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Technique of pulmonary lobectomy

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https://www.readbyqxmd.com/read/28066606/lobectomy-and-limited-resection-in-small-sized-peripheral-non-small-cell-lung-cancer
#1
Terumoto Koike, Teruaki Koike, Seijiro Sato, Takehisa Hashimoto, Tadashi Aoki, Katsuo Yoshiya, Yasushi Yamato, Takehiro Watanabe, Kohei Akazawa, Shin-Ichi Toyabe, Masanori Tsuchida
BACKGROUND: Although lobectomy is the standard surgical procedure for non-small cell lung cancer (NSCLC), recent studies show favorable outcomes after limited resection in patients with small-sized peripheral tumors. We conducted a randomized controlled trial of such patients to estimate postoperative outcomes and pulmonary function following these surgical techniques. METHODS: Between 2005 and 2008, eligible patients with tumors of 2 cm or less were randomly assigned 1:1 to undergo lobectomy or limited resection; 32 and 33 NSCLC patients in each group, respectively, were analyzed...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28049376/management-of-pleural-space-after-lung-resection-by-cryoneuroablation-of-phrenic-nerve
#2
Xiao-Jie Pan, De-Bin Ou, Xing Lin, Ming-Fang Ye
OBJECTIVES: Residual air space problems after pulmonary lobectomy are an important concern in thoracic surgical practice, and various procedures have been applied to manage them. This study describes a novel technique using controllable paralysis of the diaphragm by localized freezing of the phrenic nerve, and assesses the effectiveness of this procedure to reduce air space after pulmonary lobectomy. METHODS: In this prospective randomized study, 207 patients who underwent lobectomy or bilobectomy and systematic mediastinal node dissection in our department between January 2009 and November 2013 were randomly allocated to a cryoneuroablation group or a conventional group...
January 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28040831/pulmonary-lobectomy-techniques-in-infants-and-children
#3
Atsuyuki Yamataka, Hiroyuki Koga, Takanori Ochi, Kota Imashimizu, Kazuhiro Suzuki, Ryohei Kuwatsuru, Geoffrey Lane, Kinya Nishimura, Eiichi Inada, Kenji Suzuki
Thoracoscopic pulmonary lobectomy (TPL) techniques in infants and children are presented practically with concise descriptions and numerous illustrations. TPL is the treatment of choice for congenital pulmonary airway malformation and intralobar pulmonary sequestration, both now commonly diagnosed prenatally. Timing of surgery is somewhat controversial in asymptomatic cases with small isolated lesions. Incomplete fissures and history of chest infections are most problematic. Thorough understanding of anatomic relations preoperatively is vital for successful outcome and thin-slice computed tomography with 3D reconstruction of vessels is valuable...
December 31, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27900078/video-assisted-thoracoscopic-surgery-for-the-central-bronchogenic-carcinoma-with-invasion-of-the-main-bronchus-and-pulmonary-artery-a-case-report
#4
Jun Wan, Renquan Zhang
Surgical treatment for central bronchogenic carcinoma with invasion of the main bronchus and pulmonary artery often include bronchial anastomosis and pulmonary angioplasty. As a technique, video-assisted thoracoscopic surgery (VATS) lobectomy has proven to reduce the rate of occurrence of complications, and thereby obtain improved survival rates. In the present case study, its use in treating central bronchogenic carcinoma with invasion of the main bronchus and pulmonary artery is reported. A case study of a 68-year-old man with a history of smoking 15-20 cigarettes per day for 40 years is described, who presented with a cough and hemoptysis...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27899430/prophylactic-middle-lobe-fixation-for-postoperative-pulmonary-torsion
#5
Masahiko Higashiyama, Toshiteru Tokunaga, Takashi Kusu, Hiroto Ishida, Jiro Okami, Ken Kodama
BACKGROUND: To prevent postoperative middle lobe torsion after a right upper lobectomy, we introduced a novel technique of interlobar fixation using collagen fleece coated with fibrin. In this study, the prophylactic effects of this method on the incidence of postoperative pulmonary torsion were analyzed. METHODS: Between April 2001 and December 2015, 3786 pulmonary resection procedures (excluding total pneumonectomy) were performed in our institution, and prophylactic interlobar fixation was selectively applied when intraoperative examination indicated that the patient was at high risk of postoperative pulmonary lobe torsion...
November 29, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27865329/management-of-chest-drains-after-thoracic-resections
#6
REVIEW
Pier Luigi Filosso, Alberto Sandri, Francesco Guerrera, Matteo Roffinella, Giulia Bora, Paolo Solidoro
Immediately after lung resection, air tends to collect in the retrosternal part of the chest wall (in supine position), and fluids in its lower part (costodiaphragmatic sinus). Several general thoracic surgery textbooks currently recommend the placement of 2 chest tubes after major pulmonary resections, one anteriorly, to remove air, and another into the posterior and basilar region, to drain fluids. Recently, several authors advocated the placement of a single chest tube. In terms of air and fluid drainage, this technique demonstrated to be as effective as the conventional one after wedge resection or uncomplicated lobectomy...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27847093/robotic-lobectomy-utilizing-the-robotic-stapler
#7
Daryl Phillip Pearlstein
A drawback of robotic lobectomy is the inability of the operating surgeon to perform stapler division of the pulmonary vessels and bronchi. With the advent of the robotic stapler, the surgeon is able to control this instrument from the console. The robotic stapler presents certain challenges. This article outlines techniques to use the robotic stapler for the safe and predictable performance of lobectomies.
