Sclerosing thymoma with numerous coarse calcifications.

This patient is the youngest among the previously reported sclerosing thymoma cases, and the resected mass contained numerous coarse calcifications due to dystrophic calcification. This is an unprecedented and extremely rare case.

Efficacy and safety of intraoperative partial spray of 50% glucose for patients with spontaneous pneumothorax.

OBJECTIVES: The management for pneumothorax patients involves surgical intervention, nevertheless postoperative recurrences are often encountered. To reduce the rates of recurrence, thoracic surgeons have experimented with various novel techniques, such as pleural abrasion, chemical pleurodesis, and staple line coverage with absorbable sheets, in addition to bullectomy. And in recent years, there have been reports of the effectiveness of the use of intraoperative glucose intrapleural spray (GIS) containing 50 ml of 50% glucose solution in addition to bullectomy. However, information on the effects and adverse events of GIS is limited. Current study was aimed to assess the efficacy and safety of GIS in preventing recurrence of pneumothorax. PATIENTS AND METHODS: We conducted a retrospective study with 74 cases of bullectomy with or without GIS between 2018 and 2021 at Okazaki City Hospital. Of these cases, 50 received GIS (GIS group) while 24 were treated conservatively (C group). RESULT: The GIS group consisted of 46 males and 4 females, whereas the C group consisted of 23 males and 1 female, with mean ages of 38.5 ± 5.7 years and 30.5 ± 6.7 years, respectively. The GIS group exhibited a mean increase in blood glucose of 23.8 mg/dL postoperatively, and postoperative infections were observed in 2 cases in the GIS group (4.0%) and 2 cases in the C group (8.3%). The NRS scores of the patients in the GIS group and the C group three hours postoperatively were 4.0 and 3.1, respectively (p = 0.28). No prolongation of postoperative drainage period by GIS was observed (1.2 days and 1.4 days in the GIS and C groups, respectively). Postoperative recurrence occurred in two patients from the C group. The postoperative total drainage volumes were 341.8 ± 25.2 ml and 74.2 ± 25.5 ml in the GIS and C groups, respectively, showing a significant increase in drainage volume (p < 0.01). None of them presented dehydration-related symptoms. CONCLUSIONS: The use of intraoperative glucose intrapleural spray is effective and safe in terms of preventing recurrences and postoperative complications.

A successful case of robot-assisted thoracic surgery for apical thoracic schwannoma.

The thoracic apex is a narrow and complicated area with nerves and vessels, making it difficult to secure a visual field and perform surgical operations. Robot-assisted surgery enabled good visibility and highly flexible forceps manipulation, we were able to perform minimally invasive and safe thoracic apical tumour resection.

A xiphisternal ulcer effectively treated with xiphoidectomy.

Xiphoid syndrome is a rare musculoskeletal disorder of the xiphoid process. The main symptom is precordial pain or xiphodynia. We experienced a case in which protrusion of the xiphoid process impaired blood flow to the skin, resulting in the formation of an ulcer and exposure of the xiphoid process. To the best of our knowledge, this is the first case of a xiphisternal ulcer secondary to a protruding xiphoid process. The patient was safely and effectively treated via xiphoidectomy using a T-saw.

Tractotomy using the Penrose drain guide for deep lung injury caused by chest drainage: a case report.

BACKGROUND: Pulmonary tractotomy effectively treats deep pulmonary penetrating injuries; however, it requires the accurate insertion of forceps or a stapler into the wound tract. This report describes a case of tractotomy using the Penrose drain guide for a deep lung injury caused by chest drainage. CASE PRESENTATION: A 75-year-old man suffered multiple rib fractures and hemothorax. After admission, chest tube drainage was performed because the patient's respiratory condition deteriorated due to increased right pleural effusion. However, as the chest tube was stabbing into the right upper lobe, a pulmonary tractotomy was performed to treat the injury. Cutting the visceral pleura just over the tip of the chest tube caused the tube to completely penetrate the lung. A Penrose drain tube was fixed to the chest tube, which was then removed. The Penrose drain tube completely penetrated the lung and was coupled to the anvil side of the stapler to guide it smoothly into the wound tract. After stapling left the wound tract open, selective suture ligation of the damaged vessel and bronchioles was performed. CONCLUSIONS: Although the indications for tractotomy using the Penrose drain guide are limited, we believe that this technique can be useful in patients with deep stabbing or penetrating lung injuries with rod- or tube-shaped foreign body remnants.

Abnormal anastomosis of peripheral pulmonary arteries, initially suspected to be an arteriovenous fistula, in an adult with Williams syndrome.

Abnormal anastomosis of peripheral pulmonary arteries is rare and resembles a pulmonary arteriovenous fistula; thus, when the inflow or outflow route cannot be clearly identified in a suspected pulmonary arteriovenous fistula, the possibility of peripheral pulmonary artery anastomosis should be considered. However, the final diagnosis requires a catheterization study.

New technique for fixing rib fracture with bioabsorbable plate.

Fixation of a bone fracture with a bioabsorbable plate made of poly-L-lactide and hydroxyapatite has received attention. We adopted this technique for a rib fracture by bending the plate into a U-shape and fixing it with suture through the holes in the mesh of the plate and holes that are drilled in the edge of the fractured rib. The suture is also wound around the plate.