 involved phrenic nerve resections. Of these, 132 patients were retrospectively analyzed. Diaphragmatic displacement and pulmonary function were assessed pre- and postoperatively. Displacement was quantified by measuring thoracic height on pre- and postoperative chest X-rays (D, D'). Diaphragmatic displacement ratio was defined as: DDR = (D'-D)/D×100.</p><p><strong>Results: </strong>Seventy patients (53%) underwent preventive diaphragmatic plication during the primary surgery; 62 (47%) did not. Differences were significant overall and more pronounced in those undergoing left lobectomy or more extensive resection. In this subgroup, plication was associated with a smaller change in DDR (-30.1 ± 7.7% vs. -20.2 ± 7.7%, p = 0.002), and smaller declines in percent predicted forced vital capacity (-30.5 ± 8.0% vs. -16.8 ± 17.7%, p = 0.029) and forced expiratory volume in one second (-31.6 ± 11.0% vs. -19.0 ± 14.5%, p = 0.046).</p><p><strong>Conclusions: </strong>In patients undergoing left lobectomy or more extensive resections involving phrenic nerve resection, intraoperative diaphragmatic plication may help preserve postoperative pulmonary function. However, due to the small sample size and limited generalizability, these findings should be interpreted cautiously.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152054","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}

{"title":"The clinical impact of the tongue pressure measurement and the novel preoperative training program with the tongue strength training device.","authors":"Shiori Marui, Takeshi Shimamoto, Makoto Takehara, Koki Tamaoka, Takayoshi Tsukahara, Yu Hidaka, Yuriko Muramatsu, Kazuhisa Sakamoto","doi":"10.1093/icvts/ivaf225","DOIUrl":"https://doi.org/10.1093/icvts/ivaf225","url":null,"abstract":"<p><strong>Objectives: </strong>In cardiovascular surgery, frailty is a risk for postoperative dysphagia. This study investigated the effect of preoperative training on strengthening the tongue muscle and its clinical impact.</p><p><strong>Methods: </strong>Patients scheduled for cardiovascular surgery between 2022 and 2024 who underwent preoperative tongue pressure measurement were included. Preoperative tongue muscle training was conducted using the novel device Pecopanda.</p><p><strong>Results: </strong>Forty-two patients who purchased the Pecopanda and received preoperative training were assigned to the training group, and 66 patients without training or with maintained tongue pressure were assigned to the non-training group. Low tongue pressure below 30 kPa was observed in 44.4% of patients. Age was 76 (71-81) years in the training group and 70 (59-75) years in the non-training group. Change in tongue pressure pre- to post-operation was 0.2 (IQR: -1.3 to 7.0) kPa in the training group, and -2.2 (IQR: -4.4 to -0.5) kPa in the non-training group. Multiple regression analysis showed that changes in tongue pressure pre- and post-operation tended to be greater in the training group (β  =  1.342, 95% CI: -0.825 to 3.509). Logistic regression analysis suggested a trend towards a protective association between preoperative tongue training and deglutition diets or tube feeding at refeeding (OR = 0.81, 95% CI: 0.26 to 2.48). All patients in the training group were discharged home without the need for deglutition diets and tube feeding.</p><p><strong>Conclusions: </strong>Preoperative training with simple tongue exercises may increase tongue pressure and support clinical outcomes in patients with low tongue pressure.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132850","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}

{"title":"Long-term outcomes of concomitant left-sided cryoablation during totally endoscopic mitral valve surgery.","authors":"Ilia Bazhanov, Johannes Petersen, Yalin Yildirim, Jonas Pausch, Evaldas Girdauskas, Yousuf Al Assar, Hermann Reichenspurner, Simon Pecha","doi":"10.1093/icvts/ivaf215","DOIUrl":"https://doi.org/10.1093/icvts/ivaf215","url":null,"abstract":"<p><strong>Objectives: </strong>Concomitant atrial fibrillation ablation is a well-established procedure in patients undergoing mitral valve surgery. However, data concerning the long-term outcomes of cryoablation performed during totally endoscopic mitral valve surgery remain limited. Furthermore, different lesion sets and energy sources used in endoscopic approach may result in varying outcomes. We therefore, analyzed rhythm outcome in patients undergoing left-sided cryoablation during totally endoscopic mitral valve surgery.</p><p><strong>Methods: </strong>Patients, who underwent totally-endoscopic mitral valve surgery with concomitant left-sided cryoablation between 2016 and 2023 at our center were included in the study. The retrospective data analysis was based on 24-hour Holter monitor follow-up data.</p><p><strong>Results: </strong>A total of 123 patients were included in the study. No complications related to the ablation procedure were observed. The median follow-up period was 36.0 (interquartile range: 17-60) months. During this period, 34 episodes of atrial fibrillation recurrence were documented, corresponding to a recurrence rate of 8.43 per 100 patient-years (95% confidence interval: 5.90 to 11.73). The estimated freedom from AF at 1, 3, and 5 years were 96.6%, 86.3% and 69.4% respectively. Type of atrial fibrillation (p = 0.004; hazard ratio [HR]: 2.521; 95% confidence interval [CI]: 1.347-4.716) and left atrial volume (p = 0.003; HR: 1.010; 95% CI: 1.003-1.016) were identified as predictors for atrial fibrillation recurrence.</p><p><strong>Conclusions: </strong>Concomitant left-sided cryoablation during totally endoscopic mitral valve surgery is a safe and effective procedure for atrial fibrillation treatment. The encouraging long-term outcomes support the conside ration of this approach in totally endoscopic mitral surgery.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132620","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}

