Direct Insertion of a Dumon Stent Into an Intermediate Bronchus Fistula From the Surgical Field.

A 54-year-old man underwent right S6 segmentectomy for right lung cancer. After discharge, he presented with fever, hemoptysis, and cough, and computed tomography showed an intermediate bronchus fistula. Because direct closure or bronchoplasty was challenging, a Dumon (Novatech) stent was inserted directly into the fistula from the surgical field and covered with an autologous pericardial patch, pedicled mediastinal fat, and intercostal muscle.

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.

Bronchoesophageal Fistula After Systematic Mediastinal Lymph Node Dissection With Pulmonary Lobectomy.

We present a case of a bronchoesophageal fistula after a lobectomy with systematic mediastinal lymphadenectomy for lung adenocarcinoma. A 70-year-old woman was readmitted with postprandial cough, fever, and dysphagia on postoperative day 13. Computed tomography revealed a bronchoesophageal fistula between the left main bronchus and esophagus.

[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.

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.