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Kamiyoshihara M. THREE-DIMENSIONAL COMPUTED TOMOGRAPHY AIDS PREOPERATIVE PLANNING FOR REMOVAL OF NEUROGENIC TUMORS ORIGINATING IN THE THORACIC INLET. Chest 2020. [DOI: 10.1016/j.chest.2020.05.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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2
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Kamiyoshihara M. MULTIDISCIPLINARY APPROACH TO RECURRENCE AFTER RESECTION OF PRIMARY LUNG CANCER. Chest 2020. [DOI: 10.1016/j.chest.2020.05.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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3
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Ohsawa F, Kamiyoshihara M, Igai H, Ibe T, Yoshikawa R. P1.02-031 Clinicopathological Study of 16 Cases with Pulmonary Pleomorphic Carcinoma. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yoshikawa R, Kawatani N, Kamiyoshihara M, Igai H, Ibe T, Osawa F. P2.16-009 Strategy for Oncologic Emergency in Thoracic Disease. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Igai H, Kamiyoshihara M, Yoshikawa R, Osawa F, Ibe T. P1.16-014 The Efficacy of Thoracoscopic Right Upper Lobectomy Using Fissureless Technique in Patients with Dense Fissures. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ibe T, Yoshikawa R, Ohsawa F, Igai H, Kamiyoshihara M. P3.16-029 Recurrence within a Year after Complete Resection of Primary Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Igai H, Kamiyoshihara M, Yoshikawa R, Osawa F, Kawatani N, Ibe T, Shimizu K. V-081PERFORMING A THORACOSCOPIC RIGHT UPPER LOBECTOMY AFTER AN INITIAL ANATOMIC PULMONARY RESECTION OF THE LOWER LOBE. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Igai H, Kamiyoshihara M, Kawatani N, Ibe T, Shimizu K. V-066THORACOSCOPIC LATERAL AND POSTERIOR BASAL (S9 + 10) SEGMENTECTOMY USING INTERSEGMENTAL TUNNELLING. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Igai H, Kamiyoshihara M, Kawatani N, Ibe T. P-213THE EFFICACY OF THORACOSCOPIC FISSURELESS LOBECTOMY IN PATIENTS WITH DENSE FISSURES. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kamiyoshihara M, Igai H, Ibe T, Kawatani N. An optimal starting point for calculating the survival time of patients with pulmonary metastasectomy: Why has this not yet been unified? Eur J Cancer 2016. [DOI: 10.1016/j.ejca.2016.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Igai H, Kamiyoshihara M, Kawatani N, Ibe T, Shimizu K. O-019TROUBLESHOOTING FOR BLEEDING DURING THORACOSCOPIC ANATOMIC PULMONARY RESECTION. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kamiyoshihara M, Igai H, Kawatani N, Ibe T, Obayashi K, Shimizu K, Takeyoshi I. P0019 Lung metastasectomy for postoperative colorectal cancer in patients with a history of hepatic metastasis. Eur J Cancer 2014. [DOI: 10.1016/j.ejca.2014.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shimizu Y, Kamiyoshihara M, Okajo J, Ishii Y, Takise A. Tracheobronchial stenosis evaluated by inspiratory and expiratory three-dimensional computed tomography and impulse oscillation with three-dimensional color imaging in a patient with relapsing polychondritis. J BIOL REG HOMEOS AG 2014; 28:325-331. [PMID: 25001664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Patients with relapsing polychondritis (RP) and airway stenosis have difficulty performing conventional spirometry that requires maximum forced expiration. We report a patient with RP who showed progressive severe bronchial stenosis on three-dimensional computed tomography (3D-CT) and impulse oscillation (IOS) with 3D color imaging using a Mostgraph®. The forced oscillation technique using IOS allows within-breath evaluation without forced expiration. A 68-year-old man who had RP presented with dyspnea due to stenosis of the trachea and left main bronchus (lt. mb). Stenting was performed twice in two years. Chest 3D-CT revealed a marked difference in the extent of bronchial collapse during expiration compared with inspiration. The forced expiratory volume in 1 second (FEV1.0), reactance at 5Hz (X5), resonant frequency (Fres), and integrated low frequency reactance area (ALX) measured by IOS showed temporary improvement after placement of the first stent, but respiratory resistance at 5Hz (R5) and 20Hz (R20) remained poor. 3D color images of respiratory resistance obtained with a Mostgraph® already showed high values at the time of diagnosis, resembling the features of chronic obstructive disease (COPD). 3D color images were helpful for interpreting the changes of IOS parameters during the clinical course. In conclusion, 3D-CT in inspiration/expiration and noninvasive IOS with 3D color imaging are useful for assessing airway stenosis in RP while reducing the burden of repeated spirometry.
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Affiliation(s)
- Y Shimizu
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Gunma, Japan
| | - M Kamiyoshihara
- Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Gunma, Japan
| | - J Okajo
- Department of Nephrology, Maebashi Red Cross Hospital, Gunma, Japan
| | - Y Ishii
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - A Takise
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, Gunma, Japan
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Kamiyoshihara M, Igai H, Ibe T, Kawatani N, Shiraishi I, Obayashi K, Nakazawa S, Ohtaki Y, Shimizu K, Takeyoshi I. Anatomical segmentectomy of the lung: tip of identifying the intersegmental plane. J Cardiothorac Surg 2013. [PMCID: PMC3844749 DOI: 10.1186/1749-8090-8-s1-o226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Kamiyoshihara M, Nagashima T, Igai H, Ohtaki Y, Atsumi J, Shimizu K, Takeyoshi I. Unanticipated troubles in video-assisted thoracic surgery: a proposal for the classification of troubleshooting. Asian J Endosc Surg 2012; 5:69-77. [PMID: 22776367 DOI: 10.1111/j.1758-5910.2011.00122.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 11/01/2011] [Accepted: 11/07/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Most thoracic surgeons encounter atypical cases or unexpected situations that usually lead them to convert minimally invasive surgery to open thoracotomy. But are there other options besides open surgery? The purpose of this study was to suggest a video-assisted thoracic surgery (VATS) classification system and present tips for the application of VATS to atypical cases or unexpected situations. We have categorized VATS procedures for atypical cases or unexpected situations into two groups: the modification of techniques/instruments and the creation of additional access incisions. METHODS We retrospectively reviewed VATS with optional additional techniques. We used direct visualization or monitoring as the situation demanded, switching back and forth between the monitor and direct vision. RESULTS Of the 33 cases we reviewed, 27 patients had malignant lung disease and 6 had benign lung disease. All patients underwent lobectomies including one or more of the following: bronchoplasty (n = 12), control of the main pulmonary artery (n = 9), total adhesiotomy (n = 7), combined resection with the diaphragm (n = 3), and separation of totally fused fissures (n = 2). The mean length of the skin incision was 8 cm, the mean total operating time was 208 min, and the mean blood loss was 173 mL No operative or hospital deaths occurred. CONCLUSIONS Veteran surgeons can instinctively deal with intraoperative variance, but we frequently see inexperienced surgeons panic and change the course of their procedures. A VATS classification system may have educational benefits for newer surgeons. We believe that the creation of a categorized coping plan will help inexperienced surgeons deal with unanticipated problems.
