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Thoracic incisions

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https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#1
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28523167/a-novel-facilitated-negative-pressure-wound-therapy-for-thoracic-incision-infection-after-esophagectomy
#2
Zhi-Tian Wang, Jin-Lin Cao, Ping Yuan, Lu-Ming Wang, Zhe-Hao He, Wang Lv, Jian Hu
BACKGROUND: Negative-pressure wound therapy (NPWT) is the therapeutic management of traumatic soft-tissue wounds and infections. The efficacy of NPWT in the treatment of thoracic incision infection is unclear. We assess the effectiveness and safety of a novel facilitated NPWT for thoracic incision infection after esophagectomy. METHODS: Between Jan. 2013 and Mar. 2016, 380 patients underwent open esophagectomy in our department. Forty-five patients with thoracic incision infection were retrospectively reviewed...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523133/uniportal-video-assisted-thoracic-surgery-for-major-lung-resections-pitfalls-tips-and-tricks
#3
Mahmoud Ismail, Marc Swierzy, Dania Nachira, Jens C Rückert, Diego Gonzalez-Rivas
Nearly six years since inception, uniportal video-assisted thoracic surgery (VATS) has become a growing part of major lung resections and has revolutionized the way thoracic surgeons treat pulmonary lesions. This technique is being touted for various benefits. It ensures direct visualization together with a better exposure of the lung and allows the chance of a digital palpation of the lesion through a small incision. Postoperative pain is reduced due to the involvement of only one intercostal space without rib spreading and muscle disruption...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28520889/subxiphoid-approach-for-extracting-a-giant-solitary-fibrous-tumour-of-the-pleura
#4
Shunzo Hatooka, Yoshiki Shigematsu, Masanori Nakanishi, Kenichi Yamaki
We describe a case of resection of a solitary fibrous tumour of the pleura using video-assisted thoracic surgery and removal of the giant tumour using a subxiphoid incision without the need for minithoracotomy. Use of the subxiphoid approach as a retrieval port is simple and feasible.
May 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#5
Remigiusz Antończyk, Ewa Trejnowska, Jerzy Pacholewicz, Tomasz Wolny, Paweł Nadziakiewicz, Karolina Antończyk, Izabela Copik, Magdalena Piontek, Małgorzata Jasińska, Krzysztof Filipiak, Maciej Głowacki, Maciej Gawlikowski, Marcin Borowicz, Roman Kustosz, Jacek Waszak, Piotr Przybyłowski, Marian Zembala, Michał Zakliczyński, Michał Oskar Zembala
Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28504587/a-single-intercostal-space-thoracoscopic-approach-for-minimally-invasive-ivor-lewis-esophagectomy
#6
Saibo Pan, Lian Wang, Ming Wu, Qi Wang, Gang Shen, Gang Chen
OBJECTIVE: We present a laparoscopic and single intercostal space thoracoscopic approach (SICS group) for Ivor Lewis minimally invasive esophagectomy (MIE) and provide postoperative analgesia with a continuous multiple intercostal nerve blocking technique. The characters of this technique are evaluated. MATERIALS AND METHODS: From October 2015 to April 2016, 18 consecutive patients with esophageal cancer were treated with Ivor Lewis MIE by a SICS group. Moreover, from July 2014 to September 2015, 48 patients with esophageal cancer received Ivor Lewis MIE by four-port video-assisted thoracic surgery (VATS) approach...
May 15, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28503239/a-case-of-renal-cell-carcinoma-in-a-patient-with-situs-inversus-operative-considerations-and-a-review-of-the-literature
#7
Justin Oake, Darrel Drachenberg
Situs inversus, an uncommon mirror-image reversal of the major visceral and thoracic organs, is seldom of medical significance. However, the recognition of their unique anatomy is extremely important for those requiring surgical intervention. There are very few reported cases of renal cell carcinoma (RCC) developing in people with situs inversus. To our knowledge, this is the first reported case in Canada. A review of the literature only identified nine published cases worldwide. Here, we review and summarize pertinent information, including patient age and sex, size and location of tumour, method of surgery, and pathology...
May 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28455601/paravertebral-block-catheter-breakage-by-electrocautery-during-thoracic-surgery
#8
Noboru Saeki, Yuki Sugimoto, Yoko Mori, Takahiro Kato, Hirotsugu Miyoshi, Ryuji Nakamura, Tomomichi Koga
Advantages of thoracic paravertebral analgesia (TPA) include placement of the catheter closer to the surgical field; however, the catheter can become damaged during the operation. We experienced a case of intraoperative TPA catheter breakage that prompted us to perform an experiment to investigate possible causes. A 50-year-old male underwent a thoracoscopic lower lobectomy under general anesthesia with TPA via an intercostal approach. Following surgery, it was discovered that the catheter had become occluded, as well as cut and fused, so we reopened the incision and removed the residual catheter...
