Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia最新文献_第5页

The Below-the-Knee Approach to Percutaneous Mechanical Thrombectomy for Lower Extremity Deep Venous Thrombosis: A Retrospective Single-Centre, Single-Arm Study. 经皮机械取栓术治疗下肢深静脉血栓的膝下入路：单中心、单臂回顾性研究。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.24-00015

Wenrui Li, Lei Jin, Hai Feng, Xueming Chen, Zhiwen Zhang

{"title":"The Below-the-Knee Approach to Percutaneous Mechanical Thrombectomy for Lower Extremity Deep Venous Thrombosis: A Retrospective Single-Centre, Single-Arm Study.","authors":"Wenrui Li, Lei Jin, Hai Feng, Xueming Chen, Zhiwen Zhang","doi":"10.5761/atcs.oa.24-00015","DOIUrl":"10.5761/atcs.oa.24-00015","url":null,"abstract":"Purpose: The objective of this study was to evaluate the safety, efficacy, and feasibility of percutaneous mechanical thrombectomy (PMT) through a below-the-knee (BTK) approach for acute lower extremity deep venous thrombosis (DVT).Methods: A retrospective review of DVT patients treated with PMT by the BTK approach at our center from April 2022 to August 2023 was performed. Their preoperative demographics, intraoperative data, and postoperative outpatient outcomes were analyzed.Results: A total of 12 patients (67% men; mean age, 63 years) met the inclusion criteria. The BTK approach was successfully achieved in all patients through the posterior tibial vein (n = 1), anterior tibial vein (n = 2), and peroneal vein (n = 9). PMTs were achieved in 11 (92%) patients. Successful lysis (grade II and grade III lysis) was achieved in all patients with PMT. Four (33%) patients had residual venous occlusion over the popliteal vein. No intraoperative complications or bleeding events occurred in any of the patients.Conclusion: PMT via BTK puncture seems to be a safe and effective approach for treating lower extremity DVT. It is reserved for highly select patients with a low risk of bleeding and is performed at centers that have experience with this procedure.","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/PMC11060836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308268","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

Prospective Observation Study for Primary Spontaneous Pneumothorax: Incidence of and Risk Factors for Postoperative Neogenesis of Bullae. 原发性自发性气胸的前瞻性观察研究：术后肺泡新生的发生率和风险因素。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.23-00206

Chihiro Furuta, Motoki Yano, Yuka Kitagawa, Ryotaro Katsuya, Naoki Ozeki, Takayuki Fukui

{"title":"Prospective Observation Study for Primary Spontaneous Pneumothorax: Incidence of and Risk Factors for Postoperative Neogenesis of Bullae.","authors":"Chihiro Furuta, Motoki Yano, Yuka Kitagawa, Ryotaro Katsuya, Naoki Ozeki, Takayuki Fukui","doi":"10.5761/atcs.oa.23-00206","DOIUrl":"10.5761/atcs.oa.23-00206","url":null,"abstract":"Purpose: Details of the neogenesis of bullae (NOB), which causes recurrent primary spontaneous pneumothorax (PSP) following bullectomy, have not been reported and risk factors for NOB remain unclear. We aimed to clarify the details of NOB.Methods: We conducted a prospective study using three computed tomography (CT) examinations performed 6, 12, and 24 months after bullectomy to identify the incidence of and risk factors for NOB. We enrolled 50 patients who underwent bullectomy for PSP.Results: After excluding 11 patients who canceled the postoperative CT examination at 6 months after bullectomy, only 39 patients were analyzed. The incidence of NOB at 6, 12, and 24 months after bullectomy was 38.5%, 55.2%, and 71.2%, respectively. The rate of NOB in the operated lung was almost 2 times higher than that in the contralateral nonoperative lung. Male sex, multiple bullae on preoperative CT, long stapling line (≥7 cm), deep stapling depth (≥1.5 cm), and heavier resected sample (≥5 g) were suggested to be risk factors for NOB.Conclusions: We recognized a high incidence of postoperative NOB in PSP patients. Bullectomy itself seems to promote NOB. Postoperative NOB occurs frequently, especially in patients who require a large-volume lung resection with a long staple line.","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/PMC11082493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861273","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

