Abstract:
Background:Thoracoscopic surgery (TS) has been used more commonly as a less invasive procedure for early-stage non-small cell lung cancer (NSCLC) than conventional thoracotomy (TH) in Japan. However, limited evidential data are available to compare the treatment efficacy of TS and TH. The purpose of this study was to retrospectively investigate the difference in the long-term outcome and invasiveness of TS and TH. Methods:Total 1,166 NSCLC patients who underwent surgery between 2005 and 2013 were enrolled. Of these, 844 patients underwent surgery via TH and 322 via TS. We compared several clinicopathological factors and the long-term outcome between the two groups. We performed propensity score matching analysis to minimize differences in the patient background and tumor states. Results:The TS group included more women, non-smokers or light smokers, and healthy patients. In the TS group, the disease states were significantly less aggressive. The TS group had a much better 5-year overall survival (OS) rate of 92.6% as compared to 76.7% in the TH group (P<0.0001). Using propensity score matching, we extracted 190 patients each from the two groups. No statistical differences were present in the OS rates of the two matched groups (P=0.2223), indicating the achievement of adequate balance. For a balanced cohort, intraoperative blood loss was significantly less, and the duration of postoperative drainage was shorter in the TS group. Conclusions:We observed excellent long-term oncological outcomes in NSCLC patients after TS, with comparable treatment outcomes and less-invasiveness than TH.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Nakao M,Ichinose J,Matsuura Y,Nakagawa K,Okumura S,Mun Mdoi
10.21037/jtd.2019.07.02subject
Has Abstractpub_date
2019-07-01 00:00:00pages
3112-3121issue
7eissn
2072-1439issn
2077-6624pii
jtd-11-07-3112journal_volume
11pub_type
杂志文章abstract:BACKGROUND:Presently, the clinical effect of radical video-assisted thoracic surgery (VATS) is equal to that of traditional open chest surgery and has received worldwide recognition of its advantages: less trauma and faster recovery. In the attempt to further the advancement of minimally invasive surgery the operative ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.12.51
更新日期:2015-12-01 00:00:00
abstract:Background:Reconstruction of the aorto-mitral curtain (AMC) for invasive double-valve infective endocarditis (IE) is a rare and challenging procedure. This study presents the short- and mid-term results of reconstruction of AMC in a single center. Methods:From 2016 to 2019, 14 patients with invasive double-valve under...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2020.03.04
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients' satisfaction with the surgery. In this study, we present a simple approach involving the safe...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.12.30
更新日期:2016-12-01 00:00:00
abstract::The expanded possibilities to explore the lung deeper with new tools such as electromagnetic navigation bronchoscopy (ENB) or radial probe endobronchial ultrasonography (radial EBUS), combined with miniaturization of traditional local therapies such as radiofrequency ablation (RFA), radiotherapy, cryotherapy or photod...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.86
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:A challenge for resection of thoracic inlet tumors lies in that high risk of injuring vital blood vessels and brachial plexus still exists during the resection. And the standard surgical approach for resection of thoracic inlet tumors has not yet been well established. METHODS:Small cervical incision-assist...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.10.52
更新日期:2016-10-01 00:00:00
abstract::Refractory gastroesophageal reflux-induced chronic cough (GERC) is a special type of gastroesophageal reflux disease (GERD) with predominant cough resistant to pragmatic standard anti-reflux therapy including antisecretory agents alone or in combination with promotility agents but with a favorable response to intensif...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd-2020-icc-002
更新日期:2020-09-01 00:00:00
abstract::Three-dimensional printing (3Dp) has a broad array of medical applications and has been applied extensively in congenital heart disease given the variety and complexity of lesions encountered. 3Dps are unique when compared to other imaging modalities in that they are theoretically equally interpretable by radiologists...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.10.38
更新日期:2020-03-01 00:00:00
abstract:Background:In this retrospective study, we aimed to compare single-port (SP) and two-port (TP) video-assisted thoracic surgery (VATS) for the surgical resection of mediastinal tumor. Methods:Between December 2015 and October 2018, a total of 191 consecutive mediastinal tumor patients who underwent SP- or TP-VATS in th...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.05
更新日期:2019-11-01 00:00:00
abstract::Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.03.84
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The rate of detection of small pulmonary nodules (SPNs) has increased. Thoracoscopic resection following image-guided localization had been a reliable alternative in their treatment. We present our experience with image-guided dye localization using robotic C-arm computed tomography (CT) followed by immediat...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.09.55
更新日期:2016-10-01 00:00:00
abstract::In 2011, three authoritative academic communities, International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (IASLC/ATS/ERS), published a novel lung adenocarcinoma histologic classification. The major modifications of this classification include the abo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.09.15
更新日期:2014-10-01 00:00:00
abstract::The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital i...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2016.08.44
更新日期:2016-08-01 00:00:00
abstract:Background:Spread through air spaces (STAS) is reportedly a significant risk factor for recurrence and a prognostic factor in patients with non-small cell lung cancer (NSCLC), especially after sublobar resection. Because wedge resection (WR) is associated with insufficient margins, we hypothesized that STAS has a great...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2020.04.47
更新日期:2020-05-01 00:00:00