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Affiliation(s)
- M Kamiyoshihara
- Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Japan.
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16
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Nakano T, Shimizu K, Kawashima O, Kamiyoshihara M, Nagashima T, Ibe T, Takeyoshi I. Effect of landiolol hydrochloride, an ultra-short-acting beta 1-selective blocker, on supraventricular tachycardia, atrial fibrillation and flutter after pulmonary resection. J Clin Pharm Ther 2011; 37:431-5. [PMID: 22059486 DOI: 10.1111/j.1365-2710.2011.01315.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Supraventricular tachycardia is a common complication after pulmonary resection. The objective of this study was to investigate the efficacy of landiolol hydrochloride, an ultra-short-acting β1-blocker, in patients with post-operative supraventricular tachycardia after pulmonary resection. METHODS The response to continuous intravenous infusion of landiolol was evaluated in 25 patients who developed post-operative atrial fibrillation or atrial flutter after major pulmonary resection. Four patients had preoperative rate-controlled chronic atrial fibrillation. The heart rate and blood pressure were compared before and after infusion of landiolol. Side effects and recurrence of supraventricular tachycardia after termination of landiolol infusion were also monitored. RESULTS AND DISCUSSION The heart rate was reduced from 135±24 bpm before landiolol infusion to a plateau rate of 85±19 bpm during infusion (P<0·0001). Heart rate reduction occurred in all but two patients. Conversion to normal sinus rhythm from supraventricular tachycardia occurred in 14 patients (56%). Recurrence of supraventricular tachycardia after stopping landiolol infusion was observed in 17 patients (68%), but all patients without preoperative AF were cured of post-operative AF. There were no detectable side effects, including no adverse influence on the circulatory and respiratory systems. WHAT IS NEW AND CONCLUSION Continuous intravenous infusion of landiolol was found to be effective and safe for supraventricular tachycardia after pulmonary resection.
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Affiliation(s)
- T Nakano
- Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
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17
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Kamiyoshihara M, Nagashima T, Igai H, Atsumi J, Ibe T, Kakegawa S, Shimizu K. Video-assisted thoracic lobectomy with bronchoplasty for lung cancer, with special reference to methodology. Interact Cardiovasc Thorac Surg 2011; 12:534-8. [DOI: 10.1510/icvts.2010.258228] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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18
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Kakegawa S, Kamiyoshihara M, Ohtaki A, Ohki S, Morishita Y. [Surgical fixation of the ribs for flail chest injuries]. Kyobu Geka 2006; 59:974-9. [PMID: 17058657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The record of 20 patients presenting with flail chest injury from 1998 to 2005 was reviewed to determine surgical indication and timing. There were 4 groups with each indication as followed: 1) 8 patients with surgical indication for injury regions other than fractured ribs, 2) 5 without improvement of flail chest after internal pneumatic stabilization for more than 10 days, 3) 4 performed surgical fixation positively for flail chest with respiratory failure, 4) 3 with strong deformation of the thorax without respiratory failure. Eight patients (40%) required artificial respiration for more than 6 days after surgical stabilization. The reasons of prolonged artificial respiration included unconsciousness in 4 patients, pneumonia in 2, and others in 2. In the group consisting of 8 patients taking more than 6 days to be extubated after surgical fixation, the injury severity score (ISS) was significantly higher (p = 0.006) than that of the other group. In patients with no improvement of flail chest after internal pneumatic stabilization for more than 10 days, surgical fixation reduces the period of internal pneumatic stabilization and the risk of pneumonia. For the elderly who can develop complications easily, early indication of surgical fixation should be considered. In patients with unconsciousness or ISS > or = 25, the extubation delays frequently after surgical fixations.
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Affiliation(s)
- Seiichi Kakegawa
- Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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Kamiyoshihara M, Kakegawa S, Kawashima O, Sugano M, Nagashima T, Otani Y, Shimizu K, Nakano T, Ibe T, Morishita Y. [Surgical resection of T3 and T4 lung cancer]. Kyobu Geka 2005; 58:954-8. [PMID: 16235842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Lung cancer invading neighboring anatomical structures such as the chest wall, pericardium, diaphragm, and left atrium are categorized as T3 or T4, which is regarded as locally advanced lung cancer. The purpose of this study was to evaluate results of surgical treatment of T3-4N0-2M0 non-small cell lung cancer according to involved organs. From 1981 to April 2005, 148 patients with lung cancer invading neighboring organs were surgically treated in our hospital. The 5-year survival was 41.4% in all cases. According to 5-year survival of clinical characteristics, the chest wall (parietal pleura) group (45.5%) had a significantly better prognosis compared with the left atrium (0%, p = 0.03) and diaphragm (0%, p = 0.04) groups. T3N0 (50.3%), IIB (55.4%), IIIA (44.6%), and complete resection groups (49.0%) showed a significantly better prognosis compared with T3N2 (27.9%, p = 0.01), III B (0%, p < 0.0001), and incomplete resection groups (13.9%, p < 0.0001), respectively. These results indicate that the prognosis of patients with N2 disease or incomplete resection remains poor in regardless with the type of involved organs.
