Outcomes of thoracic endovascular aortic repair using fenestrated stent grafts in patients with thoracic aortic distal arch aneurysms.

Objectives: Thoracic endovascular aortic repair (TEVAR) for aortic arch aneurysms is challenging because of anatomical restrictions and the presence of cervical branches. Revascularization of the cervical branch is required when conventional commercial stent grafts are used. TEVAR using fenestrated stent grafts (FSG) often does not require additional procedures to revascularize cervical branches.

[Perioperative Management for Patients with Cardiovascular Diseases in General Thoracic Surgery].

For general thoracic surgeons, perioperative management for the prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac diseases. Some risk-scoring systems can estimate a patient's risk of perioperative cardiac complication. Surgery-specific risk for intrathoracic surgery is intermediate.

Blood flow analysis with computational fluid dynamics in the left atrium after left atrial plication: a prospective study.

Objective: This study aimed to evaluate blood flow stagnation in an enlarged left atrium (LA) and prove that left atrial plication (LAP) could alleviate the stagnation.

Methods: Five patients with chronic atrial fibrillation who underwent mitral valve surgery followed by LAP for an enlarged LA with a ≥ 60-mm diameter were included. We performed computational fluid dynamics (CFD) analysis using preoperative and postoperative computed tomography and four-dimensional flow magnetic resonance imaging.

Surgical Treatment Outcomes of Patients with Non-Small Cell Lung Cancer and Lymph Node Metastases.

This study aimed to investigate the appropriate subgroups for surgery and adjuvant chemotherapy in patients with non-small-cell lung cancer (NSCLC) and nodal metastases. We retrospectively reviewed 210 patients with NSCLC and nodal metastases who underwent surgery and examined the risk factors for poor overall survival (OS) and recurrence-free probability (RFP) using multivariate Cox proportional hazards analysis. Pathological N1 and N2 were observed in 114 (52.

Sublobar Resection for Non-Small Cell Lung Cancer in Octogenarians: A Prospective, Multicenter Study.

Background: Segmentectomy is a good surgical option for peripheral, early, non-small cell lung cancer (NSCLC) ≤2 cm. However, the role of sublobar resection including wedge resection and segmentectomy remains unclear for octogenarians with >2-cm but ≤4-cm early-stage NSCLC, for which lobectomy is a standard treatment.

Methods: By use of a prospective registry, 892 patients aged ≥80 years with operable lung cancer were enrolled at 82 institutions.

[Analysis of Surgical Margin Recurrence Following Segmentectomy for Early-stage Non-small Cell Lung Cancer].

Background: Surgical margin recurrence following segmentectomy is a critical issue because it may have been avoided by lobectomy.

Methods: Between January 2000 and December 2018, we retrospectively investigated 199 patients who underwent segmentectomy for c-StageⅠ non-small cell lung cancer at our hospital.

Results: Recurrence occurred in 20 cases, of which 3 cases had surgical margin recurrence.

[Emergent Treatment for Life-threating Hemoptysis].

Life-threatening hemoptysis results significant airway obstruction, abnormal gas exchange. When a patient presents with life-threatening hemoptysis, the initial steps are to provide adequate oxygenation and ventilation, secure the airway, position the patient lateral decubitus with bleeding side down, and perform initial treatments to control the bleeding. Bronchoscopy is an important early procedure and can be both diagnostic and therapeutic.

Acute aortic thrombosis in the ascending aorta after cisplatin-based chemotherapy for esophageal cancer: a case report.

Background: The risk of thrombus development is considered to be increased by malignant tumors and chemotherapy. In addition, thrombosis of the ascending aorta is rare. We report a case of ascending aortic thrombectomy in a patient with esophageal cancer who developed ascending aortic thrombus after starting neoadjuvant chemotherapy, including operative findings and surgical treatment.

Contemporary surgical management of complete atrioventricular septal defect with tetralogy of Fallot in Japan.

Objectives: Complete atrioventricular septal defect with tetralogy of Fallot is a rare and complex heart disease. This study aimed to describe contemporary management approaches for this heart disease and the outcomes.

Methods: Data were obtained from 46 domestic institutions in the Japan Cardiovascular Database (2011-2018).

The C-reactive protein to albumin ratio is a prognostic factor for stage I non-small cell lung cancer in elderly patients: JACS1303.

