Effects of the COVID-19 pandemic on surgical treatment for thoracic malignant tumor cases in Japan: a national clinical database analysis.

Objective: Surgical care has been significantly affected by the COVID-19 pandemic. This study was conducted to evaluate the effects of the pandemic on lung cancer and mediastinal tumor surgery.

Methods: Changes in the number of surgical procedures for lung cancer and mediastinal tumors were analyzed using the National Clinical Database of Japan.

[Robotic Mediastinal Tumor Surgery Using da Vinci SP Surgical System].

The da Vinci single-port (SP) surgical system is a new system in which a camera and three robotic forceps are inserted into the body through a single small wound for surgical manipulation. This paper outlines the basic techniques and tips for mediastinal tumor surgery using the da Vinci SP, especially the subxiphoid single-port approach. In addition, we will discuss the subcostal approach single-port middle or posterior mediastinal tumor surgery.

Single Lung Transplantation After Open Window Thoracotomy for Empyema: A Case Report.

A 41-year-old woman with lymphangioleiomyomatosis developed a bronchial anastomotic stenosis after left single lung transplantation (LTx). A part of the hyperinflated right native lung was excised in an attempt to remedy the left lung compression, which appeared to affect the bronchial anastomotic stenosis and ventilation/perfusion mismatch. However, a persistent air leak after the surgery caused empyema and an open window thoracotomy (OWT) was performed.

Effect of revised organ transplant law in Japan on lung transplantation.

Purpose: To investigate how revision of the organ transplant law in Japan affected lung transplantation in this country.

Methods: Lung transplant candidates registered between January, 2000 and December, 2009 were designated as the pre-revision group (n = 396) and those registered between January, 2011 and December, 2020, as the post-revision group (n = 1326). Both groups were analyzed retrospectively using data collected by the Japanese Society of Lung and Heart-Lung Transplantation.

Donor management and extremely high donor lung utilization rate in Japan.

Owing to the extremely short supply of donor lungs in Japan, a unique medical consultant (MC) system was initiated in 2002 to increase the organ availability through intensive management of donors. First, heart transplant surgeons were sent to procurement hospitals as MCs to assess donor organ function and provide intensive care to donors. MCs requested that donor attending doctors perform frequent phlegm aspiration with a bronchoscope, leading to a higher lung availability and better outcomes after lung transplantation.

The consecutive impact of COVID-19 on thoracic surgical procedures in Japan: an analysis of data from the National Clinical Database.

Purpose: The current study was designed to analyze the impact of the COVID-19 pandemic on general thoracic surgeries in Japan.

Methods: Changes in surgeries for lung cancer and metastatic lung tumors were evaluated based on National Clinical Database data regarding cancer screening.

Results: In 2021, surgeries for primary lung cancer increased by 3.

Prognostic factors for lung transplant recipients focusing on age and gender: the Japanese lung transplantation report 2022.

Purpose: To clarify the impact of donor and recipient characteristics on the survival of recipients before and after lung transplantation in the Japanese population.

Methods: Patients' data were collected for retrospective analysis from all authorized lung transplant centers in Japan. We included 1963 patients listed for lung transplantation by the end of December 2021, comprised of 658 deceased-donor and 270 living-donor lung transplants.

Honeycomb lung is a major risk factor for preoperative radiological tumor size underestimation in patients with primary lung cancer.

Background: Lung cancer frequently occurs in lungs with background idiopathic interstitial pneumonias (IIPs). Limited resection is often selected to treat lung cancer in patients with IIPs in whom respiratory function is already compromised. However, accurate surgical margins are essential for curative resection; underestimating these margins is a risk for residual lung cancer after surgery.

Living Donor Lobar Lung Transplant for a Patient With Lung Disease Caused by ABCA3 Gene Mutations: A Case Report.

Recessive gene mutations in ABCA3 cause lethal neonatal respiratory distress, and pediatric and adult interstitial lung disease. The effectiveness of medical treatments is limited and a subset of such patients will eventually require lung transplantation. A 20 months old boy developed interstitial lung disease and was treated with hydroxychloroquine, which had a significant effect.

Successful thoracic duct identification with patent blue V during thoracic duct ligation for chylothorax: a case report.

Background: Chylothorax after thoracic surgery is a rare but severe complication. When thoracic duct ligation is performed for chylothorax, identification of the leakage site and the thoracic duct course is necessary. Administering milk orally or through a nasogastric tube and injecting indocyanine green into lymph nodes and lymphatic vessels can be performed to identify the leakage site and the thoracic duct course.

[Traumatic Diaphragmatic Injury].

Traumatic diaphragmatic injury( TDI) is rare in traumas, however TDI is associated with high mortality. We follow the notation method by The Japanese Association for The Surgery of Trauma. There are blunt trauma and penetrating trauma of TDI;blunt trauma causes mainly traffic accidents, and penetrating trauma is induced stub or gunshot.

The impact of COVID-19 on thoracic surgical procedures in Japan: Analysis of data from the National Clinical Database.

