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Risk factors for distal stent graft-induced new entry after frozen elephant trunk procedure in chronic aortic dissection.
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-06 DOI: 10.1007/s11748-025-02122-5
Sho Akita, Yoshiyuki Tokuda, Yuji Narita, Sachie Terazawa, Tomo Yoshizumi, Hideki Ito, Masato Mutsuga

Background: The frozen elephant trunk (FET) procedure has emerged as an effective single-stage treatment for complex aortic pathologies. However, it carries a risk of distal stent graft-induced new entry (dSINE) in patients with chronic aortic dissection (CAD). This study investigated risk factors associated with dSINE development.

Methods: Between 2009 and 2021, 160 FET procedures were performed, including 48 cases of CAD (mean time from onset: 5.6 ± 3.8 years). After excluding five patients due to incomplete 6-month postoperative computed tomography (CT) data, 43 patients were included. A multivariable stepwise Cox proportional hazards regression analysis was conducted to identify predictors of dSINE.

Results: During a mean follow-up period of 5.9 ± 3.9 years, dSINE occurred in 22 of 43 patients (51.1%). Univariate analysis identified three significant risk factors for dSINE: total aortic diameter (TAD) > 45 mm at the distal stent-graft level (HR 5.88, 95% CI 1.35-25.52, p = 0.018), True lumen (TL) perimeter-based diameter (HR 1.22, 95% CI 1.03-1.46; p = 0.021), and TL ovality (HR 1.31, 95% CI 1.04-1.65, p = 0.022). Multivariate analysis revealed TAD > 45 mm as an independent risk factor for dSINE (HR 4.60, 95% CI 1.01-20.85, p = 0.048). The 5-year freedom from dSINE was significantly higher in patients with TAD ≤ 45 mm compared to those with TAD > 45 mm (87.5% vs. 20.8%, p < 0.01).

Conclusions: Although FET remains an important therapeutic option for CAD, dSINE represents a significant postoperative complication. TAD > 45 mm was identified as an independent risk factor. These findings may guide surgical planning for FET procedures.

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引用次数: 0
Embankment technique in extended sandwich patch repair for post-infarction ventricular septal rupture.
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-02 DOI: 10.1007/s11748-025-02125-2
Kosaku Nishigawa, Retsu Tateishi, Shunya Ono, Takeyuki Kanemura

Extended sandwich patch repair for post-infarction ventricular septal rupture is a surgical technique that closes the defect using two patches, with one on the right ventricular side and the other on the left ventricular side. In this technique, filling materials such as surgical glue are often used between the two patches. We routinely use BioGlue surgical adhesive as a filler. However, there are concerns regarding residual shunts because of incomplete closure of the defect and the risk of embolism caused by the glue leaking into the left ventricle. Therefore, we have developed a technique to create a "bank" using an absorbable hemostatic agent between the patch and the defect, aiming to secure defect sealing and prevent embolism caused by the glue. We have named this procedure the "embankment technique." In 11 consecutive cases treated with this procedure, no residual shunts or embolic events were observed.

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引用次数: 0
No survival benefit of primary tumor resection for non-small cell lung cancer patients with unexpectedly detected pleural disseminated nodules in the era of targeted therapy. 在靶向治疗时代,对意外发现胸膜播散性结节的非小细胞肺癌患者进行原发肿瘤切除术无生存益处。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 Epub Date: 2024-07-20 DOI: 10.1007/s11748-024-02055-5
Yukio Watanabe, Kazuya Takamochi, Takuo Hayashi, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Hisashi Tomita, Kenji Suzuki

Objectives: Non-small cell lung cancer (NSCLC) patients with pleural dissemination are generally contraindicated for surgery. This study aimed to investigate the survival benefits of primary tumor resection for NSCLC patients with unexpectedly detected pleural disseminated nodules during thoracotomy in the era of targeted therapy.

Methods: Of the 4984 patients with NSCLC who underwent surgery without induction therapy between 2000 and 2021, we retrospectively evaluated 90 (1.8%) patients with unexpectedly detected pleural disseminated nodule. Survival analyses were performed with Kaplan-Meier methods and Cox proportional hazards regression.