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Affiliation(s)
- M Kamiyoshihara
- Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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Otani Y, Shimizu K, Nakano T, Ibe T, Kakegawa S, Kamiyoshihara M, Sugano M, Kawashima O, Morishita Y. P-907 Is reduction surgery of lung cancer for old patients withcomplication appropriate? Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kaira K, Takise A, Kobayashi G, Kamiyoshihara M, Mori M. Pulmonary adenocarcinoma presenting as a giant pleural mass. Thorax 2005; 60:356. [PMID: 15790997 PMCID: PMC1747372 DOI: 10.1136/thx.2004.036509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K Kaira
- Maebashi Red Cross Hospital, Department of Respiratory Medicine, 3-21-36 Asahi-cho, Maebashi, Gunma 377-0014, Japan.
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Otani Y, Shimizu K, Nakano T, Kawashima O, Sugano M, Kamiyoshihara M, Kakegawa S, Ibe T, Morishita Y. [Perioperative management for lung cancer with interstitial pneumonia]. Kyobu Geka 2005; 58:46-51. [PMID: 15678966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The purpose of this study was to review perioperative managements from the clinical features and the postoperative course of lung cancer patients with interstitial pneumonia (IP). Twenty-two patients with IP were divided into 2 groups: the acute exacerbation (AE) group (6 patients) and the non-acute exacerbation (NAE) group (16 patients). There was no significant difference in the patient background between the 2 groups. In hematological examination, KL-6 levels were significantly higher in the AE group than in the NAE group. There was no significant difference in the respiratory function tests in the both groups, and the heart rate after 2 flights test was significantly higher in the AE group than in the NAE group. There was no significant difference in operation-related factors, tumor-related factors and the postoperative course in the both groups. No postoperative death occurred in our 22 patients probably due to adequate treatments of IP which was managed by our detailed manual. Long-term follow-up for lung cancer patients with IP undergoing surgical intervention is needed to prevent AE.
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Affiliation(s)
- Yoshimi Otani
- Department of Thoracic and Visceral Organ Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
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Kamiyoshihara M, Otaki A, Nameki T, Kawashima O, Otani Y, Morishita Y. [Duodenal metastasis from squamous cell carcinoma of the lung; report of a case]. Kyobu Geka 2004; 57:151-3. [PMID: 14978913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Metastatic carcinoma from primary lung cancer is usually recognized in the brain, adrenal glands, and bone. It is uncommon in the digestive system, particularly in the duodenum. We report a 63-year-old man who had undergone a left lower lobectomy for lung cancer. Anemia (Hb 6.9 g/dl) had been observed 2 months after surgery for primary lung cancer. Gastroduodenoscopy showed duodenal metastasis, and further examination demonstrated adrenal metastasis. Palliative treatment was selected and the patient died 5 months after surgery.
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Affiliation(s)
- M Kamiyoshihara
- Department of Chest Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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Kawashima O, Sugano M, Kakegawa S, Kamiyoshihara M, Shimizu K, Otani Y, Morishita Y. [The clinicopathological features of peripheral small-sized (2 cm or less) squamous cell carcinoma of the lung]. Kyobu Geka 2004; 57:56-60. [PMID: 14733100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Recently the diagnosis of peripheral small-sized lung cancers has increased with the development of computed tomography. The vast majority of them are adenocarcinoma, whereas squamous cell carcinoma is rare. From 1981 to 2002, 1,054 patients underwent pulmonary resection for primary lung cancer in National Nishigunma Hospital. Among of them, 17 patients with peripheral small-sized (2 cm or less) squamous cell carcinoma underwent lobectomy and systemic nodal dissection were retrospectively reviewed. These were 15 men and 2 women, with a mean age of 68 years (range, 56-75). Regarding the pathologic stage, 15 patients were classified in stage IA, 1 in IIA, and 1 in IIIA. Among of them, only 1 patient with n 2 disease died of cancer at 17 months after surgery. Overall 5-year and 10-year survival rates of this disease were 84.4% and 73.8%, respectively. Based on the present data, we conclude that mediastinal nodal dissection would be unnecessary in the patients with peripheral small-sized squamous cell carcinoma of the lung.
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Affiliation(s)
- O Kawashima
- Department of Thoracic Surgery, National Nishigunma Hospital, Shibukawa, Japan
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Kimura C, Kamiyoshihara M, Sakata K, Itoh H, Morishita Y. [Mediastinal mature teratoma perforating into the lung with elevated serum carbohydrate antigen 19-9 (CA19-9) levels; report of a case]. Kyobu Geka 2003; 56:247-50. [PMID: 12649920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
A 17-year-old woman was suddenly seized with anterior chest pain and admitted to our hospital. Chest X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass shadow in the left middle lung field associated with the left pleural effusion and high serum carbohydrate antigen 19-9 (CA 19-9) levels (58.5 U/ml). We performed a total resection of the tumor with adherent parts of the left lung. The tumor was 6.5 x 3. 8 x 2.9 cm in size, and was made up of soft tissues, fluid and cystic components. The histological diagnosis was a mature cystic teratoma with perforation into the lung, which contained pancreatic tissues, hepatic cells, bronchial epithelium, serous glands and so on. The levels of fluid amylase and CA 19-9 were high. We report mediastinal mature teratoma perforating into the lung and discuss the mechanism of perforation.
