General thoracic and cardiovascular surgery
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The efficacy of lung cancer screening should not be evaluated by the survival rate of lung cancer patients but by lung cancer mortality in a certain population because the survival rate can be greatly affected by several types of bias. Randomized controlled trials that were conducted during the 1970s and 1980s in Europe and the United States failed to prove the efficacy of lung cancer screening in decreasing the mortality rate; but recently the results of case-control studies in Japan have revealed that undergoing currently available screening decreases the risk of lung cancer deaths by 30%-60%. A system is now being created in Japan whereby the guidelines regarding cancer screening will continue to be updated. ⋯ However, the presence of some potential bias in these studies cannot be ignored; therefore, it is still unknown whether there is actual efficacy. Several randomized controlled trials are presently in progress overseas, but the interim results were not favorable. A randomized controlled trial should therefore immediately be started in Japan as well.
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Gen Thorac Cardiovasc Surg · Oct 2009
Case ReportsIntercostal artery pseudoaneurysm after thoracoscopic lung resection.
We present a rare case of a ruptured intercostal artery pseudoaneurysm in a 59-year-old woman that occurred after a right upper lobectomy by video-assisted thoracoscopic surgery for lung cancer. The pseudoaneurysm was diagnosed by computed tomography and successfully treated with aneurysmectomy with proximal artery ligation, removing the hematoma. She improved and was discharged 1 month later.
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Gen Thorac Cardiovasc Surg · Oct 2009
Endovascular stent-grafting of anastomotic pseudoaneurysms following thoracic aortic surgery.
Anastomotic pseudoaneurysm is a rare but life-threatening complication after thoracic aortic surgery. Endovascular stent-grafting is a less invasive treatment for thoracic aortic aneurysm; however, its clinical usefulness for anastomotic pseudoaneurysms following thoracic aortic surgery is unclear. ⋯ Endovascular stent-grafting for patients with anastomotic pseudoaneurysms of the thoracic aorta following thoracic aortic surgery has become a possible optimal treatment. However, long-term outcome remains unclear, and periodical follow-up is required.