Results: Among the evaluated patients, 58 were male, the median age was 67, and 77 (86%) were diagnosed with adenocarcinoma. Exploratory thoracotomy was performed in 21 (23%), and primary tumor resection was performed in 69 (77%) patients, including pneumonectomy in four, lobectomy in 39, and sublobar resection in 26. Epidermal growth factor receptor gene mutation and anaplastic lymphoma kinase rearrangement were detected in 33 (37%) and 4 (4%) cases, respectively. Among them, 31 patients received targeted therapy. The overall survival (OS) was not significantly different between patients with primary tumor resection and exploratory thoracotomy (5-year OS rate: 30.2% vs. 27.8%, p = 0.81). Multivariable analysis revealed that sex (p = 0.02) and targeted therapy (p < 0.01) were independent prognostic factors for OS. Survival outcomes in patients who received targeted therapy were significantly better regardless of primary tumor resection.

Conclusions: Primary tumor resection might not affect the survival in NSCLC patients with unexpectedly detected pleural disseminated nodules in the era of targeted therapy.

目的:有胸膜播散的非小细胞肺癌(NSCLC)患者通常是手术禁忌症。本研究旨在探讨在靶向治疗时代,对胸廓切开术中意外发现胸膜播散结节的 NSCLC 患者进行原发肿瘤切除术的生存益处:在2000年至2021年期间接受手术而未接受诱导治疗的4984例NSCLC患者中,我们对90例(1.8%)意外发现胸膜播散性结节的患者进行了回顾性评估。我们采用卡普兰-梅耶法和考克斯比例危险回归法进行了生存分析:在接受评估的患者中,58 人为男性,中位年龄为 67 岁,77 人(86%)被确诊为腺癌。21人(23%)进行了探查性开胸术,69人(77%)进行了原发肿瘤切除术,其中4人进行了肺切除术,39人进行了肺叶切除术,26人进行了肺叶下切除术。33例(37%)和4例(4%)分别检测到表皮生长因子受体基因突变和无性淋巴瘤激酶重排。其中,31 例患者接受了靶向治疗。原发肿瘤切除术和开胸探查术患者的总生存率(OS)无明显差异(5年OS率:30.2% vs. 27.8%,P = 0.81)。多变量分析显示,性别(p = 0.02)和靶向治疗(p 结论:原发性肿瘤切除术可能不会影响5年生存率:在靶向治疗时代,原发肿瘤切除术可能不会影响意外发现胸膜播散性结节的 NSCLC 患者的生存率。
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引用次数: 0
Comparison of segmentectomy and wedge resection for cT1cN0M0 non-small cell lung cancer. 分段切除术和楔形切除术治疗 cT1cN0M0 非小细胞肺癌的比较。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 Epub Date: 2024-07-08 DOI: 10.1007/s11748-024-02058-2
Satoshi Takamori, Makoto Endo, Jun Suzuki, Hikaru Watanabe, Satoshi Shiono

Objective: Sublobar resection is considered a standard surgical procedure for early non-small cell lung cancer, although the survival of patients undergoing sublobar resection for clinical T1cN0M0 non-small cell lung cancer remains unclear. This study aimed to compare survival between segmentectomy and wedge resection for clinical T1cN0M0 non-small cell lung cancer.

Methods: This retrospective study included patients who had undergone curative surgery for cT1cN0M0 stage IA3 non-small cell lung cancer. The overall and recurrence-free survival rates of 91 patients who underwent segmentectomy or wedge resection were compared.

Results: Thirty-nine (42.9%) and 52 patients (57.1%) were included in the segmentectomy and wedge resection groups, respectively. The median length of follow-up was 6.0 years (95% confidence interval 4.2 - - years) (Kaplan-Meier estimate). The 5 year overall survival rates were not significantly different between the segmentectomy and wedge resection groups (67.7% vs 52.0%, P = 0.132). The 5 year recurrence-free survival rate was worse in the wedge resection group than in the segmentectomy group (66.6% vs 46.9%, P = 0.047). In univariable analysis, spread through air spaces (hazard ratio, 5.889; 95% confidence interval, 2.357-14.715; P < 0.001) was an important prognostic factor for recurrence-free survival in the wedge resection group.

