Kyobu Geka. The Japanese Journal Of Thoracic Surgery[JOURNAL]
Sun
200 papers
[Secondary Pneumothorax due to Rupture of Pulmonary Rheumatoid Nodule:Report of a Case].
Onda T, Kita H, Yoshida T … +1 more , Hayashi T
Kyobu Geka · 2026 Mar · PMID 42098055
The patient is a 69-year-old man with a 15-year history of rheumatoid arthritis. He has admitted to our hospital due to dyspnea, and his chest computed tomography (CT) scan revealed right pneumothorax. Chest CT scan four...
The patient is a 69-year-old man with a 15-year history of rheumatoid arthritis. He has admitted to our hospital due to dyspnea, and his chest computed tomography (CT) scan revealed right pneumothorax. Chest CT scan four months before the onset of pneumothorax demonstrated subpleural nodule with cavity in the right lung. After chest drainage treatment, video-assisted thoracic surgery was performed. The pulmonary nodule of his right upper lobe was successfully excised. The histopathological examination showed the features of a rheumatoid nodule with bacterial infection. Pneumothorax secondary to rheumatoid nodule is a rare complication of rheumatoid arthritis.
[Thoracoscopic Right Upper Lobectomy for Lung Cancer with Tracheal Bronchus:Report of a Case].
Ide S, Saito G
Kyobu Geka · 2026 Mar · PMID 42098054
A man in his 60s presented with an abnormal shadow on chest radiography. Computed tomography (CT) showed a tumor, measuring 6.1 cm, in the right upper lobe and an anomalous bronchus arising from the trachea. Following tr...
A man in his 60s presented with an abnormal shadow on chest radiography. Computed tomography (CT) showed a tumor, measuring 6.1 cm, in the right upper lobe and an anomalous bronchus arising from the trachea. Following transbronchial biopsy and examinations, the patient was diagnosed with stageⅡB lung adenocarcinoma. The patient underwent a multiport thoracoscopic right upper lobectomy and lymph node dissection. Preoperatively, the information of the tracheal bronchus was shared in the surgical team. During the procedure, the tracheal bronchus was detected behind the azygos arch. The azygos arch and tracheal bronchus were dissected by a stapler. The tracheal bronchus stump was covered by a pedicled pericardial fat pad. No complications were observed perioperatively. Information of anomalies should be shared in the surgical team, including anesthesiologists preoperatively.
[Neoplastic Cardiac Tamponade Manifesting as Left Ventricular Diastolic Dysfunction:Report of a Case].
Suzuki H, Tanabe M, Inoue K … +3 more , Shinoda M, Ito D, Shomura S
Kyobu Geka · 2026 Mar · PMID 42098053
Left ventricular( LV) tamponade is rare and can occur in special circumstances like regional pericardial effusion overlying LV. The therapeutic approach of LV tamponade is different according to the causative factor and...
Left ventricular( LV) tamponade is rare and can occur in special circumstances like regional pericardial effusion overlying LV. The therapeutic approach of LV tamponade is different according to the causative factor and the place of loculated pericardial effusion. We report a case of neoplastic cardiac tamponade manifesting as left ventricular diastolic dysfunction. A 78-year-old man with a history of aortic arch surgery and lung cancer surgery presented with dyspnea. Echocardiogram showed posterior loculated pericardial effusion and LV diastolic dysfunction. Pericardial window operation was performed, then revealed bloody effusion and cytodiagnosis examination revealed class V( adenocarcinoma). Atypical forms of cardiac tamponade with varied clinical presentations may be seen in patients after cardiac surgery. It is important to accurately understand the pathological condition through clinical progress and echocardiography, and to select an appropriate approach and surgical procedure.
[Non-anastomotic Pseudoaneurysm due to Sternal Wire Removal After Ascending Aorta Grafting:Report of a Case].
Higaki T, Kurobe H, Fukunishi T … +5 more , Namiguchi K, Sakaue T, Ota N, Nishimura T, Izutani H
Kyobu Geka · 2026 Mar · PMID 42098052
We report a rare case of a non-anastomotic pseudoaneurysm following ascending aortic replacement. A 73-year-old woman presented with anterior chest swelling after undergoing sternal wire removal due to suspected metal al...
