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Mitsui S, Tanaka Y, Nishikubo M, Doi T, Tane S, Hokka D, Mitomo Y, Maniwa Y. Safety and efficacy of new staple-line reinforcement in lung resection: a prospective study of 48 patients. Surg Today 2024:10.1007/s00595-024-02798-x. [PMID: 38381178 DOI: 10.1007/s00595-024-02798-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/22/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE To evaluate the safety and efficacy of new staple-line reinforcement (SLR) in pulmonary resection through a prospective study and to compare the results of this study with historical control data in an exploratory study. METHODS The subjects of this study were 48 patients who underwent thoracoscopic lobectomy. The primary endpoint was air leakage from the staple line. The secondary endpoints were the location of air leakage, duration of air leakage, and postoperative pulmonary complications. RESULTS The incidence of intraoperative air leakage from the staple line was 6.3%. Three patients had prolonged air leakage as a postoperative pulmonary complication. No malfunction was found in patients who underwent SLR with the stapling device. When compared with the historical group, the SLR group had a significantly lower incidence of air leakage from the staple line (6.3% vs. 28.5%, P < 0.001) and significantly shorter indwelling chest drainage time (P = 0.049) and length of hospital stay (P < 0.001). CONCLUSIONS The use of SLR in pulmonary resection was safe and effective. When compared with conventional products, SLR could control intraoperative air leakage from the staple line and shorten time needed for indwelling chest drainage and the length of hospital stay.
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Affiliation(s)
- Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Megumi Nishikubo
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yuji Mitomo
- Clinical and Translational Research Center, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
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Tanaka Y, Tane S, Doi T, Mitsui S, Nishikubo M, Hokka D, Maniwa Y. Factors affecting the short-term outcomes of robotic-assisted thoracoscopic surgery for lung cancer. Surg Today 2024:10.1007/s00595-024-02797-y. [PMID: 38334800 DOI: 10.1007/s00595-024-02797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/12/2023] [Indexed: 02/10/2024]
Abstract
PURPOSE Robotic-assisted thoracoscopic surgery (RATS) is a relatively new approach to lung cancer surgery. To promote the development of RATS procedures, we investigated the factors related to short-term postoperative outcomes. METHODS We analyzed the records of patients who underwent RATS lobectomy for primary lung cancer at our institution between June, 2018 and January, 2023. The primary outcome was operative time, and the estimated value of surgery-related factors was calculated by linear regression analysis. The secondary outcome was surgical morbidity and the risk was assessed by logistic regression analysis. RESULTS The study cohort comprised 238 patients. Left upper lobectomy had the longest mean operative time, followed by right upper lobectomy. Postoperative complications occurred in 13.0% of the patients. Multivariate analysis revealed that upper lobectomy, the number of staples used for interlobular fissures, and the number of cases experienced by the surgeon were significantly associated with a longer operative time. The only significant risk factor for postoperative complications was heavy smoking. CONCLUSION Patients with well-lobulated middle or lower lobe lung cancer who are not heavy smokers are recommended for the introductory period of RATS lobectomy. Improving the procedures for upper lobectomy and dividing incomplete interlobular fissures will promote the further development of RATS.
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Affiliation(s)
- Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan.
| | - Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Megumi Nishikubo
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
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Tane S, Tanaka Y, Nishikubo M, Doi T, Hokka D, Maniwa Y. Console and bedside surgeon fused robot-assisted thoracic surgery. Gen Thorac Cardiovasc Surg 2023; 71:730-732. [PMID: 37525063 DOI: 10.1007/s11748-023-01964-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
In the last decade, even thoracic surgery has seen an increase in the use of robotic surgical systems, and robot-assisted thoracic surgery (RATS) is considered one of the main issues. While RATS is associated with solo manipulative freedom and high-definition optical systems, several disadvantages, such as the lack of tactile sensation and difficult learning curves for the whole team, have been raised. Therefore, to overcome these issues, we developed a 'fusion surgery' approach combining a robotic procedure with manual maneuvers, where the table surgeon retracts the lung and staples the pulmonary vasculature and bronchus. Herein, we introduce our 'fusion surgery' procedure and elaborate on its advantage from technical and educational perspectives.
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Affiliation(s)
- Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ward, Kobe, 650-0017, Japan.
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ward, Kobe, 650-0017, Japan
| | - Megumi Nishikubo
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ward, Kobe, 650-0017, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ward, Kobe, 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ward, Kobe, 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ward, Kobe, 650-0017, Japan
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Nishikubo M, Tanaka Y, Mitsui S, Doi T, Hokka D, Hojo W, Sakai H, Funakoshi Y, Yakushijin K, Ohji G, Minami H, Maniwa Y. Comparable efficacy and safety of COVID-19 vaccines for patients receiving tegafur-uracil as postoperative adjuvant chemotherapy. Surg Today 2023; 53:1057-1063. [PMID: 36752867 PMCID: PMC9907870 DOI: 10.1007/s00595-023-02649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 01/05/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE Many effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed, but a weaker response in individuals undergoing anticancer treatment has been reported. This study evaluates the immunogenic status and safety of SARS-CoV-2 vaccines for patients with non-small-cell lung cancer (NSCLC), receiving tegafur-uracil (UFT) as postoperative adjuvant chemotherapy. METHODS The subjects of this prospective study were 40 patients who underwent surgery for NSCLC and received SARS-CoV-2 vaccines postoperatively. We compared the antibody titers of SARS-CoV-2 vaccines and the adverse events between patients who received adjuvant UFT and patients who did not. RESULTS The mean anti-S1 IgG titers were not significantly different between the UFT and without-UFT groups (mean optimal density, 0.194 vs. 0.205; P = 0.76). Multivariate analysis identified the period after the second vaccination as an independent predictor of anti-S1 IgG titer (P = 0.049), but not the UFT status (with or without-UFT treatment; P = 0.47). The prevalence of adverse events did not differ significantly between the groups, and no severe adverse events occurred. CONCLUSIONS The efficacy and safety of the SARS-CoV-2 vaccines for NSCLC patients who received postoperative adjuvant UFT chemotherapy were comparable to those for NSCLC patients who did not receive postoperative adjuvant UFT chemotherapy. CLINICAL TRIAL REGISTRATION This study was registered with the University Hospital Medical Information Network (UMIN) in Japan (UMIN000047380).
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Affiliation(s)
- Megumi Nishikubo
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Suguru Mitsui
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Wataru Hojo
- R&D, Cellspect Co., Ltd., 2-4-23 Kitaiioka, Morioka, Iwate, 020-0857, Japan
| | - Hironori Sakai
- R&D, Cellspect Co., Ltd., 2-4-23 Kitaiioka, Morioka, Iwate, 020-0857, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Goh Ohji
- Division of Infection Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
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Mitsui S, Tanaka Y, Jimbo N, Doi T, Tane S, Hokka D, Maniwa Y. Programmed death ligand-1 expression and occult lymph node metastasis in non-small cell lung cancer. Thorac Cancer 2023. [PMID: 37160414 DOI: 10.1111/1759-7714.14922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Identifying the preoperative risk factors for lymph node upstaging could contribute to the development of individualized perioperative treatment for patients with non-small cell lung cancer (NSCLC). The current study aimed to evaluate the risk factors for lymph node upstaging, including gene mutation and programmed death ligand-1 expression in patients with resectable NSCLC. METHODS Data on the clinicopathological characteristics of patients who underwent lobectomy for clinical N0 NSCLC at our institution were collected. The clinicopathological findings of the pathological N0 and lymph node upstaging groups were then analyzed. Univariate and multivariate analyses were performed to examine the predictive factors for nodal upstaging. RESULTS Of 291 patients, 40 had postoperative nodal upstaging (n = 25, N1; n = 15, N2). Large tumor size and high maximum standardized uptake value were significantly associated with nodal upstaging. The nodal upstaging group had a higher proportion of patients with solid adenocarcinoma and lymphatic, vascular, and pleural invasion than the pathological N0 group. Further, the nodal upstaging group had a higher proportion of patients with positive programmed death ligand-1 expression than the pathological N0 group. Univariate and multivariate analyses showed that tumor size and positive programmed death ligand-1 expression were associated with nodal upstaging. CONCLUSION The appropriate therapeutic strategy including preoperative treatment and resection should be cautiously considered preoperatively in patients with clinical N0 NSCLC who have large tumors and positive programmed death ligand-1 expression.
