M Nagasawa

Tenri Yorozu Hospital, Тэнри, Nara, Japan

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Publications (28)23.34 Total impact

  • The Journal of the Japanese Associtation for Chest Surgery 01/2010; 24(2):140-145.
  • The Journal of the Japanese Associtation for Chest Surgery 01/2009; 23(6):905-909.
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    ABSTRACT: Not only is a radiation ulcer nonviable itself, but the surrounding irradiated tissue also shows poor healing. Therefore, healing in an irradiated field cannot be expected if a flap used for reconstruction fails even partially. For repair of radiation ulcers, a flap with a stable blood supply is required. A superiorly based vertical rectus abdominis myocutaneous (VRAM) flap is commonly used for chest wall reconstruction. Because the VRAM flap is nourished only by the superior epigastric vessels, the blood supply to the distal part of the flap often is precarious. A case is reported in which a delayed VRAM flap was used successfully to treat a radiation ulcer on the anterior chest wall. Consecutive angiograms showed that the delay procedure augmented the blood supply to the VRAM flap. The flap showed complete take without any postoperative complications. A delay procedure may make the VRAM flap more reliable for anterior chest wall reconstruction. This flap may be a valuable option for reconstruction of intractable ulcers such as radiation ulcers, and may be applicable for breast reconstruction after radiation therapy.
    Aesthetic Plastic Surgery 02/2006; 30(1):120-4. · 1.19 Impact Factor
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    ABSTRACT: We describe a case of giant pulmonary aspergilloma in a 79-year old man. He had undergone an operation for pulmonary tuberculosis of the right lung at the age of 49 years. His chest ragiograph showed a large fungus ball in the right upper lung field. Taking his age and pulmonary condition into consideration, we performed a cavernostomy and fungus ball resection to prevent life-threatening hemoptysis. The postoperative course was satisfactory and without complication. Cavernostomy may be an alternative choice in high-risk aspergilloma patients.
    Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 10/2003; 41(10):750-4.
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    ABSTRACT: We evaluated the prognostic factors for thymoma that remain controversial. We studied 72 consecutive patients treated for thymoma during the period between 1966 and 1997. Recurrence-free interval rates and overall survival rates calculated by the Kaplan-Meier method were compared using log-rank test by the Masaoka stage, extent of surgical resection, histology, or associated disease(s). Multivariate analysis was performed using Cox's proportional hazards model. Thirty-two thymomas were at Masaoka stage I, 9 at stage II, 15 at stage III, and 16 were at stage IV. There were 56 complete resections, 7 incomplete resections (2 at stage III and 5 at stage IV), and 9 biopsies (1 at stage III and 8 at stage IV). Forty-one thymomas were cortical, 16 medullary, and 15 were mixed form. Association of myasthenia gravis was found in 20 patients, and pure red cell aplasia in 7. After an average follow-up period of 103 months, the recurrence-free 5-, 10-, 15-year interval rate was 89%, 80%, 80%, respectively, and overall 5-, 10-, 15-year survival rate was 86%, 71%, 59%, respectively. Factors influencing the recurrence-free interval and overall survival included the Masaoka stage, extent of surgical resection, and association with pure red cell aplasia. Multivariate analysis revealed stage IV tumor and association with pure red cell aplasia as risk factors for recurrence. Pure red cell aplasia indicated poor prognosis for overall survival. Masaoka stage, extent of surgical resection, and association with pure red cell aplasia were prognostic factors for thymoma. Multidisciplinary treatment for stage IV tumors and better control of pure red cell aplasia, if associated, should be investigated.
    The Japanese Journal of Thoracic and Cardiovascular Surgery 02/2001; 49(1):35-41.
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    ABSTRACT: Despite the advances in surgical technology, bronchopleural fistulas (BPFs) still occur and are often fatal. We studied the risk factors for BPF formation after lung cancer operation to clarify the indication of preventive bronchial stump coverage. In addition, the reliability of our methods of bronchial closure was evaluated. We reviewed 557 consecutive bronchial stumps, corresponding to 547 patients without any coverage in pulmonary resection for lung cancer between 1989 and 1998. According to nine variables, stumps that made dehiscence were compared with uneventful ones using contingency table analysis. The incidence of BPFs according to each method of bronchial closure was calculated. BPFs developed in ten patients (1.8%). Compared with the lobar bronchus (LB), the main bronchus (MB; P<0.01; odds ratio, 23.0) and the intermediate bronchus (IB; P=0.03; odds ratio, 10.7) carried a high risk. Previous ipsilateral thoracotomy (P<0.01; odds ratio, 37.9) and preoperative chemotherapy and/or radiotherapy (P=0.02; odds ratio, 13.2) increased the risk. The incidence of BPFs with manual suture, stapling devices only, reinforcement suture at the distal side of staplers, or reinforcement suture at the proximal side of staplers was 1.8, 5.0, 1.9 and 1.0%, respectively. The main and intermediate bronchial stumps, and the stumps in cases with previous ipsilateral thoracotomy or receiving induction therapy are prone to BPFs. Preventive coverage should be considered for these stumps. Our methods for reinforcement of stapled stumps are thought to be reliable.
