Background: Surgery for lung cancer complicated by idiopathic interstitial pneumonia (IIP) is associated with a high rate of postoperative mortality. Thus, preoperative predictors of surgical mortality are needed to aid in the selection of suitable surgical candidates.
Methods: The subjects of this retrospective study were 1625 patients who underwent resection of primary lung cancer between 2000 and 2012, 203 (12.
Background: Segmentectomy is becoming more common since many lung cancers are small when found. Left upper superior segmentectomy (LUSS) is the most popular procedure for segmentectomy. Atelectasis is a common postoperative complication following segmentectomy.
View Article and Find Full Text PDFObjectives: Solid lung cancers, even subcentimetre lesions, are considered to be invasive pathologically. However, the clinicopathological features and appropriate operative strategies in patients with these small lesions are still controversial, especially for those with a radiologically solid appearance.
Methods: Between 2004 and 2011, 135 patients underwent pulmonary resection for subcentimetre lung cancer with clinical-N0 (c-N0) status.
Background: The aim of this study was to evaluate the efficacy of buttressed stapling using a stapler with an attached polyglycolic acid sheet in reducing the rate of air leak associated with pulmonary lobectomy. Materials and
Methods: A prospective, randomized, phase III study was conducted to confirm the superiority of a buttressed stapler in a test treatment group to a conventional nonbuttressed stapler in a current international standard of care group among patients undergoing pulmonary lobectomy. The primary end point was the frequency of intraoperative air leaks.
Objectives: Phase III trials regarding the feasibility of segmentectomy for lung cancer ≤ 2 cm in size are now underway in Japan and the USA. However, despite their small size, lung cancers that show a pure-solid appearance on thin-section computed tomography (CT) are considered to be invasive with a high frequency of nodal involvement.
Methods: Between 2008 and 2011, 556 clinical Stage IA lung cancer patients underwent pulmonary resection.
One of the most difficult aspects of complete segmentectomy of the lung is the identification of the intersegmental plane. Instead of a conventional residual segment inflation method, we have developed a new technique for detecting intersegmental planes using indocyanine green medium. The technique is simple and consists of (1) ligation of the segmental vein to prevent loss of the indocyanine green and (2) injection of indocyanine green through the segmental bronchus.
View Article and Find Full Text PDFObjectives: Ground glass opacity (GGO) on thin-section computed tomography (CT) has been reported to be a favourable prognostic marker in lung cancer, and the size or area of GGO is commonly used for preoperative evaluation. However, it can sometimes be difficult to evaluate the status of GGO.
Methods: A retrospective study was conducted on 572 consecutive patients with resected lung cancer of clinical stage IA between 2004 and 2011.
Objectives: Fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in the evaluation of resectable non-small-cell lung cancer (NSCLC). However, this modality cannot be used to detect histological nodal involvement, which can result in stage-migration for resectable lung cancer. In this study, we tried to evaluate the possibility of predicting histological nodal involvement in patients with NSCLC using the maximum standardized uptake value (SUVmax) of FDG-PET of the primary tumour instead of that of the lymph nodes.
View Article and Find Full Text PDFBackground: Small lung cancers showing a wide area of ground-grass opacity (GGO) on thin-section computed tomography (CT) are considered good candidates for limited surgical resection because of its minimally invasive nature. Conversely, the validity of limited resection for radiologically "solid" tumors is still controversial in small non-small cell lung carcinomas.
Methods: Between 2008 and 2010, 680 consecutive patients underwent pulmonary resection for lung cancer.
Ann Thorac Cardiovasc Surg
June 2012
Many approaches for resection of the superior mediastinal tumors have been reported. We introduce an approach, which we call the cervical anterior approach. This approach is only cervical and does not require a sternotomy.
View Article and Find Full Text PDFBackground: At Juntendo University Hospital, Japan, two patients with complete resection of bulky N2 non-small cell lung cancer (NSCLC) has survived over the long term. Therefore, we decided to retrospectively study patients who also had a complete resection of the tumor including the "bulky" superior mediastinal node for the purpose of reviewing covariates that might be related to the favorable outcome.
Methods: We retrospectively analyzed the relation between covariates and survival after complete lobectomy and mediastinal lymph node resection (from April 1997 to August 2007) in 15 patients with bulky N2 NSCLC, lymph nodes greater than 2 cm in short-axis diameter (bulky nodal disease) measured on preoperative chest computer tomography.
Purpose: A keloid scar often appears at the incision site of patients after median sternotomy. Use of silicone gel to treat hypertrophic burn scars and fresh incisions has yielded encouraging results. In this study, we report our experience with the preventive use of silicone gel sheets for keloid scars after median sternotomy.
View Article and Find Full Text PDFSegmentectomy could be one of the standard modes of surgery for the treatment of early lung cancer. However, segmentectomy could be more difficult than lobectomy as to the management of inter-segmental plane. The relationship between methods of dividing an inter-segmental plane and postoperative complication/pulmonary function was investigated in this study.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg
September 2010
Purpose: It is often difficult to control hypertrophic scars and keloids with drug therapy, steroid injection, surgery, radiation therapy, laser, or wound pressing. Use of silicone gel to treat hypertrophic burn scars and fresh incisions has yielded encouraging results. We report our experience of silicone gel sheets for patients with keloids following median sternotomy.
View Article and Find Full Text PDFBackground: Numerous reports have been published on the application of fibrin glues, biological adhesives used as sealants for air leaks after pulmonary resection; however, the use of blood products has been questioned from both safety and economic perspectives. Therefore we were prompted to attempt the use of Integran (method C), a sheet-type absorbable topical collagen hemostat that is neither expensive nor derived from blood.
Objective: To compare the efficacy of method C with that of method G, a combined approach in which TachoComb or a polyglycolic acid (PGA) sheet was fixed with a fibrin glue in a randomized controlled trial to prevent pulmonary fistula formation after lung surgery.
Gen Thorac Cardiovasc Surg
September 2009
Objective: Chronic dry cough is reported to occur in about 25% of patients following lung cancer surgery. Experimental data suggest that it may be caused mainly by stimulation of C-fibers, which are widely distributed to the lower trachea and bronchi. We assessed the clinical usefulness of suplatast tosilate (IPD) for chronic dry cough after lung cancer surgery.
View Article and Find Full Text PDFSternal dehiscence is one complication after median sternotomy. We followed a patient with sternal dehiscence for 6 months after extended thymectomy via median sternotomy. His diagnosis was myasthenia gravis without thymoma and with complicating diabetes mellitus.
View Article and Find Full Text PDFObjective: In this retrospective study, we clarified the impact of smoking on prognosis and the association of clinicopathological factors, particularly histologic subtype, in patients with small adenocarcinoma of the lung.
Methods: Between 1996 and December 2006, 121 patients presenting with adenocarcinomas that had a diameter =2 cm were analyzed. The clinicopathological records of the patients were examined for age, gender, nodal status (c-N and p-N), tumor size, serum carcinoembryonic antigen level, histologic subtype, and smoking history.
Eur J Cardiothorac Surg
January 2006
Objective: Pneumonectomy for complex aspergilloma is associated with high morbidity rates. This study aimed to improve the outcomes of this high-risk procedure by preventing postoperative complications.
Methods: Between April 1999 and December 2004, 25 patients underwent pulmonary resection for complex aspergilloma at our institution.