We report a rare case of a non-anastomotic pseudoaneurysm following ascending aortic replacement. A 73-year-old woman presented with anterior chest swelling after undergoing sternal wire removal due to suspected metal allergy. A pseudoaneurysm was identified on computed tomography (CT) at the site where the removed sternal wire had been in contact with the anterior surface of the vascular graft. Surgical repair with cardiopulmonary bypass identified a bleeding pinhole at the graft surface, successfully closed with a 4-0 monofilament mattress suture. This case suggests that prevention of such complications requires protective coverage of the graft with autologous tissue prior to chest closure, careful selection and handling of sternal wires, and thorough preoperative imaging evaluation before wire removal.
[Successful Staged Total Aortic Replacement in a Young Patient with Marfan Syndrome:Report of a Case].
Lee J, Ushioda R, Miyatani K … +1 more , Kamiya H
Kyobu Geka · 2026 Mar · PMID 42098051
We report a case of a young male patient diagnosed with Marfan syndrome who presented with lower limb ischemia due to Stanford type B aortic dissection. Initial imaging revealed significant dilation of the aortic root an...
We report a case of a young male patient diagnosed with Marfan syndrome who presented with lower limb ischemia due to Stanford type B aortic dissection. Initial imaging revealed significant dilation of the aortic root and occlusion of the right iliac artery. Surgical treatment was performed in three stages:revascularization of the lower limbs, valve-sparing aortic root and total arch replacement, and finally thoracoabdominal aortic replacement. This stepwise approach prioritized organ perfusion and allowed for safe and effective repair of the extensive aortic pathology. The postoperative course was uneventful, and the patient remains in good condition. This case highlights the importance of staged surgical strategy in complex aortic disease associated with Marfan syndrome.
[Massive Left Ventricular Thrombus Following Steroid Therapy for Immunoglobulin( Ig) G4-related Ophthalmic Disease:Report of a Case].
Kinoshita A, Sakakibara K, Nakamura C … +7 more , Yamamoto S, Shikata D, Takesue Y, Shiraiwa S, Honda Y, Kaga S, Nakajima H
Kyobu Geka · 2026 Mar · PMID 42098050
We present a 61-year-old man who developed worsening glycemic control and a massive evolving left ventricular( LV) thrombus following steroid therapy for immunoglobulin( Ig) G4-related ophthalmic disease. He had a histor...
We present a 61-year-old man who developed worsening glycemic control and a massive evolving left ventricular( LV) thrombus following steroid therapy for immunoglobulin( Ig) G4-related ophthalmic disease. He had a history of old myocardial infarction. Brain magnetic resonance imaging( MRI) disclosed a subacute cerebral infarction. Based on a large, mobile thrombus and an embolic event, surgery was indicated. He underwent successful LV thrombus removal and coronary artery bypass grafting to the left anterior descending artery. His postoperative course was uneventful, and he was discharged on day 28. This case highlights that steroid therapy can exacerbate LV thrombosis, and surgical intervention can be an effective treatment to prevent further serious embolism in high-risk patients.
[Totally Endoscopic Trans-atrial and Trans-mitral Removal of a Left Ventricular Thrombus through Right Minimally Invasive Thoracotomy in a Patient with Acute Myocardial Infarction:Report of a Case].
Sato M, Yamada A, Eizawa S … +4 more , Touma R, Morimoto Y, Gan K, Asada T
Kyobu Geka · 2026 Mar · PMID 42098049
A 49-year-old man was diagnosed with acute myocardial infarction and underwent percutaneous coronary intervention (PCI) for complete left anterior descending artery (LAD) occlusion. Two weeks later, transthoracic echocar...
A 49-year-old man was diagnosed with acute myocardial infarction and underwent percutaneous coronary intervention (PCI) for complete left anterior descending artery (LAD) occlusion. Two weeks later, transthoracic echocardiography revealed a mobile left ventricular thrombus. Due to its increasing size despite anticoagulation therapy, he was transferred to our department. Emergency surgery was performed using a totally endoscopic trans-atrial and trans-mitral approach through a right minimally invasive thoracotomy. The thrombus was completely removed under direct endoscopic visualization without the need for left ventricular incision. The postoperative course was uneventful, and no residual thrombus was observed. This minimally invasive approach is considered safe and effective for selected patients.