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Affiliation(s)
- C Kimura
- Department of Surgery, Maebashi Red-Cross Hospital, Maebashi, Japan
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Kamiyoshihara M, Kawashima O, Otani Y, Morishita Y. Clinical significance of the preoperative serum-soluble intercellular adhesion molecule-1 in non-small cell lung cancer. J Cardiovasc Surg (Torino) 2002; 43:729-34. [PMID: 12386593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND The serum-soluble intercellular adhesion molecule-1 (sICAM-1) is reported to correlate with both the metastatic potential and a poor prognosis. We analyzed the sICAM-1 concentrations and investigated whether or not the serum levels of these adhesion molecules in the peripheral venous blood could help predict the clinical staging in patients with NSCLC. METHODS From January to December 1999, 66 patients (79.5%) underwent either a lobectomy or a pneumonectomy with a mediastinal lymph node dissection at the National Sanatorium Nishi-Gunma Hospital. RESULTS The sICAM-1 concentration in the NSCLC patients was a mean value of 212.0+/-106.6 ng/ml. In contrast, the concentration of sICAM-1 in 20 healthy controls was a mean value of 117.9+/-64.1 ng/ml. In patients with NSCLC, the sICAM-1 concentrations were significantly higher than in the normal control group (p=0.002). In addition, the difference in the serum concentrations was significant between the patients with T1 and T2 disease (p=0.042), and N0 and N2 patients (p=0.042). No significant differences were observed in aging, smoking history, histological type, or pathological staging. CONCLUSIONS The sICAM-1 concentrations in lung cancer patients are thus suggested to play a role in staging, and may also serve as a useful indicator of advanced disease.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan.
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Kamiyoshihara M, Sakata K, Ichikawa H, Ishikawa S, Morishita Y. [Congenital tracheoesophageal fistula; report of an adult case]. Kyobu Geka 2002; 55:261-3. [PMID: 11889818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
We experienced an adult case of congenital tracheoesophageal fistula which was successfully treated by surgical intervention. A 69-year-old female was admitted with complaint of coughing and fever. The patient previously had had several episodes of pneumonia. Esophagography and thoracic CT demonstrated a tracheoesophageal fistula in the upper of the thoracic esophagus. Following the resection of the fistula, the trachea was closed with one layer suture and the esophagus was closed with two layer sutures. A pedicled fifth intercostal muscle was interposed between the tracheal and esophageal suture lines. There was mild inflammatory change in surrounding tissues of the fistula. Pathological examination revealed that the fistula was covered with the squamous epithelium, and had the muscularis mucosa. Her postoperative course was uneventful.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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Kawashima O, Kakegawa S, Otani Y, Kamiyoshihara M, Sugano M, Morishita Y. [Clinical study of synchronous multiple primary lung cancers; problems in diagnosis and treatment]. Kyobu Geka 2002; 55:20-4. [PMID: 11797403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We evaluated retrospectively 33 patients with synchronous multiple primary lung cancers. These were 20 men and 13 women, with a mean age of 67 years (range, 51-79 years). In 27 cases, the tumors were located in the ipsilateral lung, and in 6 cases, they were in the bilateral lung. In patients with synchronous multiple primary lung cancers, combinations of adenocarcinoma and adenocarcinoma (12 cases, 36.4%), adenocarcinoma and others (6 cases, 18.2%) were most commonly observed histologically. Lobectomy was performed in 18, bi-lobectomy in 3, pneumonectomy in 4, lobectomy with partial resection in 6, and lobectomy with laser therapy or irradiation in 2 patients. Overall 5-year survival rate of this disease was 78.3%. Eight patients died within 1 year after surgical resection, and 2 of them died of treatment-related accident. Although optimal treatment of choice for synchronous multiple primary lung cancers remains an unresolved problem, we think that careful planning of the treatment for this disease including selection of surgical methods is much important.
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Affiliation(s)
- O Kawashima
- Department of Thoracic Surgery, National Nishigunma Hospital, Shibukawa, Japan
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29
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Kamiyoshihara M, Sakata K, Ishikawa S, Morishita Y. [Pulmonary embolism following lung resection: a case report and review of the Japanese literature]. Kyobu Geka 2001; 54:1149-52. [PMID: 11761905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
A 73-year-old male was admitted to our hospital with an abnormal shadow on a chest X-ray film. Chest CT demonstrated that a tumor shadow measuring 23 x 22 mm in size with pleural retraction was located in the right lower lobe. Transbronchial lung biopsy yielded a diagnosis of primary pulmonary adenocarcinoma. We performed a right lower lobectomy with mediastinal lymph node dissection. The patient suddenly complained of a syncope attack, tachycardia, hypotension, and hypoxemia 2 days after surgery. A perfusion lung scintigram with Tc-99 m macroaggregated albumin demonstrated localized defects at both the left lower lobe and a part of the left upper lobe. Thrombolytic and anticoagulation therapy with urokinase and heparin were immediately started. A postoperative lung scintigram 14 days after the onset of pulmonary thromboembolism showed normal filling of the left lung. The patient was discharged on the 37th postoperative day, and he has been followed up with anticoagulation therapy.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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30
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Kamiyoshihara M, Sakata K, Ishikawa S, Morishita Y. Cerebral arterial air embolism following CT-guided lung needle marking. Report of a case. J Cardiovasc Surg (Torino) 2001; 42:699-700. [PMID: 11562605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We report a case of survival following a temporary cerebral air embolism, which occurred immediately after CT guided lung needle marking. A 24-year-old man was referred to our hospital for resection of a pulmonary nodule. To localize the tumor, lung needle marking under CT guidance was performed. Almost immediately, the patient experienced symptoms of cerebral arterial air embolism. The following day, the symptoms diminished, and a brain CT showed no abnormal lesions. A video-assisted thoracoscopic wedge resection was performed as scheduled, the patient's postoperative course was uneventful, and he was discharged in relatively good condition.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511 Japan.
