{"title":"Intrathoracic Needle Migration from the Mediastinum into the Thoracic Cavity.","authors":"Tomo Sato, Yasufumi Kato, Hiroaki Kataba, Koichi Yoshida, Hiroki Hayashi, Masatoshi Kakihana, Norihiko Ikeda","doi":"10.5761/atcs.cr.24-00039","DOIUrl":"10.5761/atcs.cr.24-00039","url":null,"abstract":"<p><p>Intrathoracic needles are rarely used in clinical practice. They can migrate within the body, injure large blood vessels and other organs, and cause severe complications. We report an interesting case of intrathoracic needle removal using video-assisted thoracoscopic surgery. The needle was inserted under the left clavicle, penetrated the mediastinum, and migrated into the right thoracic cavity. Although pneumothorax developed during the disease course, no severe complications were observed. This rare case illustrates the course of needle migration from the mediastinum into the thoracic cavity. Prompt imaging and surgical removal of foreign bodies are necessary in cases of intrathoracic foreign bodies.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873934","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":"Surgical and Perioperative Treatments for Esophagogastric Junction Cancer.","authors":"Yoshitomo Yanagimoto, Yukinori Kurokawa, Yuichiro Doki","doi":"10.5761/atcs.ra.24-00056","DOIUrl":"10.5761/atcs.ra.24-00056","url":null,"abstract":"<p><p>Esophagogastric junction cancer (EGJC) is a rare malignant disease that occurs in the gastroesophageal transition zone. In recent years, its incidence has been rapidly increasing not only in Western countries but also in East Asia, and it has been attracting the attention of both clinicians and researchers. EGJC has a worse prognosis than gastric cancer (GC) and is characterized by complex lymphatic drainage pathways in the mediastinal and abdominal regions. EGJC was previously treated in the same way as GC or esophageal cancer, but, in recent years, it has been treated as an independent malignant disease, and treatment focusing only on EGJC has been developed. A recent multicenter prospective study revealed the frequency of lymph node metastasis by station and established the optimal extent of lymph node dissection. In perioperative treatment, the combination of multi-drug chemotherapy, radiation therapy, molecular targeted therapy, and immunotherapy is expected to improve the prognosis. In this review, we summarize previous clinical trials and their important evidence on surgical and perioperative treatments for EGJC.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262321","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":"Prognostic Impact of Serum SCC Antigen in the 566 Upfront Surgery Group of Esophageal Squamous Cell Carcinoma: A Multi-Institutional Study of the Japan Esophageal Society.","authors":"Takashi Suzuki, Satoshi Yajima, Akihiko Okamura, Naoya Yoshida, Yusuke Taniyama, Kentaro Murakami, Yu Ohkura, Yasuaki Nakajima, Koichi Yagi, Takashi Fukuda, Ryo Ogawa, Isamu Hoshino, Chikara Kunisaki, Kosuke Narumiya, Yasuhiro Tsubosa, Kazuhiko Yamada, Hideaki Shimada","doi":"10.5761/atcs.oa.24-00028","DOIUrl":"10.5761/atcs.oa.24-00028","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the clinicopathologic and prognostic significance of squamous cell carcinoma antigen (SCC-Ag) in patients with esophageal SCC who underwent radical surgery without neoadjuvant therapy.</p><p><strong>Methods: </strong>This study included 566 patients with primary esophageal SCC who underwent radical resection without neoadjuvant therapy at 15 Japanese hospitals between 2008 and 2016. The cutoff value of SCC-Ag was 1.5 ng/mL based on the receiver operating characteristic curves. Preoperative SCC-Ag and postoperative SCC-Ag were analyzed to evaluate clinicopathological and prognostic significance. Survival curves were compared between the SCC-Ag-positive group and the SCC-Ag-negative group. The prognostic impact of SCC-Ag was evaluated using univariate and multivariate analyses.