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Affiliation(s)
- Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Miura K, Doi T, Tanaka Y, Hokka D, Jimbo N, Itoh T, Maniwa Y. Effect of myasthenia gravis on the surgical outcomes of patients with thymoma. Asian Cardiovasc Thorac Ann 2022; 30:924-930. [PMID: 35898168 DOI: 10.1177/02184923221116679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Myasthenia gravis (MG) is the most common paraneoplastic syndrome in thymoma. However, the association between MG and postoperative outcomes is controversial. Therefore, we examined the effect of MG on the surgical outcomes of patients with thymoma. METHODS This study enrolled 145 consecutive patients with thymoma who underwent surgical resection at our institution between January 2000 and December 2020. The patients were classified into thymoma with MG (MG group) and without MG (non-MG group). Data about characteristics of patients, surgical outcomes, and prognostic factors were compared between the two groups. RESULTS Of 145 patients, 47 (32%) presented with MG and 98 (68%) did not. There was no significant difference in terms of the incidence of postoperative complications, overall survival (OS), and recurrence-free survival (RFS) between the two groups. The deaths were not caused by thymoma. Among the patients aged >60 years, the MG group had a lower survival rate than the non-MG group. In the univariate analysis, age ≥60 years was a poor prognostic factor for OS, whereas in the multivariate analysis, Masaoka stage III and IV classifications were poor prognostic factors for RFS. CONCLUSION The incidence of postoperative complications did not differ between patients with thymoma and without MG. In the MG group, age ≥60 years was a poor prognostic factor for OS. The postoperative follow-up of patients aged ≥60 years with thymoma with MG should focus on not only recurrence but also progression of diseases other than thymoma.
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Affiliation(s)
- Kenji Miura
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
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Mitsui S, Tanaka Y, Doi T, Hokka D, Maniwa Y. Prognostic value of preoperative plasma fibrinogen levels in resected stage I non-small cell lung cancer. Thorac Cancer 2022; 13:1490-1495. [PMID: 35412025 PMCID: PMC9108075 DOI: 10.1111/1759-7714.14419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 12/17/2022] Open
Abstract
Background The number of surgical procedures has increased among patients with early‐stage lung cancer. If the poor prognostic factors for stage I non‐small cell lung cancer (NSCLC) can be simply validated preoperatively, appropriate treatment will be provided. The current study aimed to evaluate the prognostic value of preoperative plasma fibrinogen levels in patients with resected stage I NSCLC. Methods We retrospectively analyzed the clinicopathological information of patients (n = 149) who underwent lobectomy for stage I NSCLC between May 2014 and July 2016. Data about peripheral blood analysis, histopathological finding, and follow‐up assessment results were collected from the databases. Patients were divided into the low and high fibrinogen groups. Univariate and multivariate analyses were performed to evaluate the predictors of recurrence and survival. Results Compared with the low fibrinogen group (<377 mg/dl), the high fibrinogen group (≥377 mg/dl) had a significantly greater number of male participants (p = 0.04), smokers (p < 0.001), and those with elevated cytokeratin antigen levels (p = 0.04), lymphatic invasion (p = 0.007), and squamous cell carcinoma (p < 0.001). Plasma fibrinogen level was considered a significant independent factor for recurrence and overall survival on both the univariate and multivariate analyses (p < 0.001 and p = 0.010) and the multivariate analysis alone (p = 0.020 and p < 0.012). Conclusion Preoperative plasma fibrinogen level might be a useful predictor of recurrence and survival in patients with stage I NSCLC. The treatment strategy for patients with high fibrinogen levels could be cautiously considered preoperatively.
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Affiliation(s)
- Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Hokka D, Tanaka Y, Shimizu N, Doi T, Maniwa Y. Oxidized Regenerated Cellulose Sheets in Postoperative Intrathoracic Adhesions. Ann Thorac Cardiovasc Surg 2021; 28:32-35. [PMID: 34433704 PMCID: PMC8915933 DOI: 10.5761/atcs.nm.21-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Adhesiolysis is often necessary in intrathoracic adhesion during ipsilateral repeat lung resection. This procedure has a risk of surgical complications, including unintentional intraoperative damage of the pulmonary vessels or lung parenchyma. We used an oxidized regenerated cellulose (ORC) sheet to prevent intrathoracic adhesion after lung resection in 55 patients. The sheet was placed on the surface of the resected region and on the lung surface under the wound. No major postoperative complications were observed. Three cases underwent ipsilateral thoracic surgery for the treatment of lung malignancies, and there were no intrathoracic adhesions around the ORC sheet-covered area.
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Affiliation(s)
- Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Uchida T, Tanaka Y, Kuroda S, Hokka D, Maniwa Y. Successful treatment of refractory empyema using dual sheet covering. Asian Cardiovasc Thorac Ann 2021; 30:342-344. [PMID: 33926271 DOI: 10.1177/02184923211015078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Managing thoracic empyema with massive air leakage can be challenging. We present a case with thoracic empyema with multiple bronchopleural fistulae and extensive lung parenchymal necrosis due to drain injury. Emergency surgery was performed for respiratory distress due to massive air leakage. As direct sutures could not be achieved due to extensive parenchymal necrosis, polyglycolic acid and oxidized regenerated cellulose sheets were packed into the lesion. Although open-window thoracostomy was required for bronchopleural fistulae, the stoma closure was achieved via vacuum-assisted closure therapy. The dual sheet coverings contributed to the successful recovery by resolving multiple bronchopleural fistulae.
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Affiliation(s)
- Takahiro Uchida
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - Sanae Kuroda
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Japan
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Minami K, Jimbo N, Tanaka Y, Uchida T, Okamoto T, Shimizu N, Doi T, Hokka D, Itoh T, Maniwa Y. Fibrous bands associated with higher Masaoka stage and poor recurrence-free survival in patients with thymoma. Thorac Cancer 2020; 12:349-356. [PMID: 33236521 PMCID: PMC7862782 DOI: 10.1111/1759-7714.13755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 11/26/2022] Open
Abstract
Background Fibrous bands (FBs) are one of the histological features in tumors which can be confirmed by hematoxylin and eosin (H&E)‐stained slides. FBs have been reported to correlate with malignancy in various tumors. This study aimed to investigate whether the presence of FBs is associated with malignancy in thymoma. Methods A total of 123 consecutive patients with thymoma who underwent microscopically complete resections from January 2000 to December 2018 were enrolled into this study. H&E‐stained slides of all thymoma patients were re‐examined. Study patients were classified into two groups: with FBs (n = 36) and without FBs (n = 87). Clinicopathological characteristics, overall survival (OS), and recurrence‐free survival (RFS) were compared between the two groups. Furthermore, multivariate analyses were performed to identify whether the presence of FBs was associated with higher Masaoka stage and poor prognosis in patients with thymoma. Results The Masaoka stage was found to be higher and recurrence more likely in thymoma patients with FBs than in those without. RFS was significantly poorer in thymoma patients with FBs than in those without, although no significant difference was observed in OS between them. The presence of FBs was significantly associated with higher Masaoka stage in the multivariate analysis using logistic regression. Additionally, the presence of FBs was an independent prognostic factor for poor RFS in multivariate analysis using Cox's proportional hazards model. Conclusions The presence of FBs in patients with thymoma was associated with higher Masaoka stage, higher recurrence rate, and poorer RFS. Key points Significant findings of the study Fibrous bands (FBs) are bands of fibrosis dividing tumors into different‐sized irregular islands. The presence of FBs is associated with higher Masaoka stage and poor recurrence‐free survival in patients with thymoma. What this study adds The presence of fibrous bands might be associated with the malignant behavior of thymoma. Confirming the presence or absence of FBs may result in personalized medication for patients with thymoma.
