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Volume 18, Issue 6
Displaying 1-17 of 17 articles from this issue
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Ryoji Kawano, Shu Matsukawa, Yasuhiro Takahashi, Toshiya Yokota, Shing ...2004 Volume 18 Issue 6 Pages 696-699
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSWe evaluated the usefulness of resection of metastatic lung tumor originating from renal cell carcinoma (RCC). Eighteen patients diagnosed with a metastatic lung tumors originating from RCC between 1986 and 2000 were examined. The 5-and 10-year survival rates of these patients were 42.9% and 32.1%, respectively. Male patients, maximum tumor diameter of 2cm or more, left sided and bilateral lung tumors, and nodal involvement of pulmonary or mediastinum showed an unfavorable prognosis. Statistically significant difference of prognosis was recognized only between patients with and without lymph node metastasis (p=0.03). Consequently, patients with lung metastasis originating from RCC without lymph node metastasis are good candidates for aggressive surgical treatment. However, treatment involving immunotherapy may be optimal for patients with nodal involvement and should be carefully considered.View full abstractDownload PDF (598K) -
Kazuhito Funai, Junji Yoshida, Satoshi Shiono, Kazuya Takamochi, Mitsu ...2004 Volume 18 Issue 6 Pages 700-704
Published: September 15, 2004
Released on J-STAGE: February 23, 2011
JOURNAL FREE ACCESSThe prophylactic antibiotic guidelines for respiratory surgery were showed in 2001 as a special edition of the Journal of Japan Surgical Society. The guideline recommended second-generation cephalosporin or penicillin antibiotic agent administered for 3 to 4 days following surgery.
We considered this dosage to be excessive for routine practice. We prospectively applied a guideline of administering cefazolin right before and three hours after respiratory surgery and reviewed the safety and validity. By April 2003, we had applied the guidelines in 237 consecutive patients. Of these, 166 patients were treated under our guidelines, while 71 patients received additional antibiotics based on the guidelines' exception rules: patients with excess sputum or body temperature over 38.5°C on the first postoperative day. There were no guideline-related adverse events.
In conclusion, prophylactic cefazolin twice on the day of respiratory surgery was safe and valid.View full abstractDownload PDF (3264K) -
Keisuke Eguchi, Yotaro Izumi, Masazumi Watanabe, Masabumi Kawamura, Hi ...2004 Volume 18 Issue 6 Pages 705-709
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSSurgical staplers are useful devices for saving operation time, technical stabilization, and reducing the complications of pulmonary resection, however, the high cost of the staplers is not negligible. One hundred fortynine pulmonary resections, consisting of 89 open thoracotomies and 60 thoracoscopic operations, were performed in Keio University Hospital in Tokyo, Japan in 2002. The average numbers of staplers consumed in most types of operation were less than 4, however, more than 4 staplers were consumed for lobectomies after excisional lung biopsy (5 for open thoracotomies and 7±1.8 for thoracoscopic operations). The cost of the staplers in 65% of thoracoscopic operations accounts for more than 30% of the operation fee, which is partially reimbursed by the Japanese National Health Insurance system. The operation fee provided by the Japanese Health Insurance system does not seem to cover the cost of using staplers during thoracoscopic pulmonary resections.View full abstractDownload PDF (2207K) -
Hironori Ninomiya, Takayuki Shirakusa, Nobuharu Yamamoto2004 Volume 18 Issue 6 Pages 710-715
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 60-year-old man was admitted to our hospital with exertional dyspnea due to chronic obstructive pulmonary disease. Medicinal treatment had been given previously, but it was not effective. Chest X-ray showed flattening of the diaphragm and hyperlucency of the lung field. Chest CT scan revealed emphysematous change dominantly seen in the upper part of the lungs. Ventilation-perfusion scanning presented an inhomogenous pattern of the disease. Thoracoscopic lung volume reduction surgery (LVRS) was performed. After the procedure, FEV1.0 increased significantly but the symptoms did not improve subsequently. Drainage of persistent pleural effusion was performed, and pulmonary artery pressure elevated. Treatment for heart failure improved his respiratory status dramatically, and he is now in good health without oxygen therapy at five months after operation. He is thoroughly satisfied with the results.View full abstractDownload PDF (5769K) -
A case reportMasaki Tokumo, Itaru Nagahiro, Seiichirou Sugimoto, Hiroyuki Tao, Kanj ...2004 Volume 18 Issue 6 Pages 716-720
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 76-year-old man underwent right upper lobectomy for primary lung cancer, and he developed right empyema, bilateral pneumonia and respiratory insufficiency postoperatively. Artificial ventilation was necessary to maintain his respiratory condition. On the 28th postoperative day, air leakage was noted and a bronchoscopic examination revieled a bronchopleural fistula of the bronchial stump.rWe injected fibrin glue into the submucosal layer around the fistula for 5 times and finally the fistula closed two weeks after the first injection.View full abstractDownload PDF (1326K) -
Ryo Maeda, Katsunari Matsuoka, Takayuki Misaki, Toshi Menju, Eiichi Ha ...2004 Volume 18 Issue 6 Pages 721-724