April 28, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28449495/laser-resection-of-pulmonary-nodule-via-uniportal-thoracoscopic-surgery
#9
Calvin S H Ng, Freddie Capili, Ze-Rui Zhao, Peter S Y Yu, Jacky Y K Ho, Rainbow W H Lau
Uniportal video-assisted thoracic surgery (VATS) lung wedge resection usually requires three devices, thoracoscope, lung retracting instrument and an endo-stapler cutter to perform the procedure. With advances in miniaturization of the thoracoscope and lung retracting instruments, a major limitation to operating through a smaller uniportal incision has become the endo-stapler. We describe the surgical technique for uniportal VATS laser lung resection which uses a much narrower laser catheter device to replace the endo-stapler for resection...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28443175/the-versatile-approach-a-novel-single-incision-combined-with-anterior-and-posterior-approaches-for-decompression-and-instrumented-fusion-to-treat-tuberculosis-of-the-thoracic-spine
#10
Sudhir Kumar Srivastava, Rishi Anil Aggarwal, Sunil Krishna Bhosale, Kunal Roy, Pradip Sharad Nemade
STUDY DESIGN: Retrospective case series. PURPOSE: To describe a novel single incision that combines anterior and posterior approaches for decompression and instrumented fusion to treat tuberculosis of the thoracic spine and study the neurological and radiological outcomes. OVERVIEW OF LITERATURE: Tuberculosis of the spine remains a major health issue in many developing countries. The options for treating tuberculosis of the thoracic spine include the anterior, posterior, and combined approaches, each with its advantages and disadvantages...
April 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28441687/c-arm-positioning-is-a-significant-source-of-radiation-in-spine-surgery
#11
Elizabeth W Reiser, Rupen Desai, Sarah A Byrd, Harrison Farber, Deborah Chi, Cary S Idler, Robert E Isaacs
STUDY DESIGN: Prospective chart review. OBJECTIVE: It is well-known that radiation exposure during minimally invasive spine procedures can be substantial. Less interest has focused on setup radiation exposure before incision, including preoperative images used for surgical approach. The present study seeks to better quantify the significance of setup radiation in the total radiation exposure of minimally invasive spine surgery. SUMMARY OF BACKGROUND DATA: Radiographic localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28431730/a-new-device-of-needlescopic-thoracic-sympathectomy-through-a-skin-incision
#12
Hidehiro Yamamoto, Masayoshi Okada
We describe a new technique of performing sympathectomy with a new device. A single skin incision 3 mm long was made in the armpit. The device enables complete resection of the sympathetic segment through a single skin incision, whereas sympathectomy is limited by the use of the conventional needle technique. Even if sympathetic nerves and blood vessels were overlapping, separation of the two organs was performed safely. This device increases the possibility of planning surgical procedures for patients with difficult anatomies...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28395387/novel-techniques-and-approaches-to-minimally-invasive-thoracic-surgery
#13
Osita Onugha, Rasheed Ivey, Robert McKenna
Approximately two decades ago, thoracic surgery witnessed the leap from thoracotomy to the first video-assisted thoracic surgery (VATS) lobectomy. Minimally invasive lobectomy and hilar lymphadenectomy is now widely established as a safe and oncological sound technique that is the standard of care for early-stage lung cancer. The move toward less invasive surgery has no doubt driven the innovation of sophisticated instruments and technology to cope with the demanding need of working through a restricted incision...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28384375/risk-factors-for-anastomotic-leakage-following-esophagectomy-impact-of-thoracic-epidural-analgesia
#14
Wen Wang, Gefei Zhao, Linxin Wu, Yanpeng Dong, Chaobin Zhang, Li Sun
BACKGROUND AND OBJECTIVES: Anastomotic leakage (AL) is one of common complications after esophageal cancer surgery. Thoracic epidural analgesia (TEA) is often recommended in patients undergoing esophagectomy. However, the impact of TEA on AL is still controversial. Thus, we conducted this study to evaluate the effect of TEA on the occurrence of AL and identify risk factors for the development of AL following esophagectomy. METHODS: Our retrospective study identified patients who underwent elective esophagectomy between July 2013 and July 2016...