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31
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Kamiyoshihara M, Ishikawa S, Morishita Y. Sudden death due to rupture of an omental metastatic tumor arising from cardiac angiosarcoma. A case report. J Cardiovasc Surg (Torino) 2001; 42:495-7. [PMID: 11455285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A 32-year-old man underwent surgical excision of a malignant hemangioendothelioma of the heart and received multidisciplinary treatment. Thirty-three months later, he underwent a second surgical treatment for a recurrent tumor of the posterior chest wall of the right thorax. Five months after this surgery (thirty-eight months after the initial surgery), a second recurrent tumor in the right thorax developed. Although radiotherapy and recombinant interleukin-2 were administered, anemia of unknown origin (hemoglobin 6.7 g/dl) developed. The patient died of sudden shock due to a rupture of an omental metastatic tumor. The patient survived for 41 months after the first surgical resection. We present this case because it is the first reported case of sudden death due to bleeding from an omental metastatic tumor, and because our patient was the second-longest survivor after surgical treatment for cardiac angiosarcoma.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, 371-8511 Japan.
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32
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Kamiyoshihara M, Ishikawa S, Ihara N, Morishita Y. [Complete transection of the left main bronchus due to a blunt chest trauma: report of a case]. Kyobu Geka 2001; 54:603-5. [PMID: 11452534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A 62-year-old man was injured in a traffic accident. A chest roentgenogram showed pneumothorax, hemothorax, subcutaneous and mediastinal emphysema, multiple rib fractures, and a shift of the trachea to the right. Bilateral thorax drainage was performed, and air leakage from a left chest tube was observed. A chest computed tomogram demonstrated stenosis and deformation of the left main bronchus. Bronchofiberscopy revealed complete obstruction of the left main bronchus by the left main pulmonary artery. An emergency thoracotomy revealed complete transection of the left main bronchus and laceration. End-to-end anastomosis of the left main bronchus was performed with interrupted 4-0 PDS II suture. The patient was discharged at the 33rd hospital day.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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33
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Kamiyoshihara M, Ishikawa S, Kobayashi K, Ito H, Morishita Y. [Mediastinal lymph node carcinoma without apparent primary lesion: report of case]. Kyobu Geka 2001; 54:521-3. [PMID: 11424508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A 62-year-old man with dyspnea had an enlarged lymph node, 6.5 cm in size in the left hilum, but no primary carcinoma could be found. The patient underwent lymph node dissection under video-assisted thoracoscopic surgery, and the histological diagnosis was undifferentiated carcinoma. No primary lesion has been identified even in postoperative survey. The postoperative course was uneventful with no evidence of recurrence eight months after the operation.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Japan
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34
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Abstract
Extralobar pulmonary sequestration was incidentally detected in a 65-year-old man. Preoperatively, the lesion presented as a posterior mediastinal mass. At operation the mass was found to be attached to the paravertebral region at the level of the seventh thoracic vertebra by a feeding artery originating from the descending aorta. Only two cases of extralobar pulmonary sequestration in the posterior mediastinum have been previously reported.
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Affiliation(s)
- M Kamiyoshihara
- Department of Surgery, National Sanatorium Nishi-Gunma Hospital, Maebashi, Japan.
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35
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Kamiyoshihara M, Kawashima O, Ishikawa S, Morishita Y. Mediastinal lymph node evaluation by computed tomographic scan in lung cancer. J Cardiovasc Surg (Torino) 2001; 42:119-24. [PMID: 11292919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Computed tomography (CT) has been widely used for preoperative mediastinal lymph node evaluation in lung cancer. But its accuracy has remained controversial. We studied the predictability of N-staging by CT scan. METHODS From 1981 to 1996, 546 patients had preoperative CT scan and underwent a surgical resection with mediastinal lymph node dissection for primary pulmonary adenocarcinoma and squamous cell carcinoma. Nodes larger than 1.0 cm at short axis were considered abnormal. The discrepancy between clinical and pathologic findings in N factor was analyzed. RESULTS Sensitivity (ST), specificity (SP) and accuracy (AC) were 33.0%, 90.4% and 78.9%, respectively. No statistically significant difference in the results is detected for individual years or types of scanning device. There were statistically significant differences as follows: ST and SP by histologic type, SP by gender, SP and AC by tumor size, SP by Brinkman index, ST by tumor location, and AC by serum CEA value. CONCLUSIONS We should pay attention to false positive nodes in heavy smokers (or males), and positive nodes in adenocarcinoma, tumor larger than 3 cm or rising of serum CEA value, regardless of negative lymph node on CT scan.
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Affiliation(s)
- M Kamiyoshihara
- Department of Surgery, National Sanatorium Nishi-Gunma Hospital, Shibukawa, Gunma, Japan.
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36
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Sakata S, Yoshida I, Otani Y, Kawashima O, Kamiyoshihara M, Ishikawa S, Morishita Y. Video-assisted thoracic surgery (VATS) in a patient with impaired pulmonary function. Surg Endosc 2001; 15:98. [PMID: 11285538 DOI: 10.1007/s004640020074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/1998] [Accepted: 11/16/1999] [Indexed: 10/20/2022]
Abstract
A 72-year-old woman successfully underwent thoracoscopic wedge resection of the lung with the assistance of a minithoracotomy. Poor pulmonary function made her a high-risk operative candidate. Video-assisted thoracic surgery with the assistance of minithoracotomy may be the treatment of choice for high-risk patients with a peripheral pulmonary nodule.
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Affiliation(s)
- S. Sakata
- Second Department of Surgery, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371, Japan
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37
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Kamiyoshihara M, Kawashima O, Sakata S, Hirai T, Ishikawa S, Morishita Y. Management of ipsilateral intrapulmonary metastases in the new TNM system for non-small cell lung cancer. J Cardiovasc Surg (Torino) 2000; 41:931-4. [PMID: 11232979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Recently, the Union Internationale Contre le Cancer and American Joint Committee on Cancer reclassified not only TNM staging but also ipsilateral intrapulmonary metastases (PM) as T4 in a same lobe or M1 in different lobes. To determine whether the new PM staging is appropriate, we studied the prognosis of PM. METHODS From January 1981 to October 1997, we performed a lobectomy or pneumonectomy with mediastinal lymph node dissection, and had 42 patients with PM. We analyzed the postoperative prognosis of the patients with ipsilateral PM compared with the same stage group without PM (the non-PM). RESULTS In the previous classification of PM (the old PM), 2 patients were categorized as stage IIA, 9 as IIB, 17 as IIIA, and 14 as IIIB. After reclassification (the new PM), 37 patients were categorized as stage IIIB, and 5 as IV. The old PM stage IIIA group had a significantly poor prognosis compared with the non-PM stage IIIA. However, the prognosis of the new PM group was compatible with that of the non-PM. None of the other staging group had a significant difference in the prognosis. CONCLUSIONS The management of PM in the new TNM system for non-small cell lung cancer is appropriate.
