Pub Date : 2016-01-01DOI: 10.5761/atcs.oa.15-00230
J. Cho, K. Na, Yongjik Lee, Y. Kim, H. Ahn, C. Park, YOUNG CHUL Kim
PURPOSE Malignant pleural effusion (MPE) is common in patients with advanced cancer. Chemical pleurodesis can be considered for MPE that do not respond to chemotherapy, radiotherapy, or therapeutic thoracentesis. However, it is not yet clear which agent is more effective and safer in chemical pleurodesis. METHODS This study was designed as a single arm, multicenter, and open-label phase III clinical trial to evaluate efficacy and safety of chemical pleurodesis using mistletoe extraction (ABNOVAviscum(®) Injection). References of other agents in chemical pleurodesis were investigated to compare efficacy and safety. Efficacy was evaluated by followed up chest X-ray and changes of clinical symptoms and Karnofsky performance scale. Safety was evaluated by serious adverse event (SAE) and changes of laboratory findings. A follow-up period was 4 weeks after last pleurodesis. RESULTS Of 62 patients, 49 (79.0%) had complete response, 11 (17.7%) had partial response, and two had no response. Mean response rate was significantly different in this study comparing with reference response rate which was 64% (p <0.0001). There were two SAEs, but all were recovered without sequelas. CONCLUSION The results of this study suggest that mistletoe extraction (ABNOVAviscum(®) Injection) could be an effective and safe agent of chemical pleurodesis in patients with MPE.
{"title":"Chemical Pleurodesis Using Mistletoe Extraction (ABNOVAviscum(®) Injection) for Malignant Pleural Effusion.","authors":"J. Cho, K. Na, Yongjik Lee, Y. Kim, H. Ahn, C. Park, YOUNG CHUL Kim","doi":"10.5761/atcs.oa.15-00230","DOIUrl":"https://doi.org/10.5761/atcs.oa.15-00230","url":null,"abstract":"PURPOSE Malignant pleural effusion (MPE) is common in patients with advanced cancer. Chemical pleurodesis can be considered for MPE that do not respond to chemotherapy, radiotherapy, or therapeutic thoracentesis. However, it is not yet clear which agent is more effective and safer in chemical pleurodesis. METHODS This study was designed as a single arm, multicenter, and open-label phase III clinical trial to evaluate efficacy and safety of chemical pleurodesis using mistletoe extraction (ABNOVAviscum(®) Injection). References of other agents in chemical pleurodesis were investigated to compare efficacy and safety. Efficacy was evaluated by followed up chest X-ray and changes of clinical symptoms and Karnofsky performance scale. Safety was evaluated by serious adverse event (SAE) and changes of laboratory findings. A follow-up period was 4 weeks after last pleurodesis. RESULTS Of 62 patients, 49 (79.0%) had complete response, 11 (17.7%) had partial response, and two had no response. Mean response rate was significantly different in this study comparing with reference response rate which was 64% (p <0.0001). There were two SAEs, but all were recovered without sequelas. CONCLUSION The results of this study suggest that mistletoe extraction (ABNOVAviscum(®) Injection) could be an effective and safe agent of chemical pleurodesis in patients with MPE.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82534774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5761/atcs.oa.15-00245
S. Lentini, L. Specchia, S. Nicolardi, F. Mangia, Olivera Rasovic, G. Di Eusanio, R. Gregorini
BACKGROUND Use of a minimally invasive approach for isolated aortic valve surgery is increasing. However, management of the root and/or ascending aorta through a mini-invasive incision is not so frequent. The aim of this study is to report our initial experience with surgery of the ascending aorta through a ministernotomy approach. METHODS We retrospectively analyzed 102 patients treated for ascending aorta disease through a ministernotomy. Several types of surgeries were performed, including isolated or combined surgical procedures. Pre-operative and operative parameters and in-hospital clinical outcomes were retrospectively analyzed. RESULTS Patient mean age was 63.9 ± 13.6 years (range 29-85). There were 33 (32.4%) female and 69 (67.6%) male patients. Preoperative logistic EuroSCORE I was 7.4% ± 2.1%. Mean cardiopulmonary bypass and aortic cross-clamp time were 123.7 ± 36.9 and 100.8 ± 27.5 min, respectively. In-hospital mortality was 0%. CONCLUSIONS Our experience shows that surgery of the ascending aorta with or without combined procedures can be safely performed through an upper ministernotomy, without compromising surgical results. Although our series is not large, we believe that the experience gained on the isolated aortic valve through a ministernotomy can be safely reproduced in ascending aorta surgery as a routine practice.
