Call for abstracts

（Lung）Introducing the success of women doctors as respiratory surgeons

session outline

Women doctors, as active respiratory surgeons, are increasing every year. Women doctors are taking an important part in clinical and research activities in their respective environments. For this reason, we have set up a unique session of women doctors, by women doctors, and for women doctors. In this session, women doctors present the results obtained in daily practice and research activities. We expect speakers to make presentations and discussions on medical themes, not social themes.

（Lung）Nightmares

session outline

During the experience as a thoracic surgeon, you may encounter "a nightmare case" that you do not want to remember. We believe that sharing these experiences with experts is of great value. If possible, please present severe surgical cases that one does not want to experience again, emergency cases with desperate risks, unexpected catastrophic troubles during the operation, and cases with tremendous postoperative complications.

（Aorta）How to treat the aortic disease associated with the hostile aorta?

session outline

Severe atheromatous disease such as the shaggy aorta is associated with a high risk of embolic complicaitons during surgical treatment of aortic diseases. In patients with heavily calcified lesion such as the "porcelain aorta", special consideration is required for aortic crossclamping and anastomosis. In this session, the authors are encouraged to discuss, using a video clip, the strategies to accomplish safe surgical treatment without complications in patients with such a hostile aorta.

（Aorta）How do I reattach the intercostal arteries?

session outline

Even in the era of collateral network concept, intercostal artery reconstruction remains an important component of spinal cord protection. In this session, the authors are encouraged to present, using a video clip, their techniques to reattach the intercostal arteries, and to discuss their benefits in preventing ischemic spinal cord injury from the standpoint of rapidity, patency, and methods to avoid ischemia during reconstruction.

（Aortic Valve ・Root）Minimally invasive intervention for the calcified aortic stenosis

session outline

There are some minimally invasive intervention for the calcified aortic stenosis, such as TAVI, Sutureles valve, MICS (right mini-thoracotomy). Please show that the early and late results of these interventions. And discuss about the indication of age, therapeutic plan of patient's life cycle.

（Mitral Valve）Experts' setting and technique in minimally invasive or robotic mitral valve surgery

session outline

There are several ways of minimally invasive mitral valve surgery, i.e. endoscopic assist, totally endoscopic, or robotic assist, and each technique has its specific setting and repair technique. In this techno-academy, experts with at least several hundreds of cases of experience are supposed to present their specific settings and techniques. The room is equipped with full HD or full HD 3D video projection system.

（Heart Failure）Subvalvular repair for functional mitral or tricuspid valve regurgitation

session outline

Several surgical procedures for subvalvular apparatus have been reported for functional mitral or tricuspid valve regurgitation. In this session panelists need to present their technique based on their rationals and clinical outcomes.

（Coronary artery）Scientific verification of proximal anastomosis on CABG

session outline

No touch aorta CABG reduced stroke rate after CABG and it is recommended in guideline. However, no touch aorta CABG in narrow sense can be accomplished only by in-situ grafting and there is some limitation regarding covering all coronary arteries only by in-situ graft. Some proximal anastomosis devices have been developed and used as in wide sense no-touch aortic CABG. We would like to discuss how to use the variety of proximal anastomosis, including side clamping, no-touch aorta, devices and so on.

（Arrhythmia）Current surgical sterategy for AF

session outline

The Japanese guidelines for arrhythmic surgery have been revised. It shows that AF surgery concomitant with cardiac surgery is Class I reccomendation and LA appendage resection for patients with AF is Class IIa recommendation.On the other hand, AF surgery involves a wide range of procedures, including Maze procedure, LA Maze procedure, pulmonary vein isolation, and LA appendage resection, and the surgical strategies are diversifying due to pupularization of MICS approach and introduction of new devices. In this session, we would like to discuss new ingenuity of AF surgery and its clinicsl outcomes.

