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S. Maehara



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    P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P1.04-035 - Clinicopathologic and Biological Characteristics of Young Age Non-Small Cell Lung Cancer (ID 2421)

      09:30 - 17:00  |  Author(s): S. Maehara

      • Abstract

      Background:
      The Japan Lung Cancer Society, Japanese Association for Chest Surgery, and Japanese Respiratory Society jointly established the Japanese Joint Committee for Lung Cancer Registration. The Japanese Joint Committee reported that number of resected lung cancer patients under 40 years of age in Japan was 101 cases of 11663 registered patients in 2004. Apparently there are many people on their 50s to 70s who was resected for treatment of lung cancer. Lung cancer in patients under 40 years old is rare. Young lung cancer patients should have specific characteristics.

      Methods:
      We performed 2835 operations for lung cancer for 15years from 2000 through 2014 in our hospital. Among 2835 patients with lung cancer, 47 patients were younger than 40. Among 47 patients 26 patients were male and 21 patients were female. We examined characteristics of young lung cancer patients by clinicopathologic and molecular biologic characteristics.

      Results:
      Among patients with operation, pathological stage IA, IB, IIA, IIB, IIIA, IIIB were 24, 6, 3, 2, 6, 5 cases, respectively. 36 cases were diagnosed as adenocarcinoma. Squamous cell carcinoma was only one case. 3 cases were diagnosed as large cell carcinoma. Most of young lung cancer cases were diagnosed as adenocarcinoma. 5-year survival of resected lung cancer patients was 74%. 5-year survival of inoperable cases was 23.8%. We will show the biological characteristics of young age lung cancer patients. 9cases showed EGFR sensitive mutation. 4 cases showed the transforming EML4-ALK fusion gene.

      Conclusion:
      Young lung cancer patients showed specific clinicopathologic and molecular biologic characteristics compared with the older age patients.

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    P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
    • Presentations: 1
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      P3.08-032 - Maximizing Use of Robot-Arms in the Robot-Assisted Thoracic Surgery (ID 875)

      09:30 - 17:00  |  Author(s): S. Maehara

      • Abstract
      • Slides

      Background:
      We have previously reported on the importance of appropriate robot-arm settings and replacement of instrument-ports in robot-assisted thoracic surgery. Because the thoracic cavity requires a large space to access all lesions in various areas of the thoracic cavity from the apex to the diaphragm and mediastinum and the chest wall. Moreover it can be difficult manipulate the da Vinci[® ]Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) using only arms No. 1 and No. 2 depending on the tumor location. In this report, we show how robot-arm No. 3 can be used with maximum effectiveness in the da Vinci[®]-assisted thoracic surgery.

      Methods:
      Robot-arm No. 3 of the da Vinci® Surgical System was usually positioned on the same side of arm No. 2, and sometimes it was used as an assistant arm to avoid conflict with other arms in our previous report. We describe new effective application of robot-arm No. 3 for the da Vinci S®-assisted thoracic surgery. A 62-year-old man had an anterior mediastinal tumor suspected to be non-invasive thymoma. Instead of arm No. 1, arm No. 3 was placed in the 6th intercostal in the mid-axillary line inserted from reverse the side, rotating it behind the body of the da Vinci® Surgical System.

      Results:
      Robotic surgery enables access to tumors located throughout in the thoracic cavity. The time required for the da Vinci S ® -setting was 12 minutes and the console-time (the da Vinci S ®working time) was 75 minutes. Thymectomy was performed successfully, and the amount of bleeding was 68 ml, and there were no complications. The pathological findings were thymoma, Masaoka stage II.

      Conclusion:
      Arm No. 3 has wider range of motion than other arms because it has one more additional joint. That is the reason why arm No. 3 enables good operability and ability to reach remote lesions, such as in the apex, diaphragm, or costophrenic angle. Moreover, between the space of the camera-arm and arm No. 3 make enough working space than using arm No. 1 to avoid conflict between arms. This use of the da Vinci S ® arms should be helpful in robotic procedures for thoracic surgeons in manipulating the da Vinci S ® instrument arms. Our recent experience has taught us that arm No. 3 is extremely useful when used as the main arm instead of arm No. 1. This idea should facilitate the da Vinci S®-assisted thoracic surgery procedures as a new effective application of robot-arm No. 3.

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