Posterior Papillary Muscle Suspension for Treating Systolic Anterior Motion in Hypertrophic Obstructive Cardiomyopathy. 治疗肥厚型梗阻性心肌病收缩期前移的乳头肌后悬吊术

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.nm.23-00176

Taiki Ito, Satoru Wakasa, Koji Sato, Shinji Abe, Taro Minamida

{"title":"Posterior Papillary Muscle Suspension for Treating Systolic Anterior Motion in Hypertrophic Obstructive Cardiomyopathy.","authors":"Taiki Ito, Satoru Wakasa, Koji Sato, Shinji Abe, Taro Minamida","doi":"10.5761/atcs.nm.23-00176","DOIUrl":"10.5761/atcs.nm.23-00176","url":null,"abstract":"Systolic anterior motion of the anterior mitral leaflet can persist after ventricular septal myectomy for obstructive hypertrophic cardiomyopathy, resulting in residual pressure gradients and mitral regurgitation. However, additional procedures for systolic anterior motion involving mitral valve leaflet suturing and resection may lead to future valve disease. Therefore, we adopted posterior papillary muscle suspension, a subvalvular procedure for functional mitral regurgitation, to treat systolic anterior motion without directly intervening in the mitral valve leaflets. Papillary muscle suspension toward the posterior mitral annulus moved the papillary muscles away from the interventricular septum and successfully eliminated the systolic anterior motion and midventricular pressure gradient. In terms of avoiding direct mitral interventions, this procedure is a viable option for systolic anterior motion, especially in cases of very mild mitral regurgitation.","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/PMC10902854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725362","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

Excision of Giant Chronic Expanding Hematoma of the Thorax Caused by Rib Fractures after Proton Radiotherapy for Lung Cancer. 肺癌质子放疗后肋骨骨折引起的胸部巨大慢性膨胀性血肿切除术

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.cr.24.00121

Yukitaka Sato, Hironori Ishibashi, Yuki Funauchi, Kenichi Okubo

{"title":"Excision of Giant Chronic Expanding Hematoma of the Thorax Caused by Rib Fractures after Proton Radiotherapy for Lung Cancer.","authors":"Yukitaka Sato, Hironori Ishibashi, Yuki Funauchi, Kenichi Okubo","doi":"10.5761/atcs.cr.24.00121","DOIUrl":"10.5761/atcs.cr.24.00121","url":null,"abstract":"Chronic expanding hematoma (CEH) is defined as a hematoma that gradually expands over months to years. An 82-year-old female underwent proton radiotherapy for left upper lobe lung cancer 10 years previously. Two years after the therapy, a hematoma developed from the left 3rd to 5th dorsal rib fractures and gradually expanded, causing contraction of the left shoulder. Transcatheter arterial embolization was performed; however, the hematoma continued to expand with thrombocytopenia, and the platelet was decreased to 4.2 × 104/μL. Computed tomography showed a 17.2 × 14.0 × 10.0 cm mass between the left scapula and left dorsal ribs. The CEH of the thorax was completely excised with combined resection of the 3rd to 5th ribs, while the brachial plexus was preserved. Postoperatively, the platelet completely recovered and she could raise her left arm. A complete excision with surrounding organs preserved is the strategy used in the treatment of CEH of the thorax.","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/PMC11439597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334221","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

Extracorporeal Mechanical Circulatory Support after Pulmonary Thromboendarterectomy: Experience of One Center. 肺血栓内膜切除术后的体外机械循环支持：一家中心的经验。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.24-00070

Brunella Bertazzo, Alejandro Cicolini, Martin Fanilla, Liliana Favaloro, Jorge Caneva, Roberto R Favaloro