（HOCM）Current surgical treatment for HOCM

session outline

Japanese guideline recommends HOCM surghery by an experienced surgeon (the surgeon has experienced more than 10 patients and the institution has performed more than 20 patients) as Class I. However, number of HOCM surgery is limited to 120-130 cases per year in Japan and there are limited number of experienced surgeons. In this session, we will introduce the current surgical treatment for HOCM so that HOCM surgery can be performed safely and reliably even in limited cases. I would like you to present your original technique for HCM.

（Congenital）Surgical treatment for coronary artery anomalies of origin and course

session outline

Anomalous origin of the coronary artery is a rare congenital heart defect which often accompanies anomalous course of coronary arteries. This can cause sudden cardiac death among children and young adults and is increasingly discovered accidently due to advances in imaging technologies. It can be difficult to determine when and how these patients should be treated. The aim of this techno-academy is to share surgical experiences from different institutions and to make a contribution toward the future decision-making process concerning surgical strategy.

（Lung）Knack & Pitfalls for minimally invasive surgery in the field of respiratory surgery-Video assisted thoracic surgery vs. uniportal surgery vs. robot-assisted surgery

session outline

Minimally invasive thoracic surgery extends to thoracoscopic surgery (VATS), Uniport VATS, and robot-assisted surgery (RATS).
The session is divided into two sub-sessions. In the first half, we will present the technical maturity of VATS. Next, the speakers provide a video showing the technical achievements in lung cancer surgery, in comparison with conventional VATS vs. Uniport VATS, especially in lymphadenectomy.
In the second half, the focus will be on RATS, with invited speakers giving keynote lectures on topics in minimally invasive surgery, and participating in discussions after that. We want each speaker to discuss surgical knacks and pitfalls, comparing VATS, Uniport VATS, and RATS.

（Aorta）How to treat the extensive aortic disease involving the aortic arch?

session outline

In the era of TEVAR and the frozen elephant trunk operation, various strategies have been employed to treat extensive aortic lesion involving the aortic arch to the distal descending (below the carina level) or thoracoabdominal aorta. In this session, the authors are encouraged to discuss their strategies from the standpoint of long-term outcomes.

（Aorta）How to treat acute type A aortic dissection complicated by vital organ malperfusion?

session outline

Vital organ malperfusion is a poor prognostic factor in the surgical treatment of acute type A aortic dissection. For brain, coronary and mesenteric malperfusion, early reperfusion in the emergency room or catheter intervention prior to central repair have been tried, and intentional delay in central repair has been proposed. In this session, the authors are encouraged to discuss the latest strategies to manage the symptomatic vital organ malperfusion.

（Aortic Valve・Root）Aoric valve sparing operation - Strategy up to date

session outline

Two major valve sparing operations are reimplantation and remodeling. We should discover the early and late results, benefits and problems of these methods. Which is better, a valsalva graft and a straight graft? Is there any new technical tips? What kind of pathology prefer which technique? We will discuss the indication of both techniques. Is this same?

（Mitral Valve）Long-term outcome of Gore-Tex artificial chordae

session outline

With the spread of minimally invasive surgery, use of artificial chordae in mitral valve plasty seems to be becoming more popular. Although artificial chordae is an established technique with more than 30 years of history, there yet are some problems, i.e. lesions in the leaflets are left untreated, disruption or calcification of the chordae has been reported. In this symposium, papers about long-term outcome of artificial chordae based on significant number of cases and follow-up period are expected.

（Heart Failure）Surgery for end stage DCM-MR

session outline

Surgical challenges have been made for end-stage DCM patients with functional MR in Japan where there is a severe shortage of donor for heart transplantation and LVAD destination therapy (DT) has not been approved. This is a timing to review the outcomes of those challenges for DCM-MR with EF less than 35% and identify the candidates for LVAD DT.

（Coronary artery）Reconsideration of OPCAB and on pumo CBAG

session outline

In japan, OPCAB has been applied on over 60% patients of CABG. On the other hand, in western countries, it has been applied on less than 20% of CAB patients. The benefits of OPCAB for high-risk patients was proved, however, it has not been demonstrated for moderate or low-risk patients. If OPCAB is performed only for high-risk patients, the number of OPCAB would be limited and the each institute could not become high-volume center, in which the result of OPCAB was proved to be better than low-volume center. Once again we would like to discuss the rationale of OPCAB and on pump CABG.

