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Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Mitsuhiro Kamiyoshihara, Takashi Ibe, Natsuko Kawatani, Fumi Ohsawa, Ryohei Yoshikawa, Kimihiro Shimizu
BACKGROUND: Computed tomography (CT)-guided lung needle marking is useful to identify pulmonary nodules. However, certain complications sometimes trigger severe after-effects or death. So, we present a convenient and safe method by which small pulmonary nodules can be identified using a particular dye [2% (w/v) gentian violet]. METHODS: A patient is initially placed in the lateral operative position. Under CT guidance, a "magic marker" is used to identify the skin above the pulmonary nodule...
September 2016: Journal of Thoracic Disease
Antonio Mazzella, Anne Olland, Pierre Emmanuel Falcoz, Stephane Renaud, Nicola Santelmo, Gilbert Massard
BACKGROUND: This study evaluates the number of video-assisted thoracic surgery-lobectomies (VATS-lobectomies) required for an experienced consultant thoracic surgeon to obtain competence and to perform standard quality surgery. METHODS: We have analysed the initial VATS-experience (January 2012 to September 2014) of a confirmed senior consultant who has performed 145 consecutive anatomic resections by thoracoscopy. After excluding bilobectomies, segmentectomies, and lobectomies for infectious disease, we have focused into 119 consecutive lobectomies, classified into 4 chronologic groups of 30 each...
September 2016: Journal of Thoracic Disease
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...
October 12, 2016: Veterinary Surgery: VS
Jan Kocis, Martin Kelbl, Peter Wendsche, Radek Vesely
AIMS: A retrospective analysis of patients with thoracolumbar junction fractures who underwent video-assisted thoracoscopic surgery via a minimally invasive approach (minithoracotomy) for reconstruction of the anterior spinal column. METHODS: Between 2002 and 2014, a total of 176 patients were treated by this technique. The patients received either posterior stabilization and, at the second stage, the minimally invasive technique via an anterior approach, or the minimally invasive anterior procedure alone...
October 3, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Hemanshoo Sudhir Thakkar, Jonathan Durell, Subhasis Chakraborty, Bianca-Lea Tingle, Arnwald Choi, Darren J Fowler, Steve J Gould, Lawrence Impey, Kokila Lakhoo
Congenital airway pulmonary malformations are increasingly being diagnosed, but their management continues to remain controversial. Our approach has been to offer surgery to mitigate the risk of infection and possible malignancy. All patients routinely undergo a CT scan of the chest postnatally and once the diagnosis is confirmed, minimal access surgery is offered. Our anesthetists provide single-lung ventilation to enhance the operative view. We conducted a retrospective review over a 10-year period, during which 91 patients were prenatally suspected to have a cystic lung lesion...
October 10, 2016: European Journal of Pediatric Surgery
Nicholas E Bruns, Ian C Glenn, Neil L McNinch, Kelly Arps, Todd A Ponsky, Avraham Schlager
PURPOSE: Although recurrence remains one of the most feared complications following congenital diaphragmatic hernia (CDH) repair, there are minimal data on the optimal surgical approach to these complex situations. The purpose of this study was to survey the international pediatric surgery community to ascertain practice patterns for both minimally invasive (MIS) and open approaches for recurrent CDH. MATERIALS AND METHODS: A survey was e-mailed to members of an online community of pediatric surgeons...
October 5, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Gulhan Ertan, Abdulkadir Eren, Sila Ulus
Mesothelioma is an uncommon malignant neoplasm and a localised form of the pleura is especially very rare. Diagnosis of localised malignant pleural mesothelioma (LMPM) is very challenging. Histopathological verification is the gold standard, and studies such as CT, positron emission tomography (PET) and thoracoscopy are very valuable tools in assisting diagnosis. We report a case of histopathologically proven LMPM, which was discovered as a well circumscribed solitary subpleural nodule on PET-CT after presentation with cranial metastasis...
October 4, 2016: BMJ Case Reports
Moshe Hashmonai
At present, primary hyperhidrosis is the main indication for sympathectomy. For upper thoracic sympathetic ablation, excision of the second thoracic ganglion alone or with the first and/or third ganglia was the standard during the open surgery era. With the advent of thoracoscopy, modifications related to the level, extent, and type of ablation were proposed to attenuate compensatory hyperhidrosis. The ideal operation for sympathetic denervation of the face and upper limbs remain to be defined. Controlled double-blind studies with quantitave measurements of sweat production are required...
November 2016: Thoracic Surgery Clinics
Fahad Almehmadi, Mark Chandy, Kim A Connelly, Jeremy Edwards
Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse...
2016: Case Reports in Cardiology
O V Voskresensky, A M Gasanov, E A Tarabrin
AIM: to improve treatment of patients with spontaneous pneumothorax who had not postoperative pulmonary impermeability. MATERIAL AND METHODS: 87 patients with spontaneous pneumothorax underwent videothoracoscopy (VTS), lung resection supplemented by pleurodesis (parietal pleurectomy or pleural abrasion). Absence of pulmonary impermeability was observed in 5 (5.7%) patients. RESULTS AND DISCUSSION: Re-operation was performed in 2 patients (Vanderschuren 2 and 3) namely re-thoracoscopy and thoracotomy with additional ligation of air origins...
