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Thoracic incisions

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https://www.readbyqxmd.com/read/28107244/avoidance-of-wrong-level-thoracic-spine-surgery-using-sterile-spinal-needles-a-technical-report
#1
Kingsley R Chin, Jason Seale, Vanessa Cumming
STUDY DESIGN: A technical report. OBJECTIVE: The aim of the present study was to present an improvement on localization techniques employed for use in the thoracic spine using sterile spinal needles docked on the transverse process of each vertebra, which can be performed in both percutaneous and open spinal procedures. SUMMARY OF BACKGROUND DATA: Wrong-level surgery may have momentous clinical and emotional implications for a patient and surgeon...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28096827/lung-exposure-during-simultaneous-myocardial-revascularization-and-lung-surgery-through-median-sternotomy
#2
Dariusz Jagielak, Radoslaw Kozaryn, Rafal Pawlaczyk, Piotr Siondalski, Witold Rzyman, Jan Rogowski
Coronary artery disease is a frequent comorbidity in patients undergoing major thoracic surgery. Simultaneous operations eliminate the necessity of a second operation and, more importantly, minimize the delay in compulsory postoperative oncological therapy. We describe a relaxing incision in the contralateral pericardium, which allows for simple displacement of the heart. This maneuver improves exposure of the pulmonary hilum and middle mediastinum on the side of resection.
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28095343/patient-tailored-management-of-an-asymptomatic-massive-substernal-goiter-presenting-as-brachiocephalic-vein-occlusion-report-of-a-case-and-review-of-sternotomy-indications
#3
Georgios Sahsamanis, Eleftherios Chouliaras, Konstantinos Katis, Stavros Samaras, Stavros Daliakopoulos, Georgios Dimitrakopoulos
INTRODUCTION: Substernal goiters are characterized by the protrusion of at least 50% of the thyroid mass below the level of the thoracic inlet. Still their definition is controversial. CASE PRESENTATION: The case refers to a 44year old male who presented to our department due to swelling and a feeling of 'heaviness' of his left upper extremity for the past 6 months. CT scan revealed a massive substernal goiter extending to the great vessels. Intraoperatively, a median sternotomy was performed due to the size of the gland and the close adhesion of the isthmus and lower left thyroid lobe to the brachiocephalic vein...
January 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28040750/a-minimally-invasive-approach-for-open-surgical-thoracoabdominal-aortic-replacement-experimental-concept-for-a-novel-surgical-procedure
#4
Terézia B Andrási, Violetta Kékesi, Béla Merkely, Marius Grossmann, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVES: We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. METHODS: In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical tools and small skin incisions to develop a minimally invasive approach for TAA replacement. The following procedures were used: endoscopic exposure and closure of the lower intercostal arteries; small posterolateral thoracotomy and left retroperitoneal incisions to expose the anastomotic regions of the aorta; partial anticoagulation; passive bypass and sequential aortic clamping; tunnelling of the graft through the native aortic lumen (endoaneurysmorrhaphy) and open performance of vascular anastomosis...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28007749/intermuscular-technique-for-implantation-of-the-subcutaneous-implantable-cardioverter-defibrillator-long-term-performance-and-complications
#5
Joachim Winter, Markus Siekiera, Dong-In Shin, Christian Meyer, Patric Kröpil, Harald Clahsen, Stephen O'Connor
AIMS: The subcutaneous cardioverter defibrillator was designed to overcome electrode complications of transvenous defibrillation systems. While largely achieved, pocket complications have increased. Subcutaneous implantation of the pulse generator leaves it prone to erosion, extrusion, discomfort, and poor cosmesis. METHODS AND RESULTS: We use a demonstration electrode and pulse generator with fluoroscopy, prior to prepping and draping, to maximize the left ventricular mass between them...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27989967/modified-interscalene-approach-for-resection-of-symptomatic-cervical-rib-anatomical-review-and-clinical-study
#6
Walid Abdel Ghany, Mohamed A Nada, Ahmed F Toubar, Ahmed E Desoky, Hesham Ibrahim, Marwa A Nassef, Mostafa G Mahran
BACKGROUND: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. OBJECTIVES: in this work we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs...
October 27, 2016: World Neurosurgery
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
#7
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/27978898/-risk-factors-for-long-term-result-of-endovascular-treatment-for-auto-immune-disease-related-abdominal-aorta-pseudo-aneurysm
#8
W Ye, X Di, Q Liu, Y J Li, Y H Zheng, R Zeng, X J Song, Z L Liu, C W Liu
Objective: To summarize results of endovascular treatment for auto-immune disease related abdominal aorta pseudo-aneurysm(AIPA), and to analysis clinical predictors of long term major adverse clinical events(MACE). Methods: Retrospectively collected endovascular treatment for AIPA cases in Peking Union Medical College Hospital within 2000 to 2015. Twenty-nine cases with AIPA treated by endovascular therapy were enrolled in this study. Twenty five cases were male, range from 23 to 67 years old, mean age was (39...
