JTCVS Techniques最新文献

英文中文

Innovative triple-directional robotic extended thymectomy using the rotatable patient cart of a robot-assisted thoracic surgical system 创新的三方向机器人扩展胸腺切除术使用机器人辅助胸外科系统的可旋转病人车

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.003

Shota Nakamura MD, PhD, Keita Nakanishi MD, Yuka Kadomatsu MD, PhD, Harushi Ueno MD, Taketo Kato MD, PhD, Tetsuya Mizuno MD, PhD, Toyofumi F. Chen-Yoshikawa MD, PhD

引用次数: 0

Robot-assisted anatomical lung resection with a modular robotic system: Preliminary experience from a single-arm, prospective trial 模块化机器人系统的机器人辅助解剖肺切除术：单臂前瞻性试验的初步经验

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.05.027

Yajie Zhang MD, PhD , Tianzheng Shen MD , Yichao Han MD, PhD , Yuqin Cao MD , Hecheng Li MD, PhD, FACS

引用次数: 0

Ex vivo optimization of a bicuspid pulmonary valve using the resequenced composite autograft Ross technique 利用重组复合自体罗斯技术优化双尖瓣肺瓣的体外移植

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.005

Albert J. Pedroza MD, Benjamin Shou MD, Y. Joseph Woo MD

引用次数: 0

Transapical zone 0 thoracic endovascular aortic repair with reversed debranching under extracorporeal membrane oxygenation support 体外膜氧合支持下经根尖区0胸血管内主动脉逆行去分支修复

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.06.003

Fumitaka Suzuki MD, Ryohei Ushioda MD, Hiroyuki Kamiya MD, PhD

引用次数: 0

Redo aortic valve replacement after a floating Bentall procedure 漂浮本特尔手术后重做主动脉瓣置换术

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.06.006

Alex Nantsios MD, Hugo Monteiro Neder Issa MD, Ming Hao Guo MD, MSc, Munir Boodhwani MD, MSc

引用次数: 0

Supradiaphragmatic Roux-en-Y jejunal reconstruction after extended total gastrectomy for gastroesophageal adenocarcinoma 胃食管腺癌扩大全胃切除术后膈上Roux-en-Y空肠重建

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.05.020

Marisa Sewell MD, Smita Sihag MD, Mathew J. Bott MD, Katherine Gray MD, Bernard J. Park MD, David R. Jones MD, Daniela Molena MD

Background

Surgical management of gastroesophageal junction adenocarcinoma extending into both the esophagus and the stomach often requires distal esophagectomy and total gastrectomy (extended total gastrectomy). Roux-en-Y jejunal conduits are commonly used for reconstruction; however, concerns exist regarding the ability to obtain adequate length for a supradiaphragmatic anastomosis.

Methods

This retrospective study included patients with esophagogastric adenocarcinoma who underwent extended total gastrectomy at our institution between 2016 and 2023. Clinicopathologic characteristics were analyzed descriptively. Quality of life was assessed using a Likert scale survey. The Roux-en-Y jejunal conduit was constructed by dividing the second and occasionally third jejunal arterial branches to obtain sufficient length. Disease-free survival (DFS) was defined as the time from surgery to recurrence or death from any cause.

Results

Overall, 29 patients were included. The median patient age was 64 years, and 83% of the patients received neoadjuvant therapy. Five patients (17%) had an anastomotic leak, and 9 (31%) had grade 3-4 complications. The median DFS was 4.5 years; 72% of patients had resumed a regular diet by 3 months. Compared with standard esophagectomy patients at our institution, gastrectomy patients had a longer median length of stay (11 days vs 9 days; P = .048) but similar complication rates. With the exception of diarrhea at 2 weeks (worse for gastrectomy patients; mean score, 2.8 vs 1.4; P ≤ .001), quality of life was not statistically different between gastrectomy patients and standard esophagectomy patients.

Conclusions

Supradiaphragmatic Roux-en-Y jejunal reconstruction after extended total gastrectomy for gastroesophageal junction adenocarcinoma is a feasible approach, associated with low complication rates and adequate recovery of quality of life.

背景：胃食管交界区腺癌的手术治疗通常需要远端食管切除术和全胃切除术（扩大全胃切除术）。Roux-en-Y空肠导管常用于重建；然而，对于膈上吻合术能否获得足够的长度，存在一些担忧。方法本回顾性研究纳入2016年至2023年在我院行延长全胃切除术的食管胃腺癌患者。描述性分析临床病理特征。生活质量采用李克特量表进行评估。Roux-en-Y空肠导管是通过分隔第二和偶尔第三空肠动脉分支来构建的，以获得足够的长度。无病生存期（DFS）定义为从手术到复发或任何原因死亡的时间。结果共纳入29例患者。患者中位年龄为64岁，83%的患者接受了新辅助治疗。吻合口瘘5例（17%），3-4级并发症9例（31%）。中位生存期为4.5年；72%的患者在3个月后恢复了正常饮食。与我院标准食管切除术患者相比，胃切除术患者的中位住院时间更长（11天vs 9天；P = 0.048），但并发症发生率相似。除2周腹泻外（胃切除术患者较差，平均评分2.8 vs 1.4, P≤0.001），胃切除术患者与标准食管切除术患者的生活质量无统计学差异。结论经膈上Roux-en-Y空肠重建术治疗胃食管交界区腺癌，是一种可行的全胃切除术后空肠重建术，并发症发生率低，生活质量恢复良好。