Conclusions: The overall survival of patients who underwent segmentectomy for clinical T1cN0M0 non-small cell lung cancer was not significantly different from that of patients who underwent wedge resection. However, patients with cT1cN0M0 non-small cell lung cancer who underwent wedge resection tended to have a worse recurrence-free survival prognosis than those who underwent segmentectomy.

目的:条带下切除术被认为是早期非小细胞肺癌的标准手术方法,但临床T1cN0M0非小细胞肺癌条带下切除术患者的生存率仍不清楚。本研究旨在比较分段切除术和楔形切除术治疗临床T1cN0M0非小细胞肺癌的生存率:这项回顾性研究纳入了接受治愈性手术的 cT1cN0M0 IA3 期非小细胞肺癌患者。比较了91名接受分段切除术或楔形切除术患者的总生存率和无复发生存率:分段切除组和楔形切除组分别有 39 名(42.9%)和 52 名(57.1%)患者。中位随访时间为 6.0 年(95% 置信区间为 4.2 - - 年)(Kaplan-Meier 估计值)。分段切除组和楔形切除组的 5 年总生存率无明显差异(67.7% vs 52.0%,P = 0.132)。楔形切除组的 5 年无复发生存率低于分段切除组(66.6% vs 46.9%,P = 0.047)。在单变量分析中,通过气隙扩散(危险比,5.889;95% 置信区间,2.357-14.715;P 结论:楔形切除术组比分段切除术组的无复发 5 年生存率更低(66.6% vs 46.9%):临床T1cN0M0非小细胞肺癌分段切除术患者的总生存率与楔形切除术患者的总生存率无明显差异。然而,接受楔形切除术的 cT1cN0M0 非小细胞肺癌患者的无复发生存预后往往比接受分段切除术的患者差。
{"title":"Comparison of segmentectomy and wedge resection for cT1cN0M0 non-small cell lung cancer.","authors":"Satoshi Takamori, Makoto Endo, Jun Suzuki, Hikaru Watanabe, Satoshi Shiono","doi":"10.1007/s11748-024-02058-2","DOIUrl":"10.1007/s11748-024-02058-2","url":null,"abstract":"<p><strong>Objective: </strong>Sublobar resection is considered a standard surgical procedure for early non-small cell lung cancer, although the survival of patients undergoing sublobar resection for clinical T1cN0M0 non-small cell lung cancer remains unclear. This study aimed to compare survival between segmentectomy and wedge resection for clinical T1cN0M0 non-small cell lung cancer.</p><p><strong>Methods: </strong>This retrospective study included patients who had undergone curative surgery for cT1cN0M0 stage IA3 non-small cell lung cancer. The overall and recurrence-free survival rates of 91 patients who underwent segmentectomy or wedge resection were compared.</p><p><strong>Results: </strong>Thirty-nine (42.9%) and 52 patients (57.1%) were included in the segmentectomy and wedge resection groups, respectively. The median length of follow-up was 6.0 years (95% confidence interval 4.2 - - years) (Kaplan-Meier estimate). The 5 year overall survival rates were not significantly different between the segmentectomy and wedge resection groups (67.7% vs 52.0%, P = 0.132). The 5 year recurrence-free survival rate was worse in the wedge resection group than in the segmentectomy group (66.6% vs 46.9%, P = 0.047). In univariable analysis, spread through air spaces (hazard ratio, 5.889; 95% confidence interval, 2.357-14.715; P < 0.001) was an important prognostic factor for recurrence-free survival in the wedge resection group.</p><p><strong>Conclusions: </strong>The overall survival of patients who underwent segmentectomy for clinical T1cN0M0 non-small cell lung cancer was not significantly different from that of patients who underwent wedge resection. However, patients with cT1cN0M0 non-small cell lung cancer who underwent wedge resection tended to have a worse recurrence-free survival prognosis than those who underwent segmentectomy.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"110-117"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minimally invasive cardiac surgeries in 2021: annual report by Japanese society of minimally invasive cardiac surgery. 2021 年微创心脏外科手术:日本微创心脏外科学会年度报告。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 Epub Date: 2024-07-31 DOI: 10.1007/s11748-024-02066-2
Tomoki Shimokawa, Hiraku Kumamaru, Noboru Motomura, Hiroyuki Nishi, Hiroyuki Nakajima, Hiroyuki Kamiya, Minoru Tabata, Kazuma Okamoto, Soh Hosoba, Yoshikatsu Saiki, Taichi Sakaguchi