</p><p><strong>Results: </strong>The preoperative SCC-Ag-positive rate was 23.5% (133/566). SCC-Ag-positive status was significantly associated with old age (p = 0.042), tumor depth (p <0.001), and tumor stages (p <0.001). The preoperative SCC-Ag-positive group had significantly poorer overall survival than the SCC-Ag-negative group (p = 0.030), but it was not an independent predictor of poor prognosis. Postoperative SCC-Ag-positive status was an independent risk factor for poor overall survival (p = 0.034).</p><p><strong>Conclusion: </strong>Both pre- and postoperative SCC-Ag-positive statuses were significantly associated with poor prognosis. Postoperative SCC-Ag-positive status was an independent risk factor for predicting overall survival.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867031","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}
Lei Yang, Zhiyi Xiang, Min Dai, Qiufeng Zhang, Ying Zhou
{"title":"Prognosis of Lung Transplantation in Patients with Acute Exacerbations of Interstitial Lung Disease: A Meta-Analysis Based on Cohort Studies.","authors":"Lei Yang, Zhiyi Xiang, Min Dai, Qiufeng Zhang, Ying Zhou","doi":"10.5761/atcs.ra.24-00086","DOIUrl":"10.5761/atcs.ra.24-00086","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to examine the prognosis of patients with acute exacerbation of interstitial lung disease (AE-ILD) treated with lung transplantation compared to those with stable interstitial lung disease (ILD).</p><p><strong>Methods: </strong>We conducted a detailed search in PubMed, Embase, Web of Science, and the Cochrane Library, with the primary outcomes being overall survival (OS), acute cellular rejection (ACR), primary graft dysfunction (PGD), and length of stay (LOS).</p><p><strong>Results: </strong>Five cohort studies were included in this meta-analysis, with 183 patients enrolled in the AE-ILD group and 337 patients in the stable-ILD group. The results showed that in regard to perioperative outcomes, the AE-ILD group did not differ from the stable-ILD group in the incidence of ACR (relative risks [RR] = 0.34, p = 0.44) and the incidence of PGD Ⅲ (RR = 0.53, p = 0.43), but had a longer LOS (mean difference = 9.15, p = 0.02). Regarding prognosis, the two also did not differ in 90-day OS (RR = 0.97, p = 0.59), 1-year OS (RR = 1.05, p = 0.66), and 3-year OS (RR = 0.91, p = 0.76).</p><p><strong>Conclusion: </strong>Our study concluded that the efficacy of lung transplantation in patients with AE-ILD is not inferior to that of patients with stable ILD. Lung transplantation is one of the potential treatments for patients with AE-ILD.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556204","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":"Comparative Analysis of Metabolomic Responses in On-Pump and Off-Pump Coronary Artery Bypass Grafting.","authors":"Chananya Karunasumetta, Wijittra Tourthong, Rachata Mala, Chotika Chatgasem, Theerayut Bubpamala, Suriya Punchai, Kittisak Sawanyawisuth","doi":"10.5761/atcs.oa.24-00126","DOIUrl":"10.5761/atcs.oa.24-00126","url":null,"abstract":"<p><strong>Purpose: </strong>Although the clinical outcomes of on-pump (ONCAB) and off-pump CABG (OPCAB) are well established, their metabolomic impacts remain underexplored. This study aims to compare the metabolic profiles of ONCAB and OPCAB to identify differential metabolites associated with clinical outcomes.</p><p><strong>Methods: </strong>In a prospective cohort study conducted between January 2023 and September 2023, 100 plasma samples from 20 patients undergoing isolated elective CABG (10 per group) were analyzed. Samples were collected preoperatively and at multiple postoperative time points (Days 0-3) and processed using proton nuclear magnetic resonance (<sup>1</sup>H-NMR). Advanced statistical modeling was applied to identify differential metabolites.</p><p><strong>Results: </strong>No significant differences were found in clinical outcomes, although ONCAB showed higher postoperative CKMB levels. Both procedures induced metabolomic alterations, with ONCAB demonstrating a more substantial impact, particularly on Day 0. Key metabolites, including leucine, succinate, creatine, glucose, and adenine, affected starch and sucrose metabolism.