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Affiliation(s)
- Kazuhiro Minami
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahiro Uchida
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Okamoto
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Minami K, Jimbo N, Tanaka Y, Ogawa H, Hokka D, Nishio W, Yoshimura M, Itoh T, Maniwa Y. Insulinoma-associated protein 1 is a prognostic biomarker in pulmonary high-grade neuroendocrine carcinoma. J Surg Oncol 2020; 122:243-253. [PMID: 32346887 DOI: 10.1002/jso.25960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUNDS AND OBJECTIVES Recent studies have suggested that insulinoma-associated protein 1 (INSM1) is a useful marker for pathological diagnosis of pulmonary neuroendocrine tumors. In the present study, we investigated the association between INSM1 expression and prognosis in patients with pulmonary high-grade neuroendocrine carcinomas (HGNEC) and assessed the usefulness of INSM1 as a prognostic biomarker in these patients. METHODS Seventy-five consecutive patients with HGNEC who underwent complete surgical resections from January 2000 to December 2018 were enrolled in this study. We classified these patients into two groups: the INSM1-positive group (n = 59) and INSM1-negative group (n = 16). We compared the clinicopathological characteristics, overall survival (OS), and recurrence-free survival (RFS) between the groups. In addition, we performed univariate and multivariate analyses to identify the prognostic factors associated with postoperative survival. RESULTS Significant differences in tumor diameter and vascular invasion between the groups were found. OS and RFS were significantly poorer in the INSM1-positive group than in the INSM1-negative group. Univariate and multivariate analyses revealed that INSM1 expression was the strongest predictor of poor prognosis for OS and RFS. CONCLUSIONS INSM1 expression had the greatest influence on the prognosis in patients with HGNEC and may be a prognostic biomarker in these patients.
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Affiliation(s)
- Kazuhiro Minami
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo Prefecture, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe City, Hyogo Prefecture, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo Prefecture, Japan
| | - Hiroyuki Ogawa
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo Prefecture, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo Prefecture, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo Prefecture, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo Prefecture, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe City, Hyogo Prefecture, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo Prefecture, Japan
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12
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Shimizu N, Tanaka Y, Kuroda S, Nakamura H, Matsumoto G, Mitsui S, Sakai S, Minami K, Doi T, Hokka D, Maniwa Y. Oxidized regenerated cellulose for a clear thoracoscopic view: a single-centre randomized trial. Interact Cardiovasc Thorac Surg 2020; 30:346-352. [PMID: 31747012 DOI: 10.1093/icvts/ivz271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/12/2019] [Accepted: 10/18/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES During video-assisted thoracoscopic surgery (VATS), blood oozing from the surface of the access port wound can hamper the surgical view. Although this oozing is difficult to prevent, it can be decreased by placing a wound edge protector with oxidized regenerated cellulose (ORC) on the surface of the access port wound, thereby improving the surgical outcomes and safety of VATS. METHODS We conducted a prospective, single-centre, open-label, randomized clinical trial to evaluate the operative outcomes of VATS when using the ORC (ORC group) compared with operative outcomes without using the ORC (non-ORC group). The primary end point was interruption of the operation as a result of blood oozing from the surface of the access port wound. The secondary end points were the other intraoperative and postoperative outcomes. RESULTS A total of 108 patients were divided into the ORC group (n = 54) and the non-ORC group (n = 54). Compared with the non-ORC group, the ORC group had fewer patients with an interruption in the operation (11.1% vs 51.8%; P < 0.001), less need for wound haemostasis of the access ports during wound closure (44.4% vs 72.2%; P = 0.003), similar rates of postoperative deaths and complications and a tendency for shorter operation times (149.3 vs 168.8 min, respectively; P = 0.083). CONCLUSION The use of an ORC sheet around a wound edge protector for haemostasis can ensure a clear view during VATS. CLINICAL TRIAL REGISTRATION NUMBER UMIN000031112.
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Affiliation(s)
- Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sanae Kuroda
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hayate Nakamura
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Gaku Matsumoto
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shuto Sakai
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhiro Minami
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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13
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Kimura K, Ogawa H, Jimbo N, Hokka D, Tanaka Y, Maniwa Y. A case of leiomyosarcoma originating from a bronchogenic cyst: A case report. Mol Clin Oncol 2020; 12:244-246. [PMID: 32064101 PMCID: PMC7016609 DOI: 10.3892/mco.2020.1977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/02/2020] [Indexed: 12/23/2022] Open
Abstract
Mediastinal leiomyosarcoma is an aggressive tumor that primarily occurs in the posterior mediastinum. A bronchogenic cyst is a benign lesion that often develops in the mediastinum close to the thoracic trachea and has been reported to be the origin of certain malignancies. The present study reports an extremely rare case of an anterior mediastinal leiomyosarcoma that was considered to have originated from a bronchogenic cyst. An 82-year-old woman complained of chest pain, presenting an abnormal 70 mm mass shadow in the anterior mediastinum of a chest CT scan. Mediastinal tumor resection was performed and the tumor was diagnosed as a leiomyosarcoma. As the tumor was located adjacent to a bronchogenic cyst, it was considered to have originated from the remnant tissue of the cyst. Recurrent lesions were noted in the right lower lobe on CT scan 24 months after surgery.
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Affiliation(s)
- Kenji Kimura
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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14
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Mitsui S, Shimizu N, Tanaka Y, Nakamura H, Kuroda S, Matsumoto G, Sakai S, Kimura K, Doi T, Ogawa H, Hokka D, Maniwa Y. [Mediastinal Shift Due to the Rapidly Expanded Giant Bulla Probably Caused by the Lung Cancer]. Kyobu Geka 2019; 72:1068-1071. [PMID: 31879381] [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: 06/10/2023]
Abstract
A 39-year-old man was admitted to our hospital with back pain and numbness of the left leg. Computed tomography (CT) showed a giant bulla and tumor in the right lung, mediastinal shift to the left side and lesions suggestive of metastatic sacral tumor. Three days later, the patient visited the emergency room with dyspnea and tachycardia. Chest CT showed the progression of mediastinal shift due to the rapid expansion of the giant bulla, and an emergency surgery was performed. After induction of anesthesia, sudden respiratory and circulatory failure occurred. Considering further expansion of the giant bulla by positive pressure ventilation, veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) was applied. After establishing ECMO, the condition of the patient became stable and the giant bulla could be resected successfully.
