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anesthesia for thoracoscopy

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https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#1
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#2
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#3
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29078678/uniportal-non-intubated-lung-metastasectomy
#4
Tommaso Claudio Mineo, Francesco Sellitri, Eleonora Fabbi, Vincenzo Ambrogi
BACKGROUND: More than 15 years ago, we started a program of uniportal video-assisted thoracoscopies (VATS) lung metastasectomy in non-intubated local anesthesia. Hereby we present the short and long-term results of this combined surgical-anesthesiological technique. METHODS: Between 2005 and 2015, 71 patients (37 men and 34 women) with pulmonary oligometastases, at the first episode, underwent uniportal VATS metastasectomy under non-intubated anesthesia. RESULTS: Four patients (5...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#5
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28892265/effects-of-preemptive-analgesia-with-flurbiprofen-ester-on-lymphocytes-and-natural-killer-cells-in-patients-undergoing-esophagectomy-a-randomized-controlled-pilot-study
#6
Yi Zhou, Jinxi Huang, Yu Bai, Changsheng Li, Xihua Lu
BACKGROUND: Tumors may induce systemic immune dysfunction, which can be aggravated by surgery and anesthesia/analgesia. Data on the effect of flurbiprofen preemptive analgesia on immune dysfunction is limited. The aim of this study was to investigate the effect of flurbiprofen preemptive analgesia on lymphocytes and natural killer (NK) cells in patients undergoing thoracotomy and thoracoscopy radical esophagectomy, and to explore the analgesic methods suitable for tumor patients. METHODS: This was a randomized controlled pilot study of 89 patients with esophageal cancer treated with surgery at the Henan Cancer Hospital between January 1, 2015 and December 31, 2016...
November 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28846539/catheterization-in-an-ultrasound-guided-thoracic-paravertebral-block%C3%A2-using-thoracoscopy
#7
T Fujii, Y Shibata, Y Ban, A Shitaokoshi, K Nishiwaki
Thoracic paravertebral block (TPVB) is an efficient alternative to epidural anesthesia. The location of a catheter within the thoracic paravertebral space (TPVS) has been examined in the human cadaver studies, but it is unclear how it goes into the TPVS during catheterization. In this report, thoracoscopy was used to observe the thoracic cavity in real-time during a parasagittal in-plane approach of ultrasound-guided TPVB. During thoracoscopy, we observed whether a paravertebral catheter could be advanced caudally beyond the ribs into the neighboring TPVS...
March 2017: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#8
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28275495/resection-of-pulmonary-nodule-in-a-patient-with-subglottic-stenosis-under-modified-spontaneous-ventilation-anesthesia
#9
Jianfei Shen, Xuewei Chen, Lixia Liang, Kevin Phan, Jin-Shing Chen, Calvin S H Ng, Rene Horsleben Petersen, Diego González-Rivas, Jianxing He
Subglottic stenosis is an uncommon structural abnormality that can pose as a difficulty for patients undergoing surgery, and treatment is complex due to the special anatomical location. Pulmonary nodule resection in patients with subglottic stenosis is challenging and has not yet been reported. Here we present a case of pulmonary nodule resection in a patient with subglottic stenosis using uniportal thoracoscopy under spontaneous ventilation anesthesia (SVA). Compared with traditional double lumen endotracheal intubation, we believe this modified technique can significantly reduce airway trauma, and accelerate patient recovery...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28275489/medical-thoracoscopy-in-china-the-present-status-and-the-future
#10
REVIEW
Jing-Yuan Liu, Liang Xiong, Min Zhang, Shi-Yuan Shuai, Xiao-Shan Wei, Lin-Lin Ye, Qiong Zhou
Medical thoracoscopy (MT) refers to a minimally invasive procedure to inspect and perform a biopsy of the pleural space, as well as to perform therapeutic interventions, in a nonintubated patient under local anesthesia. This procedure provides the physician a window into the pleural space. Over the past two decades, MT has been developed very rapidly in China. We performed a review of the published data on MT in China, and estimated the present status, the challenges, and future perspectives of MT. From the data we conduct that MT is widely used well in China, not only in the diagnosis of exudative pleural effusions, but also in the management of pleural diseases, such as tuberculous pleural effusion, malignant pleural effusion and spontaneous pneumothorax...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27984383/hippocrates-quoted-if-an-empyema-does-not-rupture-death-will-occur-is-medical-thoracoscopy-able-to-make-it-rupture-safely
#11
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
https://www.readbyqxmd.com/read/27783022/new-trends-in-interventional-pulmonology
#12
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
https://www.readbyqxmd.com/read/27731519/thoracoscopy-with-concurrent-esophagoscopy-for-persistent-right-aortic-arch-in-9-dogs
#13
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
https://www.readbyqxmd.com/read/27086815/thoracoscopy-under-local-anesthesia-was-useful-for-diagnosing-yellow-nail-syndrome
#14
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
https://www.readbyqxmd.com/read/26638922/thoracoscopy-in-pleural-effusion-two-techniques-awake-single-access-video-assisted-thoracic-surgery-versus-2-ports-video-assisted-thoracic-surgery-under-general-anesthesia
#15
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
https://www.readbyqxmd.com/read/26628037/local-anesthetic-thoracoscopy-for-the-diagnosis-of-metastatic-pleural-melanoma-originated-from-oral-malignant-melanoma-case-report-and-comments
#16
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
https://www.readbyqxmd.com/read/26603428/thoracoscopic-examination-of-empyema-in-a-patient-with-sparganosis-mansoni
#17
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
https://www.readbyqxmd.com/read/26600776/an-autopsied-case-of-malignant-sarcomatoid-pleural-mesothelioma-in-which-chest-pain-developed-several-months-earlier-without-abnormality-on-imaging
#18
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
https://www.readbyqxmd.com/read/26545142/ventilation-perfusion-distributions-revisited
#19
REVIEW
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
https://www.readbyqxmd.com/read/26488940/pediatric-thoracoscopy-and-bronchial-blockers-the-continued-search-for-the-ideal-one-lung-ventilation
#20
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
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