{"title":"Extracorporeal Mechanical Circulatory Support after Pulmonary Thromboendarterectomy: Experience of One Center.","authors":"Brunella Bertazzo, Alejandro Cicolini, Martin Fanilla, Liliana Favaloro, Jorge Caneva, Roberto R Favaloro","doi":"10.5761/atcs.oa.24-00070","DOIUrl":"10.5761/atcs.oa.24-00070","url":null,"abstract":"Purpose: Pulmonary thromboendarterectomy (PTE) is the treatment for patients with chronic thromboembolic disease. In the immediate postoperative period, some patients may still experience life-threatening complications such as reperfusion lung injury, airway bleeding, and persistent pulmonary hypertension with consequent right ventricular dysfunction. These issues may require support with extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or lung transplantation. This study aims to analyze our series of PTEs that require ECMO.Methods: A descriptive and retrospective analysis of all PTE performed at the Favaloro Foundation University Hospital was conducted between March 2013 and December 2023.Results: A total of 42 patients underwent PTE with a median age of 47 years (interquartile range: 26-76). The incidence of patients with ECMO was 26.6%, of which 53.6% were veno-venous (VV) ECMO. Preoperatively, a low cardiac index (CI), high right and left filling pressures, and high total pulmonary vascular resistances (PVRs) were associated with ECMO with a statistically significant relationship. The hospital mortality was 11.9%, and the mortality in the ECMO group was 45.5%, with a statistically significant relationship. Veno-arterial ECMO has a worse prognosis than VV ECMO.Conclusions: Preoperatively, a low CI, high right and left filling pressures, and high total PVRs were associated with ECMO after PTE.","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/PMC11320365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903912","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

Evaluation of the Factors Affecting Higher Hospitalization Cost of Lung Resection for Primary Lung Cancer: A Retrospective Cohort Study. 评估原发性肺癌肺切除术住院费用较高的影响因素：一项回顾性队列研究

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.23-00180

Yukio Umeda, Shinsuke Matsumoto, Kiyohiko Hagiwara, Shoji Yoshikawa, Alex Chen

{"title":"Evaluation of the Factors Affecting Higher Hospitalization Cost of Lung Resection for Primary Lung Cancer: A Retrospective Cohort Study.","authors":"Yukio Umeda, Shinsuke Matsumoto, Kiyohiko Hagiwara, Shoji Yoshikawa, Alex Chen","doi":"10.5761/atcs.oa.23-00180","DOIUrl":"10.5761/atcs.oa.23-00180","url":null,"abstract":"Purpose: This study aims to evaluate the factors associated with the higher hospitalization cost of lung resection for primary lung cancer to contribute to the reduction of healthcare spending.Methods: A total of 435 consecutive primary lung cancer patients who underwent lung resection by a single surgeon at a single institution were enrolled. Baseline patient characteristics, operative procedures, postoperative complications, and postoperative courses were analyzed in relation to the hospitalization cost. Patients with higher costs (exceeding the third quartile [TQ]) were compared with patients with lower costs (less than TQ).Results: Median and TQ medical costs for overall cases were 11177 US dollars (USD) and 12292 USD, respectively. Smoking history, history of coronary artery disease, previous thoracotomy, multiple sealant material use, transfusion, tumor factor T3 or higher, squamous cell carcinoma, postoperative complications, and longer postoperative hospital stay (>10 POD) were significant risk factors for increased hospitalization cost in multivariate analysis. The 5-year survival rate was significantly lower in the higher hospitalization cost group.Conclusion: In addition to postoperative complications and prolonged hospitalization, patient background, histological types, and intraoperative factors were also considered as the risk factors for higher medical costs.","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/PMC11041846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704238","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 and Risk Factors Associated with Pericardiectomy in Patients with Constrictive Pericarditis: A Retrospective Study from China. 与缩窄性心包炎患者心包切除术相关的疗效和风险因素：中国的一项回顾性研究