Purpose: Although minimally invasive cardiac surgery (MICS) procedures are widely performed throughout Japan, nationwide data regarding treated cases are limited. Up-to-date results for cardiovascular surgery are vital for quality control in clinical practice. Presented here is the 2021 annual report based on data from the Japan Cardiovascular Surgery Database (JCVSD).

Methods: Records noted in the JCVSD of patients who underwent mitral valve surgery, aortic valve replacement (AVR), coronary artery bypass grafting (CABG), atrial septum defect (ASD) closure, or cardiac tumor resection via right or left minithoracotomy, as well as thoracoscopic- or port-assisted, or robotic-assisted approaches, in 2021 were examined. Perioperative parameters including mortality and morbidity was evaluated.

Results: The 30-day and in-hospital mortalities for isolated mitral valve repair (n = 1211) were 0.1% and 0.2%, respectively, while those for all mitral valve repair (n = 2017) were 0.05% and 0.2%, respectively. More than 100 facilities were found to perform fewer than five MICS mitral valve surgery cases per year. As for MICS-AVR, 30-day and in-hospital mortalities for isolated AVR (n = 818) were 0.5% and 0.5%, respectively, while those for all AVR (n = 987) were 0.6% and 1.1%, respectively. Additionally, those for MICS-CABG (n = 400) were 0.8% and 0.5%, respectively. Those for ASD (n = 183) and cardiac tumor (n = 96), were 0.5% and 0.5%, respectively, and 0% and 1.0%, respectively.

Conclusion: This is the first report of MICS results of procedures performed in Japan based on the 2021 JCVSD data. Additional results obtained with a similar data collection method are expected and details on MICS are being collected starting 2024.

