Kyobu Geka. The Japanese Journal Of Thoracic Surgery[JOURNAL]
Sun
200 papers
[Experience of One-stage Subxiphoid Uniportal Thoracoscopic Surgery for Bilateral Multiple Pulmonary Metastases of Uterine Leiomyoma].
Hayashi S, Kawada M, Tanaka R … +1 more , Kaga K
Kyobu Geka · 2025 Nov · PMID 41253310
A 42-year-old woman was admitted to our hospital with nodular legions in the bilateral lung. Bilateral lung wedge resection was performed via subxiphoid uniportal approach, and the pathological diagnosis was uterine leio...
A 42-year-old woman was admitted to our hospital with nodular legions in the bilateral lung. Bilateral lung wedge resection was performed via subxiphoid uniportal approach, and the pathological diagnosis was uterine leiomyoma pulmonary metastasis. At six months after operation, no recurrence was observed.
[Medical Care Cost for Older Adults in Japan:From the Cost Analysis of Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement].
Maze Y, Tokui T, Inoue R … +5 more , Maruyama S, Murakami M, Inoue R, Hirano R, Yamamoto N
Kyobu Geka · 2025 Nov · PMID 41253309
BACKGROUND: Japan adopts a unique healthcare system that is generous to older adults. We evaluated the cost treatment of transcatheter aortic valve replacement(TAVR) and surgical aortic valve replacement(SAVR) in older a...
BACKGROUND: Japan adopts a unique healthcare system that is generous to older adults. We evaluated the cost treatment of transcatheter aortic valve replacement(TAVR) and surgical aortic valve replacement(SAVR) in older adults in Japan. OBJECTIVE AND METHODS: The TAVR group(n=333) included patients who underwent the procedure at the age of ≧75 years. The E-SAVR (n=78) and Y-SAVR (n=81) groups included patients who underwent a simple SAVR at the age of ≧75 and ≦74 years, respectively. We compared the clinical outcomes and total inpatient costs among the three groups. RESULTS: The operative time, length of intensive care unit and hospital stay were significantly shorter in the TAVR group. Drug and blood product cost, procedure fee, and diagnosis procedure combination cost were significantly lower in the TAVR group. The surgical equipment cost and total costs were significantly higher in the TAVR group. The rate of patients' payment was significantly lower in the TAVR group;however, it remained minimal in all three groups. The 5-year survival rate was significantly lower in the TAVR group than in the SAVR group. CONCLUSIONS: The total inpatient costs were higher in patients who underwent TAVR than in those who underwent SAVR. The self-payment for medical care costs for older adults is relatively small in Japan.
[Pulmonary Nontuberculous Mycobacteriosis and Cancer at the Same Site:Report of a Case].
Nishikawa T, Inoue T, Nagahisa S … +6 more , Kuyama Y, Takahashi M, Mori M, Matsuura M, Kamikawa Y, Inoue F
Kyobu Geka · 2025 Sep · PMID 40998375
A 73-year-old man was referred to our hospital for abnormal shadow. Chest computed tomography (CT) showed a tumor with a cavity in S10 of the left lung. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed th...
A 73-year-old man was referred to our hospital for abnormal shadow. Chest computed tomography (CT) showed a tumor with a cavity in S10 of the left lung. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed the accumulation in the tumorous lesion of the cavity wall. Although the culture of the lavage fluid was positive for acid-fast bacilli and polymerase chain reaction (PCR) was positive for M. intracellulare, coexistence of cancer could not be denied. Therefore, he underwent surgery. Histopathological findings showed squamous cell carcinoma adjacent to epithelioid cell granulomatous lesion of nontuberculous mycobacteriosis.
[Intrathoracic Dumbbell-shaped Schwannoma with Preoperative Identification of the Artery of Adamkiewicz:Report of a Case].
Makimoto Y, Sato T
Kyobu Geka · 2025 Sep · PMID 40998374
A woman in her 30s with a left posterior mediastinal tumor incidentally found on a chest computed tomography (CT) was referred to our hospital. Chest CT revealed a dumbbell-shaped tumor of 37 mm in diameter located on th...
