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https://www.readbyqxmd.com/read/29629206/enhanced-recovery-pathways-in-thoracic-surgery-the-quebec-experience
#1
Julien Hubert, Etienne Bourdages-Pageau, Charles Antoine Paradis Garneau, Catherine Labbé, Paula A Ugalde
Background: Canada has a universal public health system where all resources must be allocated to optimize cost-effectiveness. Rapid diagnostic assessment programs (DAPs) and enhanced recovery protocols (ERPs) may improve timeliness of care and postoperative outcomes and thus reduce costs. The use of DAPs and ERPs in lung cancer patients who undergo lobectomy via video-assisted thoracoscopic surgery (VATS) is still controversial. This study measured the time between preoperative workup and treatment with a DAP and evaluated the impact of an ERP postoperatively in patients with early-stage non-small cell lung cancer (NSCLC) who received a VATS lobectomy...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629203/enhanced-recovery-after-surgery-and-video-assisted-thoracic-surgery-lobectomy-the-italian-vats-group-surgical-protocol
#2
REVIEW
Alessandro Gonfiotti, Domenico Viggiano, Luca Voltolini, Alessandro Bertani, Luca Bertolaccini, Roberto Crisci, Andrea Droghetti
Enhanced recovery after surgery (ERAS® ) is a strategy that seeks to reduce patients' perioperative stress response, thereby reducing potential complications, decreasing hospital length of stay and enabling patients to return more quickly to their baseline functional status. The concept was introduced in the late 1990s and was first adopted in patients undergoing open colorectal surgery. Since then, the concept of ERAS has been adopted by multiple surgical specialties. The diffusion of video-assisted thoracic surgery lobectomy (VATS-L) sets also the surgical treatment of lung cancer as a new area for ERAS development...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629202/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-perioperative-analgesia-protocols
#3
REVIEW
Federico Piccioni, Matteo Segat, Stefano Falini, Marzia Umari, Olga Putina, Lucio Cavaliere, Riccardo Ragazzi, Domenico Massullo, Marco Taurchini, Carlo Del Naja, Andrea Droghetti
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#4
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629200/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-preoperative-optimisation
#5
REVIEW
Antonio D'Andrilli, Domenico Massullo, Erino A Rendina
Preoperative patient optimisation is a key point of enhanced recovery after thoracic surgery pathways. This could be particularly advantageous when considering video-assisted thoracic surgery (VATS) lobectomy, because reduced trauma related to minimally invasive techniques is one of the main factors favouring improved postoperative outcome. Main specific interventions for clinical optimisation before major lung resection include assessment and treatment of comorbidities, minimizing preoperative hospitalization, optimisation of pharmacological prophylaxis (antibiotic and thromboembolic) and minimizing preoperative fasting...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629199/enhanced-recovery-pathways-in-thoracic-surgery-from-italian-vats-group-nursing-care-program
#6
REVIEW
Nicoletta Pia Ardò, Domenico Loizzi, Silvana Panariti, Ivana Piccinin, Francesco Sollitto
Enhanced recovery after surgery (ERAS) is an interprofessional program that can lead to hastened patient recovery and reduced time in hospital. Nursing staff play a key role in the implementation of enhanced recovery protocols. This issue focalizes the role of nurses in ERAS program for patients submitted to Thoracic Surgery, in particular for cases of major lung resection performed by a minimally invasive surgical approach (VATS, video assisted thoracic surgery).
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629197/enhanced-recovery-after-thoracic-surgery-patient-information-and-care-plans
#7
REVIEW
Majed Refai, Marco Andolfi, Paolo Gentili, Gilda Pelusi, Francesca Manzotti, Armando Sabbatini
Many studies have confirmed that the implementation of enhanced recovery after surgery (ERAS) protocols has the advantages of reducing the potential complications after thoracic surgery and the length of hospital stay. The ERAS program involves a multidisciplinary team, aimed at integrating evidence-based knowledge into clinical practice in order to reduce the patient's stress response to the surgical procedure and improve the response to stress, guaranteeing a combination of better outcomes and cost savings...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629196/a-comprehensive-protocol-for-physiokinesis-therapy-and-enhanced-recovery-after-surgery-in-patients-undergoing-video-assisted-thoracoscopic-surgery-lobectomy
#8
Alessandro Bertani, Paolo Ferrari, Danilo Terzo, Emanuele Russo, Gaetano Burgio, Lavinia De Monte, Francesco Raffaele, Andrea Droghetti, Roberto Crisci
Background: Video-assisted thoracoscopic surgery (VATS) lobectomy has recently been adopted as the gold standard surgical option for the treatment of early stage non-small cell lung cancer. Enhanced recovery after surgery (ERAS) is being progressively adopted in thoracic surgery to improve the postoperative outcomes. Even if the benefits of ERAS are universally accepted, to date a standardized and uniform approach has not been described in the medical literature. The Italian VATS group has recently proposed to include in the VATS lobectomy database a structured protocol for ERAS...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629194/enhanced-recovery-after-surgery-protocols-in-video-assisted-thoracic-surgery-lobectomies-the-best-is-yet-still-to-come
#9
EDITORIAL
Luca Bertolaccini, Gaetano Rocco, Roberto Crisci, Piergiorgio Solli
No abstract text is available yet for this article.
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29628834/comparison-of-analgesic-efficacy-and-safety-of-continuous-epidural-infusion-versus-local-infiltration-and-systemic-opioids-in-video-assisted-thoracoscopic-surgery-decortication-in-pediatric-empyema-patients
#10
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Introduction: The stripping of the densely innervated and inflamed parietal pleura in empyema during video-assisted thoracoscopic surgery (VATS) decortication can lead to significant pain and major postoperative respiratory compromise. Hence, we compared the analgesic efficacy of continuous epidural infusion versus local infiltration and systemic opioids in children undergoing VATS decortications. Methodology: Following ethics approval and informed consent, forty patients from 1 to 12 years of age were randomized into two groups, Group E (epidural) and Group L (local infiltration) after induction of anesthesia...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29625502/effectiveness-of-robotic-lobectomy-outcome-and-learning-curve-in-a-high-volume-center
#11
Danjouma Housmanou Cheufou, Khaled Mardanzai, Till Ploenes, Dirk Theegarten, Georgios Stamatis, Sandra Kampe, Clemens Aigner
BACKGROUND:  Robotic surgery has been developed as a sophisticated tool to expand possibilities in minimal invasive surgery. The learning curve for this method is short in various surgical fields; however, limited data exist on the learning curve in robotic thoracic surgery. METHODS:  This study analyzes a single center experience of robotic lobectomies using a prospectively kept database. Perioperative data and outcome of patients during the learning curve were compared with patients operated with increased institutional experience...
April 6, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29607175/-99m-technetium-and-methylene-blue-guided-pulmonary-nodules-resections-preliminary-british-experience
#12
Marco Nardini, Rocco Bilancia, Ian Paul, Shruti Jayakumar, Pavlos Papoulidis, Mohamed ElSaegh, Richard Hartley, Mark Richardson, Pankash Misra, Marcello Migliore, Joel Dunning
Background: Subcentimetre pulmonary nodules can be challenging to locate either during video-assisted thoracoscopic surgery (VATS) or by open techniques. In an era of increasing computed tomography scan availability the number of nodules that are identified that are suspicious for malignancy is rising, and thoracic surgeons require a reliable method to locate these nodules intraoperatively. Methods: Our aim was to evaluate, for the first time in the UK, resection of pulmonary nodules using radioactive dye labelling...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29607150/robotic-surgery-video-assisted-thoracic-surgery-and-open-surgery-for-early-stage-lung-cancer-comparison-of-costs-and-outcomes-at-a-single-institute
#13
Pierluigi Novellis, Edoardo Bottoni, Emanuele Voulaz, Umberto Cariboni, Alberto Testori, Luca Bertolaccini, Laura Giordano, Elisa Dieci, Lorenzo Granato, Elena Vanni, Marco Montorsi, Marco Alloisio, Giulia Veronesi
Background: Robotic surgery is increasingly used to resect lung cancer. However costs are high. We compared costs and outcomes for robotic surgery, video-assisted thoracic surgery (VATS), and open surgery, to treat non-small cell lung cancer (NSCLC). Methods: We retrospectively assessed 103 consecutive patients given lobectomy or segmentectomy for clinical stage I or II NSCLC. Three surgeons could choose VATS or open, the fourth could choose between all three techniques...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29600082/four-arms-robotic-assisted-pulmonary-resection-right-lower-middle-lobectomy-how-to-do-it
#14
Alessandro Pardolesi, Luca Bertolaccini, Jury Brandolini, Filippo Tommaso Gallina, Pierluigi Novellis, Giulia Veronesi, Piergiorgio Solli
In the last few years, robotic approach for anatomic lung resection has brought an innovative development in minimally invasive thoracic surgery. This study analyzes the technical aspects of performing the hilar dissection for a lobectomy via robotic approach. With a detailed step-by-step description and essential tips and videos, in this paper, we report the procedure to carry out a four-arm robotic middle and lower lobectomy.
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29600064/national-adoption-of-video-assisted-thoracoscopic-surgery-vats-lobectomy-the-italian-vats-register-evaluation
#15
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
https://www.readbyqxmd.com/read/29600059/video-assisted-thoracic-surgery-for-thymoma-long-term-follow-up-results-and-prognostic-factors-single-center-experience-of-150-cases
#16
Jian-Feng Li, Ben-Gang Hui, Xiao Li, Rong-Xin Xiao, Guan-Chao Jiang, Jun Liu, Jun Wang
Background: The use of video-assisted thoracic surgery (VATS) in the treatment of thymoma is becoming more and more common. The aim of this study was to evaluate safety and effectiveness of thoracoscopic treatment of thymoma and, more importantly, to report long-term follow-up results of a large single-center cohort. Methods: A retrospective review of a prospective database was performed. In total, 150 patients who underwent VATS resection for thymoma at Peking University People's Hospital from April 2001 to November 2014 were retrospectively reviewed...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29596584/high-volume-intensive-training-course-a-new-paradigm-for-video-assisted-thoracoscopic-surgery-education
#17
Alan D L Sihoe, Diego Gonzalez-Rivas, Timothy Y Yang, Yuming Zhu, Gening Jiang
OBJECTIVES: The emergence of ultra-high-volume centres promises new opportunities for thoracic surgical training. The goal of this study was to investigate the effectiveness of a novel observership course in teaching video-assisted thoracoscopic surgery (VATS) at an ultra-high-volume centre. METHODS: Two-week courses in VATS at a specialist unit now performing >10 000 major lung resections annually (>50 daily on average) were attended by 230 surgeons from around the world from 2013 to 2016...
March 27, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29590740/uniportal-video-assisted-thoracic-surgery-for-pulmonary-hamartoma-case-report
#18
Željko Djaković, Zoran Janevski
Pulmonary hamartoma is the most common benign tumor of the lung. It accounts for 77% of all benign lung tumors but less than 1% of all lung tumors. Malignant alteration is -extremely rare. Surgical removal is therapy of choice. Uniportal video-assisted thoracic surgery is an easy-to-learn variant of video-assisted thoracic surgery. The approach is very similar to classic thoracotomy. Instruments for both classic and video-assisted thoracic surgery can be combined. A case is presented of a 44-year-old female patient with pulmonary hamartoma treated by uniportal video-assisted -thoracic surgery as a new method used for the first time at our department...
December 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29587948/-analysis-of-prolonged-hospitalizations-longer-than-7-days-115-lung-cancer-patients-after-video-assistant-thoracic-surgery-vats
#19
Liang Dai, Xiaozheng Kang, Wanpu Yan, Yongbo Yang, Peiliang Zhao, Hao Fu, Haitao Zhou, Zhen Liang, Hongchao Xiong, Yao Lin, Keneng Chen
BACKGROUND: Thoracoscopic surgery has gradually become the major procedure for lung cancer surgery in our department. Its characteristics are minimal trauma and quick recovery, which make approximately 90% of patients discharge from the hospital after surgery. However, the postoperative complications still happen now and then. We analyzed the patients who had been hospitalized for longer than 7 days after thoracoscopic lung cancer surgery, aiming to summarize the types and risk factors of complications, and improve postoperative safety of patients...
March 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29587943/-a-paired-case-controlled-study-comparing-the-short-term-outcomes-of-da-vinci-rats-and-vats-approach-for-non-small-cell-lung-cancer
#20
Feng Dai, Shiguang Xu, Wei Xu, Renquan Ding, Bo Liu, Hao Meng, Yunteng Kang, Xiangrui Meng, Jie Lin, Shumin Wang
BACKGROUND: Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer. METHODS: 45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017...
March 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
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