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引用次数: 0

Redo hybrid arch frozen elephant trunk reconstruction for chronic aortic dissection previously treated with a novel bare metal stent 用新型裸金属支架治疗慢性主动脉夹层的重做混合弓冷冻象鼻重建

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.023

Diego Pena MD , Luc Dubois MD , Ahmed Mobeen MD , Michael W.A. Chu MD, MEd

引用次数: 0

The cone repair after Fontan procedure: Conversion from completed single-ventricle pathway after the Starnes procedure to biventricular physiology Fontan手术后锥体的修复：Starnes手术后从完整的单脑室通路到双脑室生理学的转变

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.05.030

Jose P. Da Silva MD , Laura Seese MD , Laura Olivieri MD , Tarek Al-Sayed MD , Jacqueline Kreutzer MD , Mario Castro Medina MD , Victor O. Morell MD , Luciana Da Fonseca Da Silva MD

引用次数: 0

Giant 8-cm coronary artery aneurysm: Surgical management 巨大的8cm冠状动脉瘤：手术治疗

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.06.026

Alexandra Murillo-Solera MD , Vaishnavi Karanam MS , Ryan Azarrafiy MD , Iverson E. Williams BS , Oscar Holmvard MD , Muhammad F. Umar MD , Thomas M. Beaver MD, MPH

We present the case of a 75-year-old man presenting asymptomatically with a large 8-cm right coronary artery aneurysm. The right coronary artery aneurysm was identified by cardiac catheterization and managed through coronary artery bypass grafting. The patient had an uneventful postoperative course and showed stable recovery at his follow-up visit.

我们提出的情况下，75岁的男子无症状表现与一个大的8厘米右冠状动脉动脉瘤。右冠状动脉动脉瘤通过心导管检查并通过冠状动脉旁路移植术处理。患者术后过程平稳，随访时恢复稳定。

引用次数: 0

Endoscopy esophageal mucosal circumferential resection followed by bypass surgery to treat tracheoesophageal fistula 内镜下食管黏膜环切术后行搭桥手术治疗气管食管瘘

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.05.016

Chunguang Li MD, PhD , Jiaying Soo MB, Bch, BAO, MD , Hong Zhang MD , Qijue Lu MD, PhD , Chang Yuan MD , Zhichao Liu MD , Bin Li MD, PhD , Rong Hua MD, PhD , Yang Yang MD, PhD , Yifeng Sun MD, PhD , Yuwei Qiu MD , Toni Lerut MD, PhD , Edward Cheong MD, PhD , Peter Grimminger MD, PhD , Nicola Tamburini MD, PhD , Yutaka Tokairin MD, PhD , Zhigang Li MD, PhD

Objective

Tracheoesophageal fistula (TEF) is a severe complication often associated with advanced thoracic malignancies or chemoradiotherapy. This study introduces an innovative approach combining endoscopic submucosal dissection (ESD) and esophageal bypass surgery. This retrospective study aimed to evaluate the prognosis of patients with TEF in complete clinical remission after definitive chemoradiotherapy who underwent repair with such approach.

Methods

This is a retrospective analysis of 12 patients with TEF secondary to thoracic malignancies treated between June 2021 and June 2022. Patients underwent ESD for de-epithelialization of the esophageal lumen, followed by esophageal bypass surgery. Key outcomes included survival rates, fistula closure rates, postoperative clinical outcomes, and functional status improvement assessed by Karnofsky Performance Status scores.

Results

All patients had complete clinical remission of their primary malignancies before treatment. TEF closure was achieved in 10 patients (83.3%) within 28 to 72 days post-ESD. Median duration from ESD to bypass surgery was 39 days. Kaplan-Meier analysis revealed a 1-year survival rate of 65% and a 2-year survival rate of 60%. Postoperative morbidity included 1 anastomotic leak and 1 case of esophageal mucoceles, both successfully managed. Functional outcomes significantly improved, with 91.6% of patients achieving a Karnofsky Performance Status score >80 at 6 months.

Conclusions

The combination of ESD and esophageal bypass surgery represents a promising approach for TEF management, demonstrating high rates of fistula closure, enhanced functional outcomes, and overall survival. Future studies should aim to validate these findings in larger cohorts and explore the long-term sustainability of these outcomes.

目的气管食管瘘（TEF）是一种严重的并发症，常与晚期胸部恶性肿瘤或放化疗相关。本研究介绍了一种结合内镜下粘膜剥离（ESD）和食管搭桥手术的创新方法。本回顾性研究旨在评估经放化疗后临床完全缓解的TEF患者采用该方法进行修复的预后。方法回顾性分析2021年6月至2022年6月期间治疗的12例胸部恶性肿瘤继发TEF患者。患者接受ESD进行食管管腔去上皮化，随后进行食管搭桥手术。主要结局包括生存率、瘘管闭合率、术后临床结局和通过Karnofsky性能状态评分评估的功能状态改善。结果所有患者治疗前原发恶性肿瘤临床完全缓解。10例患者（83.3%）在esd后28 ~ 72天内实现TEF闭合。从ESD到搭桥手术的中位时间为39天。Kaplan-Meier分析显示1年生存率为65%，2年生存率为60%。术后发生吻合口漏1例，食管粘液囊肿1例，均成功处理。功能结果显著改善，91.6%的患者在6个月时达到Karnofsky性能状态评分>；80。结论ESD联合食管旁路手术是治疗TEF的一种很有前途的方法，具有高瘘管关闭率，增强功能预后和总生存率。未来的研究应该致力于在更大的队列中验证这些发现，并探索这些结果的长期可持续性。

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