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 54-year-old man was admitted to our hospital for evaluation of a mass shadow in the right lower lung field, which had been growing for three years. He had a history of right hemothorax in a traffic accident 30 years earlier. CT scan of his chest showed a tumor shadow measuring 13cm in diameter above the right diaphragm. Intaraoperative findings revealed an intrathoracic hematoma with a tough capsule, adhering tothe right diaphragm and middle and lower lobes. Histological examination showed a hematoma surrounded by dense fibrotic tissues and no malignancy. A rare case of chronic expanding hematoma was reported.View full abstractDownload PDF (1048K) -
Yoshiko Masuda, Shin-ichi Yamashita, Katsutaka Matsumoto2004 Volume 18 Issue 6 Pages 725-729
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSWe performed video-assisted thoracoscopic surgery (VATS) for a 49-year-old man with pumonary dirophilariasis and hemophilia B. A solitary nodule in the right lung field was pointed out and resected. A frozen section of the resected nodule was intraoperatively daignosed as coagulation necrosis and finally, ultimately confirmed as pulmonary dirophilariasis. With well scheduled administration of factor IX, we were able to successfully manage the patient without any complications. HemophiliaB and dirophilariasis are rare diseases, however, they can be safely managed under the treatment guidelines for hemophilia and thoracoscopic surgery.View full abstractDownload PDF (1014K) -
Mitsuharu Sato, Yuichi Ozeki, Kiyohaya Obara, Hiroshi Hashimoto, Toshi ...2004 Volume 18 Issue 6 Pages 730-734
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 65-year-old woman was admitted to our hospital for further examination of an abnormal chest shadow found on chest X-ray. Chest CT and MRI demonstrated a giant heterogeneous and cystic tumor from the anterior mediastinum to the left lung field. Since transcutaneous needle biopsy showed carcinoma, thoracotomy was performed by posterolateral incision. The tumor was located in the left mediastinum and invaded into the left upper lobe of the lung with intrathoracic dissemination. Therefore, the tumor was resected along with the left upper lobe. Tumor measured 13×9×5.5cm, and mostly consisted of necrotic tissue and hemorrhage inside the tumor. Pathologically, the tumor was diagnosed as type B3 thymoma with cystic degeneration, Masaoka's Stage IVa. Postoperative chemotherapy and irradiation to the mediastinum were performed, but the tumor relapsed in the left thorax 2 years later and patient died 4 years after the primary surgery. Because thymoma with large cystic degeneration is rare, we present this case with a review of the literature.View full abstractDownload PDF (2422K) -
Hisashi Suzuki, Katsumi Yamabe, Katsue Yoshida2004 Volume 18 Issue 6 Pages 735-740
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 58-year-old female with large lung cysts in the right middle lobe was being followed by annual chest CT since the cysts were detected at a group screening examination. In the eighth year of follow-up, chest CT showed tumors in the lung cysts, which were diagnosed as well-differentiated adenocarcinoma by TBLB. Right middle lobectomy (ND2a) was performed. Microscopic findings showed many bronchogenic lung cysts and the proliferation of malignant cells along the cysts' inner walls. There are several reports showing that lung cancer occurs more frequently in patients with lung cysts. It is therefore important that patients with lung cysts be followed with careful attention to the development and complications of lung cancer.View full abstractDownload PDF (7050K) -
Michitaka Kimura, Keiji Kushibe, Makoto Takahama, Takeshi Kawaguchi, S ...2004 Volume 18 Issue 6 Pages 741-746
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSWe performed right upper lobectomy on two patients with lung cancer and severe emphysema. Case 1: A 65-year-old man had squamous cell carcinoma in S2 of his right lung, and forced expiratory volume in 1 second (FEV1) was 860m1. His Hugh-Jones (H-J) classification was II. He underwent right upper lobectomy (ND2a), and three months after operation FEV1 improved to 1, 100ml and H-J improved to I. Case 2: A 64-year-old man had squamous cell carcinoma in S1 of his right lung, and FEV1 was 790ml. His H-J classification was II. He underwent right upper lobectomy (ND2a), and three months after operation FEV1 improved to 1, 300ml and his H-J classification improved to I. In both cases, the preoperative CT scans showed severe emphysematous changes in the right upper lobe. Furthermore, the preoperative perfusion scintigraphy showed a lack of perfusion in the right upper lung field. We performed right upper lobectomy on these two patients with lung cancer associated with low FEV1. There were no major postoperative complications. Postoperatively, dyspnea and pulmonary function improved.View full abstractDownload PDF (4684K) -
Tetsu Yamada, Fengshi Chen, Shotaro Iwakiri, Noritaka Isowa, Koji Chih ...2004 Volume 18 Issue 6 Pages 747-750
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSWe report two elderly patients with spontaneous pneumothorax from the rupture of paravertebral gourd-shaped bulla. Both patients showed the characteristic clinical symptom of air leakage from the chest tube disappearing in the supine position was almost continuous in the standing position. Chest computed tomography showed a longitudinal air space in the right pleural space straddling over the vertebral column. They underwent video-assisted thoracic surgery, and the air space was revealed as a gourd-shaped bulla. These uniquely shaped bullae should be a reminder not to overlook bullae in elderly patients with intractable air leakage.View full abstractDownload PDF (3454K) -