（Congenital）Principles of myocardial cardioplegic protection of the infant and adult hearts and a review of recent topics on the field

session outline

Although cardioplegia is essential and fundamental for open heart surgery, the composition, dosage, temperature, and perfusion strategy used highly vary among cardiac surgeons. It is known that the calcium transport system and energy substrates in the immature heart are different from those in the mature heart. However, the number of studies in this field has recently started to decline. We will invite selected speakers to review basic science and recent topics of myocardial protection of the infant and adult hearts.

（Lung）A paradigm shift in the treatment of malignant pleural mesothelioma

session outline

Malignant pleural mesothelioma (MPM) used to be considered an incurable disease for a long time. However, current topics of MPM treatment focus on long-term survivors. For further improvement of survival, rapid refinement of infrastructures for MPM treatment is underway. The staging system was revised to version 8 in 2017, and data collection for the formulation of version 9 is ongoing. Tumor thickness is considered as a promising T-descriptor in version 9. To create an MPM-specific lymph node map is currently under discussion. The establishment of surgical nomenclature and standardized surgical reporting system is also in progress. In the context of increasing early-stage MPM, surgery is shifting to be less invasive and more standardized in order to be a part of surgery-based treatment. In this symposium, the imminent paradigm shift in MPM surgery will be discussed by world-leading experts.

（Lung）Therapy of lung cancer in a new era ~ surgery for lung cancer as a part of multimodal treatment

session outline

Advances in novel pharmacotherapy for lung cancer, such as the emergence of molecular-targeted therapies and even immune checkpoint inhibitors, are remarkable. For this reason, it can be said that an era has been reached in which advanced lung cancer can be cured by combining multimodal treatment. In this situation, in addition to the current indications for surgical resection, we anticipate that an increase in the number of curative cases will be achieved by adding surgery to the advanced cases for which there had been no indication for surgery. Therefore, surgeons need to reconsider the role that surgery should play as a part of multidisciplinary treatment, taking into account induction therapy, adjuvant therapy, salvage therapy, and even treatment for a small number of metastatic tumors (oligometastsis). We hope that this symposium will deepen the discussion on the role of multidisciplinary treatment and surgery in a new era.

（Lung）New method for lung preservation and evaluation of graft function in lung transplantation (including ex vivo lung perfusion (EVLP))

session outline

In order to solve the shortage of donors in lung transplantation, the active use of potentially damaged lungs, such as marginal donor lungs or cardiac death donors, is required. For the utilization of damaged lung, it is essential to develop both organ preservation methods that minimize the damage and methods to evaluate graft function properly. In this symposium, the latest information on preservation methods to maintain the quality of donor's lungs, including the currently adopted ex vivo lung perfusion, and direct clinical implications such as how much function can we evaluate before transplantation. We want to introduce the latest research achievements and discuss prospects.

（Esophagus）Radical lymph node dissection with preventing postoperative morbidities

session outline

Preoperative chemo (radio)-therapy has been introduced as a standard medical practice for advanced esophageal cancer in Japan. Therefore, the opportunity of achieving the radical operation is increasing by down staging even in T4 cases.
Purpose of the surgery for esophageal cancer is to achieve the radical lymph node dissection. But radical dissection for advanced esophageal cancer patients after primary treatments is related to the postoperative morbidities. Please show your surgical technique which satisfies the radicalily with preventing post operative morbidities.

（Aorta）Aortic root replacement for acute type A aortic dissection: Valve sparing vs. Bentall

session outline

As the valve-sparing aortic root replacement has become widely used, it is increasingly applied for acute type A aortic dissection necessitating.

