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Muscle sparing thoracotomy

Francis Ali-Osman, Alicia Mangram, Joseph Sucher, Gina Shirah, Van Johnson, Phillip Moeser, Natasha K Sinchuk, James K Dzandu
BACKGROUND: Patient outcomes after muscle sparing minimally invasive thoracotomy rib fixation (MSMIT-ORF) in geriatric G60 trauma patients remain poorly studied. This study determined the effect of MSMIT-ORF on pulmonary function (PFT). Non-operatively managed (NOM) patients were also described. METHODS: Medical records of G60 patients with severe rib fractures with PFTs measured before and after MSMIT-ORF were examined. Patient outcomes (MSMIT-ORF vs NOM) were adjusted in a multivariate logistic regression model...
February 20, 2018: American Journal of Surgery
Tomasz Marjański, Joanna Halman, Sonia Taniewska, Natalia Burzyńska, Anna Piekarska, Wioletta Sawicka
Introduction: Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with a fatal prognosis. The diagnosis is made on the basis of high-resolution computed tomography and histological examination in selected cases. Aim: To determine the risk of complications of open lung biopsy performed in patients with IPF. Material and methods: We performed a retrospective analysis of 51 patients who underwent diagnostic excision of pulmonary parenchyma due to IPF in the period 1995-2014...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Calogero Porrello, Roberto Gullo, Antonino Vaglica, Gregorio Scerrino, Giuseppe Salamone, Leo Licari, Cristina Raspanti, Eliana Gulotta, Gaspare Gulotta, Gianfranco Cocorullo
BACKGROUND: The lungs are among the first organ affected by remote metastases from many primary tumors. The surgical resection of isolated pulmonary metastases represents an important and effective element of therapy. This is a retrospective study about our entire experience with pulmonary resection for metastatic cancer using 1318-nm neodymium-doped yttrium-aluminum garnet laser. METHOD: In this single-institution study, we retrospectively analyzed a group of 209 patients previously treated for primary malignant solid tumors...
January 1, 2018: Surgical Innovation
Derek T Bernstein, Wu Zhuge, Shanda H Blackmon, Rex A W Marco
PURPOSE: High thoracotomy allows access to the anterior cervicothoracic and upper thoracic vertebrae; however, traditional techniques transect shoulder girdle muscles, leading to postoperative shoulder dysfunction. Muscle-sparing techniques diminish this concern, but often sacrifice the quality of exposure. We describe a novel muscle-sparing, high thoracotomy approach for the treatment of ventral cervicothoracic and upper thoracic spine lesions. METHODS: A novel muscle-sparing, high thoracotomy approach is described, utilizing a midline posterior incision with lateral extension from the lateral decubitus position...
December 7, 2017: European Spine Journal
Katsuo Usuda, Sumiko Maeda, Nozomu Motomo, Makoto Tanaka, Masakatsu Ueno, Yuichiro Machida, Motoyasu Sagawa, Hidetaka Uramoto
Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars...
December 2017: Indian Journal of Surgery
Sunny Wei, Neil Saran, Sherif Emil
BACKGROUND: Musculoskeletal deformities (MD), including scoliosis and chest wall anomalies, are potential long-term complications of neonatal thoracotomies. METHODS: We studied the incidence of MD in patients who underwent open repair of esophageal atresia between 1997 and 2012, had no other predisposition to MD, and subsequently received longitudinal follow-up in a multidisciplinary esophageal atresia clinic. Detailed chest wall and musculoskeletal exams were performed at each visit...
December 2017: Journal of Pediatric Surgery
Tariq Alzahrani
Thoracic surgical procedures can be either thoracotomy or thoracoscopy. In thoracotomy, the incision could be either muscle-cutting or muscle-sparing incision. The posterolateral thoracotomy incision is used for most general thoracic surgical procedures. This incision, which involves division of the latissimus dorsi and serratus anterior muscles, affords excellent exposure of the thoracic cavity. However, it is associated with significant morbidity, including impaired pulmonary function, postoperative chest pain, and restricted arm and shoulder movement...
July 2017: Saudi Journal of Anaesthesia
Yue Zhao, Guodong Li, Yang Zhang, Hong Hu, Jie Zhang, Yihua Sun, Haiquan Chen
OBJECTIVE: To compare short-term complications and long-term survival outcomes between muscle-sparing thoracotomy (MST) and video-assisted thoracic surgery (VATS) groups using a propensity-score matching process. METHODS: One thousand eighty-three patients with cT1 N0 M0 lung cancer from January 2009 to December 2014 who underwent lobectomy and a systematic lymph node dissection were retrospectively included, and statistical analyses including a propensity-score matching process were used to compare short-term and long-term outcomes...