December 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27939010/addition-of-video-assisted-thoracoscopic-surgery-to-the-treatment-of-flail-chest
#9
Judith P M Schots, Yvonne L J Vissers, Karel W E Hulsewé, Berend Meesters, Paul A Hustinx, Annette Pijnenburg, Jan Siebenga, Erik R de Loos
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is increasingly used in chest trauma for diagnostic and therapeutic purposes. In this report we describe our single-institutional experience with VATS in the surgical treatment of patients with flail chest after high-energy trauma. METHODS: From January 2013 to July 2014, 15 patients with flail chest after high-energy trauma were treated in our hospital. The Injury Severity Score (ISS) ranged from 16 to 44...
December 7, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27894385/-effect-of-expanded-lateral-thoracic-abdominal-flap-transferred-with-pedicle-on-repairing-large-area-of-hypertrophic-scar-after-burn-of-the-upper-extremity
#10
C D Xia, J D Xue, H P Di, J L Niu, X L Li, D Y Cao, Q Li, X H Niu
Objective: To observe the effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity. Methods: Twelve patients with large area of secondary hypertrophic scar 8 month to 3 years after healing of burn wound on the upper extremity were hospitalized in Zhengzhou First People's Hospital from October 2008 to October 2015, with scar area ranging from 11 cm×7 cm to 20 cm×10 cm. Five patients were with limited straightening and bending of elbow...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27867575/stepwise-approaches-to-optimize-strategy-for-holding-thoracoscope-during-single-port-video-assisted-thoracoscopic-surgery
#11
Chengwu Liu, Senyi Deng, Hu Liao, Lin Ma, Qiang Pu, Jiandong Mei, Lunxu Liu
Coordination between the thoracoscope assistant and the surgeon was difficult during single port video-assisted thoracoscopic surgery (SP-VATS). What's more, holding the thoracoscope was an exhausting work for the assistant and optimized strategies were intensely needed. This paper aims to share our experience in making the thoracoscope assistant feel comfortable by illustrating the stepwise approaches in optimizing the strategies for holding the thoracoscope during our practice of SP-VATS. The evolution of techniques were divided into four stages: stage I, traditional 10-mm 30° thoracoscope placed at the posterior part of the incision; stage II, 5-mm thoracoscope towed and fixed via a silk suture; stage III, 5-mm thoracoscope placed outside of a plastic wound protector; stage IV, 5-mm thoracoscope introduced into the thoracic cavity through a 5-mm laparoscopic trocar outside of a plastic wound protector and the assistant stood at a foot-stool...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867570/small-cervical-incision-facilitates-minimally-invasive-resection-of-non-invasive-thoracic-inlet-tumor
#12
Han-Yu Deng, Zhi-Hui Li, Zhi-Qiang Wang, Yun-Cang Wang, Gang Li, Yi-Dan Lin, Lun-Xu Liu
BACKGROUND: A challenge for resection of thoracic inlet tumors lies in that high risk of injuring vital blood vessels and brachial plexus still exists during the resection. And the standard surgical approach for resection of thoracic inlet tumors has not yet been well established. METHODS: Small cervical incision-assisted minimally invasive surgical technique was developed and carried out in patients with non-invasive thoracic inlet tumor in our department. RESULTS: We successfully performed the small cervical incision-assisted minimally invasive surgery in two patients with thoracic inlet tumors...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867569/does-11-5-mm-guided-single-port-surgery-has-clinical-advantage-than-multi-port-thoracoscopic-surgery-in-spontaneous-pneumothorax
#13
Hyun Woo Jeon, Young-Du Kim
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been widely used for spontaneous pneumothorax (SP). In recent years, thoracic surgeons have attempted single incision or single port surgery with the development of surgical technology and skills. Theoretically, single port surgery is expected to provide benefits such as less pain and early recovery. The purpose of this study was to determine the benefits of single port surgery in SP. METHODS: The 107 patients with SP who underwent surgery, between July 2013 and May 2015, were reviewed retrospectively...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27847075/combined-nuss-procedure-and-cardiac-procedure-through-a-left-anterolateral-thoracotomy
#14
François Roubertie, Sowmya Ramanan, Frederic Lavrand, Jean-Benoit Thambo
Aortic root aneurysms associated with severe pectus excavatum caused by Marfan's syndrome can be challenging to correct in children. Recent reports suggest single-stage correction of both cardiac and chest wall deformities through a median sternotomy. We report a 9-year-old girl with Marfan's syndrome, an ascending aorta aneurysm, mitral regurgitation, and pectus excavatum, who underwent David's procedure with mitral valve repair and the Nuss procedure to correct the thoracic deformity. This single-stage combined procedure was performed through a left anterolateral thoracotomy...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27829432/comparison-of-acute-phase-reaction-and-postoperative-stress-in-pigs-undergoing-video-assisted-thoracoscopic-versus-thoracotomy-pneumonectomy
#15
COMPARATIVE STUDY
Hai-Feng Liu, Li Gao, Tao Liu, Yan-Jiang, Hong-Bin Wang
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been used for many thoracic diseases as an alternate approach to thoracotomy. The aim of this study was to compare the surgical outcome of pneumonectomy using VATS with that using thoracotomy pneumonectomy in pigs. Fourteen pigs were equally divided into two groups; one group underwent VATS and the other group underwent transthoracic pneumonectomy. We monitored pre-, intra-, and post-operative physiologic parameters, along with blood cell count, serum C-reactive protein (CRP), serum amyloid A (SAA), interleukin-6 (IL-6) and cortisol...