（Heart Failure）Surgical strategy for stable long term LVAD support

session outline

More than half of patients who received heart transplantation in Japan in 2018 required more than 3 years of LVAD support. The aim of this panel discussion is to discuss the surgical strategies for de-novo aortic valve insufficiency and LVAD related infections to enable stable long term LVAD support.

（Coronary artery）How shoud we adopt MICS CABG nad hibrid CABG

session outline

After the first tide of MIDCAB had been declined, recently the second tide of MICA CABG is spreading. However, there are some problems or difficultness on MICA CABG for example, some limitation for the usage of BITA, the difficultness to approach to ascending aorta or difficultness on the exposure of all aspect of the heart especially for the inferior wall. Hybrid CABG is the combination of the first tide of MIDCAB and PCI in which PCI follows CABG for only LAD or left coronary. Because there is no conclusion on what is the best conduit for RCA, PCI might be the optimal methods.

（Congenital）How to achieve good Fontan circulation for a wide range of morphologies of the systemic venous system

session outline

Long-term problems have historically been recognized following the Fontan procedure and measures to prevent and overcome such problems have previously been discussed. This panel discussion is intended to focus on the wide range of morphologies of the systemic venous system in patients with many different functional single ventricles, in particular, individuals with a heterotaxy syndrome. Here, we plan to discuss the surgical management, individualized to the patient, in reconstructing an optimal venous pathway, while paying particular attention to the long-term results from different institutions.

（Congenital）Surgical management of tetralogy of Fallot: primary or staged repair?

session outline

Debate continues regarding when and how to start the surgical treatment of tetralogy of Fallot (TOF). Recently, catheter interventions, such as stenting of the right ventricular outflow tract, have been performed to prevent surgical palliation. This makes treatment strategies in TOF more complicated. In this panel discussion, we will focus on the different treatment strategies in TOF from different institutions to improve short-time and long-term outcomes in patients.

（Esophagus）Treatment strategy for senior patients with esophageal cancer

session outline

The population of senior patients with esophageal cancer is increasing with the aging of the population in Japan. The senior patients has comorbidities in cerebro- vascular, pulmonary and endocrine metabolism. They also have the history of cancer treatment and/or simultaneous cancers. Please show your strategy for senior patients with esophageal cancer.

（Aorta）Infectious aortic disease

session outline

Outcomes of surgical treatment for infectious aortic disease remain poor, because of infective complications or graft infection. To better manage this difficult disease entity, bridging TEVAR or TEVAR after infection control as a definitive treatment have been proposed. In this session, the authors are encouraged to discuss the latest treatment strategy for infectious aortic disease, including those with fistula and graft infection (graft infection within three months after open surgery should be excluded), from the standpoint of long-term outcomes.

（Heart Failure）Surgical strategies for preoperative and postoperative cardiogenic shock patients

session outline

Recent advances in mechanical circulatory support and early treatment with the heart-team approach seem to improve outcomes for cardiogenic shock. The aim of this workshop is to discuss the surgical strategies for preoperative and postoperative cardiogenic shock patients.

（Congenital）Surgical strategy for congenitally corrected transposition of the great arteries

session outline

In Japan, less than 100 surgeries are performed each year, including both open and non-open heart surgeries for congenitally corrected transposition of the great arteries. However, there are many surgical options depending on the accompanying cardiac lesions such as ventricular septal defects, pulmonary stenosis, and tricuspid regurgitation. Conventional surgical procedures, double switch, hemi-Mustard, and PA banding, are accordingly performed as standard operations. In this workshop, we will look at examples of cases that have been subjected to those surgical procedures, as well as their mid-term results, and apply this information to improve future surgical results.

（Lung）Anti-HLA antibody and antibody-related rejection in lung transplantation

session outline

It has been more than 20 years since the first living lung transplantation (1998) in Japan, and it is increasingly common to face postoperative complications and preoperative problems that we have not experienced before. These include donor-specific antibodies (DSA) and antibody-related rejection. HLA antibody testing has been included in the insurance coverage, and most medical facilities periodically conduct HLA antibody testing. However, the fact is that we still have little knowledge in this field. This session was designed to share valuable experiences at each institution. We want participants' discussion with passion on further improving the world's top-level performance of lung transplantation, and on providing safe lung transplantation to as many people as possible in Japan with the severe shortage of brain death donors.