目的:虽然微创心脏外科手术(MICS)在日本广泛开展,但全国范围内的治疗病例数据却很有限。心血管手术的最新结果对于临床实践中的质量控制至关重要。本文介绍的是基于日本心血管外科数据库(JCVSD)数据的 2021 年度报告:方法:研究了日本心血管手术数据库(JCVSD)中记录的 2021 年接受二尖瓣手术、主动脉瓣置换术 (AVR)、冠状动脉旁路移植术 (CABG)、房间隔缺损 (ASD) 关闭术或通过右侧或左侧小切口、胸腔镜或端口辅助或机器人辅助方法进行心脏肿瘤切除术的患者。对包括死亡率和发病率在内的围手术期参数进行了评估:结果:孤立二尖瓣修复术(n = 1211)的30天死亡率和院内死亡率分别为0.1%和0.2%,而所有二尖瓣修复术(n = 2017)的30天死亡率和院内死亡率分别为0.05%和0.2%。发现有 100 多家机构每年开展的 MICS 二尖瓣手术少于 5 例。至于 MICS-AVR,孤立 AVR(n = 818)的 30 天死亡率和院内死亡率分别为 0.5% 和 0.5%,而所有 AVR(n = 987)的 30 天死亡率和院内死亡率分别为 0.6% 和 1.1%。此外,MICS-CABG(n = 400)的比例分别为 0.8%和 0.5%。ASD(n = 183)和心脏肿瘤(n = 96)分别为0.5%和0.5%,以及0%和1.0%:这是第一份基于 2021 年 JCVSD 数据的日本手术 MICS 结果报告。预计将采用类似的数据收集方法获得更多结果,并从 2024 年开始收集 MICS 的详细信息。
{"title":"Minimally invasive cardiac surgeries in 2021: annual report by Japanese society of minimally invasive cardiac surgery.","authors":"Tomoki Shimokawa, Hiraku Kumamaru, Noboru Motomura, Hiroyuki Nishi, Hiroyuki Nakajima, Hiroyuki Kamiya, Minoru Tabata, Kazuma Okamoto, Soh Hosoba, Yoshikatsu Saiki, Taichi Sakaguchi","doi":"10.1007/s11748-024-02066-2","DOIUrl":"10.1007/s11748-024-02066-2","url":null,"abstract":"<p><strong>Purpose: </strong>Although minimally invasive cardiac surgery (MICS) procedures are widely performed throughout Japan, nationwide data regarding treated cases are limited. Up-to-date results for cardiovascular surgery are vital for quality control in clinical practice. Presented here is the 2021 annual report based on data from the Japan Cardiovascular Surgery Database (JCVSD).</p><p><strong>Methods: </strong>Records noted in the JCVSD of patients who underwent mitral valve surgery, aortic valve replacement (AVR), coronary artery bypass grafting (CABG), atrial septum defect (ASD) closure, or cardiac tumor resection via right or left minithoracotomy, as well as thoracoscopic- or port-assisted, or robotic-assisted approaches, in 2021 were examined. Perioperative parameters including mortality and morbidity was evaluated.</p><p><strong>Results: </strong>The 30-day and in-hospital mortalities for isolated mitral valve repair (n = 1211) were 0.1% and 0.2%, respectively, while those for all mitral valve repair (n = 2017) were 0.05% and 0.2%, respectively. More than 100 facilities were found to perform fewer than five MICS mitral valve surgery cases per year. As for MICS-AVR, 30-day and in-hospital mortalities for isolated AVR (n = 818) were 0.5% and 0.5%, respectively, while those for all AVR (n = 987) were 0.6% and 1.1%, respectively. Additionally, those for MICS-CABG (n = 400) were 0.8% and 0.5%, respectively. Those for ASD (n = 183) and cardiac tumor (n = 96), were 0.5% and 0.5%, respectively, and 0% and 1.0%, respectively.</p><p><strong>Conclusion: </strong>This is the first report of MICS results of procedures performed in Japan based on the 2021 JCVSD data. Additional results obtained with a similar data collection method are expected and details on MICS are being collected starting 2024.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"88-95"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Thoracic and cardiovascular surgeries in Japan during 2021 : Annual report by the Japanese Association for Thoracic Surgery. 更正:2021年日本的胸部和心血管手术:日本胸外科协会的年度报告。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1007/s11748-024-02113-y
Naoki Yoshimura, Yukio Sato, Hiroya Takeuchi, Tomonobu Abe, Shunsuke Endo, Yasutaka Hirata, Michiko Ishida, Hisashi Iwata, Takashi Kamei, Nobuyoshi Kawaharada, Shunsuke Kawamoto, Kohji Kohno, Hiraku Kumamaru, Kenji Minatoya, Noboru Motomura, Rie Nakahara, Morihito Okada, Hisashi Saji, Aya Saito, Masanori Tsuchida, Kenji Suzuki, Hirofumi Takemura, Tsuyoshi Taketani, Yasushi Toh, Wataru Tatsuishi, Hiroyuki Yamamoto, Takushi Yasuda, Masayuki Watanabe, Goro Matsumiya, Yoshiki Sawa, Hideyuki Shimizu, Masayuki Chida
{"title":"Correction: Thoracic and cardiovascular surgeries in Japan during 2021 : Annual report by the Japanese Association for Thoracic Surgery.","authors":"Naoki Yoshimura, Yukio Sato, Hiroya Takeuchi, Tomonobu Abe, Shunsuke Endo, Yasutaka Hirata, Michiko Ishida, Hisashi Iwata, Takashi Kamei, Nobuyoshi Kawaharada, Shunsuke Kawamoto, Kohji Kohno, Hiraku Kumamaru, Kenji Minatoya, Noboru Motomura, Rie Nakahara, Morihito Okada, Hisashi Saji, Aya Saito, Masanori Tsuchida, Kenji Suzuki, Hirofumi Takemura, Tsuyoshi Taketani, Yasushi Toh, Wataru Tatsuishi, Hiroyuki Yamamoto, Takushi Yasuda, Masayuki Watanabe, Goro Matsumiya, Yoshiki Sawa, Hideyuki Shimizu, Masayuki Chida","doi":"10.1007/s11748-024-02113-y","DOIUrl":"10.1007/s11748-024-02113-y","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"133-136"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meta-analysis of BITA versus SITA grafting in diabetic patients: evidence from propensity score-matched studies. 糖尿病患者 BITA 与 SITA 移植的 Meta 分析:倾向评分匹配研究的证据。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 Epub Date: 2024-07-17 DOI: 10.1007/s11748-024-02060-8
John Nolan, Audrey Rachel Wijaya, I Komang Adhi Parama Harta

