Randomized, controlled trial comparing the efficacy of intercostal nerve block in thoracoscopic surgery by timing: study protocol for a randomized clinical trial.

Background: Even minimally invasive thoracic surgeries carry a postoperative cost in pain. While regional anesthesia may alleviate this anticipated pain, especially intercostal nerve blocks (ICNB), the timing of block administration for optimal effect (at the beginning of surgery vs. before wound closure) remains controversial.

Intraoperative Surgical Margin Assessment of Sublobar Lung Resection Specimens Using Computed Tomography.

Background: While early lung cancers are increasingly managed with sublobar resection, inadequate surgical margin (SM) is still a major concern, increasing the risk of locoregional recurrence. In this study, we evaluated the feasibility of using computed tomography (CT) as an intraoperative SM guidance tool by comparing with histopathologic SM measurement.

Methods: Patients scheduled for segmentectomy or wedge resection were enrolled.

Congenital Pulmonary Airway Malformation with Pulmonary Arteriovenous Malformation in Adulthood: A Case Report.

Introduction: Congenital pulmonary airway malformation (CPAM) is a congenital condition rarely detected in adults because most cases of CPAM are found through prenatal testing or through testing for recurrent pneumonia or lung abscesses in childhood. Pulmonary arteriovenous malformation (PAVM) is an abnormal vascular connection between the pulmonary arteries and veins, which is often related to hereditary hemorrhagic telangiectasia, but can also be induced by infections, trauma, or thoracic surgery. Herein, we report an adult case of coexisting CPAM and PAVM.

Real-world observation of pain scores using patient-reported outcome measures in lung cancer surgery.

Objective: Although preoperative pain has been reported to affect postoperative quality of life and physical function in lung cancer surgery patients, its impact on postoperative pain remains unclear. This study aimed to describe the frequency and locations of preoperative pain and evaluate its impact on postoperative pain trajectories and chronic pain occurrence in a real-world setting.

Methods: A prospective patient-reported outcome survey was conducted at Hitachi General Hospital.

Feasibility of computed tomography-derived surgical margin assessment in an ex vivo sublobar lung resection model.

Objectives: Computed tomography (CT) imaging of a sublobar resection specimen may inform intraoperative surgical margin assessment. However, consistency with final pathological margins has not been previously evaluated. In this study, we investigated the concordance between surgical margin measurements by CT versus pathology measurements using an ex vivo sublobar lung resection model.

Lung cancer detection in perioperative patients' exhaled breath with nanomechanical sensor array.

Introduction: Breath analysis using a chemical sensor array combined with machine learning algorithms may be applicable for detecting and screening lung cancer. In this study, we examined whether perioperative breath analysis can predict the presence of lung cancer using a Membrane-type Surface stress Sensor (MSS) array and machine learning.

Methods: Patients who underwent lung cancer surgery at an academic medical center, Japan, between November 2018 and November 2019 were included.

Assessment of effectiveness and safety of thrombolytic therapy to pulmonary emboli by endobronchial ultrasound-guided transbronchial needle injection.

Objective: Endobronchial ultrasound-guided transbronchial needle injection (EBUS-TBNI) may effectively treat acute pulmonary embolisms (PEs). Here, we assessed the effectiveness of clot dissolution and safety of tissue plasminogen activator (t-PA) injection using EBUS-TBNI in a 1-week survival study of a porcine PE model.

Methods: Six pigs with bilateral PEs were used: 3 for t-PA injection using EBUS-TBNI (TBNI group) and 3 for systemic administration of t-PA (systemic group).

Sphericity of lymph nodes using 3D-CT predicts metastasis in lung cancer patients.

Background: The presence of mediastinal lymph node metastasis is important because it is related to the treatment and prognosis of lung cancer. Although prevalently used, evaluation of lymph nodes is not always reliable. We introduced sphericity as a criterion for evaluating morphologic differences between metastatic and nonmetastatic nodes.

Anatomic evaluation of Pancoast tumors using three-dimensional models for surgical strategy development.

Objective: Pancoast tumor resection planning requires precise interpretation of 2-dimensional images. We hypothesized that patient-specific 3-dimensional reconstructions, providing intuitive views of anatomy, would enable superior anatomic assessment.

Methods: Cross-sectional images from 9 patients with representative Pancoast tumors, selected from an institutional database, were randomly assigned to presentation as 2-dimensional images, 3-dimensional virtual reconstruction, or 3-dimensional physical reconstruction.

Preclinical feasibility of bronchoscopic fluorescence-guided lung sentinel lymph node mapping.

Objective: Lung sentinel lymph node mapping, where peritumorally injected material is tracked through the lymphatics, aims to find the first potential sites of nodal metastasis. We sought to evaluate the preclinical feasibility of bronchoscopic fluorescence-guided sentinel lymph node mapping.

Methods: Healthy Yorkshire pigs were used; sentinel lymph node mapping was performed with indocyanine green.

