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Thoracic incisions

Alessio Campisi, Andrea Dell'Amore, Domenica Giunta, Stefano Congiu, Niccolò Daddi, Giampiero Dolci
Primary spontaneous pneumothorax has been defined as the disease of the 'young and healthy'. There are multiple possible therapies and in recent years, surgery has evolved towards the use of the uniportal thoracoscopic approach. The objective of our study is to describe and present an innovative approach to access to the thoracic cavity in patients with spontaneous pneumothorax. The surgery was performed using a single access of 20 mm at the level of the 8th intercostal space. For the isolation and suspension of any dystrophic area, we use a 'loop' of non-absorbable braided suture inserted through the IV intercostal space and successive wedge resection using an endoscopic 10 mm mechanical stapler...
2018: Journal of Visualized Surgery
Yuanshan Yao, Haibo Shen, Yinjie Zhou, Zhenhua Yang, Hongbo Huang
The aim of this study was to investigate the feasibility and safety of thoracoscopic surgery in the treatment of lung cancer and its effect on serum D-dimer. A total of 218 patients with lung cancer treated in the Department of Thoracic Surgery of Ningbo No. 2 Hospital from January 1, 2013 to December 31, 2016, were retrospectively analyzed. Of the 218 patients, 120 patients underwent thoracotomy (thoracotomy group) and 98 patients underwent thoracoscopic surgery (thoracoscopy group). The clinical efficacy in the perioperative period and serum D-dimer level were compared between the two groups...
April 2018: Oncology Letters
Hu-Lin Christina Wang, Jia-Hao Zhang, Cheng-Hung How
BACKGROUND: Pulmonary arteriovenous malformations are rare vascular abnormalities that permit direct communication between the pulmonary artery and vein. During pregnancy, pulmonary arteriovenous malformation carries an increased risk of enlargement and rupture, which could lead to life-threatening hemothorax. This is the first case reporting successful thoracoscopic surgery for a pregnant woman with pulmonary arteriovenous malformation rupture-related hemothorax. CASE PRESENTATION: We present a case of a 32-year-old pregnant Asian woman (31 weeks' gestation) whose pulmonary arteriovenous malformation ruptured, leading to right-sided spontaneous tension hemothorax...
March 19, 2018: Journal of Medical Case Reports
Hui Li, Miguel Castro, Pascal Haigron, Jean-Philippe Verhoye, Vito Giovanni Ruggieri
PURPOSE: Minimally invasive aortic valve replacement (MIAVR) procedures remain more complex and technically challenging compared to conventional full sternotomy surgery. This technique involves a restricted surgical field and a limited workspace, which is, at present, strictly reserved for the most experienced surgeons. The MIAVR clinical outcomes are strongly dependent on the appropriate choice of the thoracic incision. This work presents a decision support system to optimize, through an interactive visualization interface, the exposure of the target structure in a limited field of view...
March 17, 2018: International Journal of Computer Assisted Radiology and Surgery
Emma van der Weijde, Nabil Saouti, Jan Albert Vos, Selma C Tromp, Robin H Heijmen
OBJECTIVES: To evaluate the indications, perioperative strategy and postoperative outcome of surgical left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) covering the LSA. METHODS: Between 2000 and 2017, a total of 101 consecutive patients underwent surgical revascularization of the LSA prior to, concomitant or following TEVAR. Revascularization was performed through a small supraclavicular incision and consisted of a transposition or bypass graft, using intraoperative transcranial Doppler monitoring...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Andrea Droghetti, Erika Basso Ricci, Paolo Scimia, Fabiola Harizai, Massimiliano Marini
BACKGROUND: The standard technique for implanting a subcutaneous defibrillator (S-ICD) requires three incisions and the pocket of the device is created in the subcutaneous tissue of the left lateral thoracic wall. However, a two-incision technique may be adopted, in which the cranial parasternal region is avoided and the device is positioned more deeply, completely under the latissimus dorsi muscle. This can also be combined with Ultrasound-Guided Serratus Anterior Plane Block (US-SAPB) for intraoperative anesthesia and perioperative analgesia...
March 1, 2018: Pacing and Clinical Electrophysiology: PACE
Qiang Chen, Qi Liu, Yan Suo, Qingping Xie
RATIONALE: Abdominal wall defects are common after tumor resection. PATIENT CONCERNS: We report an 83-year-old male patient with recurrent tumors in his abdomen, and who had an incision wound that could not be directly closed. Mesh was not suitable because the wound was infected. DIAGNOSES: Abdominal wall defect result from the resection of recurrent tumor. INTERVENTIONS: We carried out a vascularized ribs-pleural transfer operation...
March 2018: Medicine (Baltimore)
Hiroshi Furukawa, Takeshi Honda, Takahiko Yamasawa, Hisao Masaki, Kazuo Tanemoto
BACKGROUND: We retrospectively evaluated the initial clinical experience of the surgical management of extensive dissecting thoracic aortic aneurysm (TAA) via the semi-clamshell approach. METHODS: Thirteen patients (3 women and 10 men, mean age 67 ± 15 years) who underwent elective surgical intervention for extensive dissecting TAA via semi-clamshell approach in our institute between May 2007 and April 2017 participated in this study. Regarding surgical techniques, left thoracotomy with transverse sternotomy was initially performed via the third or fourth intercostal space following an incision from the right sternal borderline to the anterior axillary line on the left sternal borderline...
February 22, 2018: General Thoracic and Cardiovascular Surgery
G Leschber
More than 200 years ago the first attempts at thoracoscopy were made but only after its introduction 25 years ago has video-assisted thoracoscopic surgery (VATS) experienced rapid progress. Due to worldwide cooperation and international networking tremendous progress of the technique was made by thoracic surgeons on all continents developing the technique into a less invasive operating procedure on the thorax. For patients this meant improvement in the quality of life and ultimately better survival rates following lung cancer surgery...
February 21, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Qi-Liang Zhang, Qiang Chen, Zhi-Qin Lin, Ling-Li Yu, Ze-Wei Lin, Hua Cao
BACKGROUND The aim of this study was to investigate the safety, feasibility, and clinical effectiveness of thoracoscopy-assisted mitral valve replacement via thoracic right-anterior minimal incision. MATERIAL AND METHODS A retrospective analysis was conducted of 225 patients with mitral valve lesions who were treated in our hospital from August 2012 to August 2015. Group A included 105 patients undergoing thoracoscopy-assisted mitral valve replacement via a thoracic right-anterior minimal incision, and group B included 120 patients undergoing conventional mitral valve replacement...
February 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Giuseppe Gatti, Miroslaw Ledwon, Laszlo Gazdag, Federica Cuomo, Aniello Pappalardo, Theodor Fischlein, Giuseppe Santarpino
Single-use, closed incision management (CIM) systems offer a practical means of delivering negative pressure wound therapy to patients. This prospective study evaluates the Prevena™ Therapy system in a cohort of coronary patients at high risk of deep sternal wound infection (DSWI). Fifty-three consecutive patients undergoing bilateral internal thoracic artery (BITA) grafting were preoperatively elected for CIM with the Prevena™ Therapy system, which was applied immediately after surgery. The actual rate of DSWI in these patients was compared with the expected risk of DSWI according to two scoring systems specifically created to predict either DSWI after BITA grafting (Gatti score) or major infections after cardiac surgery (Fowler score)...
February 19, 2018: Updates in Surgery
Wen Xue, Xiao-Li Guan, Zeng-Ping Wang, Zhong-Yu Hao, Lin Liu, Yao-Wen Qian
OBJECTIVE: To investigate the clincial effects and feasibility of anterior thoracoscopically assisted surgery (TAS) with posterior one-stage total en block spondylectomy(TES) for thoracic spinal tumour. METHODS: From October 2014 to January 2016, 4 patients with thoracic spinal tumour were treated by anterior thoracoscopically assisted surgery with posterior one-stage total en block spondylectomy. There were 2 males and 2 females, aged 16, 35, 46, 60 years. Courses of disease were 1, 4, 6, 9 months...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Aris Koryllos, Erich Stoelben
Bronchus sleeve resection for operative treatment of non-small cell lung cancer (NSCLC) is a gold standard in modern thoracic surgery in cases of centrally located tumors or hilär lymph node metastases. Advanced instruments and growing surgical experience allowed surgeons to reduce the required incisions (from 3-port to uniportal) and to resect larger and more centrally located malignancies minimal invasively. It is a logical and expected advance in thoracic surgery that video-assisted thoracoscopic surgery (VATS) would be ultimately used also for complex bronchial resections...
