The following is a collection of
thoracic surgery articles from the Journal of Thoracic and Cardiovascular
Surgery (JTCVS). To read the latest issue and
browse the featured video library and other journal
highlights please visit www.jtcvs.org
THORACIC: LUNG CANCER
Propensity Score Adjusted
Comparison of Pathologic Nodal Upstaging by Robotic-,
VATS and Open Lobectomy for Non-small Cell Lung Cancer
Peter J. Kneuertz, MD; Danjouma H.
Cheufou, MD, MD; Desmond M. D’Souza, MD; Khaled
Mardanzai, MD; Mahmoud Abdel-Rasoul, MS, MPH; Dirk
Theegarten, MD; Susan D. Moffatt-Bruce, MD, PhD, MBA;
Clemens Aigner, MD, MBA; Robert E. Merritt, MD
Compared to the open lobectomy approach,
robotic lobectomy is associated with similar, and VATS
with lower lymph node assessment and pathologic
Commentary: Do we have the
right combatants? Should it be minimally invasive
surgery versus therapy that removes no lymph nodes?
Robert J. Cerfolio, MD, MBA, FACS,
incumbent on us to remove 5 N2 and at least 2 N1
lymph node stations in all patients while
implementing minimally invasive surgical techniques
in 99% of our patients with little to no morbidity.
lymph node assessment by robotic, video-assisted
thoracoscopic surgery, and thoracotomy: None meet the
Diego González-Rivas, MD, FECTS, Ramón
emphasis on approach in the past 2 decades should
not deter us from the oncologic principles of lung
cancer resection, of which systematic nodal
dissection is a fundamental component.
Invasive mediastinal staging
for resected non–small cell lung cancer in a
Raymond Osarogiagbon, MBBS,Yu-Sheng Lee,
MS, Nicholas R Faris, M. Div., Meredith A Ray, PhD,
Philip Ojeabulu, MBBS, Matthew P Smeltzer, PhD
Preoperative invasive mediastinal nodal
staging remains underused in patients with NSCLC at
high risk for nodal disease, even though use was
associated with improved survival.
mediastinal staging for patients with lung cancer—We
need to do better!
Benjamin D. Kozower, MD, MPH
and intraoperative lymph node evaluations are
paramount to accurate staging and management.
Unfortunately, this study demonstrates another
example of inadequate lung cancer care in the
mediastinal staging for lung cancer—Quality gap,
evidence gap, both?
Farhood Farjah, MD, MPH, FACS, Gerard
A. Silvestri, MD, MS, FACCP, Douglas E. Wood, MD,
evidence of suboptimal care delivery motivates
efforts to increase guideline adherence in treating
patients with lung cancer.
Local failure after
stereotactic body radiation therapy or wedge resection
for colorectal pulmonary metastases
David B. Nelson, MD MSc, Nabihah Tayob,
PhD, Quynh-Nhu Nguyen, MD, Jeremy Erasmus, MD, Kyle G.
Mitchell, MD, Wayne L. Hofstetter, MD, Boris Sepesi,
MD, Mara B. Antonoff, MD, Reza J. Mehran, MD
Stereotactic body radiation therapy
(SBRT) is associated with a higher risk of local
recurrence than wedge resection for treatment of
colorectal pulmonary metastases.
Commentary: Simple math is
not so straightforward with stereotactic body
radiotherapy for colorectal carcinoma metastases
W. Hampton Gray, MD, Scott M. Atay,
MD, Anthony W. Kim, MD
resection for colorectal pulmonary metastasis
offers superior local control compared with SBRT.
Commentary: Colorectal lung metastases
and the scalpel versus the beam
Christopher Cao, MBBS, PhD, James
stereotactic body radiotherapy is increasingly
being used to treat pulmonary metastases of
colorectal origin, surgery appears to result in
fewer recurrences and remains the preferred
Commentary: Surgery or
radiotherapy for colorectal lung metastases: Does it
Tom Treasure, MD, MS, FRCS, FRCP,
Fergus Macbeth, DM
of resection of asymptomatic lung metastases has
not been shown to improve survival. Relative
differences in local control with surgery versus
ablative therapies may be clinically irrelevant.
THORACIC: ESOPHAGEAL CANCER
Open versus Hybrid Minimally
Invasive Esophagectomy: Join the Crowd, But Don’t Throw
Away Your Abdominal Retractors Just Yet
Wayne L. Hofstetter, MD
Randomized trials comparing open to
minimally invasive esophagectomy (MIE) report
equivalent to superior perioperative outcomes for MIE.
A hybrid approach is a reasonable path to transition to
Commentary: “Sometimes the
hardest thing in life is to know which bridge to cross
and which to burn”—A word for the reluctant minimally
invasive esophageal surgeon
Benny Weksler, MD, MBA
invasive esophagectomy (MIE) offers clear benefits
to patients. Hybrid approaches may be a useful
starting point for surgeons reluctant to adopt MIE,
but they should not be their final goal.
THORACIC: LUNG TRANSPLANT
A Successful Lung Transplant
From a 3-year-old Donor After Controlled Cardiac Death
Followed by Ex Vivo Lung Perfusion: A Case Report
Marcos Galasso, MD, Rachel D Vanderlaan,
MD, PhD, Melinda Solomon, MD, MSc, Christopher
Caldarone, MD, Shaf Keshavjee, MD, MsC, Marcelo Cypel,
MD, MSc1, and Marc de Perrot, MD, MSc
We describe a successful Ltx from a
3-year-old DCD donor to a recipient with primary PVS
after assessment and treatment with EVLP.
Completion pneumonectomy and
auto-transplantation for bronchopleural fistula
Masatsugu Hamaji, MD, PhD, Toyofumi
Fengshi Chen-Yoshikawa, MD, PhD, Hiroshi Date, MD, PhD
An emergency completion pneumonectomy
was performed for a bronchopleural fistula after a
sleeve lobectomy. Our auto-transplantation technique
enabled us to spare the lower lobe.