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Affiliation(s)
- Suguru Mitsui
- Department of Thoracic Surgery, Kobe University, Kobe, Japan
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15
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Komatsu M, Kawamoto T, Kanzawa M, Kawakami Y, Hara H, Akisue T, Kuroda R, Nakamura H, Hokka D, Jimbo N, Itoh T, Hirose T. A novel
EWSR1
‐
VGLL1
gene fusion in a soft tissue malignant myoepithelial tumor. Genes Chromosomes Cancer 2019; 59:249-254. [DOI: 10.1002/gcc.22823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 01/06/2023] Open
Affiliation(s)
- Masato Komatsu
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Teruya Kawamoto
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
- Division of Orthopedic Surgery Kobe University International Clinical Cancer Research Center Kobe Hyogo Prefecture Japan
| | - Maki Kanzawa
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Yohei Kawakami
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Hitomi Hara
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science Kobe University Graduate School of Health Sciences Kobe Hyogo Prefecture Japan
| | - Ryosuke Kuroda
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Hayate Nakamura
- Division of Thoracic Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Takanori Hirose
- Department of Diagnostic Pathology Hyogo Cancer Center Akashi Hyogo Prefecture Japan
- Division of Pathology for Regional Communication Kobe University School of Medicine Kobe Hyogo Prefecture Japan
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16
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Minami K, Jimbo N, Tanaka Y, Hokka D, Miyamoto Y, Itoh T, Maniwa Y. Malignant mesothelioma in situ diagnosed by methylthioadenosine phosphorylase loss and homozygous deletion of CDKN2A: a case report. Virchows Arch 2019; 476:469-473. [DOI: 10.1007/s00428-019-02674-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/04/2019] [Accepted: 09/22/2019] [Indexed: 11/24/2022]
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17
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Minami K, Tanaka Y, Okamoto T, Shimizu N, Doi T, Ogawa H, Hokka D, Jimbo N, Nishio W, Yoshimura M, Itoh T, Maniwa Y. EP1.12-17 Neuroendocrine Marker Staining Pattern Categorization of Small-Sized Pulmonary Large Cell Neuroendocrine Carcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2262] [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: 11/27/2022]
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18
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Uchida T, Tanaka Y, Shimizu N, Kuroda S, Doi T, Hokka D, Okita Y, Maniwa Y. Diaphragmatic plication for iatrogenic respiratory insufficiency after cardiothoracic surgery. J Thorac Dis 2019; 11:3704-3711. [PMID: 31656642 DOI: 10.21037/jtd.2019.09.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The efficacy of diaphragmatic plication (DP) has been proven in many studies. However, there are few reports on DP for patients with severe respiratory conditions requiring mechanical ventilation. The study aim was to demonstrate the efficacy of DP for patients with severe respiratory insufficiency after cardiothoracic surgeries. Methods We retrospectively reviewed 10 patients who underwent DP for severe respiratory insufficiency due to postoperative diaphragmatic paralysis; eight of them required mechanical ventilation, and two needed high-flow oxygen therapy prior to DP. The symptoms, lung function, and elevation of the diaphragm were assessed before and after DP. Results All patients were successfully withdrawn from mechanical ventilation after DP and discharged without the need for oxygen therapy. The mean perioperative Medical Research Council (MRC) dyspnea scale (ATS/ERS 2004) score improved in 30 days (from 4 to 1.8) and in 90 days (from 4 to 0.6) after DP. Lung dynamic compliance was also ameliorated (mean improvement: 41.9 to 60.7 mL/cmH2O). Radiography revealed improved elevation of the diaphragm (mean improvement of 1.8 intercostal spaces, range, 1-2). Mean hospital stay after DP was 65.5 days (range, 25-187 days). One patient who underwent DP with endostapler-only suturing required re-operation because of staple line ruptures. Conclusions DP was found to be an effective form of treatment for patients with severe respiratory insufficiency after cardiothoracic surgery.
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Affiliation(s)
- Takahiro Uchida
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sanae Kuroda
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Okita
- Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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19
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Kin Y, Ogawa H, Matsumoto G, Mitsui S, Matsumoto T, Nishioka Y, Sakai S, Kimura K, Shimizu N, Hokka D, Tanaka Y, Maniwa Y. [Tumor-induced Hypophosphatemic Osteomalacia Caused by a Chest Wall Tumor]. Kyobu Geka 2019; 72:570-573. [PMID: 31353346] [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: 06/10/2023]
Abstract
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic disease characterized by hypophosphatemia and skeletal undermineralization. Overproduction of fibroblast growth factor 23( FGF23) from the responsible tumor is reported to be a causative factor. Removing the tumor is the only effective treatment for TIO, but identifying the tumor is sometimes difficult. A 43-year-old man complained of heel pain 4 years earlier, and the pain gradually expanded to the whole body. As a blood test showed the elevation of the serum FGF23 level and hypophosphatemia, he was diagnosed with FGF23-related hypophosphatemia. Chest computed tomography (CT) showed a 10-mm nodule in the right chest wall. Venous sampling for FGF23 revealed considerable elevation of the FGF23 level in the right subclavian vein. Therefore, a chest wall tumor was suspected as the tumor responsible for TIO, and surgical resection was performed. After surgery, hypophosphatemia improved within several days, and the FGF23 level also normalized.
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Affiliation(s)
- Yasuo Kin
- Department of Thoracic Surgery, Kobe University, Kobe, Japan
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20
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Ogawa H, Tanaka Y, Kitamura Y, Shimizu N, Doi T, Hokka D, Tane S, Nishio W, Yoshimura M, Maniwa Y. Efficacy of perioperative chemotherapy for pulmonary high-grade neuroendocrine carcinomas: a propensity score matching analysis. J Thorac Dis 2019; 11:1145-1154. [PMID: 31179056 DOI: 10.21037/jtd.2019.04.56] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Large-cell neuroendocrine carcinoma (LCNEC) and small cell lung cancer (SCLC) are categorized as high-grade neuroendocrine carcinoma (HGNEC). We analyzed the efficacy of perioperative chemotherapy for HGNEC and the prognostic factors. Methods We retrospectively reviewed the medical records of patients who underwent tumor resection and were diagnosed with HGNEC between January 2001 and December 2014. The overall survival (OS) was estimated by the Kaplan-Meier method. Propensity score matching was performed to compare the OS between the treatment groups. Multivariate analyses using a Cox proportional hazards model were performed to search for prognostic factors for HGNEC. Results We analyzed 146 HGNEC patients (LCNEC n=92, SCLC n=54) without synchronous multiple cancers, who underwent complete resection. Seventy patients (LCNEC n=31, SCLC n=32) received perioperative chemotherapy and all of them received a platinum-based anticancer drug. Perioperative chemotherapy significantly improved the 5-year OS rates of HGNEC patients (all stages: 74.5% vs. 34.7%, P<0.01, stage I: 88.5% vs. 40.0%, P<0.01). The efficacy of perioperative chemotherapy was similar between LCNEC and SCLC patients [LCNEC all stages: hazard ratio (HR) 0.27, P<0.01, LCNEC stage I: HR 0.27, P=0.01; SCLC all stages: HR 0.38, P=0.02, SCLC stage I: HR 0.34, P=0.06]. The survival benefit of perioperative chemotherapy for HGNEC patients was confirmed by propensity score matching analysis (HR 0.31, P<0.01). The multivariate analysis revealed that perioperative chemotherapy (HR 0.29, P<0.01), sublobar resection (HR 2.11, P=0.04), and lymph node metastasis (HR 3.34, P<0.01) were independently associated with survival. Conclusions Surgical resection combined with perioperative chemotherapy was considered to be effective even for stage I HGNEC patients. Sublobar resection might increase the risk of death in HGNEC patients.