2018: Journal of Visualized Surgery
William Grossi, Gianluca Masullo, Francesco Londero, Angelo Morelli
The object of our study is to show the causes leading to conversion, in order to observe the responsible variables and analyses if conversion influences the patient's outcome. Between January 2013 and December 2016, Udine Thoracic Department performed 180 video-assisted thoracoscopic surgery (VATS) lobectomies, and 24 cases were converted to thoracotomy due to an intra-operative complication such as arterial or venous bleeding, airway and other injuries. The VATS lobectomies' number increased over the three years: from 27 in 2013 to 55 in 2015 and 48 in 2016...
2018: Journal of Visualized Surgery
Yoshinori Iwata, Chihiro Tanaka, Shuji Komori, Narutoshi Nagao, Masahiko Kawai, Kazuhiro Yoshida, Katsuyuki Kunieda
BACKGROUND: Esophageal schwannomas are rare esophageal submucosal tumors. We herein report a case of a lobulated esophageal schwannoma resected with concurrent approach from the thorax and cervix. CASE PRESENTATION: A 74-year-old woman visited our hospital with complaint of loss of consciousness, and a lobulated mediastinal tumor was discovered by chance in computed tomography. Upper gastrointestinal endoscopy showed a smooth elevated lesion at a position of 23-28 cm from the incisor teeth...
February 13, 2018: World Journal of Surgical Oncology
Bhavna Kakkar, Munisha Agarwal, Aakanksha Sehgal, Neelam Prasad Govil
Glenn shunt is an anastomosis between superior vena cava and right pulmonary artery to palliate patients with single ventricle physiology of the heart. Chylothorax is a frequent and troublesome complication after the creation of this shunt, which if not controlled with medical management, might require pleurodesis, and thoracic duct ligation. Video-assisted thoracoscopic surgery (VATS) causes less postoperative pain, earlier mobilization, lower overall morbidity, a shortened hospital stay with reduced cost, and a cosmetic incision...
January 2018: Saudi Journal of Anaesthesia
Takashi Matsueda, Yuki Ikeno, Koki Yokawa, Yojiro Koda, Soichiro Henmi, Takeshi Inoue, Hiroshi Tanaka, Yutaka Okita
OBJECTIVES: We present our experience with one-stage replacement of thoracic aneurysm from the ascending aorta to the thoracoabdominal aorta. PATIENTS AND METHODS: Fourteen patients (10 male and 4 female; mean age 53.6 ± 12.4 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was chronic aortic dissection in 13 patients and intraoperative retrograde aortic dissection in 1 patient. Five patients had Marfan syndrome...
February 2018: Journal of Thoracic and Cardiovascular Surgery
Robert R Hagan, Joseph A Ricci, Kyle R Eberlin
Thoracic outlet syndrome (TOS) is a cause of upper extremity and shoulder dysfunction. TOS can present with a wide range of symptoms due to compression of the brachial plexus or its branches during their passage through the cervicothoracobrachial region or scalene triangle. There are three types of TOS: arterial, venous, and neurogenic. Neurogenic TOS (nTOS) is by far the most frequent type and represents more than 95% of all cases. Historically, surgical intervention for all types of TOS has evolved based on the treatment for a vascular etiology and has typically included a first rib resection...
February 2, 2018: Journal of Reconstructive Microsurgery
G Samoila, C P Twine, I M Williams
Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. However, the subclavian vein crosses the first rib anteriorly just behind the manubrium and can also be accessed via an infraclavicular incision. Methods MEDLINE® and Embase™ were searched for all studies on outcomes in patients undergoing infraclavicular first rib resection for treatment of Paget-Schroetter syndrome...
February 2018: Annals of the Royal College of Surgeons of England
Januvi Jegatheswaran, Jeffrey Warren, Deborah Zimmerman
Patients treated with peritoneal dialysis (PD) are often required to switch to hemodialysis (HD) temporarily when they develop abdominal wall hernias and dialysate leaks, peritonitis or undergo thoracic or abdominal surgeries. There are significant risks associated with incident hemodialysis including possible central venous catheter infections, thrombosis, and need for invasive procedures. Therefore, strategies to avoid temporary transfer to hemodialysis are desirable. The increased intra-abdominal pressure associated with PD is largely responsible for the issues requiring withholding PD...
January 30, 2018: Seminars in Dialysis
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