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air leak

Chie Tanaka, Michitaka Fujiwara, Mitsuro Kanda, Kenta Murotani, Naoki Iwata, Masamichi Hayashi, Daisuke Kobayashi, Suguru Yamada, Yasuhiro Kodera
INTRODUCTION: Optical trocar access is a technique to place the initial trocar in laparoscopic surgery. With optical trocar access, each tissue layer can be visualized before insertion, which can help prevent organ injury, and air leaks at the trocar site can be minimized even in obese patients. The aim of this study was to compare the time needed for trocar insertion using optical trocar access and an open method in patients who underwent laparoscopic gastrointestinal surgery. METHODS: We reviewed our prospectively collected database and identified 384 patients who underwent laparoscopic gastrointestinal surgery involving initial trocar insertion near the umbilicus by either the optical trocar access or the open method...
April 19, 2018: Asian Journal of Endoscopic Surgery
Islam M Ibrahim, Montaser Elsawy Abd Elaziz, Mohammed Ahmed El-Hag-Aly
BACKGROUND:  Autologous blood-patch pleurodesis has been effectively utilized as a treatment option for the condition of secondary spontaneous pneumothorax (SSP). Moreover, it can be used with persistent air leak, with or without residual air space. However, there have been no robust reports for the optimal timing for autologous blood-patch pleurodesis. The aim of this study is to compare early autologous blood-patch pleurodesis with conservative management of SSP. METHODS:  We conducted a randomized controlled study at the Menoufia University Hospital...
April 19, 2018: Thoracic and Cardiovascular Surgeon
Daniel L Miller, Sanjoy Roy, Edmund S Kassis, Sashi Yadalam, Sushama Ramisetti, Stephen S Johnston
INTRODUCTION: Video-assisted thoracic surgery (VATS) lung resections are complex procedures with a critical role played by endoscopic staplers in the transection of vessels, bronchi, and lung tissue. This retrospective, observational study compared hospital resource use, costs, and complications of VATS lobectomy procedures for whom powered versus manual endoscopic surgical staplers were used. METHODS: Patients ≥ 18 years of age undergoing elective VATS lobectomy during an inpatient admission from January 1, 2012 to September 30, 2016 were identified from the Premier Healthcare Database (first admission = index admission)...
April 16, 2018: Advances in Therapy
Jian Zhou, Mengyuan Lyu, Nan Chen, Zihuai Wang, Yang Hai, Jianqi Hao, Lunxu Liu
In this systematic review with meta-analysis, we sought to determine the current strength of evidence for or against digital and traditional chest drainage systems following pulmonary surgery with regards to hard clinical end points and cost-effectiveness. PubMed, EMBASE and Web of Science were searched from their inception to 31 July 2017. The weighted mean difference (WMD) and the risk ratio were used for continuous and dichotomous outcomes, respectively, each with 95% confidence intervals (CIs). The heterogeneity and risk of bias were also assessed...
April 6, 2018: European Journal of Cardio-thoracic Surgery
Rahul H Mehta, Jeffrey Hoag, Amit Borah, Emil Abramian
Cryoprobe biopsies are routinely performed by the interventional pulmonologist. Diagnostic yields are larger, with complication rates that are equal to or lower than that of traditional forceps biopsies. We will specifically evaluate one instance where a cryoprobe biopsy led to an alveolo-pleural fistula that did not resolve with simple tube thoracostomy. An endobronchial valve was placed and successfully resolved the pneumothorax and persistent air leak.
July 2018: Respirology Case Reports
Peter B McMahon, Judith C Thomas, John T Crawford, Mark M Dornblaser, Andrew G Hunt
Site-specific and regional analysis of time-series hydrologic and geochemical data collected from 15 monitoring wells in the Piceance Basin indicated that a leaking gas well contaminated shallow groundwater with thermogenic methane. The gas well was drilled in 1956 and plugged and abandoned in 1990. Chemical and isotopic data showed the thermogenic methane was not from mixing of gas-rich formation water with shallow groundwater or natural migration of a free-gas phase. Water-level and methane-isotopic data, and video logs from a deep monitoring well, indicated that a shale confining layer ~125m below the zone of contamination was an effective barrier to upward migration of water and gas...
April 10, 2018: Science of the Total Environment
W C Yu, E Lm Yu, H C Kwok, H L She, K K Kwong, Y H Chan, Y L Tsang, Y C Yeung
INTRODUCTION: Endobronchial one-way valves have been proposed as treatment for persistent air leak complicating spontaneous pneumothorax in which surgical intervention is not feasible. However, published data on efficacy, safety, and factors associated with success are scanty. METHODS: This is a retrospective study of 37 patients at a general hospital from 2008 to 2016. The impact of endobronchial valve implantation on the time to air-leak cessation after bronchoscopy was evaluated...
April 4, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Yilin Song, Tong Zhang, Zhongxian Wang
INTRODUCTION: In order to develop a good hip protector to prevent in the elderly hip fracture as a result of a fall, we studied the buffer characteristics of sponges and air cushions. METHODS: The buffer rate of material was defined, and the absorption ability of the material to instantaneous impact was evaluated. An experimental device was developed and used to measure the buffer rates of sponges and leak-allowed air cushions with orifice(s). RESULTS: According to the experimental results, the buffer rate largely depended on the hardness of the sponge materials, and on the total area of the orifice(s) for the leak-allowed air cushions...
January 2018: Journal of Applied Biomaterials & Functional Materials
Monica Casiraghi, Domenico Galetta, Alessandro Borri, Adele Tessitore, Rosalia Romano, Cristina Diotti, Daniela Brambilla, Patrick Maisonneuve, Lorenzo Spaggiari
BACKGROUND:  This study analyzed the short- and long-term outcomes of robotic-assisted thoracic surgery (RATS) for early stage non-small cell lung cancer (NSCLC). METHODS:  From November 2006 to December 2016, we performed 363 RATS procedures. This study retrospectively reviewed 339 patients who underwent RATS for clinical stages I ( n  = 318) or II ( n  = 21) NSCLC. RESULTS:  Twenty-nine patients underwent segmentectomy, 307 lobectomy, and 3 pneumonectomy...
April 1, 2018: Thoracic and Cardiovascular Surgeon
Kenneth K Sakata, Janani S Reisenauer, Ryan M Kern, John J Mullon
A persistent air leak (PAL) can be caused by either an alveolar-pleural fistula (APF) or bronchopleural fistula (BPF). Complications from PAL lead to an increase in morbidity and mortality, prolonged hospital stay, and higher resource utilization. Pulmonary physicians and thoracic surgeons are often tasked with the difficult and often times frustrating diagnosis and management of PALs. While most patients will improve with chest tube thoracostomy, many will fail requiring alternative bronchoscopic or surgical strategies...
April 2018: Respiratory Medicine
Xinwei Han, Meipan Yin, Lei Li, Ming Zhu, Kewei Ren, Yu Qi, Xiangnan Li, Gang Wu
BACKGROUND: Bronchopleural fistula after pulmonary resection is a serious complication, with major impact on the quality of life and survival. This study aims to evaluate the efficacy and safety of customized airway stenting in the treatment of bronchopleural fistula. METHODS: A series of airway stents for dedicated bronchopleural fistula occlusion were designed after taking into account the anatomical and pathophysiological features of post-pulmonary resection fistulas and the shortcomings of airway stents currently available...
March 30, 2018: Surgical Endoscopy
Hao Li, Jian Zhou, Fan Yang, Jun Wang
Traditionally, surgeons can only count on their naked eyes to identify the fissure in patients with incomplete fissures, which often cause surgical approach into the fissural parenchyma and may lead to postoperative prolonged air leak (PAL). We describe a novel technique using near-infrared (NIR) thoracoscopy with indocyanine green (ICG) to identify the fissure accurately and real-timely for the first time in a patient with totally fused oblique fissure (Craig grade 4).
January 2018: Journal of Thoracic Disease
Alberto Revelo, Sevak Keshishyan, Oleg Epelbaum, Saman Yaghoubian, Lawrence DeLorenzo, Dipak Chandy, Francis Carroll, Lisa Paul, Kassem Harris
Persistent air leak (PAL) is a common and challenging condition associated with increased morbidity and mortality, intensive care unit admission, and prolonged hospital stay. Multiple medical and surgical approaches have been developed to manage PAL. Depending on the etiology of PAL, surgical management may be effective and usually performed using video-assisted thoracoscopic surgery (VATS). Medical management is less invasive and consists of pleural or bronchoscopic methods. The non-surgical techniques for the management of PAL have not been investigated in large prospective studies, and so their use is mostly guided by observational data...
January 2018: Journal of Thoracic Disease
Jae Bum Park, Song Am Lee, Woo Surng Lee, Yo Han Kim, Jae Joon Hwang
Background: Persistent air leak (PAL) after major pulmonary resection or involved with secondary lung disease is prevalent and associated with significant morbidity. Chemical pleurodesis is a practical therapeutic tool to manage the patients with PAL. Among various sclerosing substances, viscum album (fraxini) is considered effective and safe. The aim of this study was to evaluate the efficacy and safety of viscum album pleurodesis in patients with intractable prolonged air leakage. Methods: Between February 2013 and February 2015, 73 consecutive patients who underwent pleurodesis due to PAL were enrolled in this study...
January 2018: Journal of Thoracic Disease
Duilio Divisi, Luca Bertolaccini, Mirko Barone, Dario Amore, Desideria Argnani, Gino Zaccagna, Piergiorgio Solli, Gaetano Di Rienzo, Carlo Curcio, Roberto Crisci
Background: The expertise curve of video-assisted thoracoscopic surgery (VATS) lobectomies still stirs debate and controversy both because of the number of procedures to carry out and of the evaluation of the learning threshold. The purpose of our study was the examination of the variables related to the learning curve of the video-assisted approach, to establish what may be an expression of the technical maturity of the surgeon. Methods: The National Register for VATS lobectomy built in 2013 was used to collect data from 65 Thoracic Surgery Units...
January 2018: Journal of Thoracic Disease
Xiaojie Huang, Liren Ding, Hao Xu
Persistent air leaks (PALs) are associated with increased morbidity, prolonged hospital stay, and increased treatment costs. Endobronchial 1-way valves have been recently used as a potential less invasive treatment option. We sought to investigate the effects of valve therapy in treating this condition. The patients with evidence of continuous air leak flow whose chest tubes remained in place for more than 7 days were treated with bronchoscopic closure using 1-way valves. The source of the air leak was identified by the Chartis system...
March 2018: Medicine (Baltimore)
Bernadette Ngo Nonga, Guy Aristide Bang, Bonaventure Jemea, Eric Savom, Perfura Yone, Ngahane Mbatchou, Jean Jacques Ze
Background: Surgery for pulmonary aspergilloma (PA), especially complex forms, is greatly challenging in a resource-poor setting such as Cameroon. We report our experience of surgical management of PA in this environment. Method: We prospectively assessed patients who underwent surgery for PA from January 2012 to May 2015, at the University Hospital Center of Yaoundé. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures, and outcomes...
2018: Surgery Research and Practice
Peter Sklienka, Jan Maca, Filip Bursa, Jan Neiser, Roman Kula, Marcela Kanova, Tomas Danek, Pavel Sevcik
We report a case of a 20-year-old male patient suffering from motorcycle accident complicated by rapid development of severe refractory hypoxemia and hypercapnia due to serious bilateral lung contusions and lacerations. Positive pressure mechanical ventilation induced pressure-dependent massive air leak from disrupted pulmonary tissue. Simultaneous implementation of veno-venous extracorporeal membrane oxygenation together with surfactant application allowed prolonged disconnection of patient from mechanical ventilation ("total lung rest" mode)...
March 27, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Georgia G Tsaousi, Chryssa Pourzitaki, Dimitra Chlorou, Konstantinos Papapostolou, Dimitrios G Vasilakos
PURPOSE: To assess the comparable applicability of four methods of endotracheal tube cuff (ETTc) inflation on the basis of optimal level of intracuff pressure and presence of intubation-related complications. DESIGN: Double-blind, randomized trial. METHODS: A total of 139 adult surgical patients scheduled to undergo nitrous oxide-free general anesthesia were assigned into one of four groups according to the method used for ETTc inflation. The cuff pressure and air volume applied in each method, and laryngotracheal complications were recorded...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Alessandro Gonfiotti, Alessandro Bertani, Mario Nosotti, Domenico Viggiano, Stefano Bongiolatti, Luca Bertolaccini, Andrea Droghetti, Piergiorgio Solli, Roberto Crisci, Luca Voltolini
OBJECTIVES: The Italian VATS Group database was accessed to evaluate whether preoperative and intraoperative factors may affect the safety of lymphadenectomy (LA) during video-assisted thoracic surgery lobectomy. METHODS: All video-assisted thoracic surgery lobectomy procedures performed between 1 January 2014 and 30 March 2017 for non-small-cell lung cancer with cN0 or cN1 disease were identified in the database. LA safety was evaluated based on intraoperative (operative time, bleeding and conversion rate) and postoperative (30-day morbidity and mortality, chest drain duration and length of stay) outcomes and was correlated with the number of resected lymph nodes and the rates of nodal upstaging...
March 20, 2018: European Journal of Cardio-thoracic Surgery
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