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anesthesia for thoracoscopy

Georgia Hardavella, Nikolaos A Papakonstantinou, Ioannis Karampinis, Gerasimos Papavasileiou, Shereen Ajab, Mohammed Shafaat, Stavros Malagaris, Nikolaos Anastasiou
BACKGROUND: The aim of this study was to evaluate the safety and efficacy of medical thoracoscopy through a single port [single-port medical thoracoscopy (S-MT)] for the treatment of empyema thoracis in its early stages. METHODS: We performed a retrospective analysis reviewing the medical records of 84 patients referred for empyema and treated by medical thoracoscopy at our Thoracic Departments from January 2001 until November 2014. S-MT was performed under local anesthesia with neuroleptoanalgesia and spontaneous breathing using a single 1-cm incision for debridement and lavage of the pleural cavity...
January 2017: Journal of Bronchology & Interventional Pulmonology
Angela Roberts Selzer, Matthew Murrell, Eugene Shostak
PURPOSE OF REVIEW: As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications. RECENT FINDINGS: The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures...
February 2017: Current Opinion in Anaesthesiology
Sarah Townsend, Michelle L Oblak, Ameet Singh, Michele A Steffey, Jeffrey J Runge
OBJECTIVE: To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Dogs with suspected PRAA (n=9). METHODS: Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included...
November 2016: Veterinary Surgery: VS
Shoki Ro, Satoru Ishii, Yukie Hayashi, Konomi Kobayashi, Haruna Masaki, Shion Miyoshi, Yuichiro Takeda, Masayuki Hojo, Haruhito Sugiyama
An 80-year-old woman with rheumatoid arthritis and a past history of tuberculosis presented with exertional dyspnea and edema of both legs. Chest X-ray performed on admission showed bilateral pleural effusion. Thoracoscopy under local anesthesia was performed, and vasodilation and non-specific yellowish inflammatory changes were noted in the pleura. A pathological examination showed chronic fibrosing pleuritis in addition to chronic pleural inflammatory changes with lymphoid aggregates. The nails on all fingers and toes were thickened and displayed yellow discoloration, and the edema was resistant to diuretics...
2016: Internal Medicine
Massimo Cajozzo, Giorgio Lo Iacono, Francesco Raffaele, Antonino Alessio Anzalone, Federica Fatica, Girolamo Geraci, Salvatore Dioguardi
UNLABELLED: Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs. MATERIALS & METHODS: Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the 'single-access', and two incisions for the '2-trocars technique'. RESULTS: Mortality rate was 0% in both groups. Postoperative stay: 3 dd ± 4 versus 4 dd ± 5, mean operative time: 39 min versus 37 min (p < 0...
2015: Future Oncology
Bingjun Yang, Qingzhao Li, Hui Zhao, Huibin Liu, Tao Tang, Chunyang Jiang
BACKGROUND: Oral malignant melanoma (OMM) is an aggressive tumor with very low survival rate and easy to metastasize. Pleural metastatic melanoma via primary OMM is rare. CASE PRESENTATION: In this report, we presented a case of metastatic malignant melanoma of the pleura originated from OMM. A 54-year-old man without primary skin lesion was diagnosed multiple nodular shadows, pleural invasion, and pleural effusion by chest computed tomography (CT). One cyst-form tumor on the tongue base was observed by bronchoscopy, which was diagnosed as OMM by pathological examination and then was resected...
2015: World Journal of Surgical Oncology
Keita Takeda, Junko Suzuki, Hideaki Nagai, Kaoru Watanabe, Akira Yokoyama, Takahiro Ando, Jun Suzuki, Nobuharu Ohshima, Kimihiko Masuda, Atsuhisa Tamura, Shinobu Akagawa, Masashi Kitani, Akira Hebisawa, Hirotoshi Matsui, Nobuyuki Kobayashi, Haruhiko Maruyama, Ken Ohta
A 27-year-old man was admitted to our hospital with right pleural effusion. He had suffered from right chest and back pain and a high fever for one week prior to the admission. He had been treated with clarithromycin without improvement. Since thoracoscopy under local anesthesia revealed purulent effusion, synechiae and fibrous septa in the thoracic cavity, synechiotomy was performed and we started antibiotic treatment with the diagnosis of acute bacterial empyema. At the same time, we also suspected parasitic infection because of massive eosinophilic infiltration in pleural effusion and his dietary history of eating raw frogs...