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Affiliation(s)
- Hiroyuki Ogawa
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan.,Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Yugo Tanaka
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Yoshitaka Kitamura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Nahoko Shimizu
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Takefumi Doi
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Daisuke Hokka
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Yoshimasa Maniwa
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
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21
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Shimizu N, Tanaka Y, Okamoto T, Doi T, Hokka D, Maniwa Y. How to prevent adverse events of vascular stapling in thoracic surgery: recommendations based on a clinical and experimental study. J Thorac Dis 2019; 10:6466-6471. [PMID: 30746189 DOI: 10.21037/jtd.2018.11.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Advances in the development of staplers for pulmonary vessels have contributed to safe and convenient procedures in thoracic surgery. However, adverse events (AEs) can occur during vascular stapling and cause fatal hemorrhage. We aimed to assess the risk level of using the vessel stapling procedure to reduce such AEs. Methods First, an animal experiment using pig cardiopulmonary blocks was conducted. Pulmonary arteries were closed with staplers under stressful conditions such as lifting or twisting; vessel stump endurance was analyzed through different methods. Second, AEs associated with clinical stapler use for pulmonary vessels were retrospectively reviewed by studying clinical videos of 263 patients. Results In the animal experiment, the pressure resistance was significantly lower in the twisted group than in the no strain group (no strain vs. lifting: P=0.2008, no strain vs. twisting: P=0.002, no strain vs. twisting and lifting: P<0.0001). Regarding clinical stapler use, 754 staplers were used against the vessels. AEs occurred in 9 cases, and 7 cases were suspected to be caused by vessel tension. Conclusions The pulmonary vessel stapling causes stress due to twisting and lifting that decreased stump durability. Avoiding such stress when using stapler for vessels leads to a safer thoracic surgery.
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Affiliation(s)
- Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Okamoto
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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22
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Shimizu N, Tanaka Y, Kuroda S, Nakamura H, Matsumoto G, Mitsui S, Sakai S, Minami K, Kimura K, Okamoto T, Hokka D, Maniwa Y. [Temporary Bypass with 5-Fr Catheter for Reconstruction of Superior Vena Cava]. Kyobu Geka 2018; 71:1077-1080. [PMID: 30587745] [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: 06/09/2023]
Abstract
A 21-year-old man was referred to our hospital because of an abnormal shadow on a routine chest radiogram. Enhanced computed tomography showed an 83×74 mm mass in the anterior mediastinum, with invasion of the superior vena cava (SVC). Surgical resection with sternotomy was performed. Intraoperative temporary bypass grafting with a 5-Fr catheter was performed between the right brachiocephalic vein and right atrium. The mediastinal tumor was resected with the SVC, and SVC reconstruction with a 16 mm expanded polytetrafluoroethylene graft was performed. The bypass stabilized intraoperative vital signs and enabled safe completion of the operation. The pathological diagnosis was seminoma. SVC replacement combined with temporary bypass using a small diameter catheter is technically feasible and safe.
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Affiliation(s)
- Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University, Kobe, Japan
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23
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Shimizu N, Tanaka Y, Kuroda S, Nakamura H, Matsumoto G, Mitsui S, Sakai S, Minami K, Okamoto T, Doi T, Hokka D, Maniwa Y. [Successful Treatment of a Patient with Idiopathic Subglottic Stenosis]. Kyobu Geka 2018; 71:1018-1021. [PMID: 30449870] [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: 06/09/2023]
Abstract
Idiopathic subglottic stenosis (ISS) is defined as the narrowing of the upper airway without any known cause. A 40-year-old female was referred to our hospital with the complaint of exacerbation of dyspnea causing difficulty in going out. Chest computed tomography (CT) scan and bronchoscopy revealed subglottic tracheal stenosis with a luminal diameter of 5 mm at the narrowest part. Tracheal mucosa of the stenotic lesion was smooth, and the patient had no previous medical history. Subglottic tracheal resection of the stenotic lesion and reconstruction were performed. The postoperative course was good, and the symptom of dyspnea improved significantly. Recently, some reports have suggested conservative treatments such as laser and balloon dilation for ISS, but the recurrence rate after these treatments is still high. Surgery is recommended rather than conservative treatments for patients with less severe inflammation of tracheal mucosa and other comorbidities like present case.
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Affiliation(s)
- Nahoko Shimizu
- Division of Thoracic Surgery, Kobe University, Kobe, Japan
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24
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Ogawa H, Tanaka Y, Tachihara M, Uehara K, Shimizu N, Doi T, Hokka D, Maniwa Y. ROS1-rearranged high-PD-L1-expressing lung adenocarcinoma manifesting as mediastinal tumor: A case report. Oncol Lett 2018; 17:488-491. [PMID: 30655791 DOI: 10.3892/ol.2018.9622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/07/2018] [Indexed: 12/26/2022] Open
Abstract
ROS proto-oncogene 1 receptor tyrosine kinase (ROS1)-rearranged lung cancer is rare and comprises only 1% of lung adenocarcinoma cases. It has recently been reported to have good response to crizotinib, a tyrosine kinase inhibitor of anaplastic lymphoma kinase. Driver oncogene mutations with approved therapies seldom coexist with a high expression of Programmed death-ligand 1 (PD-L1). The present case report describes a rare case of ROS1 rearrangement with high-PD-L1-expressing occult lung adenocarcinoma. A 32-year-old woman presented with chest pain and a prolonged cough. Chest computed tomography (CT) revealed a 57×36-mm tumor in the mediastinum, with no tumors detected in other regions. Positron emission tomography (PET)-CT showed a strong fluorodeoxyglucose accumulation in the tumor (SUVmax 13.2). Mediastinal tumor resection was completely resected using a video-assisted thoracic surgery approach. Pathological examination showed the tumor cells were positive for thyroid transcription factor 1, Napsin-A, ROS1, and PD-L1 (tumor proportion score >99%). ROS1 rearrangement was confirmed by fluorescence in situ hybridization. The mediastinal tumor was diagnosed as mediastinal lymph node metastasis of ROS1-rearranged PD-L1 high-expression undifferentiated lung adenocarcinoma (pathological stage 3, TxN2M0). Two months after the operation, the CT scan showed multiple mediastinum lymph nodes metastases with rapid tumor growth. The patient achieved a complete response after three cycles of S-1 plus cisplatin with concurrent radiotherapy 60 Gy/30 Fr.
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Affiliation(s)
- Hiroyuki Ogawa
- Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Motoko Tachihara
- Department of Respiratory Medicine, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Keiichiro Uehara
- Department of Diagnostic Pathology, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Nahoko Shimizu
- Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650-0017, Japan
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Tauchi S, Sakai Y, Fujimoto S, Ogawa H, Tane S, Hokka D, Tanaka Y, Nishio W, Yoshimura M, Yanagita E, Itoh T, Hayashi Y, Maniwa Y. Psf3 is a prognostic biomarker in lung adenocarcinoma: a larger trial using tissue microarrays of 864 consecutive resections. Eur J Cardiothorac Surg 2016; 50:758-764. [DOI: 10.1093/ejcts/ezw077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Tanaka Y, Tane S, Hokka D, Ogawa H, Maniwa Y. The Use of Oxidized Regenerated Cellulose for Video-Assisted Thoracic Surgery. Ann Thorac Surg 2016; 101:786-8. [PMID: 26777946 DOI: 10.1016/j.athoracsur.2015.08.078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 06/19/2015] [Revised: 08/17/2015] [Accepted: 08/28/2015] [Indexed: 10/22/2022]
Abstract
Disturbance of the surgical view during video-assisted thoracic surgery (VATS) as a result of blood oozing from the wound surface of the access port may lead to additional stress on surgeons and is difficult to prevent. We used a wound edge protector with oxidized regenerated cellulose (ORC) rings for the wound surfaces of the access ports and eliminated the problem. Furthermore, no hemostatic procedure was required for the wound surface before wound closure because the ORC rings completely stopped wound surface bleeding during the operation. ORC rings enhanced protection of the thoracoscopic port and the quality of VATS.