{"title":"Surgery of the Ascending Aorta with or without Combined Procedures through an Upper Ministernotomy: Outcomes of a Series of More Than 100 Patients.","authors":"S. Lentini, L. Specchia, S. Nicolardi, F. Mangia, Olivera Rasovic, G. Di Eusanio, R. Gregorini","doi":"10.5761/atcs.oa.15-00245","DOIUrl":"https://doi.org/10.5761/atcs.oa.15-00245","url":null,"abstract":"BACKGROUND Use of a minimally invasive approach for isolated aortic valve surgery is increasing. However, management of the root and/or ascending aorta through a mini-invasive incision is not so frequent. The aim of this study is to report our initial experience with surgery of the ascending aorta through a ministernotomy approach. METHODS We retrospectively analyzed 102 patients treated for ascending aorta disease through a ministernotomy. Several types of surgeries were performed, including isolated or combined surgical procedures. Pre-operative and operative parameters and in-hospital clinical outcomes were retrospectively analyzed. RESULTS Patient mean age was 63.9 ± 13.6 years (range 29-85). There were 33 (32.4%) female and 69 (67.6%) male patients. Preoperative logistic EuroSCORE I was 7.4% ± 2.1%. Mean cardiopulmonary bypass and aortic cross-clamp time were 123.7 ± 36.9 and 100.8 ± 27.5 min, respectively. In-hospital mortality was 0%. CONCLUSIONS Our experience shows that surgery of the ascending aorta with or without combined procedures can be safely performed through an upper ministernotomy, without compromising surgical results. Although our series is not large, we believe that the experience gained on the isolated aortic valve through a ministernotomy can be safely reproduced in ascending aorta surgery as a routine practice.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82557850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5761/atcs.oa.15-00322
Y. Chua, P. Y. Pang, Y. P. Yap, Zakir-Hussain Abdul Salam, Yang Tian Chen
OBJECTIVE To review our experience of mitral valve repair for degenerative posterior mitral leaflet prolapse, comparing the outcomes of chordal reconstruction and leaflet resection. METHODS From 2000 to 2014, 205 patients underwent successful repair for degenerative posterior mitral leaflet prolapse. One hundred and four (51.5%) underwent leaflet resection (group R) and 98 (48.5%) underwent chordal reconstruction (group C). Follow-up was 96.5% complete with a mean follow-up of 6.1 ± 4.0 years. RESULTS Mean age was 57.0 ± 11.0 years. Males accounted for 73.8%. Ring annuloplasty was performed in 195 (96.5%). There were no operative mortalities within 30 days. Overall survival was 97.8% ± 1.3% at 7 years. Outcomes at 6 years: freedom from severe mitral regurgitation (group R 97.1% ± 2.0%, group C 100%, P = 0.288), freedom from moderate or severe mitral regurgitation (group R 97.1% ± 2.0%, group C 94.4% ± 5.4%, P = 0.541). Group C patients received larger annuloplasty rings and had significantly lower postoperative transmitral gradients. CONCLUSIONS Leaflet resection and chordal reconstruction are effective techniques for repair of degenerative posterior mitral leaflet prolapse. Both techniques result in a low incidence of recurrent mitral regurgitation. Chordal reconstruction accommodates larger annuloplasty rings and is associated with lower transmitral gradients.