Background: It has been demonstrated that the use of bilateral internal thoracic artery (BITA) grafting in coronary artery bypass grafting (CABG) improves long-term survival in comparison to the use of a single internal thoracic artery (SITA) graft. However, the optimal transplantation technique for diabetic patients remains undetermined. The purpose of this meta-analysis was to compare the effectiveness and safety of BITA and SITA CABG in diabetic patients.

Methods: A comprehensive search of Google Scholar, Science Direct, and PubMed was conducted for studies with propensity score-matched comparing between BITA and SITA grafting in diabetic patients. The main goal was to know mid- to long-term mortality, and the supplementary results included incidence of deep sternal wound infection, 30-day mortality, and incidence of reoperation due to hemorrhage.

Results: The meta-analysis included 11 studies involving 3762 diabetic patients with matched propensity scores. Compared to SITA grafting, BITA grafting was associated with a significant reduction in long-term mortality (HR 0.78; 95% CI 0.67-0.91), P = 0.03, I2 = 54%. There were no significant differences between the two groups in terms of 30-day mortality, reoperation for bleeding, cerebrovascular accident, or renal failure.

Conclusions: BITA grafting appears to provide better overall survival than SITA grafting in patients with diabetes. However, using BITA grafting is associated with a greater risk of deep sternal wound infection. These findings may help guide the choice of grafting technique in diabetic patients undergoing CABG.

背景:研究表明,在冠状动脉旁路移植术(CABG)中使用双侧胸内动脉(BITA)移植与使用单侧胸内动脉(SITA)移植相比,可提高长期存活率。然而,糖尿病患者的最佳移植技术仍未确定。本荟萃分析旨在比较 BITA 和 SITA CABG 对糖尿病患者的有效性和安全性:方法:在 Google Scholar、Science Direct 和 PubMed 上全面搜索了糖尿病患者 BITA 和 SITA 移植的倾向得分匹配比较研究。主要目的是了解中长期死亡率,补充结果包括胸骨深伤口感染发生率、30 天死亡率和因出血再次手术的发生率:荟萃分析包括11项研究,涉及3762名糖尿病患者,并进行了匹配倾向评分。与 SITA 移植相比,BITA 移植可显著降低长期死亡率(HR 0.78;95% CI 0.67-0.91),P = 0.03,I2 = 54%。在30天死亡率、因出血再次手术、脑血管意外或肾衰竭方面,两组之间没有明显差异:结论:在糖尿病患者中,BITA移植似乎比SITA移植能提供更好的总生存率。结论:在糖尿病患者中,BITA移植似乎比SITA移植的总存活率更高,但使用BITA移植与胸骨深部伤口感染的风险更大相关。这些发现可能有助于指导接受 CABG 手术的糖尿病患者选择移植物技术。
{"title":"Meta-analysis of BITA versus SITA grafting in diabetic patients: evidence from propensity score-matched studies.","authors":"John Nolan, Audrey Rachel Wijaya, I Komang Adhi Parama Harta","doi":"10.1007/s11748-024-02060-8","DOIUrl":"10.1007/s11748-024-02060-8","url":null,"abstract":"<p><strong>Background: </strong>It has been demonstrated that the use of bilateral internal thoracic artery (BITA) grafting in coronary artery bypass grafting (CABG) improves long-term survival in comparison to the use of a single internal thoracic artery (SITA) graft. However, the optimal transplantation technique for diabetic patients remains undetermined. The purpose of this meta-analysis was to compare the effectiveness and safety of BITA and SITA CABG in diabetic patients.</p><p><strong>Methods: </strong>A comprehensive search of Google Scholar, Science Direct, and PubMed was conducted for studies with propensity score-matched comparing between BITA and SITA grafting in diabetic patients. The main goal was to know mid- to long-term mortality, and the supplementary results included incidence of deep sternal wound infection, 30-day mortality, and incidence of reoperation due to hemorrhage.</p><p><strong>Results: </strong>The meta-analysis included 11 studies involving 3762 diabetic patients with matched propensity scores. Compared to SITA grafting, BITA grafting was associated with a significant reduction in long-term mortality (HR 0.78; 95% CI 0.67-0.91), P = 0.03, I<sup>2</sup> = 54%. There were no significant differences between the two groups in terms of 30-day mortality, reoperation for bleeding, cerebrovascular accident, or renal failure.</p><p><strong>Conclusions: </strong>BITA grafting appears to provide better overall survival than SITA grafting in patients with diabetes. However, using BITA grafting is associated with a greater risk of deep sternal wound infection. These findings may help guide the choice of grafting technique in diabetic patients undergoing CABG.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"80-87"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complex segmentectomy for non-palpable small lung cancer adjacent to the incomplete interlobar fissure using radiofrequency identification. 利用射频识别技术对不完全叶间裂邻近的不可触及的小肺癌进行复杂肺段切除术。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 Epub Date: 2024-10-12 DOI: 10.1007/s11748-024-02087-x
Kentaro Miura, Takashi Eguchi, Kazutoshi Hamanaka, Kei Sonehara, Masamichi Komatsu, Kimihiro Shimizu

