Intrapericardial Pulmonary Vein Ligation to Prevent Stump Thrombosis During Left Upper Lobectomy.

Background: Postoperative cerebral infarction, a serious complication of surgery, is occasionally experienced with pulmonary vein stump thrombosis (PVST), which is frequently observed after left upper lobectomy (LUL). Herein, we prospectively investigated whether PVST could be safely prevented by intrapericardial ligation of the superior pulmonary vein (SPV) to shorten the SPV stump during LUL.

Methods: In a consecutive 21 patients who underwent LUL, we ligated the proximal intrapericardial SPV with 1-0 silk suture and divided the distal hilar SPV by an automatic stapling device.

Non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients.

Objectives: Spontaneous pneumothorax in young patients has a high recurrence rate, even after surgical treatment, and bulla neogenesis around stapled lesions has been reported as a cause of postoperative recurrence. We investigate the clinical safety and long-term outcome of non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients.

Methods: Twenty-seven non-stapling thoracoscopic surgeries for pneumothorax in 24 patients younger than 25 years were retrospectively reviewed.

Robot-assisted thoracoscopic surgery for large apical schwannoma in an obese patient.

Background: Neural tumors at the thoracic apex require a careful surgical technique because of the presence of vascular and neural structures and minimally invasive surgery can be challenging for these tumors, especially large tumor in obese patients. We report a case of a large apical schwannoma that treated with RATS in an obese patient.

Case Presentation: An obese, diabetic, 36-year-old obese man with a body mass index of 34.

A clinicopathologic and molecular analysis of five cases of bronchiolar adenoma with rare mutations.

Bronchiolar adenoma (BA) is a rare benign lung tumor that shows proliferation of bland bronchiolar-type epithelium containing a continuous layer of basal cells. This tumor entity has been newly added to the recent World Health Organization (WHO) classification 5th edition. This entity encompasses a spectrum of lesions: the classic ciliated muconodular papillary tumor (CMPT) and the non-classic CMPT.

Prognostic significance of spread through air spaces in pulmonary metastases from colorectal cancer.

Objectives: Surgical resection for pulmonary metastases from colorectal cancer could provide long-term survival in selected patients, and it is commonly performed in practice. However, surgical margin relapse sometimes occurs and is a problematic issue to resolve. Spread through air spaces (STAS) is one of the invasion forms in primary lung cancer and is associated with local recurrence and a poor prognosis.

One-stage closure of large bronchopleural fistula with pedicled latissimus dorsi muscle flap after preemptive antibiotics: A case report.

Introduction: Bronchopleural fistula (BPF) after lung cancer surgery is a life-threatening complication and often needs two-stage closure after fenestration. Although one-stage closure of BPF is challenging, it would provide shorter treatment time and lower patient physical burden than two-stage closure. However, there have been few reports of one-stage closure of a large BPF.

Safety and tolerability of PD-1/PD-L1 inhibitors in elderly and frail patients with advanced malignancies.

The number of elderly patients with cancer has increased due to aging of the population. However, safety of programmed cell death-1 (PD-1) or programed cell death ligand 1 (PD-L1) inhibitors in elderly patients remains controversial, and limited information exists in frail patients. The present study retrospectively identified 197 patients treated with nivolumab, pembrolizumab or atezolizumab for unresectable advanced cancer between September 2014 and December 2018.

Prognostic Significance of Perioperative C-Reactive Protein in Resected Non-Small Cell Lung Cancer.

Inflammation is reportedly associated with the development and progression of various malignancies. However, the clinical significance of preoperative and postoperative inflammation in lung cancer patients undergoing surgery is unknown. The relationship between preoperative and postoperative C-reactive protein (CRP), an indicator of inflammation, and survival was retrospectively analyzed in 356 patients who underwent complete resection of pathologic Stage I and II non-small cell lung cancers.

Programmed death-ligand 1 expression profiling in thymic epithelial cell tumors: Clinicopathological features and quantitative digital image analyses.

Objectives: Whether the extent of expression of programmed death-ligand 1 (PD-L1) is clinically significant remains uncertain, although immuno-oncological features have been studied in thymic epithelial cell tumors (TETs). We investigated the histological features of PD-L1 expression in TETs, and assessed PD-L1 expression using digital image analysis.