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Affiliation(s)
- Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
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Tane S, Sakai Y, Hokka D, Okuma H, Ogawa H, Tanaka Y, Uchino K, Nishio W, Yoshimura M, Maniwa Y. Significant role of Psf3 expression in non-small-cell lung cancer. Cancer Sci 2015; 106:1625-34. [PMID: 26291987 PMCID: PMC4714687 DOI: 10.1111/cas.12770] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 08/05/2015] [Accepted: 08/10/2015] [Indexed: 11/30/2022] Open
Abstract
The GINS complex associates with cell division cycle (Cdc) protein 45 and mini‐chromosome maintenance (Mcm) proteins 2–7 to form the Cdc45–Mcm–GINS (CMG) complex, which is essential for DNA duplication. One member of the GINS complex is Psf3. We previously found that increased Psf3 expression was strongly associated with poor survival in lung adenocarcinoma. Here, we investigated the role of Psf3 expression in non‐small‐cell lung cancer (NSCLC). We verified Psf3 expression in human NSCLC tissues (180 patients) and cell lines. Immunohistochemical analysis revealed that the overexpression of Psf3 was significantly associated with vessel invasion (P = 0.016), lymphatic invasion (P = 0.002), and pleural invasion (P = 0.036). The overall survival rate in patients with Psf3 overexpression was significantly lower than that in patients without Psf3 overexpression (P = 0.006). Multivariate survival analysis revealed Psf3 expression to be an independent risk factor for an unfavorable outcome (P = 0.049). A proximal ligation assay showed interactions between Psf3 and other CMG components (such as Mcm2 and Cdc45) in both NSCLC specimens and cell lines, indicating that Psf3 acted as the CMG complex, which could lead to excessive proliferation. Knockdown of Psf3 inhibited the proliferation of both cell lines by delaying the S phase, which revealed that Psf3 played an important role in cancer proliferation. Thus, Psf3 acted as the CMG complex, promoting excessive proliferation. These results suggest that Psf3 inhibition might be a therapeutic target for NSCLC with Psf3 overexpression.
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Affiliation(s)
- Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiro Sakai
- Division of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiromichi Okuma
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuya Uchino
- Division of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Wataru Nishio
- Division of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Tane S, Nishio W, Okuma H, Ogawa H, Hokka D, Tane K, Tanaka Y, Uchino K, Yoshimura M, Maniwa Y. Operative outcomes of thoracoscopic lobectomy for non-small-cell lung cancer. Asian Cardiovasc Thorac Ann 2015. [DOI: 10.1177/0218492315596657] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim We examined the advantages of thoracoscopy over thoracotomy in terms of perioperative outcomes and toleration of adjuvant chemotherapy. Methods Between April 2010 and March 2013, 657 patients with non-small-cell lung cancer who underwent lobectomy were classified into thoracoscopy (308 patients) and thoracotomy (349 patients) groups and compared. Results The thoracoscopy group had less blood loss compared to the thoracotomy group ( p < 0.001). When limiting the analysis to pathological stage I patients, the results were similar ( p < 0.001). In addition, the difference in blood loss between the 2 groups was greater in patients with severe pleural adhesions. The postoperative morbidity of the thoracoscopy group was significantly less than that of the thoracotomy group (13.3% vs. 21.2%, p < 0.001), and this result was similar when analyzing the pathological stage I patients (12.6% vs. 20.6%, p = 0.001). A higher percentage of the thoracoscopy group received both the full planned course and dose of adjuvant chemotherapy compared to the thoracotomy group (84.2% vs. 65.8%, p = 0.032). Conclusions These results indicate that totally thoracoscopic lobectomy is the more beneficial surgical approach with regard to the incidence of postoperative complications and toleration of adjuvant chemotherapy.
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Affiliation(s)
- Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Hiromichi Okuma
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenta Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuya Uchino
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Hokka D, Ogawa H, Tane S, Tanaka Y, Tauchi S, Maniwa Y. Ruptured thymoma causing a hemothorax: A case report. Oncol Lett 2015; 10:1810-1812. [PMID: 26622755 DOI: 10.3892/ol.2015.3476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 04/08/2015] [Indexed: 11/05/2022] Open
Abstract
A thymoma is a neoplasm that arises from the epithelial cells of the thymus, and may cause various signs and symptoms dependent upon its local extent. A non-traumatic hemothorax is extremely rare. The present study reports the case of a 77-year-old female who presented with an acute onset of chest pain. Imaging procedures revealed a mass occupying the anterior mediastinum and left hemithorax, and a left pleural effusion. Progressive anemia was noted following admission. Left hemothorax due to rupture of the anterior mediastinal mass was suspected, and emergency surgery was performed. Hemorrhage was observed on the cut surface of the tumor. An analysis of frozen sections indicated a thymoma, and a thymo-partial thymectomy was subsequently performed to remove as much of the hematoma as possible. The patient was discharged on post-operative day 13 following an uneventful recovery. The present case suggests that in previously healthy individuals, sudden-onset dyspnea and chest pain co-occurring with an acute widening of the mediastinum observed on roentgenograph may be indicative of a ruptured thymoma.
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Affiliation(s)
- Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyōgo 650-0017, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyōgo 650-0017, Japan
| | - Shinya Tane
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyōgo 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyōgo 650-0017, Japan
| | - Shunsuke Tauchi
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyōgo 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyōgo 650-0017, Japan
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Ogawa H, Uchino K, Tanaka Y, Shimizu N, Okuda Y, Tane K, Hokka D, Tane S, Tauchi S, Nishio W, Maniwa Y, Yoshimura M. Outcomes of segmentectomy for cT1bN0M0 lung adenocarcinoma and squamous cell carcinoma: a possible association with pathological invasion. Eur J Cardiothorac Surg 2014; 48:77-82. [PMID: 25429967 DOI: 10.1093/ejcts/ezu429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/22/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We evaluated the clinical benefit of segmentectomy for patients with cT1bN0M0 lung cancer. METHODS We retrospectively reviewed the medical records of 178 patients who underwent lobectomy or segmentectomy for cT1bN0M0 lung adenocarcinoma and squamous cell carcinoma from January 1995 to December 2005. We investigated the association of surgical outcomes with the presence of pathological invasion. RESULTS The median follow-up period was 93.4 months. Of 178 patients, 37 were scheduled for segmentectomy, but 6 of these patients were switched to receive lobectomy due to surgical N1 or N2 in 3 patients and insufficient surgical margins in 3 patients. In total, 31 patients underwent segmentectomy, and 147 underwent lobectomy. The 5-year overall survival (OS) was similar between the patients who underwent lobectomy (5-year OS, 81.6%) and segmentectomy (5-year OS, 77.4%, P = 0.73). Among pN0 patients without pathological invasion, there was no difference in OS between patients who underwent lobectomy (5-year OS, 89.9%) and segmentectomy (5-year OS, 88.9%, P = 0.80). In contrast, among pN0 patients with pathological invasion, OS was greater in patients who underwent lobectomy (5-year OS, 80.9%) than in those who underwent segmentectomy (5-year OS, 54.6%; P = 0.19). Moreover, a significantly higher rate of local and local + distant recurrence was observed in patients who underwent segmentectomy (45%) than in those who underwent lobectomy (15%) in this group (P = 0.02). CONCLUSIONS The results of our study suggest that segmentectomy may not be recommended for cT1b tumours if pathological invasion is suspected before surgery.