May 20, 2017: Journal of Thoracic and Cardiovascular Surgery
Michele Salati, Alessandro Brunelli, Francesco Xiumè, Marco Monteverde, Armando Sabbatini, Michela Tiberi, Cecilia Pompili, Roberto Palloni, Majed Refai
OBJECTIVES: The objective of the present study was to compare functional loss [forced expiratory volume in one second to forced vital capacity ratio (FEV1), DLCO and VO2max reduction] after VATS versus open lobectomies. METHODS: We performed a prospective observational study on 195 patients who had a pulmonary lobectomy from June 2010 to November 2014 and who were able to complete a 3-months functional evaluation follow-up program. Since the VATS technique was our first choice for performing lobectomies from January 2012, we divided the patients into two groups: the OPEN group (112 patients) and the VATS group (83 patients)...
June 1, 2017: European Journal of Cardio-thoracic Surgery
Altair da Silva Costa, Thiago Bachichi, Caio Holanda, Luiz Augusto Lucas Martins De Rizzo
Objective: To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. Methods: This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications...
November 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
I Gockel, D Lorenz
Minimally invasive resections are increasingly employed in oncologic surgery for esophageal carcinoma. The new German S3 guideline states that esophagectomy, as well as reconstruction of the esophagus, can be performed minimally invasively or in combination with open techniques (hybrid). However, the current value of different techniques - ranging from complete minimally invasive esophagectomy over hybrid to robotic surgery - remains unregarded.This review provides a critical comparison of these techniques based on current evidence...
June 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Tomasz Stankowski, Sleiman Sebastian Aboul-Hassan, Jakub Marczak, Anna Szymanska, Cyprian Augustyn, Romuald Cichon
BACKGROUND: Patent ductus arteriosus (PDA) is one of the most common congenital heart defects. Once diagnosed, an immediate pharmacologic or invasive treatment should be performed. The purpose of this work was to evaluate the safety and efficacy of surgical PDA ligation in children using video-assisted thoracoscopic surgery (VATS) in comparison with a conventional muscle-sparing posterolateral thoracotomy technique (MSPLT). MATERIALS AND METHODS: In this single-center, retrospective study 173 children qualified for surgical PDA closure were enrolled...
February 2017: Journal of Surgical Research
Aris Koryllos, Astrid Althaus, Marcel Poels, Robin Joppich, Rolf Lefering, Frank Wappler, Wolfram Windisch, Corinna Ludwig, Erich Stoelben
BACKGROUND: Thoracotomy leads to chronic neuropathic pain in up to 50% of patients and is responsible for an impaired quality of life. Intercostal nerve injury has been suggested to be responsible for this pain. In the present study the impact of paravertebral intercostal neurectomy on post thoracotomy pain was assessed. METHODS: In this single center parallel-group randomized controlled trial patients underwent muscle sparing anterolateral thoracotomy and anatomical lung resection for lung cancer...
September 2016: Journal of Thoracic Disease
Tom Treasure
Videothoracic surgery for lung cancer is now an established practice but there is a division of opinion between surgeons whose aim is to spare all patients a thoracotomy and those who have not adopted videoscopic methods for routine lobectomy. The latter remain in the majority; most patients at present have a thoracotomy. Surgeons from Europe and America met in Catania, Sicily at the 3(rd) Mediterranean Symposium on Thoracic Surgical Oncology to explore the evidence and the routes to making videothoracoscopic surgery a standard of care...
August 2016: Journal of Thoracic Disease
Mohsen Ibrahim, Cecilia Menna, Claudio Andreetti, Carlos Puyo, Giulio Maurizi, Antonio D'Andrilli, Anna Maria Ciccone, Domenico Massullo, Camilla Vanni, Giammauro Berardi, Rossella Baldini, Erino Angelo Rendina
INTRODUCTION: Chronic postthoracotomy pain is a significant adverse outcome of thoracic surgery. We evaluated with a prospective randomized trial the effect of a multimodal no-compression suture technique of the intercostal space on postoperative pain occurrence in patients undergoing minithoracotomy. METHODS: Patients undergoing a muscle-sparing lateral minithoracotomy for different thoracic diseases were randomly divided into two groups: 146 patients received intercostal muscle flap harvesting and pericostal no-compression "edge" suture (the IMF group), and 151 patients received a standard suture technique associated with an intrapleural intercostal nerve block (the IINB group)...