</p><p><strong>Conclusion: </strong>ONCAB induces more pronounced metabolic shifts immediately postsurgery, involving protein and energy turnover, oxidative stress, and disrupted glucose metabolism, indicative of cellular stress responses. A comprehensive understanding of these metabolic changes is critical for informing targeted interventions and supports the use of OPCAB as a preferred strategy for patients with elevated metabolic risks.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780941","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":"Lipid Pneumonia Mimicking Lung Cancer in a Middle-Age Woman.","authors":"Jiun-Chang Wu, Tung-Ying Chen, Huang Wen-Chien, Jie-Jen Lee, Chih-Hao Chen","doi":"10.5761/atcs.cr.24-00117","DOIUrl":"10.5761/atcs.cr.24-00117","url":null,"abstract":"<p><p>Lipid pneumonia is exceedingly rare, with only a few reported cases to date. A 46-year-old woman with a history of left breast cancer underwent a left-modified radical mastectomy, adjuvant chemotherapy, and radiotherapy. Despite no known exposure to lipids, she presented with chronic non-productive cough and general malaise. Follow-up chest computed tomography revealed progressive ground-glass opacities in the left lower lung, initially suspected to be lobar bronchioloalveolar carcinoma. Surgical intervention was performed for both diagnostic and therapeutic purposes, confirming the lesion as lipid pneumonia upon pathological examination, revealing the presence of foamy histiocytes.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549498","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":"Right Lower Sleeve Lobectomy: Detailed Technique and Perioperative Patient Management.","authors":"Hidetoshi Inoue, Takuma Tsukioka, Nobuhiro Izumi, Kantaro Hara, Satoshi Suzuki, Takuya Tanimura, Noritoshi Nishiyama","doi":"10.5761/atcs.oa.24-00026","DOIUrl":"10.5761/atcs.oa.24-00026","url":null,"abstract":"<p><strong>Purpose: </strong>This report reviews our experience with right lower sleeve lobectomy and describes our technique and approach to perioperative patient management.</p><p><strong>Methods: </strong>We retrospectively reviewed 11 patients who underwent right lower sleeve lobectomy for lung cancer. Surgical techniques and perioperative management were also investigated.</p><p><strong>Results: </strong>Bronchoplasty was performed using 4-0 absorbable monofilament sutures. The deepest portion was anastomosed using continuous sutures; interrupted sutures were used for the more superficial portions. The truncus intermedius and right middle lobe bronchus should be anastomosed in a natural position. Anastomosis patency was confirmed using intraoperative bronchoscopy. Separation of the right upper and middle lobes and pericardiotomy at the inferior edge of the superior pulmonary vein are useful for mobilizing the right middle lobe. Death during hospitalization and treatment-related death did not occur. One patient developed pneumonia, and another developed a bronchopleural fistula.</p><p><strong>Conclusion: </strong>We reported our technique of right lower sleeve lobectomy and our approach to perioperative patient management. Sharing knowledge is essential to completing this rare surgery.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862411","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}
Jingquan Han, Xi Yan, Hongwei Cui, Hang Zhang, Bei Lu, Jinzhi Xu
{"title":"Robot-Assisted Correction of a Supra-Long Tracheal Stenosis Using C-Type Nickel-Titanium Alloy Exterior Stenting and Suspension Fixation Technique: A Case Report.","authors":"Jingquan Han, Xi Yan, Hongwei Cui, Hang Zhang, Bei Lu, Jinzhi Xu","doi":"10.5761/atcs.cr.24-00012","DOIUrl":"10.5761/atcs.cr.24-00012","url":null,"abstract":"<p><p>T-tubes and airway stents are commonly used but have limited effectiveness and frequent complications. A 50-year-old male patient presented with severe tracheal stenosis, affecting an 8.7 cm length of the airway. We employed an innovative approach known as external suspension fixation of tracheal stent using robotic assistance. This method involves surgically attaching the stent to the exterior of the trachea to provide support and stabilize the softened or collapsed tracheal segments. We designed a C-shaped nickel-titanium alloy exterior stent and successfully fixed it using robotic assistance. This intervention effectively restored tracheal function and led to a favorable postoperative recovery. The technique does not affect tracheal membrane function or airway mucociliary clearance. It could potentially be considered as a new option for treating long-segment benign tracheal softening or collapse.