[Successful Surgical Repair of a Pseudo-pseudo Left Ventricular Aneurysm Following Myocardial Infarction:Report of a Case].
Sato D, Nakajima M, Osawa I … +2 more , Yokoyama T, Tsuda Y
Kyobu Geka · 2026 Mar · PMID 42098048
A 76-year-old woman underwent percutaneous coronary intervention (PCI) to the right coronary artery for subacute myocardial infarction six months earlier. Subsequently, PCI was also performed for a residual lesion in the...
A 76-year-old woman underwent percutaneous coronary intervention (PCI) to the right coronary artery for subacute myocardial infarction six months earlier. Subsequently, PCI was also performed for a residual lesion in the left anterior descending artery. On follow-up transthoracic echocardiography, performed six months later, a localized bulging of the inferior wall of the left ventricle was observed, which had markedly enlarged compared to the previous study, leading to the decision for surgical intervention. Intraoperatively, there were no significant adhesions between the aneurysm and the pericardium. A saccular aneurysm was identified in the inferior wall of the left ventricle. A thin layer of myocardial tissue was observed beneath the epicardium, suggesting the diagnosis of a pseudopseudoaneurysm. The aneurysm was incised, and patch closure was performed at the aneurysmal orifice. The postoperative course was uneventful. Left ventricular pseudo-pseudoaneurysm is an extremely rare entity. We report this case to highlight the effectiveness of surgical patch closure in the management of this condition.
[Successful Surgical Treatment for Traumatic Extrapleural Hematoma in an Elderly Patient].
Kozu Y, Kinno T, Suzuki K
Kyobu Geka · 2026 Mar · PMID 42098047
An 82-year-old man receiving anticoagulants was referred to our hospital with dyspnea and back pain. One day earlier, he bruised his back in his house. On arrival, the hemoglobin value was 5.6 g/dl, and computed tomograp...
An 82-year-old man receiving anticoagulants was referred to our hospital with dyspnea and back pain. One day earlier, he bruised his back in his house. On arrival, the hemoglobin value was 5.6 g/dl, and computed tomography( CT) showed bilateral pleural effusion along with left lower rib fractures. In the left hemithorax, irregular high-density lesion which was surrounded by a low-density stripe was observed. He was initially diagnosed with left traumatic hemothorax, and managed through inpatient care with bed rest and blood transfusion. Although anemia was improved, bilateral compression atelectasis was observed compromising cardiopulmonary function. We therefore performed surgical treatment on the 14th hospital day. Under general anesthesia, a chest tube was inserted into the right thoracic cavity, removing 1,000 ml of serous pleural effusion. We subsequently performed a left-sided thoracotomy. After suctioning 400 ml of bloody pleural effusion, we found a pleural bulge in the posterior chest wall. Hematoma was accumulated in the extrapleural space. The parietal pleura was opened and the extrapleural hematoma was bluntly curetted and evacuated. The deviated rib fracture was repaired. Postoperative course was uneventful. He was discharged home after rehabilitation on postoperative day 54.
[Reduction of Downhill Esophageal Varices After Intra-thoracic Venous Reconstruction].
Nozawa Y, Tanaka Y, Yoshikawa E
Kyobu Geka · 2026 Mar · PMID 42098046
The patient was a 54-year-old male. He underwent invasive seminoma resection, bypass grafting from the left subclavian vein to the right atrial appendage, and patch plasty of the superior vena cava( SVC) 18 years ago in...
The patient was a 54-year-old male. He underwent invasive seminoma resection, bypass grafting from the left subclavian vein to the right atrial appendage, and patch plasty of the superior vena cava( SVC) 18 years ago in 1990. In 1992, graft obstruction was demonstrated, and in 1994, subsequent downhill esophageal varices developed. Varices deteriorated to grade F3 with a red-colored sign in 2008. Therefore, bypass grafting from bilateral subclavian veins to the right atrial appendage was performed to prevent rupture. Endoscopy performed two weeks after surgery showed that the varices had improved to grade F1. The patient was discharged without adverse events. In 2023, the graft remained patent and the varices did not worsen. After SVC reconstruction, strict follow-up is necessary because fatal event in esophageal varices can occur owing to graft obstruction.