{"title":"Chordal Reconstruction versus Leaflet Resection for Repair of Degenerative Posterior Mitral Leaflet Prolapse.","authors":"Y. Chua, P. Y. Pang, Y. P. Yap, Zakir-Hussain Abdul Salam, Yang Tian Chen","doi":"10.5761/atcs.oa.15-00322","DOIUrl":"https://doi.org/10.5761/atcs.oa.15-00322","url":null,"abstract":"OBJECTIVE To review our experience of mitral valve repair for degenerative posterior mitral leaflet prolapse, comparing the outcomes of chordal reconstruction and leaflet resection. METHODS From 2000 to 2014, 205 patients underwent successful repair for degenerative posterior mitral leaflet prolapse. One hundred and four (51.5%) underwent leaflet resection (group R) and 98 (48.5%) underwent chordal reconstruction (group C). Follow-up was 96.5% complete with a mean follow-up of 6.1 ± 4.0 years. RESULTS Mean age was 57.0 ± 11.0 years. Males accounted for 73.8%. Ring annuloplasty was performed in 195 (96.5%). There were no operative mortalities within 30 days. Overall survival was 97.8% ± 1.3% at 7 years. Outcomes at 6 years: freedom from severe mitral regurgitation (group R 97.1% ± 2.0%, group C 100%, P = 0.288), freedom from moderate or severe mitral regurgitation (group R 97.1% ± 2.0%, group C 94.4% ± 5.4%, P = 0.541). Group C patients received larger annuloplasty rings and had significantly lower postoperative transmitral gradients. CONCLUSIONS Leaflet resection and chordal reconstruction are effective techniques for repair of degenerative posterior mitral leaflet prolapse. Both techniques result in a low incidence of recurrent mitral regurgitation. Chordal reconstruction accommodates larger annuloplasty rings and is associated with lower transmitral gradients.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72728076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5761/atcs.oa.15-00293
M. Hirota, T. Isomura, Minoru Yoshida, Chieko Katsumata, F. Ito, Masazumi Watanabe
PURPOSE Although pannus overgrowth by itself was not the pathology of structural valve deterioration (SVD), it might be related to reoperation for SVD of the bioprostheses. METHODS We retrospectively reviewed patients undergoing reoperation for SVD after implantation of the third-generation Mosaic aortic bioprosthesis and macroscopic appearance of the explanted valves was examined to detect the presence of pannus. RESULTS There were 10 patients and the age for the initial aortic valve replacement was 72 ± 10 years old. The duration of durability was 9.9 ± 2.0 years. Deteriorated valve presented stenosis (valvular area of 0.96 ± 0.20 cm(2); pressure gradient of 60 ± 23 mmHg). Coexisting regurgitant flow was detected in two cases. Macroscopically, subvalvular pannus overgrowth was detected in 8 cases (80%). The proportion of overgrowth from the annulus was almost even and pannus overgrowth created subvalvular membrane, which restricted the area especially for each commissure. In contrast, opening and mobility of each leaflet was not severely limited and pannus overgrowth would restrict the area, especially for each commissure. In other two cases with regurgitation, tear of the leaflet on the stent strut was detected and mild calcification of each leaflet restricted opening. CONCLUSION In patients with the Mosaic aortic bioprosthesis, pannus overgrowth was the major cause for reoperation.
{"title":"Subvalvular Pannus Overgrowth after Mosaic Bioprosthesis Implantation in the Aortic Position.","authors":"M. Hirota, T. Isomura, Minoru Yoshida, Chieko Katsumata, F. Ito, Masazumi Watanabe","doi":"10.5761/atcs.oa.15-00293","DOIUrl":"https://doi.org/10.5761/atcs.oa.15-00293","url":null,"abstract":"PURPOSE Although pannus overgrowth by itself was not the pathology of structural valve deterioration (SVD), it might be related to reoperation for SVD of the bioprostheses. METHODS We retrospectively reviewed patients undergoing reoperation for SVD after implantation of the third-generation Mosaic aortic bioprosthesis and macroscopic appearance of the explanted valves was examined to detect the presence of pannus. RESULTS There were 10 patients and the age for the initial aortic valve replacement was 72 ± 10 years old. The duration of durability was 9.9 ± 2.0 years. Deteriorated valve presented stenosis (valvular area of 0.96 ± 0.20 cm(2); pressure gradient of 60 ± 23 mmHg). Coexisting regurgitant flow was detected in two cases. Macroscopically, subvalvular pannus overgrowth was detected in 8 cases (80%). The proportion of overgrowth from the annulus was almost even and pannus overgrowth created subvalvular membrane, which restricted the area especially for each commissure. In contrast, opening and mobility of each leaflet was not severely limited and pannus overgrowth would restrict the area, especially for each commissure. In other two cases with regurgitation, tear of the leaflet on the stent strut was detected and mild calcification of each leaflet restricted opening. CONCLUSION In patients with the Mosaic aortic bioprosthesis, pannus overgrowth was the major cause for reoperation.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74687237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.5761/atcs.oa.15-00271
Takuma Tsukioka, M. Takahama, R. Nakajima, M. Kimura, Hidetoshi Inoue, Ryoji Yamamoto
BACKGROUND Long-term patency is required during treatment for benign airway stenosis. This study investigated the effectiveness of surgical airway plasty for benign airway stenosis. METHODS Clinical courses of 20 patients, who were treated with surgical plasty for their benign airway stenosis, were retrospectively investigated. RESULTS Causes of stenosis were tracheobronchial tuberculosis in 12 patients, post-intubation stenosis in five patients, malacia in two patients, and others in one patient. 28 interventional pulmonology procedures and 20 surgical plasty were performed. Five patients with post-intubation stenosis and four patients with tuberculous stenosis were treated with tracheoplasty. Eight patients with tuberculous stenosis were treated with bronchoplasty, and two patients with malacia were treated with stabilization of the membranous portion. Anastomotic stenosis was observed in four patients, and one to four additional treatments were required. Performance status, Hugh-Jones classification, and ventilatory functions were improved after surgical plasty. Outcomes were fair in patients with tuberculous stenosis and malacia. However, efficacy of surgical plasty for post-intubation stenosis was not observed. CONCLUSION Surgical airway plasty may be an acceptable treatment for tuberculous stenosis. Patients with malacia recover well after surgical plasty. There may be untreated patients with malacia who have the potential to benefit from surgical plasty.
