Bing‐Yen Wang

National Chung Hsing University

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Ya‐Fu Cheng

Changhua Christian Hospital

Ching‐Hsiung Lin

Changhua Christian Hospital

Wei‐Heng Hung

Changhua Christian Hospital

Ching‐Yuan Cheng

Changhua Christian Hospital

Chang‐Lun Huang

Changhua Christian Hospital

Chia‐Chuan Liu

Koo Foundation Sun Yat-Sen Cancer Center

Wen‐Wei Chang

Chung Shan Medical University

Sheng‐Hao Lin

Changhua Christian Hospital

Yi‐Ling Chen

Changhua Christian Hospital

Po‐Kuei Hsu

Taipei Veterans General Hospital

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Society of Thoracic Surgeons

194

Changhua Christian Hospital

University of Pennsylvania

Chung Shan Medical University

Harvard University

Johns Hopkins University

Cornell University

National Yang Ming Chiao Tung University

New York Proton Center

Istituti di Ricovero e Cura a Carattere Scientifico

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Role of respiratory secretion culture in surgical outcome prediction of bacterial empyema

Research Square (Research Square) (2023)

Chia‐Chi Liu Ya‐Fu Cheng Yi‐Ling Chen Ching‐Yuan Cheng Chang‐Lun Huang

Abstract Background: Thoracic empyema is a serious infectious disease worldwide. Video-assisted thoracoscopic surgery is strongly recommended as a treatment, and pleural fluid and tissue cultures can be obtained intraoperatively. The combination of a pleural peels tissue culture and a pleural fluid culture improves the positive culture rate. We aimed to investigate the role of respiratory secretion cultures to determine the optimal management for improving surgical outcome. Methods: This retrospective study identified 1197 patients with phase II or III thoracic empyema from our institution. Patients who underwent decortication of the pleura from April 2011 to May 2022 with a positive pleural culture were included. Results: There were 225 empyema patients with either a positive pleural fluid culture or a positive pleural peel tissue culture. Of these, 76 patients had positive respiratory secretion culture findings during hospitalization. The most common species of pathogens were Pseudomonas aeruginosa (44%), Klebsiella pneumoniae (16%), and Staphylococcus aureus (10%) in the respiratory secretion cultures and Streptococcus spp. (38%), Klebsiella pneumoniae (12%), and Staphylococcus aureus (11%) in the pleural cultures. There were 30 patients who had a common pathogen in a respiratory secretion culture and in the pleural fluid/tissue culture. Poor outcome measures were found in these patients, including the longer use of antibiotics preoperatively (19.03 ± 37.66 days versus 9.59 ± 27.09 days, p = 0.006) and a higher mortality rate during hospitalization (40.0% versus 17.4%, p = 0.002). Conclusions: The respiratory secretion culture plays an essential role in prediction of surgical outcome in bacterial empyema. Obtaining the respiratory secretion specimen promptly through proper methods helps to improve the survival of empyema patients.

Decortication

Microbiological culture

10.21203/rs.3.rs-3722145/v1

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Citations (0)

Tricuspid valve infective endocarditis complicated with multiple lung abscesses and thoracic empyema as different pathogens: a case report

Journal of Cardiothoracic Surgery (2019)

Ya‐Fu Cheng Yung‐Kun Hsieh Bing‐Yen Wang Ching-Yugn Cheng Chang‐Lun Huang

Only 4.1% of tricuspid valve IE cases require surgical intervention. The complication after tricuspid valve IE with lung abscess and empyema is rare. We report the case of a 38-year-old male (an intravenous drug abuser) diagnosed with tricuspid valve IE who underwent tricuspid valve replacement. The case was complicated by multiple lung abscesses and thoracic empyema. The pathogens causing the lung abscesses and empyema were Acinetobacter baumannii complex and Candida albicans, which were different from those causing the endocarditis. After 4 weeks of antibiotic treatment, chest X-ray revealed bilateral clear lung markings with only mild blunting of the right costophrenic angle. The pathogen causing the lung abscess is not always compatible with that causing the endocarditis. Thoracoscopic incision of the abscess with 4 to 6 weeks of broad-spectrum antibiotic treatment is effective and safe.