2016: Khirurgiia
Chetan Basavaraj Patil, Ramakant Dixit, Rakesh Gupta, Neeraj Gupta, Varna Indushekar
BACKGROUND: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. MATERIALS AND METHODS: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope...
September 2016: Lung India: Official Organ of Indian Chest Society
William S Ragalie, Paula M Termuhlen, Alex G Little
BACKGROUND: Although exposure to thoracic surgery is mandated in general surgery residency, little is known about the mix of cases that residents use to meet this requirement and how this has changed over time. We report the experience of general thoracic surgery among general surgery residents using the Accreditation Council for Graduate Medical Education (ACGME) database. METHODS: We performed a retrospective review of the prospectively maintained ACGME resident case log database from 2003 to 2013...
September 9, 2016: Annals of Thoracic Surgery
Chigozirim Ekeke, Stephen Noble, Robert E Merritt
Intrapleural foreign bodies are rare and there are few reports on the occurrence and management of this uncommon clinical presentation. We report a case of a patient with a history of ingesting multiple foreign bodies, which resulted in multiple laparotomy procedures for extraction. The patient recently required surgical removal of innumerable ingested foreign bodies from the stomach and developed a left empyema post-operatively. Subsequent imaging studies revealed evidence of a foreign object in the left pleural space without evidence of an esophageal perforation or diaphragm injury...
August 2016: Journal of Thoracic Disease
Alberto Sandri, Francesco Guerrera, Matteo Roffinella, Stefania Olivetti, Lorena Costardi, Alberto Oliaro, Pier Luigi Filosso, Paolo Olivo Lausi, Enrico Ruffini
BACKGROUND: To assess the trend of our surgical patients affected by malignant pleural mesothelioma (MPM) and submitted to diagnostic/palliative or curative surgical procedures and to validate the European Organisation for Research and Treatment of Cancer (EORTC) prognostic score in our patient population. METHODS: This is a cohort study of patients submitted to surgery for MPM from January 2007 to December 2013. Primary outcome was overall survival (OS). Univariate and multivariate-adjusted comparisons by EORTC prognostic score for OS were accomplished using Cox method...
August 2016: Journal of Thoracic Disease
Mindy Vroomen, Laurent Pison
PURPOSE: Hybrid ablation for AF is performed in a growing number of centers. Due to absence of guidelines, operative approaches and perioperative care differ per center. In this review, an overview of findings from published studies on hybrid ablations is given, and related topics are discussed (e.g., one- and two-stage approaches, lesion sets, and patient management). METHODS: A systematic literature search was performed in the PubMed and Embase databases. All identified articles were screened and checked for eligibility by the two authors...
September 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
T Potzger, M Ried, H-S Hofmann
UNLABELLED: Parapneumonic pleural effusion (PPE) occurring in early-stage (stage I) pleural empyema (PE) can be managed by chest tube drainage, which should be performed as soon as possible, to achieve re-expansion of the pulmonary parenchyma. Chronic disease leads to fibrin deposits on both pleural surfaces (stage II), followed by a thickened pleura peel (stage III). A trapped or compressed lung can only be released by surgical decortication, which may be performed with a minimally-invasive approach (video-assisted thoracoscopy) or an open technique (thoracotomy)...
September 2016: Zentralblatt Für Chirurgie
Simon C Y Chow, Calvin S H Ng
In the modern era when screening and early surveillance of pulmonary nodules is increasing in importance, the management of the pulmonary nodule represents a different challenge to thoracic surgeons. The difficulty lies in the merging of sound surgical and oncological principles with more minimally invasive and appropriate lung sparing surgery. Furthermore, the intra-operative identification and surgical management of small and sometimes multi-focal pulmonary lesions remain challenging. There have been many developments and innovations in the field of video-assisted thoracoscopic surgery (VATS) to cater for the demands from increasing incidence of pulmonary nodules with associated paradigm shift in their surgical management...
July 2016: Journal of Thoracic Disease
Federico Moser, Franco José Signorini, Pablo Sergio Maldonado, Veronica Gorodner, Arturo Lopez Sivilat, Lucio Ricardo Obeide
INTRODUCTION: Bochdalek hernia is a congenital diaphragmatic defect that results from improper fusion of the septum transversum and the pleuroperitoneal folds. It rarely persists asymptomatic until adulthood. The reported incidence is as low as 0.17%. Surgical repair of the defect can be performed through the abdomen or through the chest, and in both cases open or through laparoscopy/thoracoscopy. CASE REPORT: We present 2 cases of fully laparoscopic repair of giant Bochdalek hernia in adults...
September 7, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Gabrielle Karpinsky, Malgorzata Anna Krawczyk, Aleksandra Fatyga, Ewa Izycka-Swieszewska, Miroslawa Dubaniewicz-Wybieralska, Dagmara Szmyd, Monika Luboch-Furmanczyk, Ewa Bien
Although childhood rhabdomyosarcoma typically metastasizes to lungs, various processes may mimic metastatic etiology. Described herein is the case of an 8½-year-old boy with orbital embryonal rhabdomyosarcoma (RME) in whom three small foci were detected within both lungs on computed tomography. The lesion number and size, however, did not fulfil the Cooperative Weichteilsarkom Study Group 2006 protocol criteria for lung metastasis. Chemotherapy for localized RME produced primary tumor regression and vanishing of the left lung lesion...
September 5, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
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