A woman in her 30s with a left posterior mediastinal tumor incidentally found on a chest computed tomography (CT) was referred to our hospital. Chest CT revealed a dumbbell-shaped tumor of 37 mm in diameter located on the paravertebral region at the left Th9/10 level. The tumor extended into the Th9 intervertebral foramen, but did not extend into the spinal canal. Three dimensional (3D)-CT showed the artery of Adamkiewicz (AKA) with a hair-pin turn from the 11th left intercostal artery. We performed surgical treatment. First, the nerve root was dissected by the posterior approach. Next, the tumor was resected by thoracoscopic surgery. The postoperative pathological diagnosis was neurinoma. In surgical resection of posterior mediastinal tumors (especially on the left side) located between the eighth thoracic vertebra and the first lumbar vertebra, it is considered important to identify AKA preoperatively in order to prevent postoperative paraplegia.
[Cardiac Arrest due to Pseudoaneurysm-induced Compression after Ascending Aortic Replacement for Stanford Type A Acute Aortic Dissection:Report of a Case].
Shinoda D, Miyagawa A, Yokoyama N … +1 more , Yuri K
Kyobu Geka · 2025 Sep · PMID 40998373
We present the case of a 27-year-old male who collapsed due to severe stenosis of an artificial vessel caused by a pseudoaneurysm at the central anastomotic site after acute aortic dissection Stanford type A. Although we...
We present the case of a 27-year-old male who collapsed due to severe stenosis of an artificial vessel caused by a pseudoaneurysm at the central anastomotic site after acute aortic dissection Stanford type A. Although we believe that BioGlue mediated tissue toxicity may be one cause of this pseudoaneurysm, other factors, such as tissue separation due to tissue fragility caused by infection, inflammation, and cutting caused by the surgical procedure, are also thought to have contributed. Emergency re-operation was performed after resuscitation. The patient was eventually discharged home without adverse events on the 34th postoperative day. Careful observation in mid- to long-term and remote post-operative phases is necessary for patients subjected to procedures using BioGlue, and prompt repair of pseudoaneurysms is desirable.
[Two-stage Repair of Kommerell Diverticulum with Right Aortic Arch and Aberrant Left Subclavian Artery:Report of a Case].
Sakaguchi T, Hirayama R, Matsukawa M … +5 more , Uekihara K, Urashita S, Miyamoto T, Kojima T, Suzuki R
Kyobu Geka · 2025 Sep · PMID 40998372
A 52-year-old woman was referred to our hospital with a chief complaint of difficulty in swallowing and coughing while eating. Enhanced computed tomography (CT) revealed a Kommerell diverticulum with right aortic arch an...
A 52-year-old woman was referred to our hospital with a chief complaint of difficulty in swallowing and coughing while eating. Enhanced computed tomography (CT) revealed a Kommerell diverticulum with right aortic arch and aberrant left subclavian artery. The diverticulum compressed the esophagus and trachea. We avoided total aortic arch replacement because there were risks of circulatory arrest, selective cerebral perfusion and neurological complication including injury to recurrent laryngeal nerve. Therefore, we scheduled two-stage repair of the diverticulum. First, we performed axillo-axillary artery bypass and left subclavian artery coil embolization. After 7 days, descending aorta replacement including a diverticulum with right anterior lateral 3rd intercostal thoracotomy and lower body partial extracorporeal circulation was performed. The postoperative course was uneventful and she was discharged 20 days after the initial surgery.
[Endovascular Repair for Ruptured Thoracic Aortic Aneurysm Long after Surgery for Coarctation of the Aorta:Report of a Case].
Takamatsu Y, Kobayashi R, Sato N … +5 more , Enomoto T, Sato T, Suzuki S, Sato H, Aoki K
Kyobu Geka · 2025 Sep · PMID 40998371
Previous reports have described cases of aneurysm forming at the repair site of coarctation of the aorta (CoA) decades after initial surgery. We herein report a case of endovascular repair for a ruptured aortic aneurysm...