April 6, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28362400/minimally-invasive-transverse-aortic-constriction-in-mice
#15
Aung Moe Zaw, Connor M Williams, Helen K W Law, Billy Kwok Chong Chow
Minimally invasive transverse aortic constriction (MTAC) is a more desirable method for the constriction of the transverse aorta in mice than standard open-chest transverse aortic constriction (TAC). Although transverse aortic constriction is a highly functional method for the induction of high pressure in the left ventricle, it is a more difficult and lengthy procedure due to its use of artificial ventilation with tracheal intubation. TAC is oftentimes also less survivable, as the newer method, MTAC, neither requires the cutting of the ribs and intercostal muscles nor tracheal intubation with a ventilation setup...
March 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28349384/extended-surgery-for-t4-lung-cancer-a-30-years-experience
#16
P G Dartevelle, D Mitilian, E Fadel
T4 non-small cell lung carcinomas (NSCLC) were deemed unresectable. Advances in surgery have challenged this dogma. We describe technical aspects and result on superior vena cava (SVC), carinal, thoracic inlet tumor surgeries, and resection under cardiopulmonary bypass (CPB). SVC reconstruction requires hemodynamic control to reverse SVC clamping cerebral effects and excellent cephalic venous bed patency. Among 50 SVC resections, including 25 carinal pneumonectomies, post-operative mortality rate was 8%. In the N0-N1 group, 5- and 10-year survival rates were 46...
March 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28329330/three-port-one-incision-plus-two-port-endoscopic-mitral-valve-surgery-without-robotic-assistance
#17
Toshiaki Ito, Atsuo Maekawa, Satoshi Hoshino, Yasunari Hayashi, Sadanari Sawaki, Junji Yanagisawa, Masayoshi Tokoro
OBJECTIVES: Totally endoscopic minimally invasive mitral valve surgery (MIMVS) is technically demanding and often performed with robotic assistance. We hypothesized that three-port video-assisted thoracic surgery (VATS) would facilitate endoscopic MIMVS and evaluated its feasibility and safety. METHODS: From October 2010 to June 2016, we performed first-time MIMVS in 250 consecutive patients (122 male), with median age of 65 years (54-73 years, 25-75 percentile)...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28316217/-comparison-of-the-effect-of-lymph-node-dissection-performed-by-ivor-lewis-or-left-sided-thoracic-esophagogastrectomy-for-siewert-type-%C3%A2-adenocarcinoma-of-the-esophagogastric-junction
#18
X F Duan, L Gong, M Q Ma, J Yue, P Tang, X B Shang, H J Jiang, Z T Yu
Objective: To compare the extent of lymphadenectomy and postoperative complications between Ivor-Lewis procedure and left sided thoracotomy in patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG). Methods: The clinical data of 101 patients with Siewert type Ⅱ EG who received surgical treatment between January 2014 and September 2015 in the Department of Esophageal Cancer, Tianjin Medical University Cancer Hospital were analyzed retrospectively. These patients were divided into Ivor-Lewis group (IL, n=38) and left- sided thoracotomy group (LT, n=63) according to the operation mode...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28297830/-ct-typing-and-surgical-approach-for-adenocarcinoma-of-the-esophagogastric-junction
#19
Y Z Zhao, G S Han, P F Ma, J Li, C Y Liu, M K Huo
Objective: To investigate the feasibility, safety and efficacy of preoperative CT in the classification of adenocarcinoma of the esophagogastric junction. Methods: A total of 517 consecutive patients from May 2012 to June 2016 with esophagogastric junction carcinoma in the department of general surgery of Henan Cancer Hospital was retrospectively analyzed, according to the clinical pathological data of three type four layer method and statistics of various types of surgery in patients with preoperative enhanced CT...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28282236/comparison-of-morphine-morphine-lidocaine-and-morphine-lidocaine-ketamine-infusions-in-dogs-using-an-incision-induced-pain-model
#20
Ludovica Chiavaccini, Andrew K Claude, Robert E Meyer
We aimed to compare antinociceptive effects of IV infusions of morphine (M), morphine-lidocaine (ML), or morphine-lidocaine-ketamine (MLK) combined, in a mild-to-moderate pain model in dogs. Eighteen adult hounds were heavily sedated with IV morphine (0.2 mg/kg) and dexmedetomidine to undergo thoracic skin incisions. After reversal, dogs were randomly assigned to receive loading doses of lidocaine and ketamine (MLK), lidocaine and saline (ML), or equivalent volume of saline (M), followed by 18 hr constant infusions of morphine (0...
March 2017: Journal of the American Animal Hospital Association
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