Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
1.
BMJ Open ; 11(12): e052045, 2021 12 20.
Article in English | MEDLINE | ID: mdl-34930734

ABSTRACT

INTRODUCTION: Thoracoscopic surgery is performed for refractory or recurrent primary spontaneous pneumothorax (PSP). To reduce postoperative recurrence, additional treatment is occasionally adopted during surgery after bulla resection. However, the most effective method has not been fully elucidated. Furthermore, the preference for additional treatment varies among countries, and its efficacy in preventing recurrence must be evaluated based on settings tailored for the conditions of a specific country. The number of registries collecting detailed data about PSP surgery is limited. Therefore, to address this issue, a prospective multicentre observational study was performed. METHODS AND ANALYSIS: This multicentre, prospective, observational study will enrol 450 participants aged between 16 and 40 years who initially underwent PSP surgery. Data about demographic characteristics, disease and family history, surgical details, and CT scan findings will be collected. Follow-up must be conducted until 3 years after surgery or in the event of recurrence, whichever came first. Patients without recurrence will undergo annual follow-up until 3 years after surgery. The primary outcome is the rate of recurrence within 2 years after surgery. A multivariate analysis will be performed to compare the efficacy of different surgical options. Then, adverse outcomes correlated with various treatments and the feasibility of treatment methods will be compared. ETHICS AND DISSEMINATION: This study was approved by the local ethics committee of all participating centres. The findings will be available in 2025, and they can be used as a basis for clinical decision-making regarding appropriate options for the initial PSP surgery. TRIAL REGISTRATION NUMBER: NCT04758143.


Subject(s)
Pneumothorax , Adolescent , Adult , Humans , Multicenter Studies as Topic , Observational Studies as Topic , Pneumothorax/prevention & control , Pneumothorax/surgery , Prospective Studies , Recurrence , Research Design , Retrospective Studies , Treatment Outcome , Young Adult
2.
Kyobu Geka ; 74(3): 206-208, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33831874

ABSTRACT

A 48-year-old male was transported to the emergency room with a dirty rusty nail stuck in his chest. Three-dimensional computed tomography (3D-CT) scan revealed that the nail had penetrated the sternum and its tip was close to the left innominate vein. Emergency surgery was performed to avoid severe infections and major vascular injury. The nail was easily removed. We cleansed and debrided the wound which remained open to prevent infection, and was closed on post-operative day 3.


Subject(s)
Foreign Bodies , Wounds, Penetrating , Humans , Male , Middle Aged , Sternum/diagnostic imaging , Sternum/surgery , Tomography, X-Ray Computed , Wounds, Penetrating/diagnostic imaging , Wounds, Penetrating/surgery
3.
Lung Cancer ; 104: 79-84, 2017 02.
Article in English | MEDLINE | ID: mdl-28213006

ABSTRACT

OBJECTIVES: The standard therapy for patients with T3N0-1M0 non-small cell lung cancer (NSCLC) involving the chest wall is considered surgical resection and adjuvant therapy. However, the compliance of adjuvant therapy is relatively low, and the prognosis for those patients has been unsatisfactory. Therefore, we conducted a phase II study of induction chemoradiotherapy followed by surgery with the aim of improving the survival. PATIENTS AND METHODS: This treatment strategy consisted of induction chemotherapy (two cycles of cisplatin at 80mg/m2 on Day 1 and vinorelbine at 20mg/m2 on Days 1 and 8) concurrent with radiotherapy (40Gy in 20 fractions) followed by surgery. The inclusion criteria were patients with resectable T3N0-1M0 NSCLC involving the chest wall who were 20-70 years of age. The primary end point was the 3-year survival, assuming an expected rate of 67%. RESULTS: From January 2009 to November 2012, 51 eligible patients were enrolled. Induction therapy was completed as planned in 49 (96%) patients without treatment-related death, and 25 (51%) had a partial response. Complete resection combined with the involved chest wall was achieved in 46 (92%) patients, and a pathologic complete response was seen in 13 (26%) patients. Five patients experienced major postoperative complications, and 1 patient died of acute exacerbation of interstitial pneumonia. With a median follow-up period of 42 months, the 3- and 5-year overall survivals of all registered patients were 77% and 63%, respectively. There was a significant difference in the survival rate between patients with a pathologic complete response and those with a residual tumor (p=0.039). CONCLUSION: The mature results of this study in a multi-institutional setting showed the treatment strategy to be safe and effective with a high rate of pathologic response for patients with NSCLC involving the chest wall.