    European Journal of Cardio-Thoracic Surgery 12/2000; 18(5):519-23. · 2.81 Impact Factor
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    ABSTRACT: We present herein the case of a 50-year-old woman in whom descending necrotizing mediastinitis originating from an anterior neck abscess spread to the left upper bony thorax, resulting in osteomyelitis of the left sternocostoclavicular articulation and left partial thoracic empyema. Transcervical mediastinal irrigation and drainage was performed with aggressive antibiotic therapy, followed by resection of the left sternocostoclavicular joint and debridement of the anterior mediastinum. The patient had an uneventful postoperative course, and her left arm and shoulder mobility was well preserved.
    Surgery Today 02/1999; 29(12):1287-9. · 1.21 Impact Factor
  • The Journal of the Japanese Associtation for Chest Surgery 01/1998; 12(5):623-628.
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    ABSTRACT: A 56-year-old woman underwent plication with U-stitches by thoracoscopic surgery for left diaphragmatic eventration. Marked improvement in left lung expansion, normalization of the position of the left diaphragm on chest radiograph, and improvement of pulmonary function and dyspnea on exertion have been maintained for 2 years. Plication for diaphragmatic eventration should be performed with minimally invasive surgery.
    Chest 09/1997; 112(2):530-2. · 7.13 Impact Factor
  • Lung Cancer 07/1997; 18:169-169. · 3.74 Impact Factor
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    ABSTRACT: A 66-year-old man was hospitalized because of hemoptysis. Four years earlier, he had undergone an operation involving the use of an omental pedicle flap that was supplied by the right gastroepiploic artery for the treatment of empyema. Arteriography revealed that the right gastroepiploic artery communicated with the periphery of the right pulmonary artery. The right gastroepiploic artery was divided surgically.
    The Annals of Thoracic Surgery 05/1995; 59(4):993-5. · 3.63 Impact Factor
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    ABSTRACT: One hundred and ninety one women were diagnosed with lung cancer at our hospital. This comprised 23.7% of all lung cancer cases. Smoking habits were significantly lower in female lung cancer. Adenocarcinoma is the most common histological type of female lung cancer (64.2%). The prognoses of asymptomatic cases detected by regular examination were significantly better than those of symptomatic cases. Among resectable cases of either adenocarcinoma or squamous cell carcinoma, there were no significant differences between the prognosis for women and that for men. However, the prognosis for nonresectable cases of adenocarcinoma in women was significantly better in the 2-year survival rate (30.8%) than the prognosis for such cases in men. Since the periphery type is the most common site of adenocarcinoma in women, educating women, especially those in the high-risk group, and persuading them to undergo regular examinations are important step to increasing early-stage detection and cure.
    Kyobu geka. The Japanese journal of thoracic surgery 03/1995; 48(2):95-9.
  • The Journal of the Japanese Associtation for Chest Surgery 01/1995; 9(1):115-119.
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    ABSTRACT: A 57-year-old man who had been complicated with achalasia for thirty years was admitted because of back pain and low grade fever. Chest X-p and Chest CT showed consolidation in the left lower lung field. His respiratory condition was diagnosed as lung abscess preoperatively. After systemic chemotherapy, surgical management was done for both achalasia and this inflammatory respiratory disease. In the operation by left thoracotomy, it was revealed that this case had empyema, not lung abscess. Thus decortication of left lung and esophagomyotomy were performed simultaneously. In the treatment of achalasia, respiratory complications due to aspiration may appear. In addition, it is sometimes difficult to distinguish empyema from lung abscess preoperatively. Therefore much care should be taken during operation in order to treat these respiratory diseases.
    Kyobu geka. The Japanese journal of thoracic surgery 03/1994; 47(2):157-9.