Infective Endocarditis

Cardiothoracic surgery

Lung abscess

10.1186/s13019-019-0867-1

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Citations (7)

Comparison of extended segmentectomy with traditional segmentectomy for stage I lung cancer

Journal of Cardiothoracic Surgery (2022)

Ya‐Fu Cheng Yueh-Che Hsieh Yu‐Jun Chang Ching‐Yuan Cheng Chang‐Lun Huang

For stage I non-small cell lung cancer (NSCLC), lobectomy and segmentectomy are still controversial operations. Extended segmentectomy was proposed to make larger safe margins than segmentectomy. Image-guided video-assisted thoracoscopic surgery (iVATS) is useful to accomplish extended segmentectomy. We aimed to compare the effects of iVATS extended segmentectomy to the effects of traditional segmentectomy for stage I NSCLC.This study is a retrospective analysis in a single institute. Patients with stage I NSCLC who received segmentectomy between January 2017 and September 2020 were included. Patients were distributed to iVATS extended segmentectomy (group A), and traditional segmentectomy (group B). The impacts of the different surgical methods on resection margin were assessed.There were 116 patients enrolled in this study. Sixty-two patients distributed in group A, and the other 54 patients in group B. The resection margin to a staple line was 17.94 mm in group A versus 14.15 mm in group B, p = 0.037. The margin/tumor diameter ratio was 2.08 in group A versus 1.39 in group B, p = 0.003. The enough margin rate was 75.81% and 57.41%, respectively, for group A and group B. The subgroup analysis of iVATS extended segmentectomy showed that T1a lesions had larger margin distances than did T1b lesions (19.85 mm vs. 14.83 mm, p = 0.026).The iVATS extended segmentectomy can provide more resection margin than traditional segmentectomy. Segmentectomy is more suitable to perform when the nodule's diameter is less than 10 mm.

Cardiothoracic surgery

10.1186/s13019-022-01771-4

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Citations (3)

Subxiphoid single-incision thoracoscopic left upper lobectomy

Journal of Thoracic and Cardiovascular Surgery (2014)

Chia‐Chuan Liu Bing‐Yen Wang Chih‐Shiun Shih Yun-Hen Liu

Thoracoscopy

VATS lobectomy

Video-assisted thoracoscopic surgery

10.1016/j.jtcvs.2014.08.033

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Citations (88)

Esophageal squamous cell carcinoma and prognosis in Taiwan

Cancer Medicine (2018)

Ya‐Fu Cheng Hui‐Shan Chen Shiao‐Chi Wu Heng‐Chung Chen Wei‐Heng Hung

Abstract The prognosis of esophageal squamous cell carcinoma is poor. In order to find out appropriate treatment for each group of patients, we aim to examine the prognostic factors influencing survival for esophageal cancer patients in Taiwan. Data were obtained from the Taiwan Society of Cancer Registry. There were 14,394 esophageal cancer patients analyzed between 2008 and 2014 in this retrospective review. The impact of the clinicopathologic factors on overall survival was assessed. The following clinic‐pathologic factors were included to analyses: age, sex, tumor location, tumor length, histologic grade, clinical T, clinical N, clinical M, clinical stage, and all therapeutic methods within 3 months after diagnosis. The 5‐year survival rate was 16.8%, with a median survival of 343 days. The distribution of patients by their clinical stage is as follows: stage 0 ( n = 162; 1.1%); stage I ( n = 964; 6.7%); stage II ( n = 2392; 16.6%); stage III ( n = 6636; 46.1%); and stage IV ( n = 3661; 25.4%). In the multivariate analysis, age, sex, tumor location, tumor length, clinical T, clinical N, clinical M, and treatment remained independent prognostic factors. Our data indicated that age, sex, tumor location, tumor length, clinical T, clinical N, clinical M, and treatment remained independent prognostic factors. Patients who could receive surgery had significantly better outcomes.