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MESH Headings
- Adenocarcinoma/pathology
- Adenocarcinoma/secondary
- Adenocarcinoma/surgery
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Adenosquamous/secondary
- Carcinoma, Adenosquamous/surgery
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/secondary
- Carcinoma, Large Cell/surgery
- Carcinoma, Non-Small-Cell Lung/classification
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/secondary
- Carcinoma, Squamous Cell/surgery
- Female
- Humans
- Lung Neoplasms/classification
- Lung Neoplasms/mortality
- Lung Neoplasms/secondary
- Lung Neoplasms/surgery
- Male
- Middle Aged
- Neoplasm Staging
- Pneumonectomy
- Prognosis
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- M Kamiyoshihara
- First Department of Surgery, National Sanatorium Nishi-Gunma Hospital, Shibukawa, Japan.
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38
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Ishikawa S, Kamiyoshihara M, Doi I, Wakamatsu S, Takahashi T, Morishita Y. Sclerosant therapy for delayed cardiac tampo-nade after coronary artery bypass grafting. Jpn Heart J 2000; 41:757-60. [PMID: 11232992 DOI: 10.1536/jhj.41.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 56-year-old Japanese male with delayed cardiac tamponade which occurred 13 months after coronary artery bypass grafting (CABG) is presented. The patient was admitted to our hospital suffering from dypnea due to cardiac tamponade. Pericardiocentesis yielded a viscous bloody fluid. The patient recovered after continuous drainage followed by an intra-pericardial administration of minocycline hydrochloride. Sclerosant therapy is considered to be a treatment of choice for delayed cardiac tamponade following CABG.
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Affiliation(s)
- S Ishikawa
- Second Department of Surgery, Gunma University Faculty of Medicine, Maebashi, Japan
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39
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Sakata S, Kawashima O, Ibe T, Otani Y, Kamiyoshihara M, Sugano M, Nakajima T, Morishita Y. [Evaluation of TNM classification for lung carcinoma with satellite nodules in the same lobe as the primary]. Kyobu Geka 2000; 53:926-8. [PMID: 11048443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We conducted a validation of the treatment of satellite nodules in the UICC TNM classification of 1997. Over the past 17 years (1981 to 1997), 29 patients underwent complete pulmonary resection for primary lung cancer accompanied by satellite nodules in the same lobe as the primary. All these patients were categorized as stage IIIB according to the current staging system. The five-year survival rate of all patients was 40% and the figure was unduly better for stage IIIB patients. The three-year survival rate of 20 patients having lymphatic involvement were 18%, but those of 9 patients without it was 89%. Outcome was significantly influenced on their presence or absence of lymph node metastases. The current staging system for patients with satellite lesions in the same lobe appears to be unacceptable because they provide the different influences on prognosis and selecting treatment modality according to the N status.
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Affiliation(s)
- S Sakata
- Department of Surgery, National Sanatorium Nishigunma Hospital, Gunma, Japan
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40
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Hamada Y, Kawashima O, Sakata S, Yoshida I, Otani Y, Kamiyoshihara M, Morishita Y. [Surgical treatment of bronchial carcinoid: report of seven cases]. Kyobu Geka 2000; 53:857-61. [PMID: 10998866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Seven patients with pulmonary carcinoid including three with typical carcinoid and four with atypical carcinoid were reported. There were 3 males and 4 females, with an age range of 37 to 80 years. All patients with typical carcinoid had pathological stage I. Of the patients with atypical carcinoid, one patient had stage I, two stage IIIA and one stage IIIB. All but two patients underwent lobectomy and mediastinal lymph node dissection. Bronchoplastic operation or right pneumonectomy were performed in the two patients. All but one patient underwent absolute or relative curative operation. Only one patient died on the 4th postoperative day. One patient with atypical carcinoid died of cancer recurrence 4 years after surgery. One patient died of breast cancer. One patient underwent surgery for metachronous multiple lung cancer, and he is doing well without recurrence. In conclusion, a limited operation is thought to be acceptable only in patients with typical carcinoid in a peripheral lesion without lymph node metastasis. Lobectomy and mediastinal lymph node dissection is necessary for the atypical carcinoid case.
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Affiliation(s)
- Y Hamada
- Department of Surgery, National Sanatorium Nishigunma Hospital, Shibukawa, Japan
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41
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Kamiyoshihara M, Ishikawa S, Morishita Y. [Pulmonary cryptococcosis diagnosed by video-assisted thoracoscopic surgery with CT-guided localization: report of a case]. Kyobu Geka 2000; 53:795-7. [PMID: 10935411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We report a case of pulmonary cryptococcosis diagnosed by video-assisted thoracoscopic surgery (VATS) with CT-guided localization. A 61-year-old man was admitted to our hospital for the precise diagnosis of a solitary mass in the left upper lung. Because the mass was too small to be detected under VATS, we tried CT-guided localization for surgery. One day before VATS, we placed a marking device besides the lesions after percutaneous puncture. We used a Naruke point marker as a marking device. After this procedure, the wedge resection was performed. The pathological diagnosis was cryptococcosis of the lung. The identification of small lesions in the lung has frequently been detected by helical and thin slice CT. Therefore, CT-guided localization procedure may be the most reliable technique to employ before surgery.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Japan
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42
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Kawashima O, Kamiyoshihara M, Sakata S, Ishikawa S, Morishita Y. Comparison of two automatic staplers for closing the bronchial stump after pulmonary resection. SCAND CARDIOVASC J 2000; 34:87-9. [PMID: 10816067 DOI: 10.1080/14017430050142468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The incidence of complications following pulmonary resection using an automatic stapler was studied in 348 consecutive patients. A parallel-jaw stapler with two staple lines was used in group A (133 males, 101 females, mean age 66 years) between 1990 and 1995, and a hinged-jaw stapler with three staple lines in group B (70 males, 44 females, mean age 67 years) in 1995-1997. The incidence of bronchopleural fistula was 0.4% (1 patient) in group A and nil in group B. The incidence of intraoperative air leak requiring interrupted suture closure was 4.7% (11 patients) in group A and nil in group B (p < 0.05). Postoperative bronchopleural fistula did not develop in any of the cases, and there was no mortality. For management of the bronchial stump after pulmonary resection, the newer device firing three rows of staples is superior to the two-row device.