Previous reports have described cases of aneurysm forming at the repair site of coarctation of the aorta (CoA) decades after initial surgery. We herein report a case of endovascular repair for a ruptured aortic aneurysm that occurred at the repair site of CoA 23 years after the initial surgery. The patient was a 37-year-old man who presented to our hospital for hemoptysis. He previously underwent aortoplasty with direct suture for CoA at the age of 14 years. Computed tomography (CT) revealed a ruptured descending aortic aneurysm with perforation into the left lung;the location of the aneurysm coincided with the site of the previous CoA repair. He underwent emergent thoracic endovascular aortic repair. The postoperative course was uneventful, and the aneurysm was remained stable for over a year after the surgery.
[Subclavian-aortic Bypass Grafting for Aortic Coarctation in Adults:Report of a Case].
Nishi T, Yamazaki T
Kyobu Geka · 2025 Sep · PMID 40998370
A 56-year-old woman with a congenital bicuspid aortic valve presented with a cough. She was diagnosed with adult congenital coarctation of the aorta on computed tomography(CT) and referred to our institution. The blood p...
A 56-year-old woman with a congenital bicuspid aortic valve presented with a cough. She was diagnosed with adult congenital coarctation of the aorta on computed tomography(CT) and referred to our institution. The blood pressure gradient between the upper and lower extremities was approximately 70 mmHg. She also had mild renal impairment. She underwent left subclavian artery to descending aorta bypass through a 5th left thoracotomy with partial extracorporeal circulation. The operation was successful and the postoperative course was uneventful. The pressure gradient between the upper and lower extremities eventually decreased to 5 mmHg. The left subclavian artery to descending aorta bypass is an effective operation for this disease.
[Aortic Subannular Left Ventricular Pseudoaneurysm with Mitral Valve Regurgitation Due to Infective Endocarditis:Report of a Case].
Odate T, Miura T, Taguchi S … +2 more , Hisata Y, Yamada T
Kyobu Geka · 2025 Sep · PMID 40998369
The patient was a 40-year-old male. His main complaints were fever and heart failure. Methicillin-sensitive Staphylococcus aureus was isolated from the patient's blood culture. He was diagnosed with a left ventricular ps...
The patient was a 40-year-old male. His main complaints were fever and heart failure. Methicillin-sensitive Staphylococcus aureus was isolated from the patient's blood culture. He was diagnosed with a left ventricular pseudoaneurysm by contrast-enhanced computed tomography (CT). Severe mitral insufficiency and vegetation on the anterior mitral valve were observed on echocardiography. The patient went into shock and intratracheal intubation was performed. An intraaortic balloon pumping was started, and percutaneous cardiopulmonary support were established for cardiogenic shock. Mitral valve replacement with a mechanical valve and autologous pericardium patch closure were performed in an urgent surgery. Antibiotics were administered until his inflammatory response was negative. The patient had no recurrence of endocarditis or malfunction of the prosthetic valve and no leakage of the patchplasty for two years post-surgery.
[Hypertrophic Obstructive Cardiomyopathy Associated with Apical-basal Muscle Bundle Treated by Extended Septal Myectomy and Surgical Excision of a Muscle Bundle:Report of a Case].
Abe T, Orii K, Kondou T … +2 more , Wakatabe M, Kawasaki K
Kyobu Geka · 2025 Sep · PMID 40998368
A 74-year-old woman was diagnosed with obstructive hypertrophic cardiomyopathy and symptoms of heart failure. Transthoracic echocardiography and other imaging examinations revealed an apical-basal muscle bundle caused by...
A 74-year-old woman was diagnosed with obstructive hypertrophic cardiomyopathy and symptoms of heart failure. Transthoracic echocardiography and other imaging examinations revealed an apical-basal muscle bundle caused by a left ventricular outflow tract(LVOT) obstruction. The peak velocity was 6.1 m/s, recorded during the Valsalva maneuver, and mitral regurgitation progressed from trivial to moderate. The course of operative treatment consisted of surgical intervention in the mitral valve. The LVOT revealed an apical-basal muscle bundle, approximately 6 mm in diameter;however, this was excluded. Extended septal myectomy and intraoperative transesophageal echocardiography were performed, the latter to verify the systolic anterior motion of the mitral valve;however, mitral regurgitation was not detected. The post-operative peak velocity improved to 2.5 m/s. In conclusion, surgical treatment of obstructive hypertrophic cardiomyopathy and LVOT obstruction associated with an apical-basal muscle bundle was performed with accurate diagnosis, thus avoiding valvular surgery.