Seiichiro Sugimoto, Itaru Nagahiro, Motoi Aoe, Nobuyoshi Shimizu2004 Volume 18 Issue 6 Pages 751-754
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 74-year-old man, who had been operated on for benign thyroid tumor 16 years earlier, was referred to our hospital for further investigation and treatment of a mass shadow noted on chest X-ray in March, 2003. Chest X-ray revealed a mass shadow of the left middle lung field and osteolytic change in the left 6th rib. Chest CT scan showed a tumor of the left 6th rib. Metastatic adenocarcinoma was suspected by CT guided needle biopsy, however, we could not find the original cancer by systemic examinations. Chest wall resection and reconstruction were performed under a diagnosis of left 6th rib tumor. The pathological diagnosis was rib metastasis of thyroid papillary cancer, follicular type. The postoperative course was uneventful and he was discharged on the 18th postoperative day. It is important to follow this patient closely because total thyroidectomy and radioiodine therapy were not performed. We have to remember the possibility of rib metastasis from thyroid cancer in diagnosis of chest wall tumor like this.View full abstractDownload PDF (4021K) -
Yukio Seki, Haruko Suzuki, Syouichi Inoue, Munehisa Imaizumi2004 Volume 18 Issue 6 Pages 755-758
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSThe association between thoracic spine and sternal fractures has previously been documented. It is regarded as uncommon, but this combination can cause severe kyphotic and sternal deformities. We reported such a case, a 58-year-old man who suffered a motor vehicle crush accident. He sustained a sternal body fracture, Th4, Th5 and Th6 spine wedge compression fractures, and bilateral 2 and 3 rib fractures. His initial treatment at our hospital was bed rest for one month and then he was transferred to a nearby hospital for the purpose of social rehabilitation. Six months later, he consulted our hospital because of chest and back pain on moving and kyphotic deformity. A chest roentgenograph showed a dislocated fracture of the stemum and severe thoracic kyphosis. We successfully performed open repair of the sternum and fixation with metal plating. Careful examination should be done on all patients with a combination of fractures of the sternum and thoracic spine.View full abstractDownload PDF (3921K) -
Haruka Takeichi, Ryouta Masuda, Kazuho Yoshino, Sakashi Fujimori, Atsu ...2004 Volume 18 Issue 6 Pages 759-763
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 72-year-old male underwent a mass examination in which plain thoracic radiography detected a tumorous mass in the lower left lung field. A pulmonary lesion was suspected and thoracoscopy was conducted. In the thoracic cavity, a fibrous adhesion of intermediate severity was found over the entire posterior part of the lower left lobe, and a white detached substance was recognized among the adhesive fibers. No intra-pulmonary tumor was detected. The detached substance was a tumor that was hard and smooth on the surface and measured 25 (diameter) ×20×18mm. Its split surface appeared laminated with a brownish nucleus at the center. A histopathological examination revealed calcification at the center that was concentrically surrounded by hyaline collagenous fibers. These findings led to a diagnosis of thoracolithiasis.View full abstractDownload PDF (4595K) -
Tetsuya Yokosuka, Toshiko Kobayashi2004 Volume 18 Issue 6 Pages 764-767
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 56-year-old man was admitted to our hospital because of an enlarging abnormal shadow in the right upper thoracic space on chest X-ray. A dumbbell-type schwannoma in the spinal cord was resected (laminectomy) 6years earlier. Chest CT and MRI findings suggested the presence of another dumbbell-type tumor through the 1st intercostal space. We needed to use both intra-and extrathoracic surgical approaches because of the location of the tumor. The tumor of the intrathoracic space (this tumor seemed to originate from an intercostal nerve) was resected easily by thoracoscopic surgery, and had no connection to the extrathoracic tumor. (enveloped by brachial plexus) which was resected via subclavicular incision. Histological examination of both tumors revealed benign schwannoma.View full abstractDownload PDF (5172K) -
Satoshi Yoshikawa, Akihide Matsumura, Meinoshin Okumura, Hisaichi Tana ...2004 Volume 18 Issue 6 Pages 768-772
Published: September 15, 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSA 60-year-old woman with an abnormal shadow on a chest X-ray film was admitted to our hospital for futher investigation. We diagnosed the abnormal shadow as lung cancer in the left S5 area, while a bronchial artery aneurysm, 1.5cm in diameter, was revealed in the mediastinum in computed tomography. After embolization of the bronchial artery (BAE), we performed a lingulectomy. There have been no recurrent signs of lung cancer or bronchial artery aneurysm, as of 5 months after the operation. Bronchial artery aneurysm is a rare entity which can sometimes be fatal. A case of lung cancer with mediastinal bronchial artery aneurysm, successfully treated by BAE and surgery, is reported.View full abstractDownload PDF (4606K) -
2004 Volume 18 Issue 6 Pages e1
Published: 2004
Released on J-STAGE: June 28, 2010
JOURNAL FREE ACCESSDownload PDF (96K)
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