Predicting Respiratory Complications Following Lobectomy Using Quantitative CT Measures of Emphysema.

Purpose: In performing surgery for lung cancer, emphysema is a risk factor related to postoperative respiratory complications (PRC). However, few studies have addressed the risk of radiological emphysematous volume affecting PRC. The aim of this study was to investigate the relationship between emphysematous volume as measured on 3-dimensional computed tomography and PRC.

Risk factors of middle lobe bronchus kinking following right upper lobectomy.

Background: The incidence rate of kinking of the middle lobe bronchus following right upper lobectomy is higher compared to that with residual lung bronchus following other lobectomies. Bronchial kinking was presumed to be caused by the displacement of the residual lung lobes, but its etiology is unclear. Moreover, prevention methods and effective treatments have not yet been established.

Efficacy of Alaska Pollock Gelatin Sealant for Pulmonary Air Leakage in Porcine Models.

Background: Postoperative prolonged air leakage is a frequent complication after lung resection. We have developed a new sealant based on a hydrophobically modified Alaska pollock-derived gelatin (ApGltn) sealant. The purpose of this study was to evaluate the adhesive strength of the ApGltn sealant in comparison with a fibrin sealant using a new spray system in ex vivo and in vivo models.

Consolidation volume and integration of computed tomography values on three-dimensional computed tomography may predict pathological invasiveness in early lung adenocarcinoma.

Purpose: To investigate the relationship between three-dimensional computed tomography (3D-CT) findings and pathological invasiveness in lung adenocarcinoma.

Methods: We retrospectively evaluated 95 patients who underwent surgical resection of lung adenocarcinoma of ≤ 20 mm. The diameters, volumes, and CT values of tumor consolidation were analyzed.

Factors related to physical and mental components of quality of life in the community-dwelling frail older persons.

[Purpose] The aim of this study was to investigate factors associated with changes in both the physical and mental components of quality of life (QOL) in of community-dwelling frail older persons in long-term care and to clarify which aspects are important to maintaining physical and mental components of QOL. [Participants and Methods] In this 1 year follow-up cohort study, participants were older persons from a single day care rehabilitation center in Japan. The Medical Outcome Study 8-Item Short-Form Health Survey (MOS-SF8), which gives both physical component summary (PCS) and mental component summary (MCS) scores, was used as the main QOL assessment.

Successful use of extracorporeal membrane oxygenation for airway-obstructing lung adenocarcinoma.

Endobronchial-invasive lung cancers are generally diagnosed at advanced stages and may require emergency treatment for airway obstruction. Stent implantation is a common intervention for such obstructed airways but certain subsets of patients cannot receive adequate treatment without respiratory support. Veno-venous extracorporeal membrane oxygenation (ECMO) is a salvage therapy for respiratory failure but its usefulness in managing patients with advanced lung cancer remains unclear given the poor prognosis.

Detection of circulating tumor cells in patients with lung cancer using metallic micro-cavity array filter: A pilot study.

We have developed a metallic micro-cavity array filter and an automated detection system for capturing circulating tumor cells (CTCs). In this single institutional pilot study, we assessed the ability of this device to detect CTCs in patients with lung cancer at each stage. Patients diagnosed with lung cancer, undergoing planned surgery for lung cancer, or suspected of having lung cancer were recruited (40 recruited and 2 excluded).

Rolipram plus Sivelestat inhibits bone marrow-derived leukocytic lung recruitment after cardiopulmonary bypass in a primate model.

Cardiopulmonary bypass (CPB) recovery is complicated by lung inflammation from bone marrow (BM)-derived polymorphonuclear leukocytes (PMNs) and monocytes (MO). Although Sivelestat reduces inflammatory mediators and Rolipram inhibits PMN and MO activation, any kinetic effects to improve CPB recovery in vivo are unknown. We hypothesized that intraoperative co-administration of these compounds would reduce CPB-induced lung inflammation through downregulation of PMN and MO recruitment.

[Outcome of Surgical Treatment of Locally Advanced Lung Cancer after Induction Chemoradiotherapy].

Objective: The outcome of surgical treatment of non-small-cell lung cancer after induction chemoradiotherapy was investigated.

Subjects: The subjects were 74 patients with non-small-cell lung cancer who received induction chemoradiotherapy( ICRT) between 1998 and 2016. ICRT was administered to pT3 lung cancer invading the chest wall(20 patients), pT4 lung cancer invading the adjacent organ(22 patients), and cN2 lung cancer(32 patients).

Three-dimensional computed tomographic volumetry precisely predicts the postoperative pulmonary function.

Purpose: It is important to accurately predict the patient's postoperative pulmonary function. The aim of this study was to compare the accuracy of predictions of the postoperative residual pulmonary function obtained with three-dimensional computed tomographic (3D-CT) volumetry with that of predictions obtained with the conventional segment-counting method.

Methods: Fifty-three patients scheduled to undergo lung cancer resection, pulmonary function tests, and computed tomography were enrolled in this study.