September 2016: Journal of Thoracic Oncology
Christos Asteriou, Achilleas Lazopoulos, Thomas Rallis, Apostolos S Gogakos, Dimitrios Paliouras, Nikolaos Barbetakis
BACKGROUND: Postoperative morbidity and inhospital length of stay are considered major determinants of total health care expenditure associated with thoracic operations. The aim of this study was to prospectively evaluate the role of video-assisted thoracic surgery (VATS) compared to mini-muscle-sparing thoracotomy in facilitating early recovery and hospital discharge after pulmonary sublobar wedge resections. PATIENTS AND METHODS: A total number of 120 patients undergoing elective pulmonary sublobar wedge resection were randomly assigned to VATS (n = 60) or mini-muscle-sparing thoracotomy (n = 60)...
July 2016: Journal of Minimal Access Surgery
Yukiko Niwa, Masahiko Koike, Masashi Hattori, Naoki Iwata, Hideki Takami, Masamichi Hayashi, Mitsuro Kanda, Daisuke Kobayashi, Chie Tanaka, Suguru Yamada, Tsutomu Fujii, Goro Nakayama, Hiroyuki Sugimoto, Shuji Nomoto, Michitaka Fujiwara, Yasuhiro Kodera
In our department, we have attempted to reduce the incidence of complications of conventional esophagectomy. The objective of this retrospective study was to report the short-term outcomes of esophagectomy. We reviewed 138 consecutive patients who had undergone subtotal esophagectomy by combined laparotomy via a 12-cm upper abdominal vertical incision combined with right anterior muscle-sparing thoracotomy from August 2010 to August 2014. Most of the cervical para-esophageal lymph node dissection was completed within the thoracic cavity...
February 2016: Nagoya Journal of Medical Science
Christos Asteriou, Achilleas Lazopoulos, Thomas Rallis, Apostolos S Gogakos, Dimitrios Paliouras, Kosmas Tsakiridis, Athanasios Zissimopoulos, Drosos Tsavlis, Konstantinos Porpodis, Wolfgang Hohenforst-Schmidt, Ioannis Kioumis, John Organtzis, Konstantinos Zarogoulidis, Paul Zarogoulidis, Nikolaos Barbetakis
BACKGROUND: Video-assisted thoracic surgery (VATS) has been shown to effectively reduce postoperative pain, enhance mobilization of the patients, shorten in-hospital length of stay, and minimize postoperative morbidity rates. The aim of this prospective study is to evaluate neuroendocrine and respiratory parameters as stress markers in cancer patients who underwent lung wedge resections, using both mini muscle-sparing thoracotomy and VATS approach. METHODS: The patients were randomly allocated into two groups: Group A (n=30) involved patients who were operated on using the VATS approach, while in group B (n=30), the mini muscle-sparing thoracotomy approach was used...
2016: Therapeutics and Clinical Risk Management
Kazushi Miyata, Masahide Fukaya, Keita Itatsu, Tetsuya Abe, Masato Nagino
PURPOSE: The aim of this study was to investigate whether muscle sparing thoracotomy (MST) improved postoperative chest pain and an impairment of the postoperative pulmonary function in comparison with posterolateral thoracotomy (PLT). METHODS: Twenty-four patients with esophageal cancer who underwent PLT from September 2006 to August 2008 and 30 patients who underwent MST from September 2008 to August 2010 were selected as subjects of this study. Postoperative acute and chronic chest pain and the recovery of the pulmonary function were retrospectively compared between the two groups...
July 2016: Surgery Today
Rashmi Singh, Mark Davenport
Antenatal detection of congenital pulmonary airway malformations (CPAM) has improved immeasurably from its initial application in the 1980s and probably encompasses >80% of all such lesions. Accurate diagnosis still remains less reliable and definitive diagnosis requires detailed anatomical imaging (typically with CT scan) in the post-natal period. About 10% of all lesions will present with symptoms during the neonatal period and the choice of surgical intervention is then easy. For those that remain asymptomatic then there is still a degree of controversy about elective surgical resection...
August 2015: Seminars in Pediatric Surgery
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