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Thoracic incisions

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
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
Hanlu Zhang, Yingcai Geng, Yu Zheng, Yun Wang
A 68-year-old female was admitted to our hospital with an acute episode of chest pain, progressive cough and fever. She underwent trans-subxiphoid video-assisted thoracoscopic extended thymectomy (TsVATET) for thymoma with myasthenia gravis (MG) 9 days ago. Chest computed tomography (CT) showed anterior mediastinal oedema, and infiltrative findings involved bilateral lung. Physical examination revealed the subxiphoid wound suppuration. We diagnosed subxiphoid incision infection, anterior mediastinitis and concomitant bilateral pneumonia...
September 2016: Journal of Thoracic Disease
Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
Yu Kigasawa, Hiroya Takeuchi, Hirofumi Kawakubo, Kazumasa Fukuda, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Yuko Kitagawa
Situs inversus totalis (SIT) is a rare congenital condition in which abdominal and thoracic organs are transposed from normal positions. Laparoscopy-assisted distal gastrectomy for situs inversus totalis is technically difficult and has rarely been reported. Here, we report the case of man in his 40s with situs inversus totalis and a preoperative diagnosis of stage IA gastric cancer (cT1b, cN0, cM0). We successfully performed laparoscopy-assisted distal gastrectomy with D1+ lymph node dissection and Billroth I reconstruction...
October 13, 2016: Asian Journal of Endoscopic Surgery
Tao Wang, Yang Liu
OBJECTIVE: To retrospectively analyze the results of surgical resection in patients with pulmonary hamartoma (PH) in the Peoples Liberation Army (PLA) General Hospital during the past 30 years. MATERIALS AND METHODS: We retrospectively enrolled 226 patients with PH who underwent surgical resection in the PLA General Hospital between January 1980 and January 2010, including tumors of pulmonary parenchyma (n = 216) and endobronchial tumors (n = 10). The type of operation include tumor enucleation (n = 103), wedge resection (n = 103), and lobectomy (n = 20)...
October 2016: Journal of Cancer Research and Therapeutics
Marcello Migliore, Semih Halezeroglu, Laureano Molins, Dirk Van Raemndonck, Michael R Muller, Federico Rea, Subroto Paul
No abstract text is available yet for this article.
October 7, 2016: Future Oncology
Michael Vaiman, Inessa Bekerman
The anatomical approach to the intrathoracic goiter (ITG) was used to understand its etiology and to rationalize surgical technique of thyroidectomy. For a retrospective chart review, we selected cases of multinodular goiter with totally ITGs (n = 69; M 29, F 40), while 916 cases with cervical goiter were used for comparison. The topography of the thyroid gland was assessed against the tracheal rings and against the vertebrae. The regional anatomy of the thoracic inlet was assessed by its bony margins and the relations of structures traversing the area...
September 29, 2016: European Archives of Oto-rhino-laryngology
Matan Or, Adriaan Kitshoff, Nausikaa Devriendt, Marianne De Ridder, Galena Quist-Rybachuk, Hilde de Rooster
OBJECTIVE: To describe the surgical technique and document the application of a transdiaphragmatic approach to attenuate porto-azygos shunts inserting in the thoracic section of the azygos vein. STUDY DESIGN: Cadaveric study and prospective case series. ANIMALS: Canine cadavers (n=6) and client-owned dogs with porto-azygos shunts inserting in the thoracic section of the azygos vein (n=9). METHODS: In the cadavers, the azygos vein was filled with aqueous latex...
September 29, 2016: Veterinary Surgery: VS
Kook Nam Han, Hyun Koo Kim, Young Ho Choi
Over the past decade, the surgical approach to treating thoracic disease has shifted to minimally invasive surgery. Without compromising the outcomes, this approach may lead to fewer resections and fewer incisions for those resections. Video-assisted thoracoscopic surgery (VATS) is a recent but major advancement that has become an established approach for major thoracic surgery. More recently, robotic surgery has been gaining recognition because it can overcome the limitations of VATS and encourage a minimally invasive approach...
August 2016: Journal of Thoracic Disease
Ze-Rui Zhao, Zheng Li, Dong-Rong Situ, Calvin S H Ng
The concept of personalized medicine, which aims to provide patients with targeted therapies while greatly reducing surgical trauma, is gaining popularity among Asian clinicians. Single port video-assisted thoracic surgery (VATS) has rapidly gained popularity in Hong Kong for major lung resections, despite bringing new challenges such as interference between surgical instruments and insertion of the optical source through a single incision. Novel types of endocutters and thoracoscopes can help reduce the difficulties commonly encountered during single-port VATS...
August 2016: Journal of Thoracic Disease
Kunal M Patel, Chase C Parsons
INTRODUCTION: A mediastinal thyroid mass discovered years after a total thyroidectomy represents an unusual and uncommon clinical situation. Few cases have been reported and controversy exists regarding the etiology of this ectopic thyroid tissue as well as the optimal surgical approach for resection. We herein describe a case of a mediastinal thyroid goiter discovered five years after a total thyroidectomy. PRESENTATION OF CASE: A 54-year-old Hispanic female was diagnosed with a diffuse cervical goiter secondary to Hashimoto's Thyroiditis and subsequently underwent a total thyroidectomy...
2016: International Journal of Surgery Case Reports
Tom Treasure
Videothoracic surgery for lung cancer is now an established practice but there is a division of opinion between surgeons whose aim is to spare all patients a thoracotomy and those who have not adopted videoscopic methods for routine lobectomy. The latter remain in the majority; most patients at present have a thoracotomy. Surgeons from Europe and America met in Catania, Sicily at the 3(rd) Mediterranean Symposium on Thoracic Surgical Oncology to explore the evidence and the routes to making videothoracoscopic surgery a standard of care...
August 2016: Journal of Thoracic Disease
Mingxiang Feng, Miao Lin, Yaxin Shen, Hao Wang
A 62-year-old female was admitted to our hospital after computed tomography (CT) revealed a 2.5 cm × 2.1 cm mass in the left upper lobe. PET/CT scan diagnosed as malignant lesion with no signs of metastasis. Under general anesthesia, the patient was placed in right lateral decubitus position. A 4cm incision was made in the 4th