{"title":"Efficacy of Surgical Airway Plasty for Benign Airway Stenosis.","authors":"Takuma Tsukioka, M. Takahama, R. Nakajima, M. Kimura, Hidetoshi Inoue, Ryoji Yamamoto","doi":"10.5761/atcs.oa.15-00271","DOIUrl":"https://doi.org/10.5761/atcs.oa.15-00271","url":null,"abstract":"BACKGROUND Long-term patency is required during treatment for benign airway stenosis. This study investigated the effectiveness of surgical airway plasty for benign airway stenosis. METHODS Clinical courses of 20 patients, who were treated with surgical plasty for their benign airway stenosis, were retrospectively investigated. RESULTS Causes of stenosis were tracheobronchial tuberculosis in 12 patients, post-intubation stenosis in five patients, malacia in two patients, and others in one patient. 28 interventional pulmonology procedures and 20 surgical plasty were performed. Five patients with post-intubation stenosis and four patients with tuberculous stenosis were treated with tracheoplasty. Eight patients with tuberculous stenosis were treated with bronchoplasty, and two patients with malacia were treated with stabilization of the membranous portion. Anastomotic stenosis was observed in four patients, and one to four additional treatments were required. Performance status, Hugh-Jones classification, and ventilatory functions were improved after surgical plasty. Outcomes were fair in patients with tuberculous stenosis and malacia. However, efficacy of surgical plasty for post-intubation stenosis was not observed. CONCLUSION Surgical airway plasty may be an acceptable treatment for tuberculous stenosis. Patients with malacia recover well after surgical plasty. There may be untreated patients with malacia who have the potential to benefit from surgical plasty.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79036298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-02-25DOI: 10.5761/ATCS.CR.11.01671
Mohammad Q. Najib, Daniel W C Ng, Karyne L Vinales, H. Chaliki
The occurrence of aorto-right ventricular (aorto-RV) fistula after prosthetic aortic valve replacement is rare. Transthoracic echocardiography (TTE) with color-flow Doppler, transesophageal echocardiography (TEE), or both may be required for diagnosis. A 42-year-old woman sought care for palpitations and dyspnea due to atrial flutter 2 weeks after prosthetic aortic valve replacement and graft replacement of the ascending aorta. TTE and TEE revealed left-to-right shunt due to aorto-RV fistula.
{"title":"Aorto-right ventricular fistula: a complication of aortic valve replacement.","authors":"Mohammad Q. Najib, Daniel W C Ng, Karyne L Vinales, H. Chaliki","doi":"10.5761/ATCS.CR.11.01671","DOIUrl":"https://doi.org/10.5761/ATCS.CR.11.01671","url":null,"abstract":"The occurrence of aorto-right ventricular (aorto-RV) fistula after prosthetic aortic valve replacement is rare. Transthoracic echocardiography (TTE) with color-flow Doppler, transesophageal echocardiography (TEE), or both may be required for diagnosis. A 42-year-old woman sought care for palpitations and dyspnea due to atrial flutter 2 weeks after prosthetic aortic valve replacement and graft replacement of the ascending aorta. TTE and TEE revealed left-to-right shunt due to aorto-RV fistula.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79349530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-11-30DOI: 10.5761/ATCS.CR.11.01745
Hideki Ujiie, D. Okada, Y. Nakajima, N. Yoshino, H. Akiyama
Ahead of Print article withdrawn by publisher.