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.24-00036

Bin Li, Chao Dong, Guangyu Pan, Ruofan Liu, Minghui Tong, Jianping Xu, Shen Liu

{"title":"Outcomes and Risk Factors Associated with Pericardiectomy in Patients with Constrictive Pericarditis: A Retrospective Study from China.","authors":"Bin Li, Chao Dong, Guangyu Pan, Ruofan Liu, Minghui Tong, Jianping Xu, Shen Liu","doi":"10.5761/atcs.oa.24-00036","DOIUrl":"10.5761/atcs.oa.24-00036","url":null,"abstract":"Purpose: Pericardiectomy is the definitive treatment option for constrictive pericarditis and is associated with a high prevalence of morbidity and mortality. However, information on the associated outcomes and risk factors is limited. We aimed to report the mid-term outcomes of pericardiectomy from a single center in China.Methods: We retrospectively reviewed data collected from patients who underwent pericardiectomy at our institute from April 2018 to January 2023.Results: Eighty-six consecutive patients (average age, 46.1 ± 14.7 years; 68.6 men) underwent pericardiectomy through midline sternotomy. The most common etiology was idiopathic (n = 60, 69.8%), and 82 patients (95.3%) were in the New York Heart Association function class III/IV. In all, 32 (37.2%) patients underwent redo sternotomies, 36 (41.9%) underwent a concomitant procedure, and 39 (45.3%) required cardiopulmonary bypass. The 30-day mortality rate was 5.8%, and the 1-year and 5-year survival rates were 88.3% and 83.5%, respectively. Multivariable analysis revealed that preoperative mitral insufficiency (MI) ≥moderate (hazard ratio [HR], 6.435; 95% confidence interval [CI] [1.655-25.009]; p = 0.007) and partial pericardiectomy (HR, 11.410; 95% CI [3.052-42.663]; p = 0.000) were associated with increased 5-year mortality.Conclusion: Pericardiectomy remains a safe operation for constrictive pericarditis with optimal mid-term outcomes.","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/PMC11163141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177074","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

Midterm Clinical Outcomes after Isolated Surgical and Transcatheter Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis. 主动脉瓣狭窄低风险患者孤立手术和经导管主动脉瓣置换术后的中期临床疗效。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.24-00123

Kazuma Handa, Koichi Maeda, Kyongsun Pak, Kazuo Shimamura, Kizuku Yamashita, Ai Kawamura, Shigeru Miyagawa

{"title":"Midterm Clinical Outcomes after Isolated Surgical and Transcatheter Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis.","authors":"Kazuma Handa, Koichi Maeda, Kyongsun Pak, Kazuo Shimamura, Kizuku Yamashita, Ai Kawamura, Shigeru Miyagawa","doi":"10.5761/atcs.oa.24-00123","DOIUrl":"10.5761/atcs.oa.24-00123","url":null,"abstract":"Purpose: This study aimed to compare the clinical outcomes of isolated surgical aortic valve replacement (SAVR) and transfemoral (TF)-transcatheter aortic valve replacement (TAVR) in low-risk aortic stenosis (AS) patients.Methods: A total of 696 low-risk (Society of Thoracic Surgeons score <4%) AS patients underwent isolated SAVR or TF-TAVR at five centers. After 1:1 propensity score matching, 159 pairs were identified. Early and follow-up events, including cardiac mortality and major adverse cardiac and cerebrovascular events (MACCE: all-cause mortality, heart failure admission, reoperation, prosthetic valve endocarditis, and stroke), were compared.Results: Baseline characteristics are similar between the matched groups. There were no 30-day cardiac mortalities in either group. All-cause mortality and MACCE at 30 days did not differ. During 5-year follow-up (median 3.1 [range 0-7.2] years), the incidence of cardiac mortality (1.3% vs. 18.9%; adjusted hazard ratio [aHR], 8.89; 95% confidence interval [CI], 2.68-29.53; P <0.001), all-cause mortality (4.2% vs. 33.9%; aHR, 8.56; 95% CI, 3.41-21.45; P <0.001), and MACCE (25.1% vs. 47.0%; aHR, 2.36; 95% CI, 1.54-3.63; P <0.001) were lower in the SAVR group than in the TAVR group.Conclusions: Isolated SAVR demonstrated better outcomes in low-risk AS patients. TAVR in this subset should be chosen carefully.","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/PMC11439598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334222","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