（Aortic Valve ・Root）Surgically techniques of aortic valve plasty for the bicuspid aortic regurgitation

session outline

Surgically techniques of aortic valve plasty for the bicuspid aortic regurgitation are sometimes easy and difficult depend on the commissural angle. In this worlshop, please discuss about some pitfalls using videomovie. And add some comments about usage of autologous pericardium and its results.

（Mitral Valve）Mitral valve surgery for challenging cases

session outline

Reports of surgical technique for challenging cases in mitral valve surgery are expected, for example, MAC, difficulty in anatomical reasons, repair in IIIa lesion, or repair in adult congenital cases. Presentation should be based on serial cases operated in a consistent way, instead of single case experience. Clear videos are requested, preferably recorded in full HD format.
一例報告でなく、数例以上を系統的に統一された方法で行った報告が好ましい。鮮明なビデオ,できればフルHD(1920x1080画素）記録の準備をお願いする。

（Lung） Surgical Colosseum

session outline

In this session, treatment strategies on a particular case will be meticulously discussed. Prior to the session, the chairperson makes arrangements with the presenter about the progress of the discussion. The discussion will cover the indication of surgery, preoperative treatment, selection of surgical procedures, and management for perioperative complications. Chairperson organizes and sums up the discussions.

（Esophagus） Video Clinic： Our techniques

session outline

We would like to call for the new idea and surgical technique to treat the benign esophageal disease and esophageal cancer. This session is also conducted to give knack and pitfall to surgeons trying to get the certificates of qualified surgeons in the endoscopic surgery.

（Esophagus） Serious case experience conference

session outline

We sometime experience a serious case which is very hard to treat during esophageal disease treatment. We could share those important experiences to find a break through.

（Esophagus）How to diagnose and treat this case

session outline

We would like to call for the presentation of your experiences of the rare case or the problematic case which was difficult to be diagnosed and treated. Therapeutic strategies based on the evidences or experiences for each case would be discussed.

（Esophagus）Surgical procedures to avoid the complications after esophagectomy

session outline

We would like to call for the ideas of surgical procedure which avoid the postoperative complications after esophagectomy and surgery for benign diseases such as anastomotic leakage, recurrent nerve palsy and chylothorax after esophagectomy; gastric juice reflux after surgery for esophago-gastric junctional cancer; recurrence after hiatal hernia repair.

（Esophagus）Selection of the organ and reconstructive route after esophagectomy from the physiological viewpoin and safety

session outline

The gastric tube has been selected for the reconstruction organ after esophagectomy. But, size of the gastric tube and reconstructive route have a variation. In the case after gastrectomy or with synchronous gastric cancer, the right, the left colonic conduit or the jujinum is used. Please discuss about the selection of the organ and reconstructive route after esophagectomy from physiological viewpoint and safety.

（Esophagus）New instruments and strategy for esophageal cancer treatment

session outline

Recently, ICG (Indocyanine green) fluorography was introduced to esophageal surgery to prevent anastomotic leakage by evaluating blood flow of the reconstruction conduit. Nerve integrity monitoring (NIM) is also used to prevent postoperative recurrent laryngeal nerve palsy. Mediastinoscopic and Robotic surgery became popular after an insurance coverage. We would discuss those new instruments and technology which were introduced in esophageal cancer treatment.

（Esophagus）Oncological emergency in esophageal cancer treatment

session outline

Dyspnea from the broncho-tracheal stenosis by tumor invasion, serious pneumonia from esophago-broncheal fistula and massive bleeding from esophago-aortic fistula, etc. are the oncological emergency which we sometime experience and should be treated immediately. We hope your presentation concerning distinguished treatment for such a serious condition.