出版前的文章被出版商撤回。
{"title":"WITHDRAWN: A Case with Resection of Primary Pulmonary Clear Cell Tumor.","authors":"Hideki Ujiie, D. Okada, Y. Nakajima, N. Yoshino, H. Akiyama","doi":"10.5761/ATCS.CR.11.01745","DOIUrl":"https://doi.org/10.5761/ATCS.CR.11.01745","url":null,"abstract":"Ahead of Print article withdrawn by publisher.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73838660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-25DOI: 10.5761/ATCS.CR.10.01570
N. Enomoto, Kei-ichiro Tayama, M. Kohno, H. Otsuka, S. Yokose, K. Kosuga
We report a case of a 66-year-old man who presented with an abnormal sensation, tenderness, and pain in the middle of his chest in May 2006, two years after a mitral valve replacement for severe mitral regurgitation and a MAZE operation for chronic atrial fibrillation elective cardiac. He was immediately admitted, and the x-ray examination revealed an abnormal elongation of the xiphoid process. At the time of discharge after the initial operation in 2004, x-rays indicated that the length of the xiphoid process was 3 cm; however, in 2006 it had elongated to 6 cm and was prominent in the anterior view. The patient underwent surgical extirpation of the xiphoid process while he was under local anesthesia. Histological examination of the resected xiphoid process revealed no signs of neoplastic or maligant change. The cause of the elongation of the xiphoid process was believed to be distraction tissue neogenesis. The xiphoid process, which fractured and separated from the sternum at the initial operation, was pulled down inferiorly by the rectus abdominis muscles, following which the xiphoid process became elongated and reconnected with the sternum. In cases of a fractured or amputated xiphoid process after median sternotomy, the xiphoid process should be resected to avoid its neogenesis.
{"title":"Postoperative elongation of the xiphoid process --report of a case--.","authors":"N. Enomoto, Kei-ichiro Tayama, M. Kohno, H. Otsuka, S. Yokose, K. Kosuga","doi":"10.5761/ATCS.CR.10.01570","DOIUrl":"https://doi.org/10.5761/ATCS.CR.10.01570","url":null,"abstract":"We report a case of a 66-year-old man who presented with an abnormal sensation, tenderness, and pain in the middle of his chest in May 2006, two years after a mitral valve replacement for severe mitral regurgitation and a MAZE operation for chronic atrial fibrillation elective cardiac. He was immediately admitted, and the x-ray examination revealed an abnormal elongation of the xiphoid process. At the time of discharge after the initial operation in 2004, x-rays indicated that the length of the xiphoid process was 3 cm; however, in 2006 it had elongated to 6 cm and was prominent in the anterior view. The patient underwent surgical extirpation of the xiphoid process while he was under local anesthesia. Histological examination of the resected xiphoid process revealed no signs of neoplastic or maligant change. The cause of the elongation of the xiphoid process was believed to be distraction tissue neogenesis. The xiphoid process, which fractured and separated from the sternum at the initial operation, was pulled down inferiorly by the rectus abdominis muscles, following which the xiphoid process became elongated and reconnected with the sternum. In cases of a fractured or amputated xiphoid process after median sternotomy, the xiphoid process should be resected to avoid its neogenesis.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86026249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-08-01DOI: 10.1097/01.JTO.0000284198.63538.95
S. Haraguchi, K. Koizumi, S. Tanimura, T. Hirata, K. Hirai, I. Mikami, H. Kubokura, K. Shimizu
PURPOSE We report surgical results of lung cancer associated with postobstructive pneumonia. MATERIALS AND METHODS We report on morbidity and mortality, and we analyze the risk factors for them and the prognostic factors for overall survival of patients without mortality. RESULTS Morbidity developed in 13 of the 38 patients (34.2%). Mortality rate was 10.5%. Hemoglobin concentration before surgery and predicted postoperative forced expiratory volume in one second were significantly low in patients with morbidity and mortality based on the univariate analyses. Predicted postoperative forced expiratory volume in one second was a significant risk factor for morbidity based on a multivariate analysis. Poor prognostic factors for overall survival were serum albumin concentration, hemoglobin concentration, and performance status before surgery, combined resection, and pathological stage. Serum albumin concentration was significant based on a multivariate analysis. CONCLUSIONS Morbidity and mortality are high in patients with lung cancer associated with postobstructive pneumonia. Morbidity demonstrates significant association with low predicted postoperative forced expiratory volume in one second and hemoglobin concentration, indicating the need for preoperative transfusion in severe anemia or bronchoplasty if possible. Poor nutritional state before surgery possibly derived from cachexia may influence not only morbidity and mortality, but also prognosis.
{"title":"Surgical results of lung cancer associated with postobstructive pneumonia.","authors":"S. Haraguchi, K. Koizumi, S. Tanimura, T. Hirata, K. Hirai, I. Mikami, H. Kubokura, K. Shimizu","doi":"10.1097/01.JTO.0000284198.63538.95","DOIUrl":"https://doi.org/10.1097/01.JTO.0000284198.63538.95","url":null,"abstract":"PURPOSE\u0000We report surgical results of lung cancer associated with postobstructive pneumonia.\u0000\u0000\u0000MATERIALS AND METHODS\u0000We report on morbidity and mortality, and we analyze the risk factors for them and the prognostic factors for overall survival of patients without mortality.\u0000\u0000\u0000RESULTS\u0000Morbidity developed in 13 of the 38 patients (34.2%). Mortality rate was 10.5%. Hemoglobin concentration before surgery and predicted postoperative forced expiratory volume in one second were significantly low in patients with morbidity and mortality based on the univariate analyses. Predicted postoperative forced expiratory volume in one second was a significant risk factor for morbidity based on a multivariate analysis. Poor prognostic factors for overall survival were serum albumin concentration, hemoglobin concentration, and performance status before surgery, combined resection, and pathological stage. Serum albumin concentration was significant based on a multivariate analysis.\u0000\u0000\u0000CONCLUSIONS\u0000Morbidity and mortality are high in patients with lung cancer associated with postobstructive pneumonia. Morbidity demonstrates significant association with low predicted postoperative forced expiratory volume in one second and hemoglobin concentration, indicating the need for preoperative transfusion in severe anemia or bronchoplasty if possible. Poor nutritional state before surgery possibly derived from cachexia may influence not only morbidity and mortality, but also prognosis.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88583134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-10-01DOI: 10.1378/CHEST.126.4_MEETINGABSTRACTS.775S-B
M. Kaneda, F. Watanabe, T. Tarukawa, T. Tokui, T. Sakai
PURPOSE Combination therapy of lung wedge resection and postoperative radiation was performed to confirm the procedure's feasibility as a curative therapeutic modality. PATIENTS AND METHODS Among the patients with clinical stage I lung cancer, who could not undergo a standard lobectomy due to their poor pulmonary function, six cases were studied, who agreed with the experimental trial after the informed consent. One patient of clinical N0 with chest wall invasion (T3) was also included in combination with intraoperative chest wall radiation therapy. At first, a wedge lung resection was performed using an auto-suture technique or manual suturing. Two weeks after the surgery, concomitant radiation therapy of the area including the remnant lung around the cancer and the hilum was initiated. Total dose was 40-50 Gy. All of the patients were followed up for more than five years. RESULTS All cases tolerated the procedure and survived more than five years. Six were cancer-free. Cancer recurred in only one case. Its manifestation was pleuritis carcinomatosa. Pleural dissemination, which was undetectable at the time of operation, was presumed to be the cause of the recurrence. CONCLUSION This procedure was tolerated and feasible, preventing local recurrence following the limited surgery.
{"title":"Limited operation for lung cancer in combination with postoperative radiation therapy.","authors":"M. Kaneda, F. Watanabe, T. Tarukawa, T. Tokui, T. Sakai","doi":"10.1378/CHEST.126.4_MEETINGABSTRACTS.775S-B","DOIUrl":"https://doi.org/10.1378/CHEST.126.4_MEETINGABSTRACTS.775S-B","url":null,"abstract":"PURPOSE\u0000Combination therapy of lung wedge resection and postoperative radiation was performed to confirm the procedure's feasibility as a curative therapeutic modality.\u0000\u0000\u0000PATIENTS AND METHODS\u0000Among the patients with clinical stage I lung cancer, who could not undergo a standard lobectomy due to their poor pulmonary function, six cases were studied, who agreed with the experimental trial after the informed consent. One patient of clinical N0 with chest wall invasion (T3) was also included in combination with intraoperative chest wall radiation therapy. At first, a wedge lung resection was performed using an auto-suture technique or manual suturing. Two weeks after the surgery, concomitant radiation therapy of the area including the remnant lung around the cancer and the hilum was initiated. Total dose was 40-50 Gy. All of the patients were followed up for more than five years.\u0000\u0000\u0000RESULTS\u0000All cases tolerated the procedure and survived more than five years. Six were cancer-free. Cancer recurred in only one case. Its manifestation was pleuritis carcinomatosa. Pleural dissemination, which was undetectable at the time of operation, was presumed to be the cause of the recurrence.\u0000\u0000\u0000CONCLUSION\u0000This procedure was tolerated and feasible, preventing local recurrence following the limited surgery.","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87747780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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