Materials And Methods: Participants comprised 66 patients with TET who underwent surgical resection between 2001 and 2016.

High Neutrophil Count as a Negative Prognostic Factor for Relapse in Patients with Thymic Epithelial Tumor.

Purpose: Preoperative neutrophil count is reportedly associated with poor prognosis in cancer patients. This study aimed to investigate the clinical significance of pre-treatment peripheral blood cell counts in patients with thymic epithelial tumors (TETs).

Methods: A retrospective review of 71 patients with completely resected TETs [64 thymoma, 6 thymic carcinoma, and 1 thymic neuroendocrine tumor] between 2000 and 2018 was conducted.

Prediction models for the viability of pulmonary metastatic lesions after chemotherapy in nonseminomatous germ cell tumors.

Objectives: To analyze predictors associated with viable cells in pulmonary residual lesions after chemotherapy for metastatic testicular nonseminomatous germ cell tumors and to develop models to prioritize pulmonary resection.

Methods: Between 2008 and 2017, 40 patients underwent pulmonary metastasectomy after chemotherapy for nonseminomatous germ cell tumors. We evaluated these patients, and 326 pulmonary residual lesions were confirmed using computed tomography and pathological evaluations.

Trousseau's syndrome associated with pulmonary pleomorphic carcinoma exhibiting aggressive features: A case report.

Trousseau's syndrome is characterized as an unexpected, cancer-related thrombotic event, such as a cerebral infarction or a deep vein thrombosis/pulmonary embolism. We describe the first reported case of Trousseau's syndrome with pulmonary pleomorphic carcinoma and aggressive features. A 74 year-old man presenting with a pulmonary mass, which was identified as pleomorphic carcinoma with extensive lymph node involvement, in the left lower lobe, underwent a left lower lobectomy.

Omental Flap for Bronchopleural Fistula After Pneumonectomy and Aorta Replacement.

Bronchopleural fistula (BPF) is a fatal complication after lung cancer surgery. We report the case of a 56-year-old man treated with omental flap for BPF after pneumonectomy along with descending aorta replacement. He underwent left pneumonectomy with combined resection of the descending aorta, followed by replacement with prosthetic graft after the diagnosis of lung cancer, cT4 N1 M0 stage IIIA.

[Thymectomy].

Extended thymectomy reported by Masaoka in 1981 is a standard surgical treatment in patients with myasthenia gravis. Thoracoscopic thymectomy, which could be less invasive, has been widely accepted for an anterior mediastinal lesion in addition to the conventional median sternotomy approach. In thoracoscopic thymectomy, artificial pneumothorax using carbon deoxide(CO2) insufflation or chest wall lifting using rib hook can contribute to make better surgical view with enough working space.

Clinical features of immune-related thyroid dysfunction and its association with outcomes in patients with advanced malignancies treated by PD-1 blockade.

Programmed cell death protein-1 (PD-1) blockade therapy has improved outcomes in the treatment of advanced cancers. The therapy is well-tolerated, although it occasionally causes immune-related adverse events (irAEs). Thyroid dysfunction is one of the most common irAEs seen.

Treatment rationale and design of the induction chemotherapy and adjuvant thoracic radiation in resectable N2-3A/3B non-small cell lung cancer (ICAT) study.

Background: The optimal treatment strategy for stage N2-3A/3B non-small cell lung cancer (NSCLC) remains controversial owing to its heterogeneity. Although multimodal therapy is considered the standard therapeutic approach for stage N2-3A/3B resectable NSCLC patients, the optimal combination strategy still needs to be clarified.

Patients And Methods: In total, 25 male and female patients aged between 20 and 75 years with stage N2-3A/3B resectable NSCLC will be included.

Autoimmune hepatitis during preoperative chemotherapy in a patient with thymoma.

Autoimmune diseases associated with thymoma are well known, with myasthenia gravis being the most common, while autoimmune hepatitis (AIH) is extremely rare. The case of a 63-year-old woman with AIH that developed during preoperative chemotherapy for invasive type B2 thymoma is presented. Liver dysfunction was improved by steroid treatment using oral prednisolone, 30 mg daily, followed by tapering.

