[Surgical treatment for 2nd primary lung cancer originated close to the initial surgical margin for bronchioloalveolar carcinoma (BAC); report of a case].

77-year-old man was treated by wedge resection for bronchioloalveolar carcinoma (BAC) of right upper lobe 6 years before. Follow up computed tomography (CT) performed 5 years later revealed partial thickening of the resected line of the initial surgery which was diagnosed as adenocarcinoma with bronchoscopic cytology. Thoracoscopic right upper lobectomy and nodal dissection was performed. Histological diagnosis was papillary adenocarcinoma, which was thought to be a 2nd primary lung cancer.

[Open drainage with Vacuum Assisted Closure( VAC) therapy for Aspergillus empyema after left upper lobectomy with adjuvant radiotherapy].

A 59-year-old man was diagnosed as Aspergillus empyema with fistula after left upper lobectomy and radiation therapy. His pyrexia was continued after conservative treatment with antifungal agents. Initially, fenestration and vacuum-assisted closure (VAC) therapy were performed. The Aspergillus terreusdisappeared and inflammatory reactions were normalized. Eight days after fenestration, pectoralis major muscle flap transposition was subsequently performed. His postoperative course was uneventful. No recurrent empyema was found 15 months after surgery.

[Surgical treatment for deep pulmonary laceration with hemorrhagic shock].

59-year-old man falling from the roof was transported to our hospital by ambulance. When thoracic drainage was done for tension pneumothorax of the left lung, massive intrathoracic hemorrhage was noted as well. Chest computed tomography (CT) revealed contusion of left lower lobe. Emergency operation was done, but complete hemostasis was not achieved. To control hemorrhage from lung, intrathoracic packing was performed. After improving general condition, left pneumonectomy could be performed by 2nd operation. His postoperative course was uneventful.

[Surgical resection with adjuvant chemotherapy for locally advanced Masaoka stage IVa thymoma; report of a case].

A 39-year-old woman was presented with a mediastinal tumor and some pleural tumors. A computed tomography (CT)-guided needle biopsy of the pleural tumor was undertaken which showed thymoma, type B1 according to the World Health Organization classification. She had underwent extended-thymectomy and resection of all pleural tumors. Histopathology confirmed these lesions to be type B2 thymoma and pleural dissemination. She received adjuvant chemotherapy. Two years after surgery the patient is alive without recurrence.

Registration of resected lung cancer in Niigata Prefecture.

OBJECTIVES: Our registration of surgically treated lung cancer patients in Niigata Prefecture began in 2001. The purpose of this study was to identify the characteristics of patients and surgical treatment of lung cancer. METHODS: All patients who underwent resection for lung cancer in Niigata Prefecture from January 2001 to December 2002 were eligible for registration. A total of 31 medical data for each patient were registered. RESULTS: During the 2-year period, 1,211 patients were registered. A total of 605 cases (50%) were detected by mass screening, and 874 cases (72%) were diagnosed preoperatively. There were 718 (59%) c-stage IA cases and 317 (26%) c-stage IB cases. The most common operative procedure was lobectomy; 850 patients underwent single lobectomy. Limited resection was performed in 301 patients (25%), and video-assisted thoracoscopic surgery in 193 (16%). The most common histological type was adenocarcinoma in 860 cases (71%), followed by squamous cell carcinoma in 273 (23%). Pathologic staging yielded stage IA in 635 cases (52%) and stage IB in 262 (22%). CONCLUSIONS: The results of our registration demonstrate a very high ratio of surgically treated stage IA cases in Niigata Prefecture and that limited resection was performed in many patients. Accumulation of these data will reveal the characteristics of lung cancer surgically treated in Niigata Prefecture and will provide a basis for determining the future course of surgical treatment for lung cancer. Registration is continuing, and it will provide new and useful information about lung cancer, eventually including 5-year survival data.