abstract::We have entered an open access publishing era. The impact and significance of open access is still under debate after two decades of evolution. Open access journals benefit researchers and the general public by promoting visibility, sharing and communicating. Non-mainstream journals should turn the challenge of open a...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.03.18
更新日期:2014-05-01 00:00:00
abstract:Background:Cervical anastomotic leakage remains a great challenge for thoracic surgeons in the surgical treatment of esophageal cancer. Among the factors affecting cervical anastomosis healing, the surgical technique is the key controllable element. This study aimed to identify the risk factors of cervical anastomotic ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2020.04.36
更新日期:2020-05-01 00:00:00
abstract:Background:Intraoperative alveolar air leak (IOAAL) is one of most common complications after video-assisted thoracoscopic surgery (VATS) lobectomy. The study aimed to evaluate if, in moderate IOAAL, intraoperative polymeric biodegradable sealant (ProgelTM) reduced postoperative air leak (PAL) and consequently was cost...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.11.109
更新日期:2017-12-01 00:00:00
abstract:Background:The novel HeartMate 3 (Abbott, Chicago, IL, USA) left ventricular assist device (LVAD) was worldwide first implanted by Prof. Schmitto and his team in 2014 at the Hannover Medical School, Germany and received CE Mark approval in October, 2015 following completion of a clinical trial. Methods:Although HeartM...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.26
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Cytomegalovirus (CMV) pneumonia is a major cause of death in immunosuppressed patients. Despite the effective treatment with ganciclovir (GCV) and other antiviral agents, the mortality rate remains between 30% to 50%. Recently, the anti-malarial drug artesunate (ART) wasfound to exhibit significant anti-vira...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.07.05
更新日期:2015-07-01 00:00:00
abstract::Approximately 30% to 50% of patients will develop ischemic mitral regurgitation (MR) after a myocardial infarction, which is a result of progressive left ventricular remodeling and dysfunction of the subvalvular apparatus, and portends a poor long-term prognosis. Surgical treatment is centered on mitral valve repair u...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2016.01.27
更新日期:2016-01-01 00:00:00
abstract::While ionizing radiotherapy (RT) can provide durable local control, the relative radiosensitivity of surrounding organs such as the lungs and heart and the distributed nature of the pleura limit the ability to safely deliver RT for patients with malignant pleural mesothelioma (MPM). Recent advances in the technologica...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.07.65
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The use of uniportal video-assisted thoracoscopic surgery (VATS) has been increasing worldwide. Our main goal was to describe the evolution of uniportal surgery in the biggest private hospital in Latin America that is located in São Paulo, Brazil. METHODS:This descriptive and retrospective study included pa...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.10.79
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Red cell distribution width (RDW) might be a novel biomarker that reflects multiple physiological impairments related to atherosclerosis and coronary artery diseases (CAD). We conducted this systematic review and meta-analysis to evaluate the association of RDW between all-cause mortality and fatal/non-fatal...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.09.10
更新日期:2014-10-01 00:00:00
abstract::Diagnosing pleural effusion is challenging, especially in patients with malignant or benign fibrothorax, which is difficult to sample using standard flexible forceps (SFF) via flex-rigid pleuroscopy. An adequate sample is crucial for the differential diagnosis of malignant fibrothorax (malignant pleural mesothelioma, ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.11.92
更新日期:2016-11-01 00:00:00
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 techniq...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.03.102
更新日期:2017-03-01 00:00:00
abstract::Sleeve resection, a mainstay for centrally-located lung cancer, is a challenging procedure when the preserved lung is impaired. We herein reported a 61-year-old male who underwent right upper sleeve lobectomy for squamous cell carcinoma located at the orifice of the upper bronchus. The tumor invaded the main bronchus....
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.02.17
更新日期:2016-03-01 00:00:00
abstract::Malignant pleural mesothelioma (MPM) is a rare neoplasm that typically arises from mesothelial surfaces of the pleural cavity. Despite treatment improvements, it carries a dismal prognosis. The majority of patients either have unresectable disease or are not candidates for surgery due to medical comorbidities or old a...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.10.19
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Epidermal growth factor receptor (EGFR) mutation mostly occurred in lung adenocarcinoma, rarely in squamous cell carcinoma (SQCC). EGFR mutation rate in SQCC varied in previous reports, and the efficacy of EGFR tyrosine kinase inhibitors (TKIs) in SQCC harboring EGFR mutation has not yet been fully evaluated....
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2013.09.15
更新日期:2013-10-01 00:00:00
abstract:Background:The subcategory "solid component of tumor" is a new criterion of tumor categories in the updated eighth edition of the TNM classification. Nevertheless, the predictors of lymph node metastasis among patients with clinical T1 adenocarcinoma, based on the TNM classification 8th edition, remain unclear. This st...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2020.03.74
更新日期:2020-05-01 00:00:00
abstract:Background:The development of diagnostic technology has led to detection of an increasing number of small pulmonary nodules (SPNs), which can be difficult to locate intraoperatively. Here, we report our experience performing single-stage lipiodol localization and surgical resection in a hybrid operating room (OR). Met...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.28
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Previously, most studies did not discuss about the characteristics of lung-involved toxocariasis without eosinophilia. However, the patients are not always accompanied by eosinophilia, so it is necessary to learn about the clinical and radiologic features that may predict pulmonary toxocariasis without eosin...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.12.24
更新日期:2014-12-01 00:00:00