February 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Daizo Yaguchi, Motoshi Ichikawa, Noriko Inoue, Daisuke Kobayashi, Akinobu Matsuura, Masato Shizu, Naoyuki Imai, Kazuko Watanabe
The patient experienced chest pain for about 7 months, but a diagnosis could not be made until after death. He was diagnosed with malignant sarcomatoid pleural mesothelioma on autopsy. In this case report, difficult aspects of the diagnosis are discussed. The 70-year-old Japanese man was a driver who transported ceramic-related products. Right chest pain developed in July 2013, but no abnormality was detected on a chest computed tomography (CT) performed in September 2013, and the pain was managed as right intercostal neuralgia...
September 2015: Case Reports in Oncology
James E Baumgardner, Göran Hedenstierna
PURPOSE OF REVIEW: A major cause of hypoxemia in anesthesia is ventilation-perfusion (VA/Q) mismatch. With more advanced surgery and an aging population, monitoring of VA/Q is of increasing importance. RECENT FINDINGS: The classic multiple inert gas elimination technique has been simplified with a new approach based on mass spectrometry. VA/Q distributions can also be measured, at the bedside, by varying inspired oxygen concentration. MRI, 3-dimensional single photon emission computed tomography, positron emission tomography, and electrical impedance tomography enable imaging of perfusion and ventilation, and in some of the techniques also the distribution of inflammation...
February 2016: Current Opinion in Anaesthesiology
Elisa Cerchia, Luisa Ferrero, Francesco Molinaro, Lionel Donato, Mario Messina, François Becmeur
INTRODUCTION: Thoracoscopic surgical procedures in small infants and children require a growing demand for lung isolation in pediatric anesthesia practice. MATERIALS AND METHODS: Between January 2006 and September 2014, 16 children underwent thoracoscopic procedures that needed one-lung ventilation using a bronchial blocker. RESULTS: The thoracoscopic procedure was performed at a mean age of 99 months (range, 6-186 months) and a mean weight of 33 kg (range, 7-68 kg) without any conversion to open surgery in any case...
February 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hiroaki Nakagawa, Masatsugu Ohuchi, Takuya Fujita, Yoshitomo Ozaki, Yasutaka Nakano, Shuhei Inoue
A 68-year-old woman was referred to our hospital for a lung nodule identified on chest radiography. Computed tomography (CT) showed a 10-mm calcified nodule in the left thoracic cavity. On follow-up CT, the nodule was found in a different location within the left thoracic cavity. Thoracoscopy was performed under local anesthesia, removing a pearl-like pleural stone. Thoracolithiasis was therefore diagnosed without any complications. To the best of our knowledge, this is the first report on thoracoscopy under local anesthesia for the diagnosis of thoracolithiasis...
September 2015: Respirology Case Reports
A Haas, F Wappler
The mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is a disease triggered by a disorder in energy production within mitochondria. The cause of this syndrome is a mutation in the mitochondrial DNA where in 80% of cases an A-to-G mutation is present at nucleotide 3243 and with a prevalence of 18.4/100,000 in the population. Predominantly affected are organ systems with a high energy metabolism, such as the heart, brain and musculature. During the premedication visit a thorough patient history and examination with respect to neurological impairments must be carried out...
October 2015: Der Anaesthesist
Yann Lelonge, François Varlet, Patricio Varela, Francisco Saitúa, Laurent Fourcade, Rocio Gutierrez, Sophie Vermesch, Jean-Michel Prades, Manuel Lopez
OBJECTIVE: Recurrent tracheoesophageal fistula (RTEF) is a serious complication after primary repair of esophageal atresia and tracheoesophageal fistula (EA/TEF). Treatment of RTEF involved an open surgery by thoracotomy. Technically it is a challenge with a high morbidity and mortality. Congenital tracheoesophageal fistula (CTEF) traditionally involved an open surgery by thoracotomy or cervicotomy. Many endoscopic techniques have been developed since the past decades: thoracoscopic or bronchoscopic approach for the treatment of RTEF and CTEF; nevertheless, optimal treatment is not still determined because of few numbers of patients, short-term follow-up, and different procedures...
April 2016: Surgical Endoscopy
Takako Sasai, Tomihiro Fukushima, Takeshi Mikane, Satoru Oku, Hiroyuki Kobayashi, Etsu Iwasaki, Hideyuki Mieda, Tomoki Ishikawa, Eriko Minami, Hiroaki Tokioka
We investigated perioperative management and clinical outcome of 12 patients who were 85 years old or older and received video-assisted thoracic surgery under general anesthesia. Although all the patients had preoperative respiratory complications or cardiovascular complications, they were discharged without any additional respiratory assistance such as home oxygen therapy. Our observation suggests that it is important to evaluate the indication of anesthesia from their daily activities and pulmonary function test even if they are oldest-old...