[Idiopathic Bronchial-pulmonary Artery Fistula with Intraoperative Definitive Diagnosis by Intravenous Administration of Indocyanine Green].
Hirayama K, Matsuno M, Suzuki K
Kyobu Geka · 2025 Sep · PMID 40998367
The patient is a 73-year-old woman who was referred to our department for diagnostic surgery. A part-solid ground-glass nodule, suspected to be lung cancer, was identified in the right S6 on a preoperative chest contrast...
The patient is a 73-year-old woman who was referred to our department for diagnostic surgery. A part-solid ground-glass nodule, suspected to be lung cancer, was identified in the right S6 on a preoperative chest contrast computed tomography (CT). Additionally, a continuous bronchial artery was observed at the root of A6. Based on the CT findings, we diagnosed a bronchial-pulmonary artery fistula (BPAF) and an associated pulmonary artery aneurysm. The patient exhibited no subjective symptoms, such as blood-streaked sputum or hemoptysis. She subsequently underwent a right S6 segmentectomy. Intraoperative examination of the pulmonary artery revealed a continuous bronchial artery dorsal to A6, as anticipated. Intravenous indocyanine green (ICG) administration after root ligation of A6 showed that ICG flowed into A6 and peripherally to S6 beyond the ligated point via the bronchial artery, confirming the diagnosis of BPAF.
[New Device for Mitral Valve Repair].
Sakaguchi M, Baba T, Aratame A … +3 more , Sumii Y, Ishikawa T, Minamimura H
Kyobu Geka · 2025 Sep · PMID 40998366
PURPOSE: Our objective is to develop a new device for the treatment of mitral regurgitation by transapical chordal implantation, allowing procedures to be conducted while the heart is beating, thus eliminating the need f...
PURPOSE: Our objective is to develop a new device for the treatment of mitral regurgitation by transapical chordal implantation, allowing procedures to be conducted while the heart is beating, thus eliminating the need for extracorporeal circulation. This approach promises both simpler and more reliable procedure than existing devices. METHODS: The target disease is mitral valve prolapse, where adequate coaptation of the anterior and posterior leaflets can be achieved solely through chordal implantation. Our treatment approach involves accessing the mitral valve via the left ventricular apex, attaching an artificial chorda tendineae to the prolapsed mitral valve leaflet, and pulling it to an appropriate length towards the left ventricular apex. We propose the design and operational mechanism of a device to facilitate this procedure. RESULTS: The device utilizes a grasper with a hollow structure to catch the prolapsed valve leaflet and then attaches the artificial chordae tendineae to the valve leaflet by using a clip within the hollow structure. This structure enables visual confirmation of the procedure using a fiber scope, thus ensuring greater procedural reliability. CONCLUSION: This device represents a conceptual breakthrough, although several considerations remain, such as the durability of the materials used and their compatibility with tissue.
[Minimally Invasive Cardiac Surgery for Partial Anomalous Pulmonary Venous Connection and Sinus Venosus Atrial Septal Defect].
Morita S, Higashi K, Narumiya Y … +5 more , Toya T, Inoue T, Tateishi A, Hisamochi K, Tamura K
Kyobu Geka · 2025 Sep · PMID 40998365
We report a successful case of minimally invasive cardiac surgery for partial anomalous pulmonary venous connection and sinus venosus atrial septal defect. A 45-year-old man had a severely enlarged right heart due to par...
We report a successful case of minimally invasive cardiac surgery for partial anomalous pulmonary venous connection and sinus venosus atrial septal defect. A 45-year-old man had a severely enlarged right heart due to partial anomalous pulmonary venous connection and sinus venosus atrial septal defect, but no evidence of severe pulmonary hypertension was observed. Right third intercostal approach was used to incise the right atrium and the superior vena cava at the level of the partial anomalous pulmonary venous connection confluence so that the partial anomalous pulmonary venous connection orifice and the sinus venous atrial septal defect were well observed under endoscopic assistance. Intracardiac repair was performed by suturing a Gore-Tex patch with a continuous suture of 5-0 polypropylene thread through the two incision lines in the heart. Postoperative examination revealed no residual shunt or stenosis of the pulmonary vein or the superior vena cava, and the patient was discharged without complications.
[Successful Steroid Therapy for Early Relapse of Immunoglobulin (Ig) G4 Related Constrictive Pericarditis].
Murase R, Fusegawa M, Motohashi M
Kyobu Geka · 2025 Sep · PMID 40998364
The causes of constrictive pericarditis are known to include previous cardiac surgery, radiotherapy, collagen disease, and tuberculosis, but in recent years, reports of constrictive pericarditis due to immunoglobulin(Ig)...
The causes of constrictive pericarditis are known to include previous cardiac surgery, radiotherapy, collagen disease, and tuberculosis, but in recent years, reports of constrictive pericarditis due to immunoglobulin(Ig)G4-related diseases have increased. We report a case of IgG4-related constrictive pericarditis that relapsed early after pericardiectomy and was well controlled by steroid therapy. The patient was a 69-year-old man who was diagnosed with idiopathic constrictive pericarditis. He underwent pericardiectomy and very early postoperative course was favorable, but the disease recurred around a week or so. Postoperative pathological examination and immunohistochemistry revealed IgG4-related constrictive pericarditis, and steroid therapy was started. The patient's heart failure symptoms were alleviated, and thickened pericardium got thin following steroid therapy. During treatment of constrictive pericarditis, it is necessary to keep IgG4-related diseases in mind.
[Surgical Treatment Strategy for Pyothorax in Maintenance Hemodialysis Patients].
Tanaka Y, Tsunezuka Y, Tsuboniwa N … +6 more , Izawa N, Sasaki Y, Fu Y, Koyama I, Tsukazaki H, Tsukazaki T
Kyobu Geka · 2025 Sep · PMID 40998363
Patients on dialysis with end-stage renal failure often develop pleural effusion, which is typically managed by dehydration. However, distinguishing empyema from pleural effusion is crucial, since empyema may not present...
Patients on dialysis with end-stage renal failure often develop pleural effusion, which is typically managed by dehydration. However, distinguishing empyema from pleural effusion is crucial, since empyema may not present with typical symptoms like fever, leading to potential misdiagnosis. This study examines the surgical treatment of empyema in dialysis patients. Between 2021 and 2024, among 404 dialysis patients, 5(1.2%)developed empyema. The patients(4 males, 1 female)had a mean age of 69.8 years, and all had diabetic nephropathy-induced renal failure. Two patients presented with asymptomatic pleural effusion, while three patients had fever and leukocytosis. Two patients had encapsulated effusions requiring early surgery. Surgery was performed in four cases after antibiotic treatment, while one received drainage and antibiotics alone. All underwent thoracoscopic procedures, with one patient requiring fenestration for recurrent multidrug-resistant empyema.
[Left Upper Sleeve Lobectomy for Endobronchial Tuberculosis that Caused the Stenosis of the Left Main Bronchus and the Complete Obstruction of the Left Upper Bronchus].
Kawakami T, Nanami H, Shimoda K … +3 more , Hiramatsu M, Shiraishi Y, Arai T
Kyobu Geka · 2025 Sep · PMID 40998362
A 44-year-old female had a history of the treatment of pulmonary tuberculosis at the age of 17 and was diagnosed with the stenosis of the left main bronchus at the age of 18. Twenty-five years after the completion of pul...
A 44-year-old female had a history of the treatment of pulmonary tuberculosis at the age of 17 and was diagnosed with the stenosis of the left main bronchus at the age of 18. Twenty-five years after the completion of pulmonary tuberculosis treatment, she suffered from severe dyspnea and wheeze. Her symptoms were due to endobronchial tuberculosis;the left main bronchus was stenotic and the left upper bronchus was completely obstructed, causing atelectasis of left upper lobe. Despite two years of medical treatment, her symptoms did not improve and she was referred to our hospital. She underwent bronchoscopic balloon dilatation twice, and her bronchial stenosis was alleviated. However, she still had a severe dyspnea due to bronchial malacia. We decided to perform a left upper sleeve lobectomy. Her symptoms were dramatically resolved after the surgical operation. Treatment of endobronchial tuberculosis remains challenging and there is no established treatment strategy. From the view of minimally invasive treatment, bronchoscopic intervention should be the treatment of choice. However, surgical treatment should be considered for the patients who did not improve with bronchoscopic intervention or who had re-stenosis after it.