Intravascular Stapling Technique for Interlobar Fissure Division in the Left Lower Lobectomy.

Introduction: Prolonged air leak is the most common complication after pulmonary resection. This occurs more frequently in patients with incomplete interlobar fissure, chronic obstructive pulmonary disease, or emphysema. Interlobar lymphadenopathy can make interlobar fissure division difficult.

[Wedge Resection in Poor Risk Patients with Clinical-N0 Pure Solid Lung Cancer].

Objective: Sublobar resection is practically indicated in poor risk patients compromised cardiopulmonary reserve or for small ground-glass opacity-dominant adenocarcinomas. The aim of this study was to clarify the surgical outcomes of wide wedge resection in poor risk patients with clinical-N0 pure solid lung cancers.

Methods: Between 2008 and 2015, 55 poor risk patients, who underwent wedge resection for clinical-N0 pure solid lung cancer, were retrospectively reviewed.

Pulmonary artery reconstruction using an autologous pulmonary vein patch in pulmonary resection.

Pulmonary artery (PA) reconstruction has been accepted to avoid pneumonectomy in locally advanced lung cancer surgery because of its satisfactory outcomes with regard to long-term survival and its low postoperative morbidity and mortality rates. Several techniques of PA reconstruction have been documented. However, the availability of PA reconstruction using an autologous pulmonary vein (PV) patch is unclear.

Long-Term Prognostic Impact of Severe Postoperative Complications After Lung Cancer Surgery.

Background: Postoperative complications are reportedly related to poor prognosis following lung cancer surgery; however, the difference in the prognostic impact according to immune-nutritional status is unknown.

Methods: In 411 patients with completely resected non-small cell lung cancer, the relationship between severe postoperative complications (SPCs; Clavien-Dindo grade III or higher) and survival was retrospectively analyzed, with special reference to preoperative immune-nutritional status based on the prognostic nutritional index (PNI), which was calculated using serum albumin level and total lymphocyte count.

Results: A total of 52 (12.

Clinical application of postoperative non-invasive positive pressure ventilation after lung cancer surgery.

Objective: The purpose of this study was to clarify the clinical efficacy of postoperative non-invasive positive pressure ventilation (PONIV) after pulmonary lobectomy in patients with lung cancer.

Methods: From August 2010 and July 2015, 143 patients with lung cancer who underwent pulmonary lobectomy were retrospectively reviewed. PONIV was used immediately after surgery until the morning of postoperative day (POD) 1.

Significance of PD-L1 expression in pulmonary metastases from head and neck squamous cell carcinoma.

Background: The mechanism by which tumors escape the immune system has been actively investigated and is partly explained by the programmed death-1 (PD-1) and its ligand (PD-L1) pathway. This study is aimed at clarifying the prognostic significance of PD-L1 expression in patients with surgically resected pulmonary metastases of head and neck squamous cell carcinoma (HNSCC).

Patients And Methods: A retrospective review was conducted of 26 HNSCC patients who underwent complete resection of pulmonary metastases.

Spontaneous Regression of Primary Pulmonary Synovial Sarcoma.

We report a rare case of primary pulmonary synovial sarcoma that underwent spontaneous regression after a transbronchial biopsy. A 38-year-old woman with a well-demarcated solitary mass shadow on chest roentgenogram was referred to us. A transbronchial biopsy was performed, and immunohistochemical results as well as detection of SYT-SSX1 (SYnovial sarcoma Translocation-Synovial Sarcoma X chromosome breakpoint) transcripts resulted in a diagnosis of synovial sarcoma.

Risk Stratification According to the Prognostic Nutritional Index for Predicting Postoperative Complications After Lung Cancer Surgery.

Background: The prognostic nutritional index (PNI), an immune nutritional marker based on serum albumin levels and total lymphocyte count, predicts postoperative complications in various types of malignancies. However, the clinical significance of the PNI for postoperative complications following lung cancer surgery is uncertain.

Methods: Patients with resected non-small cell lung cancer (n = 515) were retrospectively analyzed and the relationship between the preoperative PNI and postoperative complications was evaluated.