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M Murasugi

Publications and source records attributed to M Murasugi.

17 recordsLinked to original sources
PubMed2005

[Simulation of lung lobe resection with personal computer].

Various patterns of branching are seen for pulmonary arteries and veins in the lung hilum. However, thoracic surgeons usually cannot expect to discern much anatomical detail preoperatively. If the surgeon can gain an understanding of individual patterns preoperatively, the risks inherent in exposing the pulmonary vessels in the hilum can be avoided, reducing invasiveness. This software will meet the increasing needs of them in video-assisted thoracoscopic surgery (VATS) which prefer lesser dissections of the vessels and bronchus of hilum. We have produced free application software, where we can mark on pulmonary arteries, vein, bronchus and tumor of the successive images of computed tomography (CT). After receiving a compact disk containing 60 images of 2 mm CT slices, from tumor to hilum, in DICOM format, we required only 1 hour to obtain 3-dimensional images for a patient with other free software (Metasequoia LE). Furthermore, with Metasequoia LE, we can simulate cut the vessels and change the figure of them 3-dimensionally. Although the picture image leaves much room for improvement, we believe it is very attractive for residents because they can simulate operations.

Computer Simulation↗
PubMed2004

[Clinical study on video-assisted thoracic surgical simultaneously stapled subsegmentectomy for peripheral lung tumors].

BACKGROUND: The purpose of this study is to confirm the safety and validity of video-assisted thoracic surgical simultaneously stapled subsegmentectomy (simultaneously stapling of all subsegmental bronchi and vessels in their natural construction). METHODS: The clinicopathologic information of the 10 patients who underwent video-assisted thoracic surgical simultaneously stapled subsegmentectomy for primary lung cancer (6) and metastatic lung tumor (4) were reviewed retrospectively. The patient population consisted of 7 men and 3 women with a mean age of 70.2 years. RESULTS: Median operative time was 201 minutes. Average blood loss was 76 ml. Mean duration of thoracic drainage was 3 days. There was no surgical mortality. Recurrence was diagnosed in 2 of 6 lung cancer patients (each of contralateral lung metastasis and brain metastasis), and 1 of 2 died 26 months after the operation. All patients have been followed for a mean period of 30.4 months with no local recurrence. CONCLUSIONS: Video-assisted thoracic surgical simultaneously stapled subsegmentectomy is safe and may be an acceptable alternative to segmentectomy, and wedge resection for strictly selective patients with peripheral lung tumors.

Adenocarcinoma↗
PubMed2004

[Stenting in obstruction of superior vena cava; clinical experience with the self-expanding endovascular prosthesis].

From August 1997 to December 2002, 14 consecutive patients with superior vena cava syndrome with the self-expanding endovascular prosthesis. Diagnoses were adenocarcinoma in 6, small cell carcinoma in 4, squamous cell carcinoma in 1, metastatic lung cancer in 2, and invasive thymoma in 1. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were measured on their admission and perioperative period. Expecting only 1 patient complete symptomatically relieved within 3 days of stent implantation. Superior vena cava pressure or radial pressure of the stent was sufficient to relieve obstruction. Preoperative ANP level were normal, BNP level were increased. Postoperatively both ANP level and BNP level were slightly increased under intravenous dopamine hydrochloride. Implantation of the self-expanding stent endovascular prosthesis for superior vena cava syndrome provides rapid symptomatic relief and improves the patient's quality of life.

Adult↗
PubMed2004

[Squamous cell carcinoma caused by dysplasia on the bullous wall].

We experienced a squamous cell lung carcinoma caused by dysplasia around the bullous wall after right upper lobectomy by tuberculosis. A case is 70 years old male who was resected right upper lobe caused by tuberculosis 50 years ago. He was pointed out an abnormal shadow on the chest X-ray in March 2002. There were bullous change in right lung field on the chest computed tomography (CT). There was appeared a tumor contiguous to the bullous wall. A part of bullous wall surrounding the tumor was thickened bronchio-alveolar lavage gave proof of squamous cell carcinoma. Right basal segmentectomy and subcarinal lymph node dissection was done, because of severe adhesion a right middle lobe. Radiation therapy at the mediastinum is performed, because of positive subcarinal lymph nodes. It is rare case of squamous cell carcinoma caused by dysplasia, we reported.

