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Respiratory Surgery

doctor

Ryuta Fukai MD, PhD, Director, Division of Thoracic Surgery

Education
Juntendo University
Specialities
Respiratory Surgery
Special Qualifications and Medical Society Memberships
  • Councilor of The Japanese Association for Chest Surgery
  • Board Certified Specialist of Japan Surgical Society
  • Board Certified Instructor of Japan Surgical Society
  • Specialist of Respiratory Surgery
  • General Clinical Oncologist & Tentative Instructor of Clinical Oncology of Japanese Board of Cancer Theapy
  • Specialist of Bronchoscope
Epidemiology
  • Lung cancer is the most common cause of cancer death in Japan, exceeding that of the other five cancers combined (colon, pancreas, stomach, liver, and breast). Symptoms often do not appear until the disease is advanced, and the symptoms also can be mistaken for other health conditions. Accordingly, the mortality of lung cancer has remained high due to a disproportionate presentation of lung cancer at an advanced, usually incurable stage. The 5-year overall survival exceeded 20% in only three countries: Japan (30%), Israel (24%), and Mauritius (37%). 1)
 

Surgery for lung cancer

VATS lobectomy (our main procedure for lung cancer)
  • Non-small cell lung cancer (NSCLC) accounts for 80% of lung cancer cases. Surgical resection is the standard treatment for early stage NSCLC, and patients operated on for Stage IA tumors now have a survival of approximately 80%. Reports have indicated that long-term outcomes of clinical Stage I NSCLC remain unchanged when surgery is performed via thoracotomy or thoracoscopy. Moreover, close to 80% of all lung cancer patients in Japan who are eligible for surgery are in Stage I 2), so thoracoscopic surgery is being more often to treat lung cancer in Japan. Video-assisted thoracoscopic surgery (VATS) with hilar/mediastinal lymph node dissection for primary lung cancer has become more popular over the last few decades, and it has been reported that patients treated with this procedure experience significantly lower the incidence of postoperative complication and shorter duration of the postoperative drainage compared with thoracotomy cases. 3)
  • Shonan
VATS lobectomy with hilar/mediastinal lymph node dissection in our hospital
  • ①The camera port at 7th or 8th intercostal space of the posterior axillary line (1.5cm)
  • ②The accessory surgical port at 6th or 7th intercostal space of the inferior angle of the scapular (2-3cm)
  • ③The surgical port at 4th or 5th intercostal space of the middle to the anterior axillary line (3-5cm)
  • Shonan
 
Our operative results of VATS lobectomy for lung cancer (from August 2014 to December 2017)
 
  • Number of cases: 122 cases
  • Age (years): 69.6 (41-84) years
  • Operative duration (min.): 220 (107-459) min.
  • Blood loss (ml): 349 (10-3400) ml
  • Hospital stay (days): 9.8 (5-30) days
 
We reported our results of VATS lobectomy with hilar/mediastinal lymph node dissection. 4)
 
References
  • 1: Salmon P, Colditz GA. Lung cancer: Epidemiology and Carcinogenesis. In: Shields’ General Thoracic Surgery, 8th edition (ed by LoCicero J III, et al), p1145-1160, Wolters Kluwer, 2019.
  • 2: Committee for scientific affairs, The Japanese association for thoracic surgery. Thoracic and cardiovascular surgeries in Japan during 2017: Annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2020; 68(4): 414-449.
  • 3: Whitson BA, et al. Surgery for early-stage non-small lung cancer: a systemic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg. 2008; 86(6): 2008-18.
  • 4. Fukai R et al. Outcomes of video-assisted thoracoscopic surgery for lung cancer performed by a team of general surgeons- a retrospective study. Jpn J Med. 2019; 2(2): 353-357.

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General Consultation Service Hours

【Morning hours】

7:30 ~ 12:00
(11:00 for Plastic Surgery)
(~11:30 for Internal Medicine initial visit)

【Afternoon hours】

12:30 ~ * Hours vary by department

【Evening hours】

16:45 ~ 19:00

※Some departments are by appointment only. Consultation Service Hours may vary by department. Please ask the clerk at the reception desk or call +81-467-46-1717 for further details regarding operating hours.

Days Closed

Sundays and Holidays

Shonan ER

Open 24 hours a day 365 days a year

※For more information, please contact us at +81-467-46-1717 or Fax +81-467-45-0190 or contact us.