Purpose: To establish the prognostic significance of C-reactive protein (CRP) and albumin in octogenarians with non-small cell lung cancer (NSCLC) based on the study of the Japanese Association for Chest Surgery (JACS 1303).

Methods: A total of 618 octogenarians with pathological stage I NSCLC, who underwent pulmonary resection, were included in the analysis. We conducted multivariable Cox regression analysis to evaluate the CRP to albumin ratio (CAR) as a potential prognostic factor.

Valve-sparing aortic root replacement and aortic valve repair for a 2-year-old girl with Loeys-Dietz syndrome.

We report the case of a 2-year-old girl with Loeys-Dietz syndrome complicated by aortic root dilatation and aortic regurgitation. We performed valve-sparing aortic root replacement with reimplantation technique and aortic valve repair using central plication and free-margin reinforcement simultaneously. The postoperative course was uneventful and the latest echocardiography, 5 years after procedure, revealed trivial aortic insufficiency.

Senolytic vaccination improves normal and pathological age-related phenotypes and increases lifespan in progeroid mice.

Elimination of senescent cells (senolysis) was recently reported to improve normal and pathological changes associated with aging in mice. However, most senolytic agents inhibit antiapoptotic pathways, raising the possibility of off-target effects in normal tissues. Identification of alternative senolytic approaches is therefore warranted.

Prognostic Impact of Mediastinal Lymph Node Dissection in Octogenarians With Lung Cancer: JACS1303.

Introduction: The prognostic significance of mediastinal lymph node dissection (MLND) in elderly patients with non-small cell lung cancer (NSCLC) remains unclear. This post hoc analysis of a nationwide multicenter cohort study (JACS1303) evaluated the prognostic significance of MLND in octogenarians with NSCLC.

Materials And Methods: We included 622 octogenarians with NSCLC who underwent lobectomy.

Maximum Standardized Uptake Value on Positron Emission Tomography is Associated With More Advanced Disease and High-risk Features in Lung Adenocarcinoma.

F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) has been widely used for preoperative staging of lung adenocarcinomas. The aim of this study was to determine whether a high maximum standardized uptake value (SUVmax) could correlate with pathological characteristics in those patients. We retrospectively reviewed patients with clinical stage 0-IA lung adenocarcinoma who underwent preoperative F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography followed by curative anatomical resection.

Oncological issues in staging mediastinal lymph node metastasis for left lung cancer.

Objective: We aimed to discuss the underlying oncological issues in staging of mediastinal lymph node metastasis in patients with left lung cancer who underwent extended radical lymphadenectomy (ERL).

Methods: This multi-institutional retrospective study analyzed 116 patients with left non-small-cell lung cancer who underwent bilateral paratracheal lymph node dissection (ERL) via median sternotomy. The clinicopathological records of patients with mediastinal lymph node metastasis were examined for prognostic factors, including age, sex, histology, tumor size, cN number, preoperative data, metastatic stations (number and distribution), pT, and adjuvant chemotherapy.

Survival of Octogenarians with Early-Stage Non-small Cell Lung Cancer is Comparable Between Wedge Resection and Lobectomy/Segmentectomy: JACS1303.

Background: Anatomic resection with lymph node dissection or sampling is the standard treatment for early non-small cell lung cancer (NSCLC), and wedge resection is an option for compromised patients. This study aimed to determine whether wedge resection can provide comparable prognoses for elderly patients with NSCLC.

Methods: The study analyzed the clinicopathologic findings and surgical outcomes during a median follow-up period of 39.

Mutational signatures in squamous cell carcinoma of the lung.

Background: Tumor mutational burden (TMB) has been identified as one of the predictors for the response to anti-programmed cell death-1 (anti-PD-1) antibody therapy and reported to correlate with smoking history in lung adenocarcinoma. However, in squamous cell carcinoma of the lung, the association between TMB and clinicopathological background factors, such as smoking history, has not been reported, including in our previous study. The mutational signature is a tool to identify the mutagens that are contributing to the mutational spectrum of a tumor by investigating the pattern of DNA changes.

Salvage surgery to treat tumor regrowth after stereotactic body radiotherapy in primary non-small cell lung cancer.

Background: Stereotactic body radiotherapy (SBRT) is considered to be an effective and safe treatment in patients with primary lung cancer. If local recurrence is confirmed following SBRT, surgical treatment is a possibility. The present study aimed to clarify the safety and survival outcomes of salvage surgery in primary lung cancer patients with local recurrence following SBRT.