En Bloc Resection of a Primary Tumor and Lymph Nodes in Non-Small-Cell Lung Cancer. 非小细胞肺癌的原发肿瘤和淋巴结整体切除术

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.24-00108

Toshiyuki Nagata, Masaya Aoki, Koki Maeda, Go Kamimura, Aya Takeda, Masami Sato, Kazuhiro Ueda

{"title":"En Bloc Resection of a Primary Tumor and Lymph Nodes in Non-Small-Cell Lung Cancer.","authors":"Toshiyuki Nagata, Masaya Aoki, Koki Maeda, Go Kamimura, Aya Takeda, Masami Sato, Kazuhiro Ueda","doi":"10.5761/atcs.oa.24-00108","DOIUrl":"10.5761/atcs.oa.24-00108","url":null,"abstract":"Purpose: We established a novel surgical procedure for resectable non-small-cell lung cancer (NSCLC), which involves resection of the affected lobe and regional lymph nodes without separation, namely en bloc surgery. We introduced the technical details and early and late outcomes by comparing them with those of conventional surgery.Methods: We retrospectively analyzed patients who underwent lobectomy with hilar and mediastinal lymph node dissection for stages I-III NSCLC. A propensity score-matched analysis was performed based on demographic variables.Results: Propensity score-matching yielded 317 pairs. En bloc surgery was not associated with a longer operation time, a higher amount of intraoperative bleeding, or a higher frequency of postoperative complications. The number of resected lymph nodes (P = 0.277) and frequency of N upstaging (P = 0.587) did not differ between the groups. However, en bloc surgery was associated with higher overall survival in comparison to conventional surgery (P = 0.012). According to a stratification analysis, the survival advantage of en bloc surgery over conventional surgery was remarkable in pathological N-positive disease (P = 0.005), whereas it disappeared in pathological N-negative disease (P = 0.147).Conclusion: En bloc surgery is feasible and can be performed in patients with possible N-positive NSCLC.","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/PMC11381205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134731","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

Prognostic Significance of CONUT Score in Elderly NSCLC. 老年 NSCLC 中 CONUT 评分的预后意义

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2024-01-01 DOI: 10.5761/atcs.oa.24-00009

Masaya Tamura, Takashi Sakai, Naoki Furukawa, Marino Yamamoto, Ryohei Miyazaki, Hironobu Okada

{"title":"Prognostic Significance of CONUT Score in Elderly NSCLC.","authors":"Masaya Tamura, Takashi Sakai, Naoki Furukawa, Marino Yamamoto, Ryohei Miyazaki, Hironobu Okada","doi":"10.5761/atcs.oa.24-00009","DOIUrl":"10.5761/atcs.oa.24-00009","url":null,"abstract":"Purpose: This study evaluated the Controlling Nutritional Status (CONUT) score as a prognostic predictor in elderly non-small cell lung cancer (NSCLC) patients with surgical resection.Methods: Overall, 114 patients over 80 years old undergoing curative resection for NSCLC were retrospectively analyzed. Receiver operating characteristic (ROC) analysis was conducted to evaluate the capacity of immune-inflammatory markers to predict overall survival (OS). Cox-proportional hazards regression analysis was implemented to investigate prognostic markers for OS.Results: Based on ROC curves, the CONUT score was found to be the most valuable prognostic marker (area under the curve = 0.716). The high CONUT (≥2) group included 54 patients, and the low CONUT (0 or 1) group included 60 patients. The high CONUT group had poorer prognosis rates compared to the low CONUT group with regard to OS (5-year OS: 46.3% vs. 86.0%, p = 0.0006). In the multivariate data analysis, histology, lymphatic invasion, and CONUT score (hazard ratio: 4.23, p = 0.0003) were found to be exclusive and independent prognostic markers for OS.Conclusion: Preoperatively, the CONUT score can be used as a novel prognostic marker in elderly NSCLC patients. CONUT evaluations can also be used to design nutritional interventions to improve patient outcomes.","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/PMC11082491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874363","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