November 9, 2016: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/27823841/minimally-invasive-repair-of-pectus-excavatum-in-children-results-of-a-modified-nuss-procedure
#16
A Durry, C Gomes Ferreira, T Tricard, P Gicquel, F Becmeur
INTRODUCTION: Pectus excavatum (PE) is the most common deformity of the anterior thoracic wall. The Nuss technique allows the thorax to be reshaped with the aid of a retrosternal metallic bar. The aim of this study is to evaluate and compare the complication rate between the original Nuss technique and a lightly modified approach. MATERIAL AND METHOD: We performed a retrospective single-center observational study based on the medical files of patients operated for PE in the Pediatric Surgery Unit between July 2004 and July 2015...
November 4, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27817951/transform-multicenter-experience-with-rapid-deployment-edwards-intuity-valve-system-for-aortic-valve-replacement-us-clinical-trial-performance-of-a-rapid-deployment-aortic-valve
#17
Glenn R Barnhart, Kevin D Accola, Eugene A Grossi, Y Joseph Woo, Mubashir A Mumtaz, Joseph F Sabik, Frank N Slachman, Himanshu J Patel, Michael A Borger, H Edward Garrett, Evelio Rodriguez, Patrick M McCarthy, William H Ryan, Francis G Duhay, Michael J Mack, W Randolph Chitwood
BACKGROUND: The TRANSFORM (Multicenter Experience With Rapid Deployment Edwards INTUITY Valve System for Aortic Valve Replacement) trial (NCT01700439) evaluated the performance of the INTUITY rapid deployment aortic valve replacement (RDAVR) system in patients with severe aortic stenosis. METHODS: TRANSFORM was a prospective, nonrandomized, multicenter (n = 29), single-arm trial. INTUITY is comprised of a cloth-covered balloon-expandable frame attached to a Carpentier-Edwards PERIMOUNT Magna Ease aortic valve...
October 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27810460/bystander-cricothyroidotomy-with-household-devices-a-fresh-cadaveric-feasibility-study
#18
Christian Braun, Ulrich Kisser, Astrid Huber, Klaus Stelter
INTRODUCTION: In various motion pictures, medical TV shows and internet chatrooms, non-medical devices were presented as tools for life-saving cricothyroidotomies. However, there is uncertainty about whether it is possible for a bystander to perform a cricothyroidotomy and maintain gas exchange using improvised household items. This study examines the ability of bystanders to carry out an emergency cricothyroidotomy in fresh human cadavers using only a pocket knife and a ballpoint pen...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27763880/a-retrospective-study-to-evaluate-use-of-negative-pressure-wound-therapy-in-patients-undergoing-bilateral-internal-thoracic-artery-grafting
#19
Giuseppe Santarpino, Lazlo Gazdag, Joachim Sirch, Ferdinand Vogt, Miroslaw Ledwon, Theodor Fischlein, Steffen Pfeiffer
Bilateral internal thoracic artery (BITA) grafting may be associated with a higher risk of postoperative deep sternal wound infection than monolateral internal thoracic artery grafting due to a limited blood supply to the thoracic chest wall. Because preliminary studies suggest negative pressure wound therapy (NPWT) may reduce the risk of infection, a retrospective chart review of 129 patients who underwent BITA between February 2003 and October 2014 was conducted. Of those, 21 patients received NPWT for 5 days immediately following surgery and the incisions of 108 patients were covered with a conventional gauze dressing...
December 2015: Ostomy/wound Management
https://www.readbyqxmd.com/read/27747175/nuss-bar-procedure-past-present-and-future
#20
REVIEW
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
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