[Esophageal Surgery with Artificial Intelligence].
Takeuchi M, Kitagawa Y
Kyobu Geka · 2025 Sep · PMID 40998360
Artificial intelligence (AI) is increasingly enabling multifaceted support in robot-assisted esophagectomy, including automated recognition of surgical phases, identification of critical anatomical structures, and assess...
Artificial intelligence (AI) is increasingly enabling multifaceted support in robot-assisted esophagectomy, including automated recognition of surgical phases, identification of critical anatomical structures, and assessment of surgical skills. AI facilitates real-time visualization of surgical progress, reduces the risk of complications, and enhances surgical education. In particular, AI-based support for identifying the recurrent laryngeal nerve and alerting excessive traction serves as a powerful aid to surgeons, contributing to improved surgical quality and safety as a next-generation navigation tool.
[Mediastinoscopic and Transabdominal Robotic Esophagectomy Using da Vinci Xi].
Mitsui T, Hakozaki Y
Kyobu Geka · 2025 Sep · PMID 40998359
Mediastinoscopic esophagectomy (ME) for esophageal cancer, first reported by Tangoku et al. in 2004, has evolved into a standardized procedure incorporating radical lymphadenectomy. The surgery is performed using a media...
Mediastinoscopic esophagectomy (ME) for esophageal cancer, first reported by Tangoku et al. in 2004, has evolved into a standardized procedure incorporating radical lymphadenectomy. The surgery is performed using a mediastinoscope from the neck and a laparoscope from the abdomen, creating a connected operative field within the mediastinum. ME avoids thoracotomy and one-lung ventilation, preserving respiratory muscles and significantly reducing postoperative pneumonia, while maintaining pulmonary function and quality of life. Meta-analyses have shown that although recurrent laryngeal nerve palsy is relatively common, ME results in shorter operative time, less blood loss, lower incidence of pneumonia, and a reduced overall complication rate compared to conventional approaches. Its greatest advantage lies in expanding surgical indications to patients who were previously considered inoperable due to thoracic adhesions, poor pulmonary function (e.g., chronic obstructive pulmonary disease (COPD)), or prior thoracic surgery. These patients often cannot tolerate radiation either, making ME particularly valuable. As Japan's population continues to age, the need for ME is expected to grow. Although ME was covered by national insurance in 2018, evidence from Japan remains limited. The 2022 esophageal cancer guidelines refrain from recommending ME due to insufficient data. However, recent retrospective studies using propensity score matching have shown significantly better overall and disease-free survival compared to thoracotomy, and prospective multicenter trials are underway.
[da Vinci Single-port Esophagectomy via the Subcostal Approach].
Daiko H
Kyobu Geka · 2025 Sep · PMID 40998358
The introduction of the da Vinci SP system has led to the classification of surgical robotic platforms into multiple-port and single-port systems. Esophagectomy for esophageal cancer can now be performed through various...
The introduction of the da Vinci SP system has led to the classification of surgical robotic platforms into multiple-port and single-port systems. Esophagectomy for esophageal cancer can now be performed through various approaches, including transthoracic, transcervical, transhiatal, and subcostal routes. Future studies are warranted to determine which robotic system is most suitable for each approach and provides optimal short- and long-term outcomes.
[Virtual Cross-match in Lung Transplantation].
Miyahara S, Shiraishi T
Kyobu Geka · 2025 Sep · PMID 40998357
Organ transplantation involves an immune response, and prevention of rejection leads to long-term survival after organ transplantation. In Japan, a physical cross-match (PXM) is performed before organ allocation, in whic...
Organ transplantation involves an immune response, and prevention of rejection leads to long-term survival after organ transplantation. In Japan, a physical cross-match (PXM) is performed before organ allocation, in which the donor's lymphocytes are reacted with the recipient's serum, and if an immune response is confirmed, the recipient is excluded from the organ allocation. In other countries, virtual cross-match (VXM) is performed, which is simpler and more accurate, but also has aspects that are difficult to interpret. This article outlines the flow of immunological testing in clinical practice, and describes the principles and practice of physical and virtual cross-match.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe