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Nicola Passuello, Gioia Pozza, Stella Blandamura, Michele Valmasoni, Cosimo Sperti
A 71-year-old man presented with a thymic mass involving the superior vena cava. A mediastinoscopical biopsy initially suggested a diagnosis of type A thymoma. After neoadjuvant chemotherapy, the patient underwent en-bloc thymectomy and vascular resection for a pathology-confirmed type B3 thymoma involving the superior vena cava, the left brachiocephalic vein and the distal part of the right brachiocephalic vein. Adjuvant radiotherapy was administered. Two years after the primary surgery, abdominal computed tomography (CT) and whole body fluorodeoxyglucose (18-FDG) positron emission tomography (PET) scans showed a single hepatic lesion that was treated with wedge liver resection...
April 2017: Journal of International Medical Research
Luis Raúl Meza-López, José Angel Cigarroa-López, Silvia Hernández-Meneses, David Arturo Castán-Flores, Genaro Hiram Mendoza-Zavala, José Antonio Barragán-Zamora, Arturo Carrillo-Muñoz, Daniel Alejandro Munguía-Canales
No abstract text is available yet for this article.
April 2017: Archivos de Cardiología de México
Andreas Kirschbaum, Tanja Maier, Afsin Teymoortash
Dilational tracheotomy is a minimally invasive method that can be performed at the bedside on patients requiring long-term mechanical ventilation. In our 70-year-old male patient, percutaneous dilational tracheotomy (Ciaglia Blue Rhino, Cook Medical Inc., Bloomington, Indiana, United States) was performed because of bilateral pneumonia with sepsis. There were no initial problems. Nine days later, while the patient was being repositioned, the tracheal cannula became dislocated. Despite extending the cervical incision it was not possible to recannulate...
December 2016: Thoracic and Cardiovascular Surgeon Reports
Jinbai Miao, Mei Li, Yili Fu, Xiaoxing Hu, Bin Hu, Hui Li
Video-assisted mediastinoscopy (VAM) is the most commonly used invasive method for the preoperative mediastinal staging of lung cancer and for the diagnosis of other mediastinal diseases. However, VAM has the risk of causing life-threatening bleeding consequent to the specific mediastinal anatomy. We adopted the ultrasonic technique for VAM biopsies that can easily distinguish the lymph nodes from the surrounding great vessels and thus makes the procedure easier and safer.
November 2016: Annals of Thoracic Surgery
Hideki Itano, Takayuki Takeda, Hideto Nakahara, Yoshihiro Kubota, Osamu Nakai
INTRODUCTION: Cervical mediastinoscopy can provide a minimally invasive access to the paratracheobronchial mediastinum within its reachable range, but its operability is substantially limited because of its small operative field, poor visualisation, and one-handed operation. PRESENTATION OF CASES: Patient 1, a 56-year-old woman, presented with a 22×17mm, non-symptomatic, (18)F-fluorodeoxy glucose (FDG)-avid, solid schwannoma originating from the vagus nerve trunk in the right upper paratracheal space...
2016: International Journal of Surgery Case Reports
Wenlong Shao, Jianfei Shen, Weiqiang Ying, Jianxing He
No abstract text is available yet for this article.
June 2016: Journal of Thoracic and Cardiovascular Surgery
Sergi Call, Carme Obiols, Ramon Rami-Porta, Juan Carlos Trujillo-Reyes, Manuela Iglesias, Roser Saumench, Guadalupe Gonzalez-Pont, Mireia Serra-Mitjans, Jose Belda-Sanchís
BACKGROUND: The aim of this study was to evaluate the results of video-assisted mediastinoscopic lymphadenectomy (VAMLA) for staging of non-small cell lung cancer (NSCLC). METHODS: This was a prospective observational study of all consecutive VAMLAs performed from January 2010 to April 2015 for staging NSCLC. For left lung cancers, extended cervical videomediastinoscopy was added to explore the subaortic and paraaortic nodes. Patients with negative VAMLA results underwent tumor resection and lymphadenectomy of the remaining nodes...
April 2016: Annals of Thoracic Surgery
Qian-Yun Wang, Jing-Pei Li, Lei Zhang, Nan-Qing Jiang, Zhong-Lin Wang, Xiao-Ying Zhang
OBJECTIVE: The purpose of this study was to detect the feasibility, safety, and effectiveness of mediastinoscopic esophagectomy for early esophageal cancer. METHODS: The clinical data of 194 patients who underwent mediastinoscopic esophagectomy for early esophageal cancer in our center from December 2005 to October 2014 were retrospectively analyzed. RESULTS: All the surgery was performed successfully. The average duration of thoracic surgery was 48...
July 2015: Journal of Thoracic Disease
Hitoshi Fujiwara, Atsushi Shiozaki, Hirotaka Konishi, Toshiyuki Kosuga, Shuhei Komatsu, Daisuke Ichikawa, Kazuma Okamoto, Eigo Otsuji
We herein describe a single-port mediastinoscopic method for upper mediastinal dissection in esophageal cancer surgery. After the left cervical incision and lymphadenectomy, a Lap-Protector (Hakko, Tokyo, Japan) was inserted into the wound and an EZ Access port (Hakko) was attached. Esophageal mobilization with en bloc lymphadenectomy along the left recurrent laryngeal nerve was then performed using a port-in-port technique with conventional flexible laparoscopy. Carbon dioxide insufflation expanded the intramediastinal space, and minute structures in the deep mediastinum around the aortic arch, such as nerves, bronchial arteries, and lymphatic vessels, were clearly visualized, allowing lymphadenectomy to be safely and carefully performed along the nerve...
September 2015: Annals of Thoracic Surgery
Seung Hyup Hyun, Hee Kyung Ahn, Myung-Ju Ahn, Yong Chan Ahn, Jhingook Kim, Young Mog Shim, Joon Young Choi
OBJECTIVE: We evaluated the prognostic impact of volume-based assessment by pretreatment (18)F-FDG PET/CT in patients who had clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) treated with neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgical resection. MATERIALS AND METHODS: We reviewed 161 consecutive patients who had stage IIIA-N2 NSCLC treated with neoadjuvant CCRT followed by surgery. In all cases, N2 disease was pathologically confirmed by mediastinoscopic biopsy, endobronchial ultrasound-guided transbronchial needle aspiration, or video-assisted thoracoscopic surgery...
September 2015: AJR. American Journal of Roentgenology
Hiroshi Okumura, Yasuto Uchikado, Masataka Matsumoto, Itaru Omoto, Ken Sasaki, Yoshiaki Kita, Takaaki Arigami, Yoshikazu Uenosono, Akihiro Nakajo, Tetsuhiro Owaki, Shinichiro Mori, Sumiya Ishigami, Shoji Natsugoe
PURPOSE: Mediastinoscope-assisted transhiatal esophagectomy (MATHE) is a useful surgical procedure in esophageal cancer patients who have limited indications for transthoracic operations due to preoperative complications. METHODS: In the last 10 years, 63 patients underwent MATHE at our department. We examined the clinical data of these patients and assessed the indications, postoperative outcomes, and prognostic factors of MATHE. RESULTS: The 5-year overall survival (OS) rate was 53...
August 2015: Langenbeck's Archives of Surgery
Juan Carlos Trujillo-Reyes, Ramón Rami-Porta, Sergi Call Caja, Josep Belda-Sanchis
Pericardial effusion may be associated with many diseases, but sometimes its aetiology is not easy to elucidate. Subxiphoid video-pericardioscopy is useful for the study of the pericardial cavity. Through a subxiphoid approach, the pericardium is incised and a rigid (usually a video-mediastinoscope) or a flexible endoscope (flexible bronchoscope or flexible choledoscope) is inserted into the pericardial cavity. The inner surface of the parietal pericardium and the epicardium can be explored and biopsies can be taken under visual control...
2015: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Annikka Weissferdt, Neda Kalhor, Cesar A Moran
AIMS: To present six cases of cystic well-differentiated squamous cell carcinoma of the thymus. METHODS AND RESULTS: The patients were six men aged between 48 and 75 years (average: 61.5 years) who were symptomatic with chest pain, shortness of breath, and dyspnoea. Diagnostic imaging showed anterior mediastinal masses, and surgical resection was accomplished in all cases. Grossly, the tumours measured 40-90 mm in greatest diameter (average: 65 mm), and were described as ill-defined lesions with a prominent cystic component and focal areas of haemorrhage and necrosis...
February 2016: Histopathology
Amit Girish Kachalia, Pius Ochieng, Kinjal Kachalia, Habibur Rahman
CASE: An eighty year old African-American female was evaluated for cough, chest pain, asymptomatic anemia and 21 pound weight loss over a six month period. Computerized tomography (CT) revealed a spiculated 2.8 cm right upper lobe lung nodule, other smaller nodules and lymphadenopathy. Gallium scan revealed abnormal uptake of radiotracer in lacrimal, hilar and mediastinal glands. Broncho-alveolar lavage showed CD4/CD8 ratio of 2:1 with 15% lymphocytes. Biopsy of right upper lobe lesion and mediastinoscopic lymph node biopsy showed numerous matured uniform non-caseating granulomatous inflammation, however stains and culture for Acid fast bacilli (AFB)/fungal organisms were negative...
2014: Respiratory Medicine Case Reports
Yutaka Tokairin, Kagami Nagai, Hisashi Fujiwara, Taichi Ogo, Masafumi Okuda, Yasuaki Nakajima, Kenro Kawada, Yutaka Miyawaki, Hisayo Nasu, Keiichi Akita, Tatsuyuki Kawano
The use of mediastinal surgery for minimally invasive esophagectomy (MIE) has been proposed; however, this method is not performed as radical surgery because it has been thought to be impossible to perform complete upper mediastinal dissection, including the left tracheobronchial lymph nodes (106tbL). We herein describe a new method for performing complete dissection of the upper mediastinum. We developed a method for performing complete mediastinoscopic esophagectomy as radical surgery via the bilateral transcervical and transhiatal approach in 6 Thiel-embalmed human cadavers...
April 2015: International Surgery
N Kitagawa, M Shinkai, H Take, K Mochizuki, F Asano, H Usui, H Miyagi, T Kido, N Kurauchi, H Osaka, S Yamashita
BACKGROUND: Extended thymectomy is indicated for children with myasthenia gravis (MG) when drug-resistance or dependence is seen. We have employed a technique for mediastinoscopic extended thymectomy (MET) on children with MG. METHOD: A total of 14 children underwent MET at Kanagawa Children's Medical Center between 2005 and 2013. A mediastinal operation field was made by a V-shaped hook infrasternally to extirpate the thymus with adipose tissue around the thymus...
April 2015: Journal of Pediatric Surgery
Carme Obiols, Sergi Call, Ramón Rami-Porta, Juan Carlos Trujillo-Reyes
Bilateral pulmonary nodules represent a challenge in distinguishing between synchronous bronchogenic carcinomas and metastatic disease. In the case of potentially curable synchronous lung cancer, it is recommended to treat each lesion with curative intent if there is no evidence of mediastinal involvement or extrathoracic disease. In this situation, surgical staging of the mediastinum is recommended. This case shows the utility of a transcervical approach to perform precise mediastinal staging and lymphadenectomy, and to access the pleural cavity to resect a pulmonary nodule...
October 2015: Asian Cardiovascular & Thoracic Annals
Ho Jin Kim, Yong-Hee Kim, Se Hoon Choi, Hyeong Ryul Kim, Dong Kwan Kim, Seung-Il Park
OBJECTIVES: Although video-assisted mediastinoscopic lymphadenectomy (VAMLA) has greatly increased the accuracy of mediastinal staging, its clinical value as a therapeutic tool for complete mediastinal lymph node dissection in the treatment of left-sided lung cancer is not well elucidated. METHODS: We identified the consecutive 649 patients with left-sided lung cancer undergoing minimally invasive pulmonary resection between July 2002 and June 2013. Among them, 225 patients underwent VAMLA combined with pulmonary resection (VAMLA + VATS group), while the remaining 424 patients underwent VATS procedure only (VATS group)...
January 2016: European Journal of Cardio-thoracic Surgery
Cheng Ji, Bin Zhang, Weidong Zhu, Chunhua Ling, Xudong Hu, Yanbin Chen, Jianan Huang, Lingchun Guo, Haodong Xu
Accurate lymph nodal staging of lung cancer is critical for determining the treatment options. With the help of (18)F-fluorodeoxyglucose positron emission tomography/computer tomography ((18)F-FDG-PET/CT), the clinician can rule out/in the regional lymph nodes positive for metastasis in the patients with lung cancer in a majority of cases. However, a small proportion of cases with false positivity of metastasis have been reported. Transbronchial needle aspirations and mediastinoscopic biopsies are still necessary to determine whether enlarged hypermetabolic mediastinal lymph nodes are positive for lung cancer metastasis...
2014: International Journal of Clinical and Experimental Pathology
ZhiChu Qin, En Qiang Linghu, Ya Qi Zhai, HuiKai Li
BACKGROUND/AIMS: This animal study was performed to evaluate the feasibility and safety of endoscopic transesophageal biopsy by using submucosal tunneling technology novel homemade instruments in the posterior mediastinum. METHODOLOGY: In six survival pigs, a mid-esophageal mucosal incision and a 10-cm submucosal tunnel was created. The endoscope attached to homemade decompression tube was passed through the muscular layers into the posterior mediastinal space. The mediastinal compartment, lung, descending thoracic aorta, vertebra, and exterior surface of the esophagus will be identified, and mediastinal living tissue as lymph node biopsy will also be accomplished...
September 2014: Hepato-gastroenterology
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