Aged↗
PubMed2004

[Inadvertent coil migration that required urgent thoracotomy during embolization for the treatment of pulmonary arteriovenous fistula].

A 70-year-old woman was referred to our department because of a solitary nodular shadow, 2 cm in diameter, in the right mid zone on a chest X-ray. Chest computed tomography revealed a pulmonary arteriovenous fistula (PAVF) in S4 of the right lung. Although the patient did not present with PAVF-related symptoms or hypoxemia, in view of the threat of serious complications, a therapeutic decision was made for coil embolization of the pulmonary artery feeding the PAVF. During the endovascular embolization procedure, the coil migrated into the mitral valve chordae tendinae. Urgent thoracotomy was therefore performed and the coil was safely retrieved from the site. Via the same thoracotomy incision, the PAVF with its surrounding tissue was also resected from the right lobe of the lung. The inadvertent coil migration in this patient may be explained by the fact that the fistula was not large enough to allow the coil to stay in place for the prevention of blood flow from the feeding vessel. These findings indicate that surgical resection of PAVF should be selected when the size of the fistula is too small for coil embolization. Otherwise, if transcatheter embolization is preferred, the detachable balloon approach may be appropriate.

Aged↗
PubMed2003

[Video-assisted thoracic surgery for the resection of pulmonary metastases].

We report the use of video-assisted thoracic surgery (VATS) as a treatment or pulmonary metastases. Between July 1994 and March 2002, 75 patients were treated for metastatic lung tumor by VATS. These patients included 45 males and 30 females with an average age of 60.6 years. Their primary diseases were Colon cancer (38), renal cell carcinoma (12), breast cancer (6), seminoma (3), thyroid carcinoma (3), parotid cancer (2), pharyngeal cancer (2) and the others (9). Tumor size ranged from 6 to 62 mm in diameter. A preoperative high resolution spiral computed tomography (CT) scan was used to locate the nodule in all patients. Ten recurrence cases were performed re-resection by VATS approach with an average period was 22 month. We conclude that VATS is a good candidate for the resection of lung metastases in the selected cases.

Adult↗
PubMed2001

Thoracoscopic surgery for pneumothorax in older patients.

BACKGROUND: Secondary pneumothorax is more common in older pneumothorax patients. Therefore, we set out to investigate the usefulness of thoracoscopic surgery in this group. METHODS: A total of 59 operations were performed on patients aged > or = 50 years, with the goal of excising only the lesions responsible for air leaks by using the minimum degree of dissection. If the patients were found to have numerous bullae, the lesions responsible were identified by pleurography. The duration of chest tube drainage, hospital stay, and recurrence were assessed. RESULTS: The air leaks stopped and all patients were discharged without drains. Postoperative drainage time was 3.8 +/- 3.0 days. Postoperative hospital stay was 10.8 +/- 9.2 days. Six patients died of other diseases, but there was only one recurrence of pneumothorax. CONCLUSION: We consider video-assisted thoracic surgery (VATS), with the goal of excising only the lesions responsible for air leaks, to be particularly efficacious in older pneumothorax patients.

Aged↗
PubMed2001

The role of video-assisted thoracoscopic surgery in the diagnosis of the small peripheral pulmonary nodule.

BACKGROUND: The use of imaging techniques to detect small peripheral pulmonary nodules often results in a missed diagnosis. Thoracoscopy had limited application until recently, when advances in technology allowed thoracic surgeons greater visualization and mobility within the chest. METHODS: Between September 1992 and June 1997, 81 patients were treated for small peripheral pulmonary nodules by pulmonary wedge excision using video-assisted thoracoscopic techniques. The patients were 39 men and 42 women with an average age of 59.5 years. RESULTS: A definitive diagnosis was obtained in all cases. Malignancies were found in 44 patients (55%), which involved primary lung cancer in 28 patients and metastatic lesions in 16 patients. The rate of malignancy in nodules measuring 1 cm or less was 18%. There was no operative mortality or morbidity. CONCLUSIONS: We conclude that video-assisted thoracoscopic lung biopsy is a more effective and less invasive diagnostic tool for small peripheral pulmonary nodules.