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27834025/indocyanine-green-fluorescence-navigated-robotic-segmentectomy
#8
Chen-Ping Hsieh, Yun-Hen Liu, Yi-Cheng Wu, Ming-Ju Hsieh, Yin-Kai Chao
BACKGROUND: Pulmonary segmentectomy with radical lymphadenopathy has been considered effective to manage small primary lung cancers [1, 2]. This procedure provides the advantages of minimal invasive surgery and is reported sufficient for safe margin. However, segmentectomy is more difficult to be performed than lobectomy because intersegmental plane cannot be detected easily. Several methods have been reported for identifying the actual intersegmental plane [3-7], but the sensitivity of these methods is limited to the lung conditions like patients with emphysematous lung and needed skilled surgeon to perform...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27814899/sleeve-lobectomy-may-provide-better-outcomes-than-pneumonectomy-for-non-small-cell-lung-cancer-a-decade-in-a-nationwide-study
#9
Pierre-Benoit Pagès, Pierre Mordant, Stéphane Renaud, Laurent Brouchet, Pascal-Alexandre Thomas, Marcel Dahan, Alain Bernard
INTRODUCTION: Whenever feasible, sleeve lobectomy is recommended to avoid pneumonectomy for lung cancer, but these guidelines are based on limited retrospective series. The aim of our study was to compare outcomes following sleeve lobectomy and pneumonectomy using data from a national database. METHODS: From 2005 to 2014, 941 sleeve lobectomy and 5318 pneumonectomy patients were recorded in the French database Epithor. Propensity score was generated with 15 pretreatment variables and used to create balanced groups with matching (794 matches) and inverse probability of treatment weighting (standardized difference was 0 for matching, and 0...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27744322/excellent-outcome-of-donor-lobectomy-with-various-surgical-techniques-for-the-interlobar-artery%C3%A2
#10
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Akihiro Aoyama, Hideki Motoyama, Kyoko Hijiya, Toshi Menju, Toshihiko Sato, Makoto Sonobe, Hiroshi Date
OBJECTIVES: Donor lobectomies in living-donor lobar lung transplantation sometimes require additional surgical procedures on the interlobar pulmonary artery. We retrospectively reviewed the surgical techniques and outcomes of living-donor lobectomy. METHODS: Between 2008 and 2015, 116 living-donor lobectomies were performed in 64 consecutive living-donor lobar lung transplantations (52 bilateral, 12 single). The surgical techniques and outcomes were reviewed retrospectively...
October 15, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27705088/thoracoscopic-lobectomy-in-infants-and-children-utilizing-a-5%C3%A2-mm-stapling-device
#11
Steven Rothenberg
PURPOSE: Thoracoscopic lobectomy for congenital cystic lung disease has become an accepted and in many institutions the preferred technique. However, the technical challenges are many. Previous endoscopic staplers (12 mm) used commonly in adults are too large for use in infants This study evaluates the safety and efficacy of using a 5 mm stapling device to seal and divide major pulmonary structures. METHODS: From July 2014 to March 2016, 26 patients of age 6 weeks to 13 months underwent thoracoscopic lobectomy for CPAM or sequestration...
December 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27645980/pulmonary-arterioplasty-with%C3%A2-end-to-end-anastomosis-of-the-lingular-branch-to-the-interlobar-pulmonary-artery-in-living-donor-lobectomy
#12
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Akihiro Aoyama, Hiroshi Date
In living-donor lobar lung transplantation, donor lobectomies must be performed carefully both for donors and recipients. In some cases pulmonary arterioplasty is required for preserving branches of pulmonary artery. This report describes a successful case of pulmonary arterioplasty with end-to-end anastomosis of the interlobar artery and the lingular branch in living-donor lobectomy. Because the harvest of autologous pericardium can be avoided both in donor and recipient surgical procedures by using this technique, living-donor lobar lung transplantation can be performed more safely and simply...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27621885/a-reverse-direction-technique-of-single-port-left-upper-pulmonary-resection
#13
Min Zhang, Alan D L Sihoe, Ming Du
BACKGROUND: Single-port video-assisted thoracoscopic surgery (VATS) left upper lobectomy is difficult amongst all the lobes. At the beginning of single-port lobectomies, the upper lobes were believed not to be amenable for single-port approach due to the difficult angulation for staplers. Gonzalez reported the first single-port VATS left upper lobectomy in 2011. METHODS: We report a new technique of single-port VATS left upper lobectomy with the concept of "reverse direction"...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27621876/initial-experience-of-single-port-video-assisted-thoracoscopic-surgery-sleeve-lobectomy-and-systematic-mediastinal-lymphadenectomy-for-non-small-cell-lung-cancer
#14
Hao Chen, Guobing Xu, Bin Zheng, Wei Zheng, Yong Zhu, Zhaohui Guo, Chun Chen
BACKGROUND: In this study, we evaluate the feasibility and safety of single-port video-assisted thoracoscopic surgery (VATS) sleeve lobectomy (SL) and systematic mediastinal lymphadenectomy and summarize our surgical experience. METHODS: From October 2014 to December 2015, eight cases of single-port VATS SL [seven male patients and one female patient, median age 56.0 (range, 38-63) years] were performed by a single group of surgeons in Fujian Medical University Fujian Union Hospital...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27621851/ct-guided-microcoil-vats-resection-of-lung-nodules-a-single-centre-experience-and-review-of-the-literature
#15
Laura L Donahoe, Elsie T Nguyen, Tae-Bong Chung, Lan-Chau Kha, Marcelo Cypel, Gail E Darling, Marc de Perrot, Shaf Keshavjee, Andrew F Pierre, Thomas K Waddell, Kazuhiro Yasufuku
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface. METHODS: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014. RESULTS: A total of 63 patients were included (37% male, mean age 61...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27575276/pain-quality-of-life-and-clinical-outcomes-after-robotic-lobectomy
#16
Valerie Lacroix, Zahra Mosala Nezhad, David Kahn, Arnaud Steyaert, Alain Poncelet, Thierry Pieters, Philippe Noirhomme
Background To evaluate pulmonary function, pain, and quality of life at midterm after robotic lobectomy performed in a single institution. Methods Sixty-five consecutive patients underwent robotic thoracic surgery over 32 months using a complete four-arm portal technique. Sixty-one patients underwent lobectomies predominantly for stage I non-small cell lung cancer. Pulmonary function tests were repeated at midterm follow-up. Pain and quality of life were evaluated during the follow-up on a subgroup of 39 patients, excluding the learning period...
August 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27568150/novel-methods-of-intraoperative-localization-and-margin-assessment-of-pulmonary-nodules
#17
Jane Keating, Sunil Singhal
Lung cancer screening has lead to frequent diagnosis of solitary pulmonary nodules, many of which require surgical biopsy for diagnosis and intervention. Subcentimeter and central nodules are particularly difficult to visualize or palpate during surgery, thus nodule localization can be a difficult problem for the thoracic surgeon. Although minimally invasive techniques including transthoracic computed tomography and bronchoscopic-guided biopsy may establish a diagnosis, these methods do not help locate nodules during surgery and can lead to inadequate tissue sampling...
2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27553197/penetrating-thoracic-trauma-patients-with-gross-physiological-derangement-a-responsibility-for-the-general-surgeon-in-the-absence-of-trauma-or-cardiothoracic-surgeon
#18
Dietrich Doll, Markus Eichler, Pantelis Vassiliu, Kenneth Boffard, Tim Pohlemann, Elias Degiannis
BACKGROUND: Penetrating trauma is becoming increasingly common in parts of the world where previously it was rare. At the same time, general surgeons and surgical trainees are becoming more specialized, and less comfortable operating within areas beyond their zone of specialization. OBJECTIVE: The purpose of this manuscript is to assess the technical difficulties encountered in operating on patients who have sustained penetrating trauma, and to prove to general surgeons that the technical skills and techniques required are no different to those required for abdominal surgery, and do not require additional dexterity...
January 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27526650/the-influence-of-reconstructive-technique-on-perioperative-pulmonary-and-infectious-outcomes-following-chest-wall-resection
#19
Jonathan D Spicer, Jitesh B Shewale, Mara B Antonoff, Arlene M Correa, Wayne B Hofstetter, David C Rice, Ara A Vaporciyan, Reza J Mehran, Garrett L Walsh, Jack A Roth, Stephen G Swisher, Boris Sepesi
BACKGROUND: Emerging technologies for prosthetic reconstruction after chest wall resection have yielded a wide variety of reconstructive options for thoracic surgeons. The ideal chest wall reconstruction and its impact on perioperative outcomes has not been well defined. Our goal was to determine whether mesh characteristics such as rigidity or absorbability altered perioperative pulmonary and infectious outcomes. METHODS: Our institutional database was queried for patients who underwent chest wall resection and reconstruction for primary or secondary chest wall tumors between the years 1998 and 2013...
August 12, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27499975/urgent-pulmonary-lobectomy-for-blunt-chest-trauma-report-of-three-cases-without-mortality
#20
Marco Chiarelli, Martino Gerosa, Angelo Guttadauro, Francesco Gabrielli, Giuseppe Vertemati, Massimo Cazzaniga, Luca Fumagalli, Matilde De Simone, Ugo Cioffi
BACKGROUND: The majority of patients with severe blunt chest trauma is successfully treated with supportive measures and thoracostomy tube; only few cases need urgent thoracotomy. Lung-sparing techniques are treatments of choice but major pulmonary resections are necessary in case of injuries involving hilar vessels or bronchi. Currently the mortality associated with pulmonary lobectomy performed for chest trauma is 40%. METHODS: Over a 2-year period [2013-2014], 210 patients with chest trauma were hospitalized at our Institution...
July 2016: Journal of Thoracic Disease
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