Subject(s)
Carcinoma, Non-Small-Cell Lung/therapy , Chemoradiotherapy , Induction Chemotherapy/methods , Lung Neoplasms/therapy , Thoracic Wall/pathology , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Cisplatin/administration & dosage , Cisplatin/therapeutic use , Combined Modality Therapy , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Prospective Studies , Survival Rate , Treatment Outcome , Vinblastine/administration & dosage , Vinblastine/analogs & derivatives , Vinblastine/therapeutic use , Vinorelbine
4.
Ann Thorac Surg ; 98(4): 1184-91, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25110336

ABSTRACT

BACKGROUND: The chest wall is the most common neighboring structure involved by locally advanced lung cancers. However, the optimal treatment strategy for such tumors has not been established. This phase II trial was therefore conducted with the aim of evaluating whether induction chemoradiotherapy followed by surgery improves the survival of patients with T3N0 or T3N1 lung cancer involving the chest wall. METHODS: Patients with resectable T3N0 or T3N1 non-small cell lung cancer involving the chest wall were candidates for this study. Induction therapy consisted of two cycles of cisplatin and vinorelbine chemotherapy concurrent with 40 Gy of radiation. Surgical resection was performed 3 to 6 weeks after the last day of chemotherapy. RESULTS: From January 2009 to November 2012, 51 eligible patients (40 stage IIB and 11 stage IIIA tumors) were entered in this study. Induction therapy was completed as planned in 49 (96%) patients, and 25 (51%) had a partial response revealed on computed tomography. Forty-eight patients underwent pulmonary resection combined with chest wall resection, and 44 (92%) underwent a complete resection. Pathologic examinations of the resected specimens revealed no viable tumor cells in 12 (25%) cases and minimal residual disease in 31 (65%) cases. Five patients experienced major postoperative complications, and 1 patient died of postoperative exacerbation of interstitial pneumonia. CONCLUSIONS: The initial results of this study showed the treatment regimen to be safe and feasible with a high rate of a pathologic response for patients with lung cancer involving the chest wall in a multiinstitutional setting.


Subject(s)
Carcinoma, Non-Small-Cell Lung/therapy , Chemoradiotherapy , Lung Neoplasms/therapy , Pneumonectomy , Thoracic Wall/pathology , Adult , Aged , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Combined Modality Therapy , Female , Humans , Induction Chemotherapy , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging
5.
Ann Thorac Cardiovasc Surg ; 20(5): 370-7, 2014.
Article in English | MEDLINE | ID: mdl-24200667

ABSTRACT

PURPOSE: The use of staplers for thoracic surgery has been regarded as a safe procedure though sometimes adverse events (AEs) of stapling are experienced. The aim of this study is to analyze AEs of lung tissue stapling. METHODS: A retrospective multi-institutional review was conducted by 27 institutions of the Central Japan Lung Cancer Surgery Study Group. During the research period, lung tissue stapling was performed 10908 times. RESULTS: Total number of AEs related to stapling was 81 (0.74%). Seventy events occurred intraoperatively and 11 events occurred postoperatively. Intraoperative stapling AEs were air leakage (n = 26), laceration of the adjacent lung tissue (n = 23), stapling failure (n = 14), oozing (n = 4), and others (n = 3). The postoperative AEs were prolonged air leakage (n = 9), bleeding from the chest wall (n = 1), and postoperative bleeding (n = 1). Only one case died of acute exacerbation of interstitial pneumonia which was induced after completion lobectomy to cure postoperative bleeding. No relationship was seen between the incidence of AE and cartridge colors or compression types of staplers except the length of cartridges. CONCLUSION: Lung tissue stapling in thoracic surgery was safe. The most frequent cause of AEs was stapler-tissue thickness mismatch. The appropriate selection of the cartridge color may decrease the AE incidence of the lung tissue stapling.


Subject(s)
Lung/surgery , Postoperative Complications/etiology , Surgical Stapling/adverse effects , Thoracic Surgical Procedures/adverse effects , Equipment Design , Humans , Japan , Postoperative Complications/mortality , Retrospective Studies , Risk Factors , Surgical Staplers , Surgical Stapling/instrumentation , Surgical Stapling/mortality , Thoracic Surgical Procedures/instrumentation , Thoracic Surgical Procedures/mortality , Treatment Outcome
6.
Nihon Kokyuki Gakkai Zasshi ; 45(12): 921-6, 2007 Dec.
Article in Japanese | MEDLINE | ID: mdl-18186236