Objective: The COVID-19 pandemic has far-reaching collateral health impacts on the ongoing delivery of surgical care worldwide. The current study was designed to analyze the impact of the COVID-19 pandemic on the number of surgeries of general thoracic surgery in Japan.

Methods: Changes in the number of surgeries for total and three representative tumors were analyzed using the National Clinical Database data with reference to the pandemic infection rate and lung cancer screening.

The phase angle as a predictor of postoperative complications in patients undergoing lung cancer surgery.

Purpose: The phase angle (PhA), calculated by bioelectrical impedance analysis, is used as a nutritional risk indicator. A low preoperative PhA has been reported as a marker of postoperative complications in patients with cancer; however, the relationship between the PhA and postoperative complications in patients with lung cancer remains unknown. We conducted this study to assess the predictive ability of the preoperative PhA for postoperative complications in patients undergoing surgery for primary lung cancer.

γH2AX, a DNA Double-Strand Break Marker, Correlates with PD-L1 Expression in Smoking-Related Lung Adenocarcinoma.

In recent years, the choice of immune checkpoint inhibitors (ICIs) as a treatment based on high expression of programmed death-ligand 1 (PD-L1) in lung cancers has been increasing in prevalence. The high expression of PD-L1 could be a predictor of ICI efficacy as well as high tumor mutation burden (TMB), which is determined using next-generation sequencing (NGS). However, a great deal of effort is required to perform NGS to determine TMB.

Tracheobronchial reconstruction by inverted Barclay's method for tracheobronchial injury in an 8-year-old girl: a case report.

Background: Tracheobronchial injury in children is rare but can be highly fatal in severe cases. Therefore, prompt diagnosis and treatment are required. The appropriate treatment method depends on the extent and severity of the injury.

Aortogenic embolic stroke after sleeve pneumonectomy with median sternotomy for lung cancer: a case report.

Background: The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation in selected cases, which may reduce the difficulty in achieving anastomosis under intubation of the left main bronchus. However, with median sternotomy, the ascending aorta requires repeated mobilization to expose the operative field for anastomosis, which can cause an aortogenic embolic stroke.

Case Presentation: A 70-year-old Asian man presenting 6 months after developing hemoptysis was diagnosed with right upper lobe lung cancer (stage T4N0M0), invading the lower trachea and basal bronchus.

Evaluation of prognosis after thoracoscopic lobectomy for primary lung cancer.

Introduction: Thoracoscopic lobectomy for primary lung cancer is performed at many institutions. However, few reports are available on postoperative prognosis for progressive stages. In 2004, we adopted lobectomy by video-assisted thoracoscopic surgery (VATS), which would be applicable to the clinical stages up to stage IIIA.

Subxiphoid uniportal bilateral lung wedge resection.

Subxiphoid uniportal bilateral lung wedge resection, in which all manipulations are performed via a 3-cm wound positioned below the xiphoid process, can be performed in the supine position without the patient having to change positions. It also enables one-stage bilateral lung resection. We report the surgical procedure and initial results of subxiphoid uniportal bilateral lung wedge resection.

Early outcomes in 147 consecutive cases of subxiphoid single-port thymectomy and evaluation of learning curves.

Objectives: The aim of the present study was to examine some initial results and learning curves concerning subxiphoid single-port thymectomy (SSPT), thereby clarifying the safety of this surgical approach and describing the precautions for adopting it.

Methods: From March 2011 to August 2019, a total of 203 patients underwent thymectomy for either anterior mediastinal tumours or myasthenia gravis at Fujita Health University Hospital. Of these 203 patients, 147 patients who had undergone SSPT were selected as participants for the present study.

Ex vivo lung CT findings may predict the outcome of the early phase after lung transplantation.

Purpose: We developed an ex vivo lung CT (EVL-CT) technique that allows us to obtain detailed CT images and morphologically assess the retrieved lung from a donor for transplantation. After we recovered the lung graft from a brain-dead donor, we transported it to our hospital and CT images were obtained ex vivo before lung transplant surgery. The objective of this study was to investigate the correlation between the EVL-CT findings and post-transplant outcome in patients who underwent bilateral lung transplantation (BLT) or single lung transplantation (SLT).

Prediction of pulmonary function after major lung resection using lung perfusion scintigraphy with single-photon emission computed tomography/computed tomography.

Objective: Precise prediction of postoperative pulmonary function is extremely important for accurately evaluating the risk of perioperative morbidity and mortality after major surgery for lung cancer. This study aimed to compare the accuracy of a single-photon emission computed tomography/computed tomography (SPECT/CT) method that we recently developed for predicting postoperative pulmonary function versus the accuracy of both the conventional simplified calculating (SC) method and the method using planar images of lung perfusion scintigraphy.

Methods: The relationship between the postoperative observed % values of the forced expiratory volume in 1 second (FEV) or diffusing capacity for carbon monoxide (DL or DL') and the % predicted postoperative (%ppo) values of FEV, DL, or DL' calculated by the three methods were analyzed in 30 consecutive patients with lung cancer undergoing lobectomy.