Female↗
PubMed2001

Bullectomy is beneficial in the pulmonary blood flow/driving pressure relationship in bullous emphysema patients.

OBJECTIVES: Few physiological studies have been on pulmonary circulation, including the relationship between pulmonary blood flow and driving pressure, and viscosity changes arising from hematocrit changes before versus after lung volume reduction Surgery or bullectomy in emphysematous patients. METHODS: We studied the relationship between pulmonary blood flow and driving pressure before and after bullectomy using a unilateral pulmonary artery occlusion test based on pulmonary blood flow fractions obtained by pulmonary blood flow scintigraphy in 7 patients with pulmonary emphysema associated with bullae. RESULTS: Among the 7 undergoing bullectomy, the pulmonary blood flow/driving pressure relationship decreased in 5 and was unchanged in 2. Of the 11 lungs treated by bullectomy, this relationship decreased in 8 lungs, but not 3 (p < 0.01). No significant difference was seen in oxygen partial pressure in arterial and mixed venous blood or hematocrit. CONCLUSION: We concluded that bullectomy shifted the pulmonary blood flow/driving pressure relationship downword in some cases with significant bullae.

Aged↗
PubMed2000

Combined thoracic aortic or upper digestive tract resection for lung cancer and malignant mediastinal tumor.

OBJECTIVE: We studied possible indications and combined resection in patients with lung cancer and mediastinal tumors requiring combined thoracic aortic or upper digestive tract resection. METHODS: Ten patients with lung cancer and malignant mediastinal tumors (9 men and 1 woman aged 39 to 72 years; mean: 60.5) underwent combined aortic or upper digestive tract resection. RESULTS: Five--3 [corrected] with primary lung cancer, 1 with thymic cancer, and 1 with liposarcoma--, underwent combined aortic resection. In 2 each, lung cancer and malignant mediastinal tumor had infiltrated the thoracic aorta. The remaining case of lung cancer was complicated by aortic aneurysm in the distal arch. Cardiopulmonary bypass was conducted in 4, and selective cerebral perfusion in 2. Three patients are alive after 11, 22, and 61 months without disease recurrence. Those undergoing combined upper digestive tract resection all had lung cancer, with 4 having tumors infiltrating the esophagus or corpus ventriculi. The remaining patient had both lung and esophageal cancer. The patient treated with combined corpus ventriculi resection has survived 24 months and the patient treated with combined esophageal resection has survived 12 months without disease recurrence. The 1-year survival rate was 60%, 2-year 23%, and 3-year 23%. Prognosis was generally poor with the longest survival 13 months with N2 lung cancer. CONCLUSIONS: In combined resection due to malignant mediastinal tumor, T4N0-1 lung cancer, or diseases such as aortic aneurysm, prognosis can be expected to improve. Despite the often poor prognosis in T4N2 lung cancer, surgical intervention may be indicated to avoid complications due to tumor invasion and to lengthen survival and improve quality of life.

Adult↗
PubMed1991

[ECMO treatment for ARDS].

Between February 1988 and March 1990, ECMO was performed (veno-arterial perfusion; 3 cases, venovenous; one case) is 4 ARDS patients. However no patient could be weaned from ECMO (32-80 hours) and all died. The causes of deaths were attributed to the complications of ARDS itself that existed before ECMO therapy and ECMO was highly effective in providing temporally life support. We consider that entry criteria of ECMO should not be based on gas exchange alone and that lung compliance and circulatory insufficiency should be taken into account.

Adult↗
PubMed1989

[Effect of morphine in cancer pain].

The usefulness of oral morphine to alleviate pain has been tested in 70 patients with cancer. The efficacy was found to be 87% (61/70). The starting dose was 10 mg/d-12 mg/d (mean 36 mg/d), and the maximum dose was 10 mg/d-3,600 mg/d. Twenty four of these patients were able to stay at home or go to the hospital for dose treatment. In 27 patients, oral morphine dose were able to administrated until death. Although vomiting and constipation were frequent side effects, the administration of adjuvant drugs relieved these symptoms. It was found that these oral morphine doses did not shorten a patient's life span. Thus we have concluded that oral morphine proved a useful, safe, and convenient drug for the control of cancer pain.

Administration, Oral↗