[Surgical Removal of a Retained Balloon Catheter During Percutaneous Coronary Intervention].
Ide H, Sasahara A, Onishi Y … +3 more , Shibata K, Ohara K, Nie M
Kyobu Geka · 2026 Mar · PMID 42098045
A 76-year-old man with angina pectoris underwent percutaneous coronary intervention (PCI) of the left anterior descending artery. While attempting to withdraw the balloon catheter, it fractured and became irretrievable,...
A 76-year-old man with angina pectoris underwent percutaneous coronary intervention (PCI) of the left anterior descending artery. While attempting to withdraw the balloon catheter, it fractured and became irretrievable, and he was transferred to our hospital. The ascending aorta was incised under cardiopulmonary bypass to remove the retained catheter, which was entangled with a coronary stent, requiring partial excision of the stent to achieve removal. Intraoperative coronary angiography revealed intimal injury of the left coronary artery. Due to the high risk of subsequent dissection and occlusion, coronary artery bypass grafting (CABG) was performed. The postoperative course was uneventful, and the patient was discharged. This case illustrates a rare complication of PCI in which catheter retention with stent entanglement necessitated surgical removal and concomitant CABG. Prompt surgical intervention is necessary in such cases to prevent life-threatening complications.
[Extensive Atrial Resection for Marked Atrial Enlargement due to Long-standing Persistent Atrial Fibrillation].
Mizuta S, Sato S, Nakajima S … +3 more , Osanai A, Yamamoto J, Sawazaki M
Kyobu Geka · 2026 Mar · PMID 42098044
A 67-year-old female, diagnosed with atrial fibrillation over 35 years ago, presented with mild heart failure symptoms. However, due to mild mitral regurgitation, she had been managed conservatively at local hospital. Re...
A 67-year-old female, diagnosed with atrial fibrillation over 35 years ago, presented with mild heart failure symptoms. However, due to mild mitral regurgitation, she had been managed conservatively at local hospital. Recently, she developed severe dyspnea and was referred to our institution for surgical intervention. Comprehensive evaluation revealed significant enlargement of both atria, leading to a restrictive ventilatory impairment. The surgical procedure included mitral annulus repair, tricuspid annulus repair, maze procedure, and extensive cylindrical resection of the left atrium, along with right atrial repair, all performed under cardiopulmonary bypass. Post-surgery, her atrial volume decreased from 830 ml to 275 ml, and her vital capacity improved from 1.28 l to 1.77 l. Following the procedure, she maintained sinus rhythm, with complete resolution of her dyspnea. These improvements have been sustained for three years postoperatively.
[Catamenial Pneumothorax During Endometriosis Treatment].
Matsuno M, Suzuki K, Hirayama K
Kyobu Geka · 2026 Mar · PMID 42098043
Here, we report a case of catamenial pneumothorax that occurred during endometriosis treatment. A 46-year-old woman presented with a history of right pneumothorax. At 43 years of age, the patient was diagnosed with endom...
Here, we report a case of catamenial pneumothorax that occurred during endometriosis treatment. A 46-year-old woman presented with a history of right pneumothorax. At 43 years of age, the patient was diagnosed with endometriosis and progesterone therapy was initiated. The patient developed rightsided chest pain and was diagnosed with right-sided pneumothorax. Video-assisted thoracoscopic surgery was performed, because of persistent air leakage. Intraoperative findings revealed a suspected pleural defect in the right upper lobe and multiple perforations around the central tendon of the right diaphragm. The pleural defect was resected, and the diaphragm surface was covered with a polyglycolic acid sheet. Pathologically, the diagnosis was associated with thoracic endometriotic pneumothorax, including immunostaining findings. Hormonal therapy was continued after discharge. The patient has remained free of recurrence for one year postoperatively.
[Synchronous Double Cancer of Left Lung and Esophagus Which Was Performed Simultaneous Resection].
Yuki H, Tanaka N, Fujimori H
Kyobu Geka · 2026 Mar · PMID 42098042
We report a case of synchronous double cancer involving the left lung and esophagus treated with a minimally invasive one-stage procedure combining thoracoscopic lobectomy and mediastinoscopic esophagectomy. Although a t...
