[Introduction of Support for Thoracoscopic Surgery by Clinical Engineers:Task Shift as Scopist by Clinical Engineers].

On October 1, 2021, the Clinical Engineer Law was revised and expanded the task of clinical engineers (CEs). After that, they can hold and operate a endoscope in endoscopic surgery. On June 9, 2022, our hospital asked CEs to directly participate in thoracoscopic pleural biopsy as scopist( scope operator) for the first time, and since then, a total of 54 thoracoscopic surgery cases were performed by CEs as scopist over the course of one year.

[Complete Transection of the Cervical Trachea Caused by Chest Blunt Trauma].

A 52-year-old man was injured when driving through the gate by a motorcycle without noticing the rope between the gateposts. He developed hoarseness, subcutaneous emphysema and dyspnea, and was transferred to our hospital by an ambulance. Chest X-ray and computed tomography showed subcutaneous and mediastinal emphysema, and complete transection of the cervical trachea.

[Penetrating Injury of the Lung with a Glass Splinter].

A 62-year-old man got drunk and dived into the windowpane. He received lacerations on his face and incised wound at his right chest, and was carried to our hospital. Computed tomography showed a glass splinter, about 14 cm of length, in the chest cavity.

The Clinical Impact of Solid and Micropapillary Patterns in Resected Lung Adenocarcinoma.

Introduction: Since the new adenocarcinoma (ADC) classification was presented in 2011, several authors have reported that patients with solid (S) and/or micropapillary (MP) predominant patterns showed a worse prognosis. On the other hand, there are several patients who have S and/or MP patterns even if their patterns are not predominant. However, the evaluation of these patients is uncertain.

[Primary Synovial Sarcoma in the Anterior Mediastinum;Report of a Case].

We report a rare case of synovial sarcoma in the anterior mediastinum. A 43-year-old man consulted our hospital with a complaint of dyspnea and chest discomfort. Chest computed tomography revealed an anterior mediastinal mass.

[Hemorrhagic Cerebral Infarction after Right Segmental Lung Resection；Report of a Case].

Postoperative hemorrhagic cerebral infarction is rare but fatal complication. We report a case of hemorrhagic cerebral infarction after lung cancer surgery without a history of atrial fibrillation and cerebrovascular disease. A 58-year-old man who have a history of diabetes mellitus, hypertension and dyslipidemia underwent right segmental lung resection.

[Vagal Nerve Schwannoma Complicated with Bloody Pleural Effusion；Report of a Case].

A 51-year-old male who had received hemodialysis twice a week was referred to our hospital for a further examination of bloody pleural effusion in the right chest. He has been suffering from a fever and cough for 2 months. Chest computed tomography and magnetic resonance imaging revealed a pleural effusion in the right pleural cavity and posterior mediastinal tumor in paravertebral lesion.

[Port site recurrence after thoracoscopic resection of the pulmonary metastasis of sigmoid colon cancer].

A 71-year-old female underwent thoracoscopic resection for pulmonary metastasis from sigmoid colon cancer in March 2012. After 7 months, postoperative computed tomography (CT) showed a chest tumor around the left 6th rib. At the same time, she complained of left chest pain.

Noninvasive Differential Diagnosis of Pulmonary Nodules Using the Standardized Uptake Value Index.

Objectives: We previously showed that the standardized uptake value (SUV) index, which was defined as the ratio of the maximum SUV of the tumor to mean SUV of the liver, was a surrogate marker of lung cancer aggressiveness. In this study of patients with pulmonary nodules (PNs), we explored whether the SUV index could be used to differentiate small malignant from small benign PNs.

Methods: A total of 284 patients with solitary PNs ≤2 cm in size underwent positron emission tomography/computed tomography and surgery.

[Intravascular papillary endothelial hyperplasia of the lung].

We report a rare case of pulmonary intravascular papillary endothelial hyperplasia. The patient was a 63-year-old male. Multiple lung nodules were noted on chest computed tomography( CT) at preoperative check for gastric cancer.

[A case of recurrent lung cancer with bone metastases treated with tegafur-uracil and zoledronic acid for long-term survival].

We present the case of an 84-year-old man with lumbago due to bone metastases from lung cancer that recurred three years after surgery. The patient received carboplatin-paclitaxel combination as first-line chemotherapy for the treatment of lung cancer, and palliative radiotherapy for the treatment of bone metastases. Gemcitabine was administered as second-line chemotherapy.

Smoking is a perioperative risk factor and prognostic factor for lung cancer surgery.

Objective: The aim of this study was to investigate the smoking status of lung cancer patients and to confirm the risk of smoking for patients undergoing lung cancer surgery.

Methods: We conducted a retrospective study of patients undergoing lung cancer surgery. Between May 2004 and March 2013, 716 patients underwent lung cancer surgery at our institution.

Detection of non-aggressive stage IA lung cancer using chest computed tomography and positron emission tomography/computed tomography.

Objectives: In contrast to lung cancer with ground-glass opacity, the radiological investigation of solid lung cancer has not been well examined. The aim of this study was to explore chest computed tomography (CT) and positron emission tomography (PET)/CT findings with regard to outcomes after lung cancer surgery in order to radiologically classify clinical stage IA lung cancers by tumour aggressiveness.

Methods: Three hundred and fifteen clinical stage IA patients were analysed.

The correlation of the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification with prognosis and EGFR mutation in lung adenocarcinoma.

Background: The purpose of this study was to validate the prognostic effect and the frequency of mutations in the gene expressing epidermal growth factor receptor (EGFR) in lung adenocarcinoma of Japanese patients, on the basis of the new adenocarcinoma classification proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society.

Methods: The new classification was used to reclassify 486 adenocarcinomas. The percentage of each histopathologic subtype and the predominant pattern were determined.

Positive intraoperative pleural lavage cytology is a predictive marker of disease recurrence in stage I lung adenocarcinoma.

Objectives: This study aimed at analysing the relationship between the pleural lavage cytology (PLC) status and clinicopathological characteristics, including the outcome of examined patients and tumour recurrence sites in surgically resected stage I non-small-cell lung carcinoma.

Methods: From April 2002 to August 2012, PLC was performed immediately after thoracotomy in 428 consecutive patients undergoing pulmonary resection for lung cancer. The relationship between clinicopathological characteristics and the PLC status was retrospectively analysed.

Stage II-IV lung cancer cases with lymphovascular invasion relapse within 2 years after surgery.

Objective: For recurrent lung cancer, postoperative follow-up methods have not been adequately assessed, and no evidence-based postoperative surveillance methods currently exist. Herein, we evaluated postoperative lung cancer recurrence and the personalized postoperative surveillance periods and methods used.

Methods: Follow-up after surgery consisted of a regular outpatient clinic check-up, including physical examination, history, blood tests, and chest X-ray, which were conducted three or four times per year for 5 years.

Prognostic impact and initial recurrence site of lymphovascular and visceral pleural invasion in surgically resected stage I non-small-cell lung carcinoma.

Objectives: This study aimed to analyse and validate the prognostic impact and effect of the initial recurrence site of lymphovascular and visceral pleural invasion (VPI) on survival outcomes for Stage I non-small-cell lung carcinoma (NSCLC).

Methods: We retrospectively reviewed 433 patients undergoing resection of Stage I NSCLC. The relationship between the clinicopathological background and the pathological variables, lymphovascular invasion (LVI) and VPI, was evaluated by univariate and multivariate analyses.

New IASLC/ATS/ERS classification and invasive tumor size are predictive of disease recurrence in stage I lung adenocarcinoma.

Introduction: The purpose of this study is to analyze and validate the prognostic impact of the new lung adenocarcinoma (ADC) classification proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society and invasive tumor size in stage I lung ADC of Japanese patients.

Methods: We reclassified 191 stage I ADCs according to the new classification. The percentage of each histological subtype and the predominant type were determined.

Postoperative complications in elderly patients after lung cancer surgery.

Objectives: The purpose of this study was to identify the risk factors for postoperative complications in elderly patients undergoing lung cancer surgery. These complications remain higher in elderly patients than in young patients, and decreasing their incidence is an important goal. We investigated surgical factors in particular, including surgical time, blood loss and thoracotomy length.

Limited resection for clinical Stage IA non-small-cell lung cancers based on a standardized-uptake value index.

Objectives: In a previous study, we found that a standardized-uptake value (SUV) index obtained from positron emission tomography (PET)/computed tomography (CT) data was significantly correlated with prognosis in patients with pathological Stage I lung adenocarcinoma. However, this value has not been studied in early stage lung cancer patients undergoing limited resection. In this study, we investigated if an SUV index could be used to identify patients with clinical Stage IA lung cancers that were appropriate for limited resection.

[Management of a lung tumor accompanied by aortic dissection; report of a case].

During an annual health check-up, a 75-year-old man was admitted to our hospital due to an abnormal shadow in the left upper lung field. A computed tomography (CT) scan taken at his 1st hospital visit showed a calcified nodule in the left upper lobe and Stanford type A aortic dissection. We could not perform bronchofiberscopy due to the risk associated with the aortic dissection and could not make a diagnosis prior to surgery.

Positron emission tomography for predicting recurrence in stage I lung adenocarcinoma: standardized uptake value corrected by mean liver standardized uptake value.

Objective: F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has become an important staging tool for patients with lung cancer, and determination of the standardized uptake value (SUV) is probably the most widely used method for evaluating patients. Although SUV is recognized as a powerful surrogate marker for lung cancer outcomes, SUV standardization and reproducibility in clinical practice remain major concerns. The aim of this study was to evaluate the corrected SUV as a universal marker for lung cancer recurrence.

Positron emission tomography/computed tomography and lymphovascular invasion predict recurrence in stage I lung cancers.

Background: Although pathologic stage I lung cancers generally have a favorable prognosis, approximately 20% of patients experience recurrence after surgery. Therefore, a method of selecting patients who need adjuvant therapy is necessary. The goal of this study was to evaluate the significance of positron emission tomography (PET)/computed tomography (CT) results after lung cancer surgery and to identify the predictive factors for recurrence in cases of pathologic stage I lung cancer.