Abstract:
:This review provides an update on the current role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and mediastinoscopy (Med) in assessment of patients with non-small cell lung cancer (NSCLC). Invasive mediastinal lymph node (LN) staging is the major application for both of these techniques. Up until recently, Med was the gold standard for invasive mediastinal LN staging in NSCLC. However, EBUS-TBNA has shown to be equivalent, and in some studies better than Med for invasive staging of lung cancer. EBUS-TBNA offers access to N1 LNs and development of the thin convex probe EBUS (TCP-EBUS) will expand EBUS-TBNA access from the paratracheal region and central airways to more distal parabronchial regions allowing for more extensive N1 LN assessment and sampling more distal lung tumors. EBUS-TBNA is more cost-effective than Med and it is currently recommended as the test of first choice for invasive mediastinal LN staging in lung cancer. Confirmatory Med should be performed selectively in patients with high pretest probability of metastatic disease. Addition of esophageal ultrasound fine needle aspiration (EUS-FNA) may increase diagnostic yield of EBUS-TBNA mediastinal staging. Both Med and EBUS-TBNA can be used in primary lung cancer diagnosis, restaging of the mediastinum following neoadjuvant therapy and in diagnosis of lung cancer recurrence. In the future, a combination of EBUS-TBNA with or without EUS-FNA and Med is most likely going to provide the most optimal invasive assessment of the mediastinum in patients with lung cancer. The decision on test choice and sequence should be made on a case-by-case basis and factoring in local resources and expertise.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Czarnecka-Kujawa K,Yasufuku Kdoi
10.21037/jtd.2017.03.102subject
Has Abstractpub_date
2017-03-01 00:00:00pages
S83-S97issue
Suppl 2eissn
2072-1439issn
2077-6624pii
jtd-09-S2-S83journal_volume
9pub_type
杂志文章,评审abstract::Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world. Althou...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.09.33
更新日期:2017-09-01 00:00:00
abstract::Primary pleural myxoid liposarcoma is a rare tumor. Here, we report a primary myxoid liposarcoma occupying the majority of the left thoracic cavity with features suggesting invasion. Computed tomography (CT) at medical check-up incidentally revealed a bulky inhomogeneous fatty mass. The tumor's large size made a predi...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.03.29
更新日期:2017-03-01 00:00:00
abstract:Background:Hemoptysis can be a life-threatening condition that requires urgent treatment. Surgery still plays an important role in managing this critical situation, although previous reports have reported high postoperative morbidity and mortality rates. We report our experience with surgical resection for hemoptysis c...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.122
更新日期:2018-06-01 00:00:00
abstract::Prosthetic valve endocarditis (PVE) after transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) is a potential life threatening complication. Better understanding of the incidence, predictors, clinical presentation, diagnostic measures, complications and management of PVE may help ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.10.28
更新日期:2016-10-01 00:00:00
abstract:Background:Whether lobe-specific lymph node dissection (L-SLND) could serve as an alternative to systematic lymph node dissection (SLND) in treating early-stage non-small cell lung cancer (NSCLC) remains unclear. Therefore, we conducted this comprehensive meta-analysis to compare the effect of L-SLND with that of SLND ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.04.137
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To report a rare case of atypical histiocytic tumor of the lung with a review of literature. METHODS:The clinical materials were noted. Literature related to this condition from the past 50 years was reviewed from the group of histiocytic tumors. RESULTS AND CONCLUSIONS:Clinical manifestations were non-spec...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2013.07.26
更新日期:2013-08-01 00:00:00
abstract:Background:Eosinophilic chronic obstructive pulmonary disease (COPD) patients have eosinophilic airway inflammation. No prospective study has reported blood eosinophil counts in an endemic area for parasitic infection. The primary objective was to compare exacerbation rates. The secondary objectives were patient-report...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-19-4101
更新日期:2020-09-01 00:00:00
abstract::We present a case of unusual cardiac paraganglioma (PG) initially misdiagnosed as atypical carcinoid tumor of the lung and discuss key clinical and pathologic characteristics that guide surgical management of these rare chromaffin cell tumors. A 64-year-old female with persistent cough and back pain was found to have ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.11.132
更新日期:2018-01-01 00:00:00
abstract::Immunotherapy agents in metastatic non-small cell lung cancer (NSCLC) can result in improved quality of life and survival when compared with platinum-based chemotherapy. Novel response patterns such as pseudoprogression and hyperprogression, however, have been described and pose a challenge to treating physicians. Pre...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.01.79
更新日期:2018-02-01 00:00:00
abstract:Background:Robotic surgery is increasingly used to resect lung cancer. However costs are high. We compared costs and outcomes for robotic surgery, video-assisted thoracic surgery (VATS), and open surgery, to treat non-small cell lung cancer (NSCLC). Methods:We retrospectively assessed 103 consecutive patients given lo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.123
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Plaques with a large necrotic core or lipid pool and thin-cap fibroatheroma manifest as attenuated plaques on intravascular ultrasound (IVUS). Their impact on TIMI grade flow and clinical outcomes remains undefined. We performed a systematic review and meta-analysis to summarize the association between atten...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.02.51
更新日期:2016-03-01 00:00:00
abstract::Post pneumonectomy bronchopleural fistula (BPF) is a life-threatening complication requiring pleural cavity drainage to avoid acute mediastinal shift and contralateral aspiration pneumonia. Chest drain insertion in this situation may be technically difficult because of drastic anatomical changes such as mediastinal di...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.11.145
更新日期:2018-01-01 00:00:00
abstract::Non-small-cell lung cancer (NSCLC) is a uniformly fatal disease and most patients will present with advanced stage. Treatment outcomes remain unsatisfactory, with low long-term survival rates. Standard treatment, such as palliative chemotherapy and radiotherapy, offers a median survival not exceeding 1 year. Hence, co...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2010.12.03
更新日期:2011-03-01 00:00:00
abstract::A novel strategy of one-stage surgery in combination with thoracic endovascular grafting and resection for T4 lung cancer invading the thoracic aorta and spine is described. A 56-year-old man with locally advanced lung cancer infiltrating the aortic wall and spine underwent neoadjuvant chemotherapy and thoracic irradi...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.10.101
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Adjuvant cisplatin-based chemotherapy (ACT) after resection of stages II-IIIA non-small cell lung cancer (NSCLC) modestly increased survival in several clinical trials. This study evaluated the subsequent impact of those trials on ACT use in clinical practice. METHODS:Patients who underwent lobectomy or mor...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.01.42
更新日期:2015-03-01 00:00:00
abstract:Background:Differences in short-term and 1-year outcomes of percutaneous edge-to-edge mitral repair between patients with functional and degenerative mitral regurgitation (MR) remain unclear. We performed a systematic review and meta-analysis to investigate the safety and efficacy of MitraClip (MC) in patients with dif...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.06.107
更新日期:2018-07-01 00:00:00
abstract:Background:Pulmonary complications (PCs) may influence long-term survivor. We sought to determine the long-term impacts of major pulmonary complications (MPCs) and identify the independent risk factors in non-small cell lung cancer (NSCLC) patients. Methods:A retrospective study was conducted to analyze the PCs of 828...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.10.144
更新日期:2017-12-01 00:00:00
abstract:Background:Outcome of patients with advanced non-small cell lung cancer (NSCLC) treated with platinum-based doublet chemotherapy is usually poor, with overall survival ranges from 8-13 months. However, the overall survival is improved to 21-28 months in the era of epidermal growth factor receptor (EGFR) tyrosine kinase...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.143
更新日期:2018-04-01 00:00:00
abstract::With the improvement in thoracoscopic and laparoscopic surgery, thoracoscopic and laparoscopic esophagectomy (TLE), a minimally invasive approach, has attracted increasing attention as an alternative to open three-field esophagectomy. From June 2012 to October 2013, 90 patients underwent laparoscopic and thoracoscopic...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.02.04
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Surgical use of robots has evolved over the last 10 years. However, the academic experience with robotic lung segmentectomy remains limited. We aimed to analyze our lung segmentectomy experience with robot-assisted thoracoscopic surgery. METHODS:Prospectively recorded clinical data of 21 patients who underwe...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.06.40
更新日期:2014-07-01 00:00:00
abstract::Thoracic damage control surgery (TDCS) is a decision making tool and derivate of the damage control concept (DCC), where physiological stabilization has a priority over anatomical reconstruction under the pressure of time. Intrathoracic haemorrhage control and pleural decompression are the two main immediate tasks of ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.11.32
更新日期:2019-02-01 00:00:00
abstract:Background:It is critical to have an accurate measurement of solid tumor size in order to predict the invasiveness of small lung adenocarcinomas. Some lesions cannot be measured accurately via High-resolution computed tomography (HRCT) due to their irregular shape and unclear borders. For this reason, we evaluated the ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-2131
更新日期:2020-12-01 00:00:00
abstract:Background:The purpose of this study is to evaluate outcomes in upfront local response and survival of patients with esophageal cancer and distant metastasis. Methods:This retrospective study included 34 patients (25 males) aged 42-92 years (median, 70 years) with a histological diagnosis of esophageal squamous cell c...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.45
更新日期:2018-03-01 00:00:00
abstract:Background:To describe a single-institutional experience with an innovative technique using CT-guided injection of autologous blood for localization of nonpleural-based pulmonary nodules prior to thoracoscopic excisional biopsy in pediatric patients. Methods:A retrospective review of all patients under the age of 18 w...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-19-3800
更新日期:2020-08-01 00:00:00
abstract:Background:Bronchopleural fistula (BPF) remains a serious complication after surgery for lung cancer with bronchial resection. A free pericardial fat pad (FPFP) is applied in high-risk cases to reduce BPF frequency. BPF may occur 6 months after surgery. Thus, we evaluated the residual FPFP volume at 6 months after surg...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.81
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Patient-initiated action plans are an important component of COPD self-management (SM) interventions. When integrated into SM interventions, these action plans have proven to be effective in reducing exacerbation severity, hospitalisations, and costs and in improving health status in patients with COPD witho...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.11.14
更新日期:2014-11-01 00:00:00
abstract:Background:The purpose of this study was to systematically assess the subjective and objective outcomes of macrolide therapy for chronic rhinosinusitis (CRS). Methods:PubMed, Embase and Cochrane databases were searched for clinical trials detailing the effects of macrolide therapy in patients with CRS and published up...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.10.41
更新日期:2018-10-01 00:00:00
abstract:Background:Although emphysema and small cell lung cancer (SCLC) are prevalent in smokers, no previous study has investigated the prognostic impact of computed tomography (CT)-determined emphysema in SCLC. This study was undertaken to analyze the prognostic value of emphysema scores as determined by baseline CT scans in...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.97
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:There is increasing evidence that a considerable proportion of patients with diabetes remain undiagnosed and untreated, however, it is unclear whether this is associated with more severe coronary artery disease (CAD) and microvasculature changes compared with diagnosed patients. We assessed CAD extent and se...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.05.61
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to identify specious radiologic and/or physiologic prognostic marker(s), which lead to optimize of the patient follow-up frequency. METHODS:Eighty consecutive patients with newly diagnosed pulmonary sarcoidosis. Patients underwent chest radiography, high-resolution computed ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.01.17
更新日期:2017-01-01 00:00:00