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Affiliation(s)
- Hiroyuki Ogawa
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
| | - Kazuya Uchino
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan
| | - Yugo Tanaka
- Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
| | - Nahoko Shimizu
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan
| | - Yusuke Okuda
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan
| | - Kenta Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan
| | - Daisuke Hokka
- Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
| | - Shunsuke Tauchi
- Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan
| | - Yoshimasa Maniwa
- Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-City, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan
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Ogawa H, Tanaka Y, Koma YI, Hokka D, Tane S, Tauchi S, Uchino K, Yoshimura M, Maniwa Y. Pulmonary large cell neuroendocrine carcinoma exhibiting extensive pagetoid spread in the bronchial epithelium: A case report. Oncol Lett 2014; 8:2621-2623. [PMID: 25364438 PMCID: PMC4214490 DOI: 10.3892/ol.2014.2538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 07/01/2014] [Indexed: 01/15/2023] Open
Abstract
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive malignant tumor, which was proposed as a novel type of neuroendocrine tumor in 1991. Although it is categorized as a non-small cell lung carcinoma, the precise pathological condition is unknown due to its rare occurrence. The present study outlines the case of a patient presenting with an LCNEC that exhibited pagetoid spread from the region of the primary tumor to the bronchial epithelium (distance, >30 mm). The pagetoid spread was unconfirmed preoperatively, however, was identified by intraoperative rapid diagnosis. This caused us to suffer the perioperative decision of additional resection and resulted in an incomplete resection, as suture of the bronchus was not possible. Pagetoid spread, which is often apparent in the breast, presents as a rare pattern of infiltration of cancer cells when a massive carcinoma is identified beneath the intraepithelial spread. Although preoperative diagnosis of pagetoid spread is difficult due to its rarity and undefined clinical features, it is important for surgeons and pathologists treating lung cancer patients to be aware of potential pagetoid spread in the thoracic region.
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Affiliation(s)
- Hiroyuki Ogawa
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Yugo Tanaka
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Yu-Ichiro Koma
- Department of Pathology, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Daisuke Hokka
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Shunsuke Tauchi
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Kazuya Uchino
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Yoshimasa Maniwa
- Department of Thoracic Surgery, Kobe University Hospital, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
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Hokka D, Uchino K, Tane K, Ogawa H, Tane S, Tanaka Y, Tauchi S, Nishio W, Yoshimura M, Maniwa Y. Pleural lavage cytology as an independent prognostic factor in non-small-cell lung cancer patients with stage I disease and adenocarcinoma. Mol Clin Oncol 2014; 3:244-248. [PMID: 25469303 DOI: 10.3892/mco.2014.416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/05/2014] [Indexed: 11/06/2022] Open
Abstract
We previously reported that cancer cells may be detected through pleural lavage cytology (PLC). In this study, we sought to re-examine the prognostic significance of the PLC status based on an extended dataset with an additional follow-up period. Pleural lavage following thoracotomy was cytologically examined in 1,317 consecutive patients who were diagnosed with NSCLC between 1987 and 2004 at the Thoracic Surgery Units of Kobe University Graduate School of Medicine and Hyogo Cancer Center. Among the investigated patients, 46 exhibited positive cytological findings. The prognosis of these patients was significantly worse compared to that of patients without positive PLC. Of the 844 pathological stage I patients, 18 had a positive PLC status and their prognosis was significantly worse compared to that of patients with stage I disease without positive PLC. In conclusion, positive PLC findings were associated with a poor prognosis and this finding was significant for patients with stage I disease. These results suggest the need for PLC status evaluation during staging and treatment planning in patients with NSCLC.
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Affiliation(s)
- Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017; Japan
| | - Kazuya Uchino
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Kenta Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017; Japan
| | - Sinya Tane
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017; Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017; Japan
| | - Shunsuke Tauchi
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017; Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017; Japan
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Tane S, Nishio W, Ogawa H, Hokka D, Tane K, Tanaka Y, Tauchi S, Uchino K, Sakai Y, Ohbayashi C, Yoshimura M, Maniwa Y. Clinical significance of the 'not otherwise specified' subtype in candidates for resectable non-small cell lung cancer. Oncol Lett 2014; 8:1017-1024. [PMID: 25120650 PMCID: PMC4114594 DOI: 10.3892/ol.2014.2302] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 05/13/2014] [Indexed: 01/15/2023] Open
Abstract
The histological subtype of non-small-cell lung cancer (NSCLC) is a significant factor when selecting treatment strategies. However, cases are occasionally encountered that are diagnosed as ‘not otherwise specified’ (NOS) prior to surgery, due to an uncertain histological subtype. The present study investigated the prognostic significance of the NOS subtype for patients with resectable NSCLC. Between 2001 and 2011, 1,913 patients were diagnosed with NSCLC using transbronchial biopsy and underwent surgical resection at two facilities in Japan. Of these patients, 151 (7.9%) were pre-operatively diagnosed with NSCLC-NOS (NOS group) and the remainder had confirmed histological subtypes (confirmed group). The present study compared the clinicopathological features and prognoses of these groups. Analyses of resected specimens revealed that pleomorphic cell carcinoma, large cell neuroendocrine cell carcinoma, large cell carcinoma and adenosquamous carcinoma were significantly more common in the NOS group than in the confirmed group (P<0.001, P=0.002, P=0.019 and P=0.014, respectively). The five-year survival rate was significantly poorer in the NOS group (60.5 vs. 67.1%; P=0.010), particularly for stage I disease (70.8 vs. 80.7%; P=0.007). The results of a multivariate analysis of overall survival indicated that NOS was a significant independent prognostic factor (hazard ratio, 1.40; 95% confidence interval, 1.02–1.86; P=0.041). These results indicated that pre-operative NOS was significantly associated with poorer survival, including for stage I disease. In conjunction with other clinicopathological parameters, NOS can be a useful prognostic factor when deciding on a treatment strategy for NSCLC.
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Affiliation(s)
- Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Hiroyuki Ogawa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kenta Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Shunsuke Tauchi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kazuya Uchino
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Yasuhiro Sakai
- Division of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Chiho Ohbayashi
- Division of Pathology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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Tane S, Ogawa H, Hokka D, Tanaka Y, Tauchi S, Maniwa Y. F-039 * THE SIGNIFICANCE OF NECTIN-LIKE MOLECULE-5 OVEREXPRESSION IN PATIENTS WITH LUNG ADENOCARCINOMA. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.39] [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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Chen X, Hokka D, Maniwa Y, Ohbayashi C, Itoh T, Hayashi Y. Sirt1 is a tumor promoter in lung adenocarcinoma. Oncol Lett 2014; 8:387-393. [PMID: 24959282 PMCID: PMC4063576 DOI: 10.3892/ol.2014.2057] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 03/03/2014] [Indexed: 12/28/2022] Open
Abstract
Sirtuin 1 (Sirt1) is a nicotinamide adenine dinucleotide-dependent class III histone deacetylase. It reportedly can repress cellular apoptosis and senescence to affect DNA repair, stress response and aging. Notably, previous data have indicated that Sirt1 is both a tumor promoter and a tumor suppressor in tumorigenesis. However, Sirt1 expression in primary lung adenocarcinoma remains unknown. Immunohistochemical staining was performed to investigate Sirt1 expression in cancer cells in 125 consecutive resected cases of primary lung adenocarcinoma. Sirt1 expression was found to be increased in 26 (20.8%) of the 125 cases, which correlated significantly with five clinicopathological factors: Ki67 index, hypoxia-inducible factor 1 (HIF1) molecule expression, tumor-node-metastasis (TNM) classification, pulmonary vein invasion and lymphatic duct invasion. In the Sirt1-positive expression group, Sirt1 expression correlated with a higher Ki67 index and higher TNM classification, particularly for lymph node invasion and metastasis, and with a higher number of pulmonary vein invasion and lymphatic duct invasion. Additionally, a negative correlation was identified between HIF1-positive expression and Sirt1-negative expression. These results indicate that Sirt1 overexpression plays a promotional role in tumorigenesis and is closely associated with invasion and metastasis and, thus, it may be associated with prognosis.