{"title":"The prognostic significance of subcarinal lymph node dissection in esophagectomy for middle and lower thoracic squamous cell carcinoma.","authors":"Si Wei Xu, Jun Feng Liu, Yu Rong, Xin Bo Liu, Zhi Hua Shi, Bing Ji Cao, Shao Wei Zhang","doi":"10.1093/icvts/ivaf219","DOIUrl":"10.1093/icvts/ivaf219","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study assesses the prognostic value of subcarinal lymph node dissection (SCLND) in esophageal squamous cell carcinoma (ESCC) of the middle and lower thoracic regions.</p><p><strong>Methods: </strong>The study, conducted at the Fourth Hospital of Hebei Medical University, included 1587 patients with ESCC who underwent radical resection from 2008 to 2014, comprising 204 patients in the non-SCLND group and 1383 patients in the SCLND group. After applying inverse probability of treatment weighting (IPTW) to adjust for confounders, Kaplan-Meier curves, log-rank tests, and Cox regression were used for survival analysis, performed using R.</p><p><strong>Results: </strong>SCLN metastasis was found in 9.8% of patients. Factors influencing metastasis included pathologic T stage (P < 0.001) and N stage (P < 0.001). SCLN metastasis significantly affected overall survival, with 5-year rates of 49.0% for non-metastatic versus 7.0% for metastatic patients. SCLND improved long-term survival for T3-T4a stage patients but not for T1-T2.</p><p><strong>Conclusions: </strong>Despite a low SCLN metastasis rate, its presence significantly worsens prognosis. SCLND does not significantly improve long-term survival in patients with pathologic T1-T2 tumors, but it may confer a survival benefit in T3-T4a stage disease, supporting individualized surgical decisions regarding lymph node dissection.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12526115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132782","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":"Prospective observational study comparing systemic inflammatory responses across different perfusion systems during isolated on-pump Coronary Artery Bypass Grafting.","authors":"Kaan Kırali, Sibel Aydın, Ayhan Güneş, Mehmet Aksüt, Eray Metin Güler, Mustafa Emre Gürcü","doi":"10.1093/icvts/ivaf221","DOIUrl":"10.1093/icvts/ivaf221","url":null,"abstract":"<p><strong>Objectives: </strong>Minimal Invasive Extracorporeal Circulation (MiECC) and Hybrid System (HS) have been introduced to potentially reduce this inflammatory response compared to conventional Cardiopulmonary Bypass (cCPB). The hybrid system combines elements of conventional and minimized circuits, including a collapsible reservoir, integrated arterial filter, and hypobaric oxygenator, allowing rapid conversion and air embolism control.This study aims to provide a comparative analysis of biomarkers of systemic inflammatory response induced by MiECC, HS and cCPB systems in isolated CABG patients.</p><p><strong>Methods: </strong>In this prospective pilot observational study a total of 66 patients who underwent isolated on-pump CABG performed under aortic cross-clamp enrolled. in this single-center, prospective pilot study. Systemic inflammatory markers (IL-1β, IL-6, IL-8, TNF-α, LE, HIF-1α) and oxidative status were measured at five intervals: preoperative (pre-pump), intraoperative (on-pump), and at 6, 12, and 24 hours postoperatively (post-pump).</p><p><strong>Results: </strong>A total of 66 patients were enrolled: MiECC (n = 20), Hybrid System (HS, n = 22), and cCPB (n = 24). Notably, 2 patients initially assigned to MiECC required intraoperative conversion to cCPB due to haemodynamic instability. Both MiECC and HS groups consistently showed lower levels of systemic inflammatory biomarkers and oxidative stress indicators at all intraoperative and postoperative time points compared to cCPB. For instance, IL-6 levels at 6 hours post-op were 292 pg/mL in MiECC, 311 pg/mL in HS, and 514 pg/mL in cCPB; Oxidative Stress Index values at the same time point were 70 in MiECC, 66 in HS, and 142 in cCPB. Hemoglobin decline was least pronounced in the MiECC group, and red blood cell transfusion was required in 50% of cCPB patients, compared to 10% in MiECC and 13.6% in HS. HIF-1α levels were higher in HS than MiECC at 12 hours post-op (3.8 vs 2.6 ng/mL). No substantial differences were observed between groups in troponin, creatinine, or lactate values.</p><p><strong>Conclusions: </strong>MiECC and HS show a similar profile in alleviating systemic inflammation, with notable reductions in inflammatory biomarkers and key clinical oxidative outcomes compared with cCPB. These results underscore the potential of MiECC and HS to improve clinical recovery by minimizing the inflammatory effect in on-pump CABG procedures.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132640","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}