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262320","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":"Curved Axillary Incision with Video-Assisted Thoracoscopic Surgery: An Alternative Approach for Teenage Female with Large Apical Chest Wall Tumor.","authors":"Ryoichiro Doi, Hiromi Ichikawa, Keitaro Matsumoto, Koichi Tomoshige, Ryusuke Machino, Shinji Okano, Takeshi Nagayasu","doi":"10.5761/atcs.cr.23-00189","DOIUrl":"10.5761/atcs.cr.23-00189","url":null,"abstract":"<p><p>Primary chest wall tumors are rare, their common clinical features are not well known, and surgical resection remains the main treatment. Apical chest wall tumors require large skin incisions and dissection of the chest wall muscles, making it difficult to maintain cosmetic appearance, respiratory function, and support of the upper extremity. There are few treatment options and no studies have reported on thoracotomy that spares muscles and preserves cosmetic superiority. However, in benign chest wall tumors in young patients, it is necessary to consider radicality, cosmetic superiority, and muscle sparing. We used a combined axillary incision and thoracoscopic approach to treat a massive myxoid neurofibroma at the apical chest wall in a 14-year-old female and were able to preserve the chest wall, upper limb function, and cosmetic aspects. This report provides a detailed description of the combined axillary incision and thoracoscopic approach for apical chest wall tumors.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095318","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}
Yongkang Di, Rongrong Fu, Zhiyi Xiang, Huiwen Sun, Min Dai, Qiufeng Zhang, Yuexiu Si
{"title":"Comparison of Prognosis for Lung Transplantation between Older and Younger Donors: A Systematic Review and Meta-Analysis Based on Cohort Studies.","authors":"Yongkang Di, Rongrong Fu, Zhiyi Xiang, Huiwen Sun, Min Dai, Qiufeng Zhang, Yuexiu Si","doi":"10.5761/atcs.ra.24-00092","DOIUrl":"10.5761/atcs.ra.24-00092","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to compare the prognosis of lung transplantation recipients based on donor age.</p><p><strong>Methods: </strong>A detailed search was performed in PubMed, Embase, Web of Science, and the Cochrane Library for cohort studies on lung transplantation. The prognosis of lung transplant recipients was investigated based on the donor age, with the primary outcomes being 1-year overall survival (OS), 3-year OS, 5-year OS, and 5-year chronic lung allograft dysfunction (CLAD)-free survival.</p><p><strong>Results: </strong>This meta-analysis included 10 cohort studies. Among the short-term outcomes, the older donor group demonstrated no significant difference from the young donor group in primary graft dysfunction within 72 hours, use of extracorporeal membrane oxygenation, length of ventilator use, and intensive care unit hours. However, a longer hospital stay was associated with the older donor group. In terms of long-term outcomes, no difference was found between the two groups in 1-year OS, 3-year OS, and 5-year OS. Notably, patients with older donors exhibited a superior 5-year CLAD-free survival.</p><p><strong>Conclusions: </strong>The results of this meta-analysis indicate that older donors are not inferior to younger donors in terms of long-term and short-term recipient outcomes. Lung transplantation using older donors is a potential therapeutic option after rigorous evaluation.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903911","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}