Video-assisted thoracoscopic right anterior, lateral, and medial segmentectomy for primary lung cancer of the middle lobe with incomplete interlobar fissures.

A 63-year-old woman was referred to our hospital due to an abnormal shadow in the right middle lung field on chest X-ray. Chest computed tomography revealed a 2.0 cm nodule in the right lateral segment of the middle lobe.

New technique for fixing rib fracture with bioabsorbable plate.

Fixation of a bone fracture with a bioabsorbable plate made of poly-L-lactide and hydroxyapatite has received attention. We adopted this technique for a rib fracture by bending the plate into a U-shape and fixing it with suture through the holes in the mesh of the plate and holes that are drilled in the edge of the fractured rib. The suture is also wound around the plate.

Type AB thymoma with brain metastasis: Report of a case.

Type AB thymomas are considered to be nonaggressive tumors, and the great majority are classified as Masaoka stage I or II. This report presents a case with Masaoka stage I and type AB thymoma, which metastasized to the brain 2 years 5 months after removal of the primary tumor. The original mediastinal lesion was adhesive but not invasive to the lung.

Proposal of new nodal classifications for non-small-cell lung cancer based on the number and ratio of metastatic lymph nodes.

Objective: The study aimed to evaluate the effectiveness of two new nodal classifications based on the number of metastatic lymph nodes (LNs) or ratio of metastatic to examined LNs (LNR) in making a prognosis, compared with the current nodal classification based on the location of metastatic LNs.

Methods: We analyzed 651 non-small-cell lung cancer patients who had undergone complete resection with the removal of more than five LNs between 1986 and 2003, excluding preoperative treatment cases, and a Tis, T4, N3, and M1 status, along with limited resection and operative death cases. The cutoff numbers for each category in the two new nodal classifications (number of metastatic LNs (nN0-2): 0, 1-2, and >3, and LNR (rN0-2): 0, 1-12, and >12%) were defined so that the numbers corresponded with paired categories within the current nodal classification.

Azygos flap as a novel method for superior vena cava reconstruction.

In the surgical treatment of lung cancers invading the superior vena cava (SVC), primary closure is preferred for reconstruction when the resected area is small, but the repaired vessel can become constricted. A novel method for SVC repair with azygos flap, which is a longitudinally opened azygos arch, is a facile and effective treatment, and may prevent a reduction in the lumen if the area of tumor invasion is small and close to the azygos arch. When the azygos arch is not invaded by the tumor, this procedure should therefore be considered as one alternative method for SVC reconstruction.

Thymoma concomitant with a right aortic arch.

A 63-year-old woman was referred to our hospital because screening had detected an anterior mediastinal tumor with a right aortic arch. She underwent typical total thymectomy via a median sternotomy but developed left recurrent laryngeal nerve (RLN) palsy postoperatively. The pathology examination revealed that the tumor was a stage I thymoma.

Acute occlusion of left coronary ostium associated with congenital quadricuspid aortic valve.

A 10-year-old girl suffered from chest discomfort during exercise. She experienced an acute myocardial infarction accompanied by an obstruction in an orifice to the left coronary artery. An emergency operation revealed that the aortic valve was quadricuspid, and a left-sided small cusp had adhered to the aortic wall resulting in an unusual sac with a tiny slit.