Pulmonary segmentectomy for small non-palpable tumors, such as lung cancer or pulmonary metastasis, is challenging owing to possible insufficient surgical margins. Particularly, extensive segmentectomy beyond the second lobe may be required to obtain a sufficient surgical margin for a tumor adjacent to an incomplete interlobar fissure. Radiofrequency identification (RFID) marking systems have proven beneficial for detecting small lung tumors during surgery. Herein, we present two representative cases of complex segmentectomy (left-side video-assisted thoracoscopic extended S8 + S9 segmentectomy and left-side robot-assisted thoracoscopic extended S1+2 b + c segmentectomy) for small lung cancer adjacent to an incomplete interlobar fissure. Extensive segmentectomy was avoided, and preservation of lung parenchyma was feasible using an RFID system. The patients could undergo segmentectomy safely with a sufficient surgical margin. In conclusion, an RFID system facilitates secure and safe precise segmentectomy while minimizing the resected pulmonary volume.

对肺癌或肺转移瘤等无法扪及的小肿瘤进行肺段切除术具有挑战性,因为手术切缘可能不足。特别是,对于邻近不完整叶间裂的肿瘤,可能需要进行第二肺叶以外的广泛肺段切除术,以获得足够的手术切缘。事实证明,射频识别(RFID)标记系统有利于在手术过程中检测肺部小肿瘤。在此,我们介绍了两例复杂肺段切除术(左侧视频辅助胸腔镜扩大 S8 + S9 肺段切除术和左侧机器人辅助胸腔镜扩大 S1+2 b + c 肺段切除术)治疗邻近不完整叶间裂的小肺癌的代表性病例。通过使用 RFID 系统,避免了广泛的肺段切除术,并保留了肺实质。患者可以安全地接受肺段切除术,并有足够的手术切缘。总之,射频识别(RFID)系统有助于进行安全可靠的精确肺段切除术,同时最大限度地减少切除的肺容积。
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引用次数: 0
Outcomes of thoracic endovascular aortic repair for complicated type B acute aortic dissection from a multicenter Japanese post-market surveillance study.
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1007/s11748-025-02123-4
Yoshimasa Seike, Sophie B Green, Keita Mori, Kimberly Reid, Hitoshi Matsuda

Objectives: A primary goal of thoracic endovascular aortic repair (TEVAR) for type B acute aortic dissection (BAAD) is exclusion of the primary entry tear with a suitable stent graft (SG) to reestablish true lumen flow and promote aortic remodeling. This study aimed to determine the safety and efficacy of a conformable thoracic SG in a Japanese population with complicated BAAD.

Methods: Between 2016 and 2017, 43 patients with complicated BAAD were enrolled in this prospective, nonrandomized, multicenter post-market surveillance study at 27 sites in Japan. All patients underwent TEVAR using the Gore TAG Conformable Thoracic Endoprosthesis (CTAG) (W.L. Gore and Associates, Flagstaff, AZ).

Results: The most common TEVAR indication for complicated BAAD was malperfusion (41.9%; 24 out of 43) and aortic rupture was observed in 32.5% of patients (14 out of 43). All SG implants were successfully completed and there was no patient with surgical conversion. Thirty-day mortality was 7.0% (3 out of 43) and one patient (2.3%) experienced spinal cord ischemia during hospitalization. Entry tear exclusion was achieved in 91.3% of patients at 1 month, and 95.7% at 24 months. Through 24 months after TEVAR, no retrograde type A aortic dissection was observed and distal stent graft induced new entry was observed in two patients (4.7%).

Conclusion: TEVAR utilizing the CTAG device for complicated BAAD in Japan demonstrated a low incidence of perioperative mortality and complications. Complications directly attributed to the SG including RTAD and dSINE were uncommon and the midterm outcomes were deemed satisfactory.

{"title":"Outcomes of thoracic endovascular aortic repair for complicated type B acute aortic dissection from a multicenter Japanese post-market surveillance study.","authors":"Yoshimasa Seike, Sophie B Green, Keita Mori, Kimberly Reid, Hitoshi Matsuda","doi":"10.1007/s11748-025-02123-4","DOIUrl":"https://doi.org/10.1007/s11748-025-02123-4","url":null,"abstract":"<p><strong>Objectives: </strong>A primary goal of thoracic endovascular aortic repair (TEVAR) for type B acute aortic dissection (BAAD) is exclusion of the primary entry tear with a suitable stent graft (SG) to reestablish true lumen flow and promote aortic remodeling. This study aimed to determine the safety and efficacy of a conformable thoracic SG in a Japanese population with complicated BAAD.</p><p><strong>Methods: </strong>Between 2016 and 2017, 43 patients with complicated BAAD were enrolled in this prospective, nonrandomized, multicenter post-market surveillance study at 27 sites in Japan. All patients underwent TEVAR using the Gore TAG Conformable Thoracic Endoprosthesis (CTAG) (W.L. Gore and Associates, Flagstaff, AZ).</p><p><strong>Results: </strong>The most common TEVAR indication for complicated BAAD was malperfusion (41.9%; 24 out of 43) and aortic rupture was observed in 32.5% of patients (14 out of 43). All SG implants were successfully completed and there was no patient with surgical conversion. Thirty-day mortality was 7.0% (3 out of 43) and one patient (2.3%) experienced spinal cord ischemia during hospitalization. Entry tear exclusion was achieved in 91.3% of patients at 1 month, and 95.7% at 24 months. Through 24 months after TEVAR, no retrograde type A aortic dissection was observed and distal stent graft induced new entry was observed in two patients (4.7%).</p><p><strong>Conclusion: </strong>TEVAR utilizing the CTAG device for complicated BAAD in Japan demonstrated a low incidence of perioperative mortality and complications. Complications directly attributed to the SG including RTAD and dSINE were uncommon and the midterm outcomes were deemed satisfactory.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Thoracic and cardiovascular surgeries in Japan during 2020 : Annual report by the Japanese Association for Thoracic Surgery. 更正:2020年日本的胸部和心血管手术:日本胸外科协会的年度报告。
IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1007/s11748-024-02112-z
Goro Matsumiya, Yukio Sato, Hiroya Takeuchi, Tomonobu Abe, Shunsuke Endo, Yasutaka Hirata, Michiko Ishida, Hisashi Iwata, Takashi Kamei, Nobuyoshi Kawaharada, Shunsuke Kawamoto, Kohji Kohno, Hiraku Kumamaru, Kenji Minatoya, Noboru Motomura, Rie Nakahara, Morihito Okada, Hisashi Saji, Aya Saito, Hideyuki Shimizu, Kenji Suzuki, Hirofumi Takemura, Tsuyoshi Taketani, Yasushi Toh, Wataru Tatsuishi, Hiroyuki Yamamoto, Takushi Yasuda, Masayuki Watanabe, Naoki Yoshimura, Masanori Tsuchida, Yoshiki Sawa
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引用次数: 0
期刊
General Thoracic and Cardiovascular Surgery
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