ABSTRACT

Myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) is an autoantibody that is frequently found in patients with vasculitides. We encountered some MPO-ANCA positive patients with interstitial pneumonia who lacked vasculitides, but its meaning remains unclear. We measured MPO-ANCA titers in 69 patients with interstitial pneumonia (IP) who did not have collagen vascular diseases and observed their outcome. MPO-ANCA was positive in 5 patients and its prevalence was 7.2%. Patients with MPO-ANCA positive showed higher positivity in rheumatoid factor (RF) than patients with MPO-ANCA negative. The sensitivity and specificity of a combination of anti-nuclear antibody-negative and RF-positive were 80.0% and 87.7%, respectively. Two patients were accompanied by microscopic polyangiitis and the 3-year survival rate was 40% in all patients with MPO-ANCA. Measurement of MPO-ANCA titers in patients with IPs is meaningful for determining therapeutic strategy.


Subject(s)
Antibodies, Antineutrophil Cytoplasmic/blood , Lung Diseases, Interstitial/immunology , Peroxidase/immunology , Aged , Female , Humans , Male
7.
Chest ; 126(5): 1687-93, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15539745

ABSTRACT

STUDY OBJECTIVES: To facilitate marking and to reduce its complications, we performed barium marking using an ultrathin bronchoscope with virtual bronchoscopic (VB) navigation before thoracoscopic surgery for small pulmonary peripheral lesions. We then evaluated the feasibility, safety, and efficacy of this technique. DESIGN: A pilot study. SETTING: A tertiary teaching hospital. PATIENTS: The subjects were consecutive patients with small pulmonary peripheral lesions (ie,

Subject(s)
Bronchoscopy/methods , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Thoracoscopy/methods , Aged , Barium Sulfate , Bronchoscopes , Contrast Media , Equipment Design , Feasibility Studies , Female , Fluoroscopy , Humans , Male , Middle Aged , Pilot Projects
8.
Jpn J Thorac Cardiovasc Surg ; 51(1): 16-7, 2003 Jan.
Article in English | MEDLINE | ID: mdl-12645149

ABSTRACT

We report a case of a 40-year-old man with chylopericardium who developed purulent pericarditis caused by Salmonella enteritidis. Thoracoscopic pericardiotomy with debridement effectively controlled the pericardial infection.


Subject(s)
Pericardial Effusion/complications , Pericarditis/etiology , Salmonella Infections/complications , Salmonella enteritidis , Adult , Humans , Male
9.
Cancer Genet Cytogenet ; 137(1): 33-42, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12377411

ABSTRACT

We established a new lung cancer cell line, designated Y-ML-1B, from a lung cancer of a 70-year-old Japanese man with leukocytosis and thrombocytosis. Before surgical resection, the white blood cell and platelet counts were elevated to 34,400/mm3 and 668,000/mm3, respectively, and the granulocyte colony-stimulating factor (G-CSF) level in the serum was increased at 141 pg/mL. The primary tumor showed an undifferentiated morphology with large cells and induced extensive thickening of the pleura in the right hemithorax. The Y-ML-1B cells grow as a monolayer, with a doubling time of 19 hours, and are tumorigenic in nude mice, which showed a morphology similar to the primary tumor in xenografts. Analysis of the supernatant of cell culture medium of Y-ML-1B showed elevated levels of G-CSF and other cytokines such as interleukin (IL)-6, IL-8, and granulocyte-macrophage colony-stimulating factor (GM-CSF), consistent with the high levels detected in the patient's serum. Cytogenetic analysis revealed aneuploidy of greater than 56 in metaphases with many structural abnormalities. Mutation analysis of the tumor suppressor genes showed that Y-ML-1B is inactivated in TP53 and RASSF1A, but not in p14(ARF), p16(INK4A), or RB. Neither activating mutations of KRAS or NRAS nor amplification of MYC or MDM2 were detected. Y-ML-1B expressed N-cadherin but not E-cadherin. This newly established cell line might serve as a useful model for studying the molecular pathogenesis for large cell cancers of the lung which express high levels of cytokines.


Subject(s)
Carcinoma, Large Cell/genetics , Granulocyte Colony-Stimulating Factor/genetics , Lung Neoplasms/genetics , Aged , Animals , Base Sequence , Carcinoma, Large Cell/pathology , Cell Culture Techniques/methods , Cell Division , Chromosome Mapping , DNA Primers , Humans , Karyotyping , Lung Neoplasms/pathology , Male , Mice , Mice, Nude , Neoplasm Proteins/genetics , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Proto-Oncogenes , Transplantation, Heterologous , Tumor Cells, Cultured
SELECTION OF CITATIONS
SEARCH DETAIL
...