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| No. | Article Type | Article Title | Article Page |
|---|---|---|---|
| 1 | Clinical Research | Characteristics of Patients with Surgical Closure of an Atrial Septal Defect during Infancy | 155 - 161 |
| 2 | Clinical Research | Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality | 162 - 170 |
| 3 | Clinical Research | Surgery for Diaphragmatic Hernia Repair: A Longitudinal Single-Institutional Experience | 171 - 176 |
| 4 | Commentary | Commentary: Is the Data Strong Enough to Prorocolize the Approach in Diaphragmatic Hernia Repair? Aspects of Technique and the Sample Size of a Longitudinal Single-Center Study | 177 - 178 |
| 5 | Clinical Research | Using Continuous Flow Data to Predict the Course of Air Leaks After Lung Lobectomy | 179 - 185 |
| 6 | Clinical Research | Impact of Interatrial Septal Reconstruction on Atrial Tachyarrhythmia after Surgical Resection of Myxoma | 186 - 193 |
| 7 | Commentary | Commentary: Does Patch Repair of the Interatrial Septum Minimize the Incidence of Postoperative Atrial Tachyarrhythmia? | 194 - 196 |
| 8 | Clinical Research | Aortic Valve Replacement and Concomitant Multi-Vessel Coronary Artery Bypass: The Impact of Using the Bilateral Internal Thoracic Arteries on Early and Late Clinical Outcomes | 197 - 203 |
| 9 | Commentary | Commentary: What Is the Optimal Graft Strategy for Coronary Bypass Grafting with Concomitant Aortic Valve Replacement? | 204 - 205 |
| 10 | Clinical Research | Delayed Sternal Closure Using a Vacuum-Assisted Closure System in Adult Cardiac Surgery | 206 - 212 |
| 11 | Commentary | Commentary: Open Your Mind to Open Chest Management | 213 - 215 |
| 12 | Case Report | Abrupt Bulla Formation by Visceral Pleural Detachment after Pulmonary Lobectomy: A Case Report | 216 - 219 |
| 13 | Case Report | Well-Differentiated Papillary Mesothelial Tumor: An Unusual Radiologic Presentation: A Case Report | 220 - 223 |
| 14 | Case Report | HeartMate 3 Implantation via Only Left Thoracotomy: A Case Report | 224 - 227 |
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J Chest Surg 2023; 56(3): 177-178
Published online May 5, 2023 https://doi.org/10.5090/jcs.23.019
Copyright © Journal of Chest Surgery.
Hyo Yeong Ahn, M.D. 
, Hoseok I, M.D.
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Medical Research Institution, Pusan National University School of Medicine, Busan, Korea
Correspondence to:Hyo Yeong Ahn
Tel 82-51-240-7267
Fax 82-51-243-9389
E-mail doctorahn02@hanmail.net
ORCID
https://orcid.org/0000-0003-3198-8237
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Linked Article: J Chest Surg. 2023;56(3):171-176 https://doi.org/10.5090/jcs.22.129
Figure 1.Fig. 1
Figure 2.Fig. 2
In this issue of the
Since the variety in size, location, and severity contributes to different surgical outcomes and prognoses, the number of patients in this study was too small to protocolize the approach and derive any definitive conclusions. Specifically, with regard to the transthoracic approach, there is a lack of evidence to prove the value of video-assisted thoracoscopic surgery (VATS) in the management of DH based on merely 5 cases.
As mentioned in the article, in cases with longer duration, “tension-free” repair using mesh is recommended. To prevent injury to the lung and to protect the abdominal organs, the thoracic approach allowed better visualization of the surgical field than the abdominal approach, ensuring safe dissection in cases with a longer hernia duration [3]. Open surgery is safe and facilitates the effective use of various instruments, allowing the diaphragm to lie at the lowest level. Especially, using VATS, flattening the diaphragm is not as easy to achieve as it is through open surgery. In this study, there is no discussion of methods to flatten the diaphragm at the lowest level during VATS. We recommend pneumatic compression with carbon dioxide (CO2) gas during VATS. This is an effective and safe option to maintain the dissection plane and to easily flatten the diaphragm. However, during pneumatic compression, CO2 could move into the abdominal space, resulting in inadequate compression of the diaphragm in some cases. This can be overcome by approximation of the mesh using tagging sutures just after dissecting the plane under the diaphragm.
This paper summarized the surgical approaches to the management of DH. Due to the variety of conditions affecting these patients, surgeons are faced with making the best decision in the moment. This study is subject to the main weaknesses of single-center studies, including a small sample size. Since it is necessary to outline the selection criteria and proper indications in DH patients depending on their clinicopathologic characteristics, more evidence is needed to protocolize the approach and derive any definitive conclusions.
Author contributions
All the work was done by Hyo Yeong Ahn and Hoseok I.
Conflict of interest
No potential conflict of interest relevant to this article was reported.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
J Chest Surg 2023; 56(3): 177-178
Published online May 5, 2023 https://doi.org/10.5090/jcs.23.019
Copyright © Journal of Chest Surgery.
Hyo Yeong Ahn, M.D. , Hoseok I, M.D.
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Medical Research Institution, Pusan National University School of Medicine, Busan, Korea
Correspondence to:Hyo Yeong Ahn
Tel 82-51-240-7267
Fax 82-51-243-9389
E-mail doctorahn02@hanmail.net
ORCID
https://orcid.org/0000-0003-3198-8237
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Linked Article: J Chest Surg. 2023;56(3):171-176 https://doi.org/10.5090/jcs.22.129
Figure 1. Fig. 1
Figure 2. Fig. 2
In this issue of the
Since the variety in size, location, and severity contributes to different surgical outcomes and prognoses, the number of patients in this study was too small to protocolize the approach and derive any definitive conclusions. Specifically, with regard to the transthoracic approach, there is a lack of evidence to prove the value of video-assisted thoracoscopic surgery (VATS) in the management of DH based on merely 5 cases.
As mentioned in the article, in cases with longer duration, “tension-free” repair using mesh is recommended. To prevent injury to the lung and to protect the abdominal organs, the thoracic approach allowed better visualization of the surgical field than the abdominal approach, ensuring safe dissection in cases with a longer hernia duration [3]. Open surgery is safe and facilitates the effective use of various instruments, allowing the diaphragm to lie at the lowest level. Especially, using VATS, flattening the diaphragm is not as easy to achieve as it is through open surgery. In this study, there is no discussion of methods to flatten the diaphragm at the lowest level during VATS. We recommend pneumatic compression with carbon dioxide (CO2) gas during VATS. This is an effective and safe option to maintain the dissection plane and to easily flatten the diaphragm. However, during pneumatic compression, CO2 could move into the abdominal space, resulting in inadequate compression of the diaphragm in some cases. This can be overcome by approximation of the mesh using tagging sutures just after dissecting the plane under the diaphragm.
This paper summarized the surgical approaches to the management of DH. Due to the variety of conditions affecting these patients, surgeons are faced with making the best decision in the moment. This study is subject to the main weaknesses of single-center studies, including a small sample size. Since it is necessary to outline the selection criteria and proper indications in DH patients depending on their clinicopathologic characteristics, more evidence is needed to protocolize the approach and derive any definitive conclusions.
Author contributions
All the work was done by Hyo Yeong Ahn and Hoseok I.
Conflict of interest
No potential conflict of interest relevant to this article was reported.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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