  • C Huang, M Kitano, T Shindo, M Nagasawa
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    ABSTRACT: Pneumonectomy may result in complications such as continuous intrathoracic bleeding and mediastinal shift. We used a thoracic balloon made of silicone rubber in 15 postpneumonectomy patients in an attempt to prevent such complications. Two types of thoracic balloons were used in our series. Type 1 thoracic balloon is a simple balloon requiring cooperation with a drainage tube, and Type 2 is a combination balloon and drainage tube. During surgery, air was injected into the thoracic balloon through an air filter. After removal of the thoracic balloon, infusion of sulfur hexafluoride, SF 6, into the thoracic cavity was performed on the 7th to 10th postoperative days. Placement of thoracic balloons in the pleural space after pneumonectomy is a simple, safe and useful method of preventing both intrathoracic bleeding and mediastinal shift.
    Kyobu geka. The Japanese journal of thoracic surgery 01/1994; 46(13):1112-4.
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    ABSTRACT: We evaluated the postoperative lung function determined by spirometry in 54 patients with funnel chest (48 males and 6 females: age range, 4-18 years). Thirty-one patients had sternal turnover as corrective surgery, while 23 had sternal elevation with absorbable PLA (polylactic acid) strut. The mean value of vital capacity as a percentage of predicted (%VC) was 97.3% before operation. %VC was decreased at 3 months (80.5%), 6 months (87.4%), 12 months (82.8%), 24 months (85.9%), and 36 months (77.7%) after the operation (p < 0.01). In patients who had sternal elevation, %VC was decreased at 3 months but not at 6 months, 12 months, 24 months, or 36 months after the operation, while %VC was decreased at any point after the operation in patients who had sternal turnover. No significant changes were seen in forced expiratory volume in one second as a percentage of predicted (FEV1.0%), nor in the ratio of residual volume to total lung capacity (RV/TLC). In conclusion, sternal elevation with PLA strut is a better corrective surgery for funnel chest than sternal turnover, because of its less lung function loss after the operation.
    [Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai 12/1993; 41(11):2161-5.
  • F Tanaka, M Kitano, T Shindo, S Koh, M Nagasawa
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    ABSTRACT: From January 1970 to March 1991, 72 operations in 55 patients (31 males and 24 females) with metastatic lung tumors were performed in our department. Their cumulative survival rates was 25.5% at five years. With analysis of the various prognostic factors, patients both with solitary metastases and without lymph node metastases had a good prognoses. However, even in patients with recurrent lung metastatic tumors, long time survival was achieved with reoperation in two patients. We concluded that reoperation with or without effective chemotherapies was effective in selected patients.
    Kyobu geka. The Japanese journal of thoracic surgery 05/1993; 46(4):307-12.
  • The Journal of The Japanese Association for Chest Surgery. 01/1993; 7(4):464-471.
  • M Kitano, M Nagasawa, F Tanaka, S Koh
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    ABSTRACT: The first plombage-operation for pulmonary tuberculosis was by Dr. Nagaishi (1947) and Dr. Wilson, who developed the plombage method employing hollow polymethylmethacrylate spheres. Although the method presented a relatively effective option at a time when no effective drugs were available, its use was discontinued because of such complications as lung injury, cavity-perforation, and empyema. Therefore, soft elastic resin materials, such as those used in sponge-plombage and air-plombage, replaced the hard resin materials. Each plombage method is associated with a certain medical historical period, in Japan. Still the "Kinchyu" method was used. However, the complication of chronic empyema with bronchopleural fistula was difficult to treat. A notable recent method is the pedicled omentum plombage method, which is effective in the treatment of patients who have not responded to standard operations. Finally there was surely a clinical significance in each medical historical period.
    Kyobu geka. The Japanese journal of thoracic surgery 01/1993; 45(13):1141-5.
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    ABSTRACT: A 65-year-old male was admitted to our institute because of bloody sputum. A tumor in right S6 was detected by X-ray, CT and MRI. Bronchoscopic study showed that the right lower bronchus was occluded by the tumor, in which non-epithelial malignant cells were detected. Therefore right bilobectomy was performed. This tumor was a pedunculated endobronchial type measuring 6 x 4 x 3cm. Histologically, the tumor presented carcinomatous (squamous cell carcinoma and adenocarcinoma) and sarcomatous elements. Immunohistologically, many malignant cells were positively stained by vimentin and muscle-actin, which suggested differentiation from muscle components.
    Kyobu geka. The Japanese journal of thoracic surgery 09/1992; 45(9):809-12.