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Muscle sparing thoracotomy

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
Christian Piolat, Frédéric Lavrand, Sabine Sarnacki
Thoracic surgery for pediatric tumors may induce a large variety of sequelae that mainly concern skin, muscles and bones (ribs), thoracic nerve and spinal cord and respiratory system. Muscle-sparing thoracotomy, intrathoracic expanders inserted after right pneumonectomy, early orthopedic evaluation and follow-up are useful preventive proceedings able to decrease postoperative sequelae. Surgery for abdominal tumors in children is part of a sequence where each therapeutic treatment can induce its own sequelae possibly potentiated by other therapies...
July 2015: Bulletin du Cancer
Anne M Kuritzky, Bassam I Aswad, Richard N Jones, Thomas Ng
BACKGROUND: Propensity-matched studies have shown lobectomy by VATS to be superior to thoracotomy. However, these studies do not control for institution or surgeon expertise and do not compare VATS strictly with muscle-sparing thoracotomy (MST). STUDY DESIGN: From a single surgeon experienced in both VATS and MST, patients undergoing lobectomy for clinical stage I non-small cell cancer were evaluated. Video-assisted thoracic surgery was chosen if the patient requested this approach, otherwise MST was used...
June 2015: Journal of the American College of Surgeons
Hun-Young Yoon, Suhwon Lee, Soon-Wuk Jeong
The levels of pain, duration of approaching and closure, and surgical exposure associated with intercostal thoracotomy were compared between muscle-sparing and traditional techniques in 20 dogs. Postoperative pain was assessed based on numerical pain scores using behavioral observation, heart rate, respiratory rate, and wound palpation. Time for approaching and closure were measured, and the extent of intrathoracic organ exposure for the surgical procedures was described for each technique. There were significant differences in numerical pain scores at 2 h as well as 1, 2, 3, 4, 5, 6, and 7 days after surgery between the two groups (p < 0...
2015: Journal of Veterinary Science
Alfonso Fiorelli, Anna Cecilia Izzo, Elisabetta Maria Frongillo, Assunta Del Prete, Giovanni Liguori, Emilio Di Costanzo, Giovanni Vicidomini, Mario Santini
OBJECTIVES: Continuous wound infusion of local anaesthetics has been successfully applied for postoperative pain control in several procedures but, surprisingly, it is underused in thoracic surgery. We aimed to investigate the effects of wound analgesia associated with systemic patient-controlled analgesia in patients undergoing lung cancer resection with muscle-sparing thoracotomy. METHODS: Sixty consecutive patients undergoing lung cancer resection via standard muscle-sparing thoracotomy were randomized into two groups (wound analgesia and placebo groups)...
January 2016: European Journal of Cardio-thoracic Surgery
Jan F Gielis, Wolfgang Jungraithmayr, Gaëlle A Boulet, John Paul Bogers, Walter Weder, Paul Cos, Paul E Y Van Schil
BACKGROUND: Pulmonary ischemia-reperfusion injury (IRI) causes postoperative morbidity in patients undergoing lung transplantation, isolated lung perfusion, and cardiopulmonary bypass and may lead to potentially lethal pathologies such as respiratory shock. In-depth study of this pathology requires a reliable animal model. Mice are a popular species to develop experimental models because of their logistic advantages and the availability of knock outs. However, their small size warrants microsurgical techniques and a skilled surgeon...
April 2015: Journal of Surgical Research
Pedro Esteban González, Nuria M Novoa, Gonzalo Varela
OBJECTIVES: The patient's position during an axillary thoracotomy can cause postoperative pain and decrease mobility of the ipsilateral shoulder. In this study, we assessed whether the implementation of a standardized analgesia program using transcutaneous electrical nerve stimulation (TENS) decreases local pain and improves ipsilateral shoulder mobility. METHOD: Randomized, single-blind, single-center clinical trial of 50 patients who had undergone anatomical lung resection via axillary muscle-sparing thoracotomy...
December 2015: Archivos de Bronconeumología
Sezai Cubuk, Orhan Yucel
No abstract text is available yet for this article.
January 2015: Interactive Cardiovascular and Thoracic Surgery
Kyle Kalkwarf, Richard Betzold, Zachary Young, Matthew Steliga
SESSION TITLE: Surgery Student/Resident Case Report PostersSESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly that often develops in combination with cardiac malformations such as atrial septal defect. It most often occurs as an anomaly of the right superior pulmonary vein draining into the superior vena cava (SVC) rather than the left atrium...
October 1, 2014: Chest
Masatsugu Hamaji, Fumitsugu Kojima, Teruya Komatsu, Tatsuaki Tsuruyama, Hiroshi Date, Tatsuo Nakamura
OBJECTIVES: Intrapleural adhesions following thoracotomy may be associated with prolonged operating time or a higher complication rate at reoperation. The aim of this experimental study was to investigate the anti-adhesion property of a bioabsorbable sheet following thoracotomy in a canine model. METHODS: Ten adult beagle dogs underwent bilateral muscle-sparing thoracotomies with single ribs resected under general anaesthesia. A bioabsorbable sheet composed of poly-L-lactide copolymer (45 wt%) and ε-caprolactone (45 wt%) layered with polyglycolic acid (10 wt%) was sutured intrapleurally on the parietal pleura to cover the defect on the left, but not placed on the right side as a control...
December 2014: Interactive Cardiovascular and Thoracic Surgery
Hideki Ota, Hideki Kawai, Shuntaro Togashi, Tsubasa Matsuo
Severe intrathoracic hemorrhage from pulmonary parenchyma is the most serious complication of pulmonary laceration after blunt trauma requiring immediate surgical hemostasis through open thoracotomy. The safety and efficacy of video-assisted thoracoscopic surgery (VATS) techniques for this life-threatening condition have not been fully evaluated yet. We report a case of pulmonary laceration with a massive hemothorax after blunt trauma successfully treated using a combination of muscle-sparing minithoracotomy with VATS techniques (video-assisted minithoracotomy)...
2014: Case Reports in Emergency Medicine
Marco Aurélio Marchetti-Filho, Luiz Eduardo Villaça Leão, Altair da Silva Costa-Junior
OBJECTIVE: To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal nerve during closure). METHODS: We selected 40 patients who were candidates for elective thoracotomy in the Thoracic Surgery Department of the Federal University of São Paulo/Paulista School of Medicine, in the city of São Paulo, Brazil...
March 2014: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
John S Thurber, Jason A Unger, William C DeVries
We present an unusual case of right lower lobe intralobar pulmonary sequestration in a previously healthy and physical active 27-year-old U.S. Marine, who presented with new onset hemoptysis after doing push-ups. Diagnosis was obtained by chest X-ray and contrast computed tomography scan. Preoperatively the patient underwent fluoroscopy-guided embolization of the aberrant systemic artery supplying the sequestration. The segmental resection of the sequestration was then successfully performed through a muscle-sparing thoracotomy...
April 2014: Military Medicine
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