10.1002/cam4.1499

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Single-incision Versus Multiple-incision Thoracoscopic Lobectomy and Segmentectomy

Annals of Surgery (2014)

Bing‐Yen Wang Chun‐Yu Liu Po‐Kuei Hsu Chih‐Shiun Shih Chia‐Chuan Liu

To compare the perioperative outcomes of single-incision and multiple-incision thoracoscopic lobectomy and segmentectomy.Reports of single-incision thoracoscopic lobectomy and segmentectomy for lung cancer are limited, and a comparison between single-incision and multiple-incision thoracoscopic lobectomy or segmentectomy for lung cancer has not been previously reported.From January 2005 to June 2013, a total of 233 patients with lung cancer underwent thoracoscopic lobectomy or segmentectomy via a single-incision or multiple-incision technique. A propensity-matched analysis, incorporating preoperative variables, was used to compare the short-term outcomes between single-incision and multiple-incision thoracoscopic lobectomy and segmentectomy.Overall, 50 patients underwent single-incision thoracoscopic pulmonary resections, including 35 lobectomies and 15 segmentectomies, and 183 patients underwent multiple-incision thoracoscopic lobectomy or segmentectomy between January 2005 and December 2011. Propensity matching produced 46 patients in each group. The length of hospital stay and the complication rate were not significantly different between the 2 groups. Single-incision thoracoscopic lobectomy and segmentectomy were associated with shorter operative time (P = 0.029), more numbers of lymph nodes (P = 0.032), and less intraoperative blood loss (P = 0.017) than with the multiple-incision approach. No in-hospital mortality occurred in either group.Single-incision thoracoscopic lobectomy and segmentectomy are feasible, and perioperative outcomes are comparable with those of the multiple-incision approach.

Surgical incision

Video-assisted thoracoscopic surgery

VATS lobectomy

Thoracoscopy

10.1097/sla.0000000000000712

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Citations (123)

Optimal Timing for Video-Assisted Thoracic Surgery Decortication in Chronic Empyema: A survival analysis

Research Square (Research Square) (2024)

Ching-Min Lin Yi‐Ling Chen Ya‐Fu Cheng Ching‐Yuan Cheng Chang‐Lun Huang

Abstract Background Video-assisted thoracic surgery decortication for phase 3 thoracic empyema is widely accepted, but the optimal timing for such surgical intervention has not been established. We aim to investigate and assess the optimal decortication timing, in terms of overall survival, for chronic empyema. Methods 204 patients with pneumonia-caused phase 3 empyema were treated with video-assisted thoracic surgery decortication over 10 years at Changhua Christian Hospital. The 90-day post-operative survival status was analyzed, and we compared the survivor group versus the non-survivor group. A receiver operating characteristic curve was used to identify the optimal decortication timing. Results A comparison of characteristics between survivors and non-survivors showed statistical differences among age, presence of cardiovascular disease, presence of end-stage renal disease, duration to surgery, length of intensive care unit stay, and overall length of hospital stay. Receiver operating characteristic curve analysis determined the cut-off for video-assisted thoracic surgery decortication, based on optimal 90-day post-operative survival, to be 7.5 days after hospitalization; mortality increases threefold thereafter. Multivariate analysis revealed that age, end-stage renal disease, pleural effusion pH ≦ 7.2 and duration to surgery > 7.5 days negatively impacted 90-day post-operative survival. Conclusions Patients who underwent decortication surgery within 7.5 days of hospital admission had better overall survival.

