Kyobu geka. The Japanese journal of thoracic surgery
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We created a method using handmade branched graft to do the aortic arch surgery easier and safer. We made the branched graft using 12 and 8 mm vascular graft. A 77-year-old man with Stanford type A aortic dissection was operated with this method under deep hypothermia. ⋯ Postoperative course was uneventful and there was no complication. The treatment of our branched graft was easier than that of ready-made 4-branched graft. We could perform the operation under clear view for its movability with minimal cerebral ischemic time.
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Case Reports
[Experience with thoracoscopy for rifle gunshot penetrating trauma of the chest; report of a case].
A 57-year-old man came to our hospital by ambulance for a chest injury by a rifle gunshot. He had a penetrating injury of the chest wall, hemopneumothorax and pulmonary laceration. He was managed with chest drainage, oxygen inhalation. ⋯ He discharged without postoperative complications 17 days after the injury. Open thoracotomy is reported to be required in only about 10-15% of patients with chest injuries. However, operative indication of the chest injuries may spread in the future with the spread of thoracoscopy and its low invasiveness.
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Because pneumonectomy causes a high-risk of perioperative mortality and morbidity, we have tried extended sleeve lobectomy (ESL) for patients with locally advanced lung cancer. The purpose of this study is to analyze the risk of complications and local relapses of ESL. Twelve patients underwent ESL, one-lobe and segment resection for 7, bi-lobe resection for 4, and bi-lobe and segment resection for 1. ⋯ Two of 12 patients (17%) had an anastomosis complication. One (8%) had a staple line relapse. We conclude that ESL is a practicable technique for locally advanced lung cancer to avoid pneumonectomy.