February 2015: Masui. the Japanese Journal of Anesthesiology
Ye Ning, Yanan Wang, Xiandong Tao, Hua Tang, Jingjing Jiang, Yonghua Li, Guangyuan Sun, Lei Xue, Xuewei Zhao
OBJECTIVES: Thoracic sympathectomy is considered the most effective method to treat palmar hyperhidrosis. We presented a novel procedure for thoracic sympathectomy treating palmar hyperhidrosis which could be performed under monitored anesthesia care. The aim of this study was to evaluate the continuing efficacy and safety of this innovative surgery. METHOD: From May 2011 to May 2014, we performed the single-port endoscopic thoracic sympathectomy (ETS) with a flexible thoracoscopy in 32 patients under monitored anesthesia care...
September 2015: World Journal of Surgery
Andrey Akopov, Vladimir Egorov, Igor Deynega, Pavel Ionov
BACKGROUND: Many of thoracic minimally invasive interventions have been proven to be possible without general anesthesia. This article presents results of video-assisted thoracic surgery (VATS) application under local anesthesia in patients with lung abscesses and discusses its indications in detail. METHODS: The study involved prospective analysis of treatment outcomes for all acute infectious pulmonary destruction (AIPD) patients undergoing VATS under local anesthesia and sedation since January 1, 2010, till December 31, 2013...
May 2015: Annals of Translational Medicine
Ming-Hui Hung, Kuang-Cheng Chan, Ying-Ju Liu, Hsao-Hsun Hsu, Ke-Cheng Chen, Ya-Jung Cheng, Jin-Shing Chen
Intubated general anesthesia with single-lung ventilation has been considered mandatory for thoracoscopic lobectomy for nonsmall cell lung cancer. Few reports of thoracoscopic lobectomy without tracheal intubation are published, using either thoracic epidural anesthesia (TEA) or intercostal blockade. The comparisons of perioperative outcomes of nonintubated thoracoscopic lobectomy using epidural anesthesia and intercostal blockade are not reported previously. From September 2009 to August 2014, a total of 238 patients with lung cancer who underwent nonintubated thoracoscopic lobectomy were recruited from our prospectively maintained database of all patients undergoing nonintubated thoracoscopic surgery using TEA or intercostal blockade...
April 2015: Medicine (Baltimore)
Prasert Sawasdiwipachai, Settapong Boonsri, Sirilak Suksompong, Paron Prowpan
PURPOSE: The use of an endobronchial blocker in conjunction with a supraglottic device in elective thoracic cases has never been studied. The aim of this study was to report the success rate and time to placement of the endobronchial blocker in anaesthetized patients with a laryngeal mask airway (LMA)-ProSeal™ in place. METHODS: This was a single-center, prospective, descriptive pilot study that enrolled 30 patients aged 18-75 years, with ASA I-III, who underwent elective thoracotomy or video-assisted thoracoscopy...
October 2015: Journal of Anesthesia
Loganathan Nattusamy, Karan Madan, Anant Mohan, Vijay Hadda, Deepali Jain, Neha Kawatra Madan, Sudheer Arava, Gopi C Khilnani, Randeep Guleria
BACKGROUND: Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed pleural effusion. Literature on its utility from developing countries is limited. We herein describe our initial experience on the utility of semi-rigid thoracoscopy from a tertiary care teaching and referral center in north India. We also perform a systematic review of studies reporting the utility of semi-rigid thoracoscopy from India. PATIENTS AND METHODS: The primary objective was to evaluate the diagnostic utility of semi-rigid thoracoscopy in patients with undiagnosed exudative pleural effusion...
March 2015: Lung India: Official Organ of Indian Chest Society
Hung-Yi Lu, Yen Chu, Yi-Cheng Wu, Chien-Ying Liu, Ming-Ju Hsieh, Yin-Kai Chao, Ching-Yang Wu, Hsu-Chia Yuan, Po-Jen Ko, Yun-Hen Liu, Hui-Ping Liu
BACKGROUND: Single-port transumbilical surgery is a well-established platform for minimally invasive abdominal surgery. The aim of this study was to compare the hemodynamics and inflammatory response of a novel transumbilical technique with that of a conventional transthoracic technique in thoracic exploration and lung resection in a canine model. METHODS: Sixteen dogs were randomly assigned to undergo transumbilical thoracoscopy (n = 8) or standard thoracoscopy (n = 8)...
April 2015: International Journal of Surgery
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