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Affiliation(s)
- O Kawashima
- Department of Surgery, National Sanatorium Nishigunma Hospital, Shibukawa, Gunma, Japan.
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43
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Kamiyoshihara M, Hamada Y, Ishikawa S, Iizuka T, Nakano M, Morishita Y. [Hyperbaric oxygen as an adjunctive treatment for descending necrotizing mediastinitis: report of a case]. Kyobu Geka 2000; 53:715-7. [PMID: 10935394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We report a case of 59-year-old man of descending necrotizing mediastinitis (DNM) secondary to peritonsillar abscess. A 59-year-old man with diabetes mellitus was admitted to a local hospital because of cervical swelling related to a peritonsillar abscess. Despite administration of antibiotics, swelling of the neck, dysphagia and dyspnea deteriorated. Therefore he was urgently undergone a tracheotomy and transferred to our hospital by an ambulance. The surgery consisted with neck and anterior mediastinal drainage through neck and cervical collar incision. Culture of drainage fluid showed clostridium difficile. On postoperative day 5, we started hyperbaric oxygen therapy (HBOT). After lavage and HBOT, the patient improved by degrees, and discharged on postoperative day 82. DNM is a rare but serious complication of otopharyngeal and deep neck infection that spreads down to the mediastinum through the cervical-facial planes. Its mortality rate remains high even with aggressive surgical drainage and appropriate antibiotics. Our patient was successfully treated with urgent surgical drainage, antibiotics and HBOT. HBOT might be of great value as an adjunctive management to control this fatal infection.
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Affiliation(s)
- M Kamiyoshihara
- Department of Thoracic and Cardiovascular Surgery, Maebashi Red Cross Hospital, Japan
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Kamiyoshihara M, Kawashima O, Ishikawa S, Morishita Y. Long-term results after pulmonary resection in elderly patients with non-small cell lung cancer. J Cardiovasc Surg (Torino) 2000; 41:483-6. [PMID: 10952346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND The number of elder by patients with lung cancer is expected to increase. But, there was no report that 10 years completely passed in surgically treated elderly patients (E-pts). This study assesses late results of surgery. METHODS From 1981 to 1987, 160 patients with non-small cell lung cancer underwent lobectomy or pneumonectomy with mediastinal lymph node dissection. Of these, 37 (23%) were 70 years of age or older. The outcome of this group was compared with that of 123 non-elderly patients (NE-pts). RESULTS There were no significant differences in the background between E-pts and NE-pts. Five- and 10-year survivals in the E-pts were 35.1%, and 24.3%, respectively. In outcome more than 5 years from operation, E-pts had a significantly poorer prognosis than NE-pts (p=0.04) by any causes of death, but a similar prognosis by primary death. E-pts died of nontumor-related death significantly more than NE-pts (p=0.6). CONCLUSIONS This study showed that E-pts could consummate their lives completely. Additionally, when long-term prognosis of the postoperative E-pts was discussed, we should contemplate that E-pts had more deaths from nontumor-related causes.
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Affiliation(s)
- M Kamiyoshihara
- Department of Surgery, National Sanatorium, Nishi-Gunma Hospital, Shibukawa, Japan.
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45
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Kawashima O, Kamiyoshihara M, Sakata S, Endo K, Saito R, Morishita Y. The clinicopathological significance of preoperative serum-soluble interleukin-2 receptor concentrations in operable non-small-cell lung cancer patients. Ann Surg Oncol 2000; 7:239-45. [PMID: 10791856 DOI: 10.1007/bf02523660] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Serum-soluble interleukin-2 receptor (IL-2R) concentrations have been found to be elevated in cancer patients. However, the importance of this finding in patients with non-small-cell lung cancer (NSCLC) has not been previously established. METHODS Preoperative serum-soluble IL-2R concentrations were determined in 65 consecutive patients with operable NSCLC. The correlation of preoperative serum-soluble IL-2R concentrations with various clinicopathological features of this cancer was evaluated to clarify the clinical significance of this parameter. RESULTS Although serum-soluble IL-2R concentrations were not significantly higher in operable NSCLC patients than in normal controls (P = .1180), serum-soluble IL-2R concentrations were significantly higher in patients with stage IIIB or IV disease than in normal controls (P = .0001). The presence of intrapulmonary metastasis was the only clinicopathological feature that was significantly correlated to serum-soluble IL-2R concentration (P = .0004). The sensitivity of serum-soluble IL-2R concentration in identifying the presence of intrapulmonary metastasis was 87.5%; specificity was 75%. CONCLUSIONS Elevated preoperative serum-soluble IL-2R concentrations in patients with operable NSCLC reflect the occurrence of intrapulmonary metastasis. Preoperative examination of serum-soluble IL-2R concentrations may be valuable in the detection of the intrapulmonary metastasis preoperatively.
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Affiliation(s)
- O Kawashima
- Department of Surgery, National Sanatorium Nishigunma Hospital, Shibukawa, Gunma, Japan.
