Feasibility and safety of uniport robotic-assisted thoracoscopic surgery in initial series of anatomical pulmonary resections under learning curve.

Objectives: Uniport robotic assisted thoracoscopic surgery (U-RATS) is a recently adopted approach in thoracic surgery and is assumed to require a learning curve for surgeons because of technical difficulties. We aimed to verify the feasibility and safety of solo surgery in U-RATS in an initial series of patients, comparing with initial series of uniport video-assisted thoracoscopic surgery (U-VATS).

Methods: The surgical and post-operative outcomes of 25 U-RATS cases were compared with 25 U-VATS cases.

Accuracy of lung ultrasound examinations of residual congestion performed by novice residents in patients with acute heart failure.

Aims: The popularity of B-line-guided congestion assessment by lung ultrasound (LUS) has been increasing. However, the ability of novice residents to detect residual congestion with B-line-guided assessment by LUS after decongestion treatment is poorly understood. In this study, we investigated whether novice residents (no prior echocardiography experience) can acquire the skills for B-line-guided residual congestion assessment and whether the range of variation in assessment is acceptable in actual clinical use.

A retrospective analysis of treatment selection and risk factors of treatment failure and recurrence in patients with spontaneous pneumothorax.

Background: Conservative observation with/without oxygen supplementation, aspiration, or tube drainage is selected as an initial treatment for spontaneous pneumothorax. In this study, we examined the efficacy of initial management for cessation of air leak and prevention of recurrence, with consideration of the degree of lung collapse.

Methods: Spontaneous pneumothorax in patients who underwent initial management in our institute between January 2006 and December 2015 were included in this retrospective, single-institutional study.

Stagnating blood flow related to thrombus formation in pulmonary vein stump after left upper lobectomy.

Objectives: A thrombus can occur in the stump of the pulmonary vein after left upper lobectomy, potentially causing postoperative cerebral infarction. This study aimed to verify the hypothesis that stagnation of blood flow inside the pulmonary vein stump causes thrombus formation.

Methods: The three-dimensional geometry of the pulmonary vein stump after left upper lobectomy was recreated using contrast-enhanced computed tomography.

Successful endobronchial occlusion in empyema with broncho-pleural fistula secondary to COVID-19 pneumonia: a case report and literature review.

A few cases of empyema secondary to coronavirus disease 2019 (COVID-19) pneumonia have been reported. Here, we report our experience of a successful endobronchial occlusion using endobronchial Watanabe spigots (EWSs) for empyema with broncho-pleural fistula secondary to COVID-19 pneumonia. A 62-year-old man was diagnosed with COVID-19 and progressed to empyema with broncho-pleural fistula.

The predictive value of preoperative risk assessments and frailty for surgical complications in lung cancer patients.

Purpose: To assess the predictive value of frailty and risk assessments for postoperative complications in lung cancer patients, we reviewed various risk indicators: including FEV1, ppoFEV1, the Zubrod performance status, the American Society of Anesthesiologist score, and risk models based on the Japan National Clinical Database (NCD) and the European Society of Thoracic Surgeons (ESTS) database.

Methods: Patients who underwent elective surgery between April 2016 and May 2019 were enrolled. A statistical analysis was performed to compare any differences among the risk indicators.

Measurement of intrapleural pressure in patients with spontaneous pneumothorax: a pilot study.

Background: The initial management of pneumothorax remains controversial, and we speculated that this might be because there is no method available for evaluation of air leak during initial management. We have developed a system for measurement of intrapleural pressure in pneumothorax to address air leak without the need for chest drainage. The aim of this clinical study was to confirm the ability of this measurement system and to determine the clinical impact of management of air leak.

Ligating the pulmonary vein at the pericardial reflection is useful for preventing thrombus formation in the pulmonary vein stump after left upper lobectomy.

Objectives: Thrombus formation in the pulmonary vein stump after left upper lobectomy is supposedly a risk factor for systemic thrombosis, resulting in a critical course for the patient. The purpose of this study was to assess the efficacy of the proximal ligation method preventing thrombus formation and thrombosis comparing the two groups of patients (those who did and those who did not undergo pulmonary vein ligation).

Methods: We performed a surgical procedure to shorten the pulmonary vein stump in the left upper lobectomy.

Clinical and pathological characteristics of spontaneous pneumothorax in women: a 25-year single-institutional experience.

Objectives: Accumulating evidence suggests that spontaneous pneumothorax (SP) in women, while relatively rare, has higher rates of post-treatment recurrence than in men. Our aim was to further elucidate the clinical and pathological characteristics of SP in women.

Methods: We retrospectively reviewed 59 female patients with no known underlying lung disease undergoing surgery for their SP from January 1990 to December 2015.

Recurrent cerebral attack caused by thrombosis in the pulmonary vein stump in a patient with left upper lobectomy on anticoagulant therapy: case report and literature review.

Background: Thrombus formation in the pulmonary vein stump after pulmonary resection has recently been identified as a cause of systemic thrombosis including brain infarction. However, there is limited research focusing on the clinical course of pulmonary vein stump thrombus, and optimal treatment and prevention strategies of this important complication have not been established.

Case Presentation: A 77-year-old woman was diagnosed with lung cancer of the left upper lobe, cT4N2M0, cStage IIIB.

Efficacy and long-term clinical outcome of bronchial occlusion with endobronchial Watanabe spigots for persistent air leaks.

Background: We reviewed our clinical experience and examined the efficacy and long-term outcome of bronchial occlusion with endobronchial Watanabe spigots (EWSs).

Methods: We retrospectively reviewed the clinical charts of patients who had undergone endoscopic bronchial occlusion with EWSs between July 2002 and July 2004. The affected bronchi were identified by chest computed tomography, pleurography, and balloon occlusion test.

A decrease in the size of ground glass nodules may indicate the optimal timing for curative surgery.

Objectives: Although ground glass nodules (GGNs) are generally considered to grow slowly to a large size, their natural progression remains unclear, and a decrease in tumor size has been reported in a few previous studies. The study aimed to retrospectively review the radiologic and pathological characteristics of resected ground glass nodules (GGNs) followed with chest computed tomography (CT) for at least a year before surgery to clarify the natural progression of GGNs.

Patients And Methods: The chest CT cans and clinical charts of 32 GGNs in 31 patients who underwent pulmonary resection between January 2006 and March 2013 were retrospectively reviewed.

Three-step management of pneumothorax: time for a re-think on initial management.

Pneumothorax is a common disease worldwide, but surprisingly, its initial management remains controversial. There are some published guidelines for the management of spontaneous pneumothorax. However, they differ in some respects, particularly in initial management.

Lesions in patients with multifocal adenocarcinoma are more frequently in the right upper lobes.

Objectives: Opportunities to treat multifocal lung cancers, mostly adenocarcinoma, are increasing due to the development of imaging technologies. The optimal therapy modality to treat multifocally growing lung cancers remains obscure. To determine the features of multifocal lung cancers, we retrospectively reviewed patients with multiple lung lesions.

Impact of previous gastrectomy on postoperative pneumonia after pulmonary resection in lung cancer patients.

Postoperative pneumonia is a serious complication following pulmonary resection. Aspiration of oesophageal reflux contents is known to cause pulmonary complications in patients with a history of gastrectomy. In this study, we compared the incidence of postoperative pneumonia in patients with or without previous gastrectomy.

Primary squamous cell carcinoma in the gastric remnant.

A 67-year-old male developed primary gastric squamous cell carcinoma (SCC) 13 years after undergoing distal gastrectomy for gastric cancer. Gastroscopy revealed a type 2 gastric remnant tumor and tumor biopsies revealed poorly differentiated carcinoma. The patient underwent remnant gastrectomy with lateral segment hepatectomy, splenectomy, partial resection of diaphragm, and distal partial esophagectomy.