Decortication

Cardiothoracic surgery

Video-assisted thoracoscopic surgery

10.21203/rs.3.rs-4147121/v1

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Citations (0)

Clinical Outcome of Intraoperative Recurrent Laryngeal Nerve Monitoring during Thoracoscopic Esophagectomy and Mediastinal Lymph Node Dissection for Esophageal Cancer

Journal of Clinical Medicine (2022)

Chang‐Lun Huang Chun‐Min Chen Wei‐Heng Hung Ya‐Fu Cheng Ruei-Ping Hong

Mediastinal lymph dissection in esophagectomy for patients with esophageal cancer is important. The dissection of recurrent laryngeal nerve (RLN) lymph nodes could cause RLN injury, vocal cord palsy, pneumonia, and respiratory failure. This retrospective study aimed to evaluate the effects of intraoperative RLN monitoring in esophagectomy and mediastinal lymph node dissection in preventing RLN injury and vocal cord palsy. This study included 75 patients who underwent minimally invasive esophagectomy and mediastinal lymph node dissection for esophageal cancer with (38 patients) and without (37 patients) IONM at Changhua Christian Hospital from 2015 to 2020. The surgical and clinical outcomes were reviewed. Patients in the IONM group had more advanced clinical T status, shorter operation time (570 vs. 633 min, p = 0.007), and less blood loss (100 mL vs. 150 mL, p = 0.019). The IONM group had significantly less postoperative vocal palsy (10.5% vs. 37.8%, p = 0.006) and pneumonia (13.2% vs. 37.8%, p = 0.014) than that in the non-IONM group. IONM was an independent factor for less postoperative vocal cord palsy that was related to postoperative 2-year survival. This study demonstrated that IONM could reduce the incidence of postoperative vocal cord palsy and pneumonia.

Esophagectomy

Vocal Cord Paralysis

Aspiration Pneumonia

10.3390/jcm11174949

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Citations (11)

Photodegradable coumarin-derived amphiphilic dendrons for DNA binding: Self-assembly and phototriggered disassembly in water and air-water interface

Colloids and Surfaces B Biointerfaces (2018)

Jiayu Ou Yu-Chan Shih Bing‐Yen Wang Chih‐Chien Chu

Interface (matter)

10.1016/j.colsurfb.2018.12.018

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Citations (4)

Clinical Outcomes of Laparoscopic Greater Curvature Plication and Laparoscopic Sleeve Gastrectomy: a Case-Matched Control Study

Obesity Surgery (2018)

Yu-Hsien Li Bing‐Yen Wang Yu‐Ching Huang Lien‐Cheng Tsao Chien‐Pin Chan

Laparoscopic greater curvature plication (LGCP) is a new bariatric procedure that is similar to laparoscopic sleeve gastrectomy (LSG) in that it uses a restrictive mechanism. Comparative studies between LGCP and LSG were still limited. The aim of this study was to compare the clinical outcomes of the two procedures based on the same clinical conditions. From January 2012 to December 2015, 260 patients with morbid obesity underwent LGCP and LSG in a single center. Data on patient demography, operation time, complications, hospital stay, body mass index loss, percentage of excess weight loss (%EWL), and improvement in comorbidities were collected. A propensity-matched analysis, incorporating pre-operative variables, was used to compare the short-term outcomes between LGCP and LSG. Propensity matching produced 48 patients in each group. Patients who underwent LGCP were predominately female (75.5%, 41.1% of the LSG patients were female, p = 0.028). Baseline BMI and excess weight were significantly lower in the LGCP group (p < 0.001). The LSG group showed a greater decrease in excess body weight than the LGCP group (LSG, 47.36 ± 12.95% in 3 months, 57.97 ± 19.28% in 6 months, 66.28 ± 25.42% in 12 months; LGCP, 39.67 ± 12.58% in 3 months, 47.40 ± 19.30% in 6 months, 48.02 ± 20.17% in 12 months, p = 0.008, 0.032, 0.010). Perioperative complications and resolution of obesity-related comorbidities were not significantly different between the two groups. LGCP and LSG are both feasible and safe procedures for surgical weight reduction. In short-term follow-ups, LSG demonstrates a better excess body weight reduction while having perioperative complications similar to LGCP.

Sleeve gastrectomy

10.1007/s11695-018-3527-y

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Citations (13)