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46
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Kamiyoshihara M, Kawashima O, Ishikawa S, Morishita Y. [Retroperitoneal lipoma through the foramen of Bochdalek detected as a mass of chest roentgenogram: report of a case]. Kyobu Geka 1999; 52:1141-3. [PMID: 10589200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Retroperitoneal lipomas are relatively uncommon. They are generally asymptomatic tumors. We experienced a 70-year-old man who had retroperitoneal lipoma detected as a mass of chest roentgenogram. Transcutaneous needle biopsy yielded a diagnosis of lipoma. We performed surgical resection because the tumor was growing. The complete resection of the tumor was done uneventfully. The pathological diagnosis of the tumor was benign mature lipoma. The sagittal view of the chest MRI gave precise and useful anatomical informations. This tumor was considered to originate from the retroperitoneal fatty tissue at the subdiaphragmatic region and to extend into the posterior mediastinum though the foramen of Bochdalek. We present herein this case because of a unique growing form, which is the first report in the Japanese literature to our knowledge.
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Affiliation(s)
- M Kamiyoshihara
- Department of Surgery, National Sanatorium Nishi-Gunma Hospital, Maebashi, Japan
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47
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Sakata S, Yoshida I, Otani Y, Kawashima O, Kamiyoshihara M, Ishikawa S, Morishita Y. Carbon dioxide insufflation aids video-assisted thoracic surgery in a young child. Thorac Cardiovasc Surg 1999; 47:399-400. [PMID: 10670803 DOI: 10.1055/s-2007-1013185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 3-year-old girl with pectus excavatum successfully underwent exploration using video-assisted thoracic surgery. A complete pericardial defect was identified. The lung was kept totally collapsed during the procedure using low-flow (1 L/min), low-pressure (7 mmHg) carbon dioxide insufflation. This technique is expected to be a safe adjunct to thoracoscopic procedures in infants and small children.
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Affiliation(s)
- S Sakata
- Second Department of Surgery, Gunma University School of Medicine, Japan
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Abstract
A 58-year-old man was found to have a basaloid carcinoma of the thymus, initially detected as an abnormal shadow on chest radiograph. The patient underwent resection followed by radiotherapy, and has survived 25 months without recurrence. Although this rare tumor may be related to multilocular thymic cyst, its pathogenesis is obscure. We discuss clinicopathologic features of our case and others.
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Affiliation(s)
- O Kawashima
- Department of Surgery, National Sanatorium Nishigunma Hospital, Shibukawa, Gunma, Japan.
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Kawashima O, Kurihara T, Kamiyoshihara M, Sakata S, Ishikawa S, Morishita Y. Management of malignant pericardial effusion resulting from recurrent cancer with local instillation of aclarubicin hydrochloride. Am J Clin Oncol 1999; 22:396-8. [PMID: 10440198 DOI: 10.1097/00000421-199908000-00015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
To determine the efficacy of aclarubicin hydrochloride in local control of malignant pericardial effusion, the authors carried out a trial of pericardial drainage with local administration of this agent in five patients, whose effusions had produced cardiac tamponade. All patients were women, and their primary cancers, all initially treated surgically, had arisen in the breast (two patients), or lung (three patients). Mean patient age was 54.2 years (range, 43-62). In four patients, improvement permitted removal of the drainage catheter. Two patients (40%) had a complete remission of the malignant pericardial effusion. The other three patients were difficult to evaluate because nonpericardial metastases limited their survival. All patients, however, showed disappearance of malignant cells from the pericardial sac with no cytopathologically demonstrable recurrence. In our few patients, intrapericardial aclarubicin appeared to be highly effective against malignant pericardial effusion.
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Affiliation(s)
- O Kawashima
- Department of Surgery, National Sanatorium Nishigunma Hospital, Shibukawa, Gunma, Japan
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Kamiyoshihara M, Kawashima O, Sakata S, Hirai T, Ishikawa S, Morishita Y. Does an incomplete interlobar fissure influence survival or recurrence in resected non-small-cell lung cancer? Lung Cancer 1999; 25:33-8. [PMID: 10466860 DOI: 10.1016/s0169-5002(99)00047-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE There have been various reports on prognostic factors in non-small-cell lung cancer (NSCLC) under a complete resection, but an incomplete interlobar fissure has not been discussed yet. We attempted to clarify whether this influences survival or recurrence. PATIENTS AND METHODS From 1981 to 1994, 239 patients (43%) who had a single lobectomy with mediastinal lymph node dissection were pathologically diagnosed as stage IA/IB or IIA/IIB (excluding T3N0M0). These patients were divided in two groups: patients with a complete interlobar fissure group (group L); and patients with an incomplete one (group NL). Postoperative survivals and cancer-free periods were retrospectively assessed. Patients' characteristics had no statistical difference between groups L and NL by N category. RESULTS The 5-year survival was 77.0% in group L-N0, 79.3% in group NL-N0, 48.7% in group L-N1, and 66.2% in group NL-N1. No statistical difference was found between groups L-N0 and NL-N0, L-N1 and NL-N1, L-T1N0 and NL-T1N0, L-T1N1 and NL-T1N1, L-T2N0 and NL-T2N0, and L-T2N1 and NL-T2N1. The 5-year-relapse-free survival was 81.2% in group L-N0, 85.4% in group NL-N0, 69.4% in group L-N1, and 72.2% in group NL-N1. No statistical difference was found between groups L-N0 and NL-N0, L-N1 and NL-N1, L-T1N0 and NL-T1N0, L-T1N1 and NL-T1N1, L-T2N0 and NL-T2N0, and L-T2N1 and NL-T2N1. There was no statistical difference in recurrent sites between groups L-N0 and NL-N0, and L-N1 and NL-N1. CONCLUSION We conclude that the incomplete interlobar fissure does not influence the prognosis of resected stage I or II NSCLC (excluding T3N0M0).
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Affiliation(s)
- M Kamiyoshihara
- Department of Surgery, National Sanatorium Nishi-Gunma Hospital, Shibukawa, Gunma, Japan.
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