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Affiliation(s)
- Xue Chen
- Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Chiho Ohbayashi
- Department of Pathology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yoshitake Hayashi
- Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
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Tane S, Ohno Y, Hokka D, Ogawa H, Tauchi S, Nishio W, Yoshimura M, Okita Y, Maniwa Y. The efficacy of 320-detector row computed tomography for the assessment of preoperative pulmonary vasculature of candidates for pulmonary segmentectomy. Interact Cardiovasc Thorac Surg 2013; 17:974-80. [PMID: 24014617 DOI: 10.1093/icvts/ivt391] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The purpose of this study was to compare the efficacy of 320-detector row computed tomography (CT) with that of 64-detector row CT for three-dimensional assessment of pulmonary vasculature of candidates for pulmonary segmentectomy. METHODS We included 32 patients who underwent both 320- and 64-detector CT before pulmonary segmentectomy, which was performed by cutting the pulmonary artery and bronchi of the affected segment followed by dissection of the intersegmental plane along the intersegmental vein. Before the operation, three-dimensional pulmonary vasculature images were obtained for each patient, and the arteries and intersegmental veins of the affected segments were identified. Two thoracic surgeons independently assessed the vessels with visual scoring systems, and kappa analysis was used to determine interobserver agreement. The Wilcoxon signed-rank test was used to compare the visual scores for the assessment of the visualization capabilities of the two methods. In addition, the final determination of pulmonary vasculature at a given site was made by consensus from thoracic surgeons during operation, and receiver operating characteristic analysis was performed to compare their efficacy of pulmonary vasculature assessment. Sensitivity, specificity and accuracy of either method were also compared by means of McNemar's test. RESULTS Of the 32 cases, there were no operative complications, but 1 patient died of postoperative idiopathic interstitial pneumonia. Visualization scores for the pulmonary vessels were significantly higher for 320- than those for 64-detector CT (P < 0.0001 for the affected arteries and P < 0.0001 for the intersegmental veins). As for pulmonary vasculature assessment, the areas under the curve showed no statistically significant differences in between the two methods, while the specificity and accuracy of intersegemental vein assessment were significantly better for 320- than those for 64-detector row CT (P < 0.05). Interobserver agreement for the assessment yielded by either method was almost perfect for all cases. CONCLUSIONS Three hundred and twenty-detector row CT is more useful than conventional 64-detector row CT for preoperative three-dimensional assessment of pulmonary vasculature, especially when we identify the intersegmental veins, in candidates for pulmonary segmentectomy.
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Affiliation(s)
- Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho, Chuo-ku, Kobe, Japan
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Tane S, Hokka D, Tauchi S, Maniwa Y. F-039THE EFFICACY OF 320-DETECTOR ROW COMPUTED TOMOGRAPHY FOR ASSESSMENT OF PREOPERATIVE PULMONARY VASCULATURE OF CANDIDATES FOR PULMONARY SEGMENTECTOMY. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.39] [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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Tane S, Nishio W, Hashimoto S, Hokka D, Maniwa Y, Funada Y, Kotani Y, Hirai C, Ohbayashi C, Yoshimura M. Ewing's sarcoma family of tumors originating in the main bronchus. Thorac Cancer 2012; 3:353-356. [PMID: 28920284 DOI: 10.1111/j.1759-7714.2011.00105.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Ewing's sarcoma family tumors (ESFT), which include Ewing's sarcoma and primitive neuroectodermal tumors (PNET), have been reported to originate in a variety of sites, mostly in the extremities. Previous reports have shown ESFT originating in the thoracic region, such as chest wall and peripheral lung. We herein report the first case of the ESFT that originated in the main bronchus. Endobronchial snare resection was followed by five courses of chemotherapy (VDC-IE; including vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide) and sequential radiation. After the treatment, the patient's condition has improved, and he has remained disease-free for the past year.
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Affiliation(s)
- Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Waratu Nishio
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shotaro Hashimoto
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiro Funada
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshikazu Kotani
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chihoko Hirai
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chiho Ohbayashi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiro Yoshimura
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, JapanDivision of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
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Hokka D, Maniwa Y, Tane S, Tauchi S, Nishio W, Yoshimura M. PSF3 is a Novel Prognostic Biomarker in Lung Adenocarcinoma. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32801-5] [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] Open
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Hokka D, Yoshikawa K, Morimoto M, Hashimoto S, Kamimura R, Tai K, Hoshida Y. [Lung cancer incidentally detected at the treatment of pneumothorax ; report of two cases]. Kyobu Geka 2012; 65:255-257. [PMID: 22374606] [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: 05/31/2023]
Abstract
We report 2 cases of lung cancer incidentally detected following pneumothorax. Case 1:A 40-year-old man complaining of dyspnea was admitted with right pneumothorax. Chest computed tomography (CT) after chest drainage showed a cavitary nodule with pleural indentations in the right lower lobe. It was indicated at surgery that pneumothorax was caused by perforation of the tumor into the pleural cavity. Right lower lobectomy was performed because the pathological diagnosis of the nodule was a large cell carcinoma. The final histopathological diagnosis was stage II A (pT2aN1M0). The patient died of recurrence 14 months after surgery. Case 2:A 47-year-old man who admitted with right pneumothorax was found to have a nodule with pleural indentations closely a bulla at the apex of the right lung by chest CT after chest drainage. Pneumothorax was indicated to be caused by rupture of the bulla at surgery. Right upper lobectomy was performed because the pathological diagnosis of the nodule was a squamous carcinoma. The final histopathological diagnosis was stage I A (pT1bN0M0). The patient is alive at 2 years after the operation without recurrence. Lung cancer detected following pneumothorax which was caused by perforation of the tumor is generally considered to have poor prognosis. Whereas, prognosis of lung cancer incidentally detected following pneumothorax depends on its staging.
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Affiliation(s)
- Daisuke Hokka
- Department of Thoracic Surgery, Sumitomo Hospital, Osaka, Japan
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Hokka D, Yoshikawa K, Morimoto M, Kamimura R, Miyake J, Hoshida Y. [Mediastinal goiter; report of a case]. Kyobu Geka 2011; 64:173-175. [PMID: 21387628] [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: 05/30/2023]
Abstract
A 76-year-old female was admitted to our hospital because of an abnormal shadow on chest computed tomography (CT) which showed the tumor extending from left lower end of the thyroid to the aortic window along the left side of the trachea, indicating the retrosternal goiter. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were within normal ranges. The tumor was resected through cervical collar incision and median sternotomy. The pathological diagnosis was an adenomatous goiter. The patient was discharged without complications.
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Affiliation(s)
- Daisuke Hokka
- Department of Thoracic Surgery, Sumitomo Hospital, Osaka, Japan
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Hokka D, Yoshikawa K, Morimoto M, Kamimura R, Tane K, Hoshida Y. [Catamenial pneumothorax; report of a case]. Kyobu Geka 2010; 63:1181-1183. [PMID: 21174672] [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: 05/30/2023]
Abstract
A 39-year-old woman was referred to our hospital because of pneumothorax related to menstruation. Chest X-ray showed right pneumothorax. Right thoracoscopy revealed 3 fenestrations on the diaphragm. Partial resection of the diaphragm including these lesions were performed. Intrathoracic minocycline was applied expecting pleural adhesion after surgery. Histopathological examination confirmed the presence of endometriosis on the resected diaphragm.
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Affiliation(s)
- Daisuke Hokka
- Department of Thoracic Surgery, Sumitomo Hospital, Osaka, Japan
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