We report a case of synchronous double cancer involving the left lung and esophagus treated with a minimally invasive one-stage procedure combining thoracoscopic lobectomy and mediastinoscopic esophagectomy. Although a two-stage approach is often selected due to the technical complexity and invasiveness of simultaneous surgery, both tumors in this case were advanced, and a single-stage resection was considered the most appropriate option to avoid losing the opportunity for curative treatment. The postoperative course was complicated by anastomotic leakage, which was managed conservatively;however, early recurrence of esophageal cancer occurred, followed by multiple brain metastases from small cell lung carcinoma. These recurrences may have been related to limited mediastinal lymph node dissection, performed to preserve bronchial blood flow, and to the delayed initiation of adjuvant therapy due to treatment for esophageal recurrence. This case demonstrates not only the feasibility and advantage of a less invasive simultaneous approach but also emphasizes the need to optimize lymph node dissection strategies and the timing of postoperative therapy in complex synchronous malignancies.
[Diaphragmatic Hernia Mimicking Lung Tumor:Report of a Case].
Shomura S, Inoue K, Suzuki H
Kyobu Geka · 2026 Feb · PMID 42098020
A 59-year-old woman consulted our hospital because of an abnormal shadow on chest X-ray. A chest computed tomography (CT) revealed a tumor on the diaphragm. A diagnosis of lung tumor was suspected and she underwent video...
A 59-year-old woman consulted our hospital because of an abnormal shadow on chest X-ray. A chest computed tomography (CT) revealed a tumor on the diaphragm. A diagnosis of lung tumor was suspected and she underwent video-assisted thoracoscopic surgery. The intraoperative findings revealed a tumor through the defect hole in the right diaphragm. Histological examination revealed fibrotic tissue. The final diagnosis was a diaphragmatic hernia. For lung tumors on the diaphragm, diaphragmatic hernia should also be considered in the differential diagnosis.
[Right Pyothorax Associated with Liver Abscess:Report of a Case].
Onda T, Kita H, Yoshida T
Kyobu Geka · 2026 Feb · PMID 42098019
The patient is a 66-year-old man. He came to our hospital with fever for two weeks. Based on blood sampling and abdominal computed tomography (CT) scan, a diagnosis of liver abscess was made, and antibiotic treatment was...
The patient is a 66-year-old man. He came to our hospital with fever for two weeks. Based on blood sampling and abdominal computed tomography (CT) scan, a diagnosis of liver abscess was made, and antibiotic treatment was started, but symptoms did not improve, so percutaneous drainage was performed. One week later, he became dyspnea and chest CT scan revealed right pyothorax, so video-assisted thoracoscopic curettage was performed. It has been reported that liver abscesses are complicated by pyothorax in a few percent of cases. There are two hypotheses as to the mechanism. The one is the spread of inflammation from the liver abscess through the diaphragm into the pleural space, and the other is iatrogenic complication of percutaneous liver drainage.
[Resection of Metastatic Lung Tumor with Abnormal Bronchial Bifurcation and Running Pulmonary Artery:Report of a Case].
Fujimura T, Okagawa T, Niimi S
Kyobu Geka · 2026 Feb · PMID 42098018
The patient is a 69-year-old woman who underwent surgery for rectal cancer in January 202X. In July 202X+2, computed tomography (CT) revealed a nodule shadow with a maximum diameter of 4 mm in S1 of the right lung. After...
The patient is a 69-year-old woman who underwent surgery for rectal cancer in January 202X. In July 202X+2, computed tomography (CT) revealed a nodule shadow with a maximum diameter of 4 mm in S1 of the right lung. After three months, the nodule increased in size. Based on the patient's history, a metastatic lung tumor was suspected, and the patient underwent surgical resection. Preoperative CT revealed the presence of B1 tracheobronchus and abnormal running of A1. B 1 was more centrally located than usual and branched directly from the trachea, whereas A1 branched from the main pulmonary artery trunk. S1 segmentectomy was performed for suspected metastatic lung tumor nodule in S1. Abnormal running of the pulmonary artery poses a risk of vascular injury during surgery. In the case of abnormal bronchial branching, the pulmonary vessels may be abnormal, and it is important to recognize such abnormalities using contrast-enhanced or three-dimensional CT preoperatively.
[Rupture of Intercostal Aneurysm Associated with von Recklinghausen's Disease:Report of a Case].
Sakamoto S, Kurumisawa S, Akutsu H … +4 more , Muraoka A, Arakawa M, Kimura N, Kawahito K
Kyobu Geka · 2026 Feb · PMID 42098017
Vascular lesions, including aneurysms, are rare but well-documented complications of von Recklinghausen's disease. Although aneurysms associated with this condition are often asymptomatic, rupture can lead to life-threat...
Vascular lesions, including aneurysms, are rare but well-documented complications of von Recklinghausen's disease. Although aneurysms associated with this condition are often asymptomatic, rupture can lead to life-threatening events such as hemothorax. We report a 63-year-old male with von Recklinghausen's disease who presented with sudden onset of chest pain. Imaging revealed left-side hemothorax, and contrast-enhanced computed tomography( CT) suggested rupture of the left 10th intercostal artery. Given his hemodynamic stability, percutaneous coil embolization was performed. Angiography revealed two adjacent aneurysms at the origin of the left 10th intercostal artery, both of which were successfully embolized. Postoperative course was uneventful, and the patient was discharged on postoperative day 6. This case highlights the importance of considering vascular complications in von Recklinghausen's disease and supports the efficacy and safety of coil embolization in managing ruptured intercostal artery aneurysms.
[Acute Stanford Type A Aortic Dissection with Right Ventricular Infarction Treated with Total Arch Replacement After Percutaneous Coronary Intervention:Report of a Case].
Yamane K, Higuchi T, Kurashiki T … +2 more , Ootsuki Y, Nakamura Y
Kyobu Geka · 2026 Feb · PMID 42098016
A 60-year-old man was admitted to our hospital with chest and back pain. Electrocardiogram, echocardiography, and contrast-enhanced computed tomography (CT) confirmed a Stanford type A acute aortic dissection with right...
A 60-year-old man was admitted to our hospital with chest and back pain. Electrocardiogram, echocardiography, and contrast-enhanced computed tomography (CT) confirmed a Stanford type A acute aortic dissection with right ventriclar infarction and left ventricular inferior wall asynergy due to right coronary artery malperfusion. The patient presented with shock vital signs. So, immediately percutaneous coronary intervention (PCI) was performed to obtain the right coronary revascularization, after which total arch replacement and frozen elefant trunk was performed. Postoperatively, the patient remained stable without right heart failure. In patients with right ventricular infarction, preoperative PCI prior to surgery may be a useful option.
[Primary Percutaneous Coronary Intervention for Acute Aortic Dissection with Left Coronary Artery Malperfusion:Report of a Case].
Aiso K, Takagi H
Kyobu Geka · 2026 Feb · PMID 42098015
Left main coronary artery (LMCA) malperfusion due to acute aortic dissection (AAD) is relatively rare but life-threatening. Almost all such patients suffer from cardiogenic shock, and cardiopulmonary arrest occurs in app...
Left main coronary artery (LMCA) malperfusion due to acute aortic dissection (AAD) is relatively rare but life-threatening. Almost all such patients suffer from cardiogenic shock, and cardiopulmonary arrest occurs in approximately half of them. A 64-year-old man with chest pain was taken to our hospital by ambulance. Acute coronary syndrome was suspected as electrocardiography showed changes in ST segment. Coronary angiography revealed severely stenotic LMCA. Percutaneous cardiopulmonary support was initiated for subsequent cardiogenic shock. Dissection in the LMCA on intravascular ultrasonography suggested that AAD occurred and dissection extended into the LMCA. Percutaneous coronary intervention (PCI) to the LMCA was performed with a drug-eluting stent. Post-PCI contrast-enhanced computed tomography (CT) scan demonstrated Stanford type A AAD. Subsequently, ascending-aortic replacement was successfully carried out. Postoperative echocardiography showed well preserved cardiac contraction. Primary PCI under percutaneous cardiopulmonary support for AAD and LMCA malperfusion shortens myocardial ischemic time and improves prognosis.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe