Factors related to post-thoracotomy pain following robotic-assisted thoracic surgery.

Background: Robotic-assisted thoracic surgery (RATS) is a minimally invasive procedure; however, some patients experience persistent postoperative pain. This study aimed to investigate factors related to postoperative pain following RATS.

Methods: The data of 145 patients with lung cancer, who underwent RATS with a four-port (one in the sixth intercostal space [ICS] and three in the eighth ICS) lobectomy or segmentectomy between May 2019 and December 2022, were retrospectively analyzed.

Chest wall tuberculosis: precision surgery with indigo carmine in limited cases for safe and intuitive lesion excision.

In addition to treatment with antituberculosis drugs, complete surgical excision is important for the cure of chest wall tuberculosis. However, surgery is often challenging to perform due to different factors such as the strong adhesion of tuberculous lesions to the surrounding normal tissue, growth of neovascularization and presence of fragile necrotic tissues. Firm adhesions, bleeding and fragile tissue make it difficult to determine the boundary with normal tissue and completely excide the lesion.

Impact of a pneumatic surgical robot with haptic feedback function on surgical manipulation.

Although robotic-assisted surgery has the advantages of low patient burden and high precision without unsteady hand movements, the lack of tactile sensations may result in unexpected iatrogenic organ damage. The Saroa (Riverfield Inc., Tokyo, Japan) is a pneumatically driven robot that provides real-time haptic feedback to the surgeon.

Mille Feuille Method as a Novel Surgical Technique for Intractable Pneumothorax.

Most cases of intractable pneumothorax are complicated by underlying lung diseases, which lead to poor intrathoracic conditions. Therefore, the treatment becomes even more challenging, and standard surgical techniques cannot always be applied to treat pneumothorax. We report a novel surgical technique using polyglycolic acid mesh and fibrin glue for intractable pneumothorax, named the mille feuille method.

Use of a radiofrequency identification system for precise sublobar resection of small lung cancers.

Background: The incidence of sublobar resection is increasing because of the rise in the detection of small lung cancers. However, local recurrence needs to be addressed, and several methods are needed for the resection with secure margins of non-visible and non-palpable tumors.

Methods: We retrospectively reviewed the use of a radiofrequency identification (RFID) system in sublobar resection of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) at our institute.

Elucidation of prognostic factors and the effect of anti-fibrotic therapy on waitlist mortality in lung transplant candidates with idiopathic interstitial pneumonias.

Background: Lung transplantation (LTx) is the last resort for patients who fail to respond to drug therapy and progress to advanced idiopathic interstitial pneumonias (IIPs). However, more than one-third of patients registered for LTx face despair because of rapid disease progression and donor shortage. This study aimed to identify the risk factors of waitlist mortality in LTx candidates with IIPs and investigate the association of anti-fibrotic therapy with waitlist mortality.

Preoperative chest computed tomography evaluation for predicting intraoperative lung resection strongly depends on interpreters experience.

Objectives: Preoperative planning of lung resection extent is decisive for preoperative functional work-up and selection for multimodal treatment. It is mainly based on preoperative chest CT. We aimed at evaluating chest CT adequacy to predict the extent of lung resection and hypothesized a relation with CT interpreters' level of experience.

Long-term survival of thoracoscopic surgery compared with open surgery for clinical N0 adenocarcinoma.

Background: Early stage non-small cell lung cancer (NSCLC) is good candidate for video-assisted thoracoscopic surgery (VATS). Long-term outcome compared between VATS and open surgery remains unclear. The aim of this study was to assess the long-term outcome of VATS in early stage adenocarcinoma.

Acute limb ischemia of the lower extremity associated with left upper lobe surgery for primary lung cancer.

Thrombosis formation in the pulmonary vein stump after pulmonary lobectomy has recently been reported to be an extremely rare cause of arterial embolism. We herein report the first case series of acute limb ischemia encountered after video-assisted thoracoscopic left upper lobectomy or left upper division segmentectomy for primary lung cancer. The patients underwent embolectomy, and their perioperative courses were uneventful.

Gastric Volvulus After Left Lower Lobectomy.

Gastric volvulus is a rare complication after pulmonary resection. To date, only eight cases of postpulmonary resection gastric volvulus have been reported in the English literature, and several of these patients underwent left pneumonectomy or had hiatal hernia. This report describes a case of postlobectomy gastric volvulus in a 73-year-old woman without hiatal hernia.

Totally thoracoscopic surgery and troubleshooting for bleeding in non-small cell lung cancer.

Background: Although accumulating data support the feasibility and efficacy of video-assisted thoracic surgery anatomic resection, few studies have reported on intraoperative complications, such as vessel injury. The purpose of this study was to evaluate intraoperative vessel injury and to analyze troubleshooting.

Methods: Twenty-six of 557 patients with non-small cell lung cancer who underwent thoracoscopic anatomic lung resection were identified as having intraoperative vessel injury between January 2004 and December 2011.

Successful application of subcutaneous adipose tissue with fibrin glue in conservative treatment of tracheobronchial rupture.

An 84-year-old woman underwent aortic and mitral valve replacement. After weaning from cardiopulmonary bypass, hemorrhage was observed in the endobronchial tube. The bleeding bronchus was isolated to protect the airway using the blocker cuff of a Univent tube (Fuji Systems Corp, Tokyo, Japan).

Bronchial stump aspergillosis after stapled lobectomy for lung cancer.

Aspergillus causes several pulmonary complications, but bronchial stump aspergillosis (BSA) is very rare. To date, 31 cases of bronchial stump aspergillosis have been reported in the English, German, and Japanese literature. The bronchial stump was closed by hand-sewn suturing in most cases, but we report herein two cases of BSA that developed after stapled closure of the bronchial stump.

Serum level of HE4 is closely associated with pulmonary adenocarcinoma progression.

The human epididymis 4 (HE4) protein is expressed in the epididymis and respiratory tract. We previously reported that HE4 is also expressed in pulmonary adenocarcinoma. The purpose of this study was to investigate serum levels of HE4 as a biological marker in pulmonary adenocarcinoma.

Contralateral mediastinal lymph node micrometastases assessed by video-assisted thoracoscopic surgery in stage I non-small cell left lung cancer.

Objectives: Survival of patients with left-sided stage I non-small cell lung cancer (NSCLC) is unsatisfactory, probably because of the high incidence of contralateral mediastinal node involvement. In this study, occult micrometastases to the right upper mediastinal nodes were retrospectively investigated in patients with left-sided stage I NSCLC.

Methods: Nineteen patients with clinical stage I NSCLC underwent video-assisted thoracoscopic lobectomy and bilateral mediastinal node dissection (BMD).

Thoracoscopic segmentectomy for T1 classification of non-small cell lung cancer: a single center experience.

Objectives: Segmentectomy is one of the treatment options for small-sized non-small cell lung cancer (NSCLC). Although growing results support the feasibility and efficacy, it still remains unclear in segmentectomy. The International Association for the Study of Lung Cancer recommended a revised classification of TNM staging in 2009 (the seventh edition) and multidisciplinary classification of adenocarcinoma.

Sentinel node navigation surgery by thoracoscopic fluorescence imaging system and molecular examination in non-small cell lung cancer.

Purpose: The application of sentinel node navigation surgery in non-small cell lung cancer (NSCLC) is not popular because of the difficulty of sentinel node identification and the low incidence of complications after systemic lymph node dissection. We report the intraoperative assessment of sentinel node metastasis by thoracoscopic ICG fluorescence imaging system and real-time reverse transcription-polymerase chain reaction (RT-PCR).

Methods: Sixty-one patients who underwent surgery between January 2009 and December 2010 were investigated for sentinel node biopsy.

Thoracoscopic segmentectomy with intraoperative evaluation of sentinel nodes for stage I non-small cell lung cancer.

Objectives: Segmentectomy is the treatment of choice for small-sized non-small cell lung cancer (NSCLC); however, it is difficult to decide the surgical procedure because accurate evaluation of hilar lymph node metastasis remains unclear. We here report the outcome of video-assisted thoracic surgery (VATS) segmentectomy with and without the assessment of sentinel nodes.

Materials And Methods: Eighty-three patients with stage IA NSCLC underwent VATS segmentectomy between January 2003 and December 2010.

Splice variant HE4-V3 expression is associated with favorable prognosis in pulmonary adenocarcinoma.

The human epididymis 4 (HE4) gene product, also known as whey-acidic-protein four-disulfide core domain protein 2, was identified as the transcript expressed in the epididymis and respiratory tract. HE4 is also expressed in lung adenocarcinoma. We investigated mRNA expressions of full-length HE4 and splice variants in lung adenocarcinoma, and the clinical impact of these genes was evaluated.

Ki-67 labeling index is associated with recurrence after segmentectomy under video-assisted thoracoscopic surgery in stage I non-small cell lung cancer.

Objectives: Video-assisted thoracoscopic surgery (VATS) segmentectomy for small or early stage non-small cell lung cancer (NSCLC) remains controversial. Here, we investigated the clinical importance of predicting recurrence by Ki-67 in VATS segmentectomy for stage I NSCLC.

Methods: In a retrospective study, 44 consecutive patients in p-stage I underwent VATS segmentectomy between September 2003 and April 2009.

HE4 expression can be associated with lymph node metastases and disease-free survival in breast cancer.

Background: This study investigated the potential of HE4 to predict disease-free survival for patients with breast cancer.

Patients And Methods: One hundred and twenty-nine patients with breast cancer underwent surgery from January 2004 to September 2009. Immunohistochemical analysis (IHC) and RT-PCR were used to determine the expression of HE4 which was compared with the clinicopathological factors or prognosis.

Prognostic significance of HE4 expression in pulmonary adenocarcinoma.

We investigated the possibility of human epididymis 4(HE4) to predict survival for patients with pulmonary adenocarcinoma. One hundred and thirty-seven patients with pulmonary adenocarcinoma underwent surgery in our institute from 2000 to 2008. We used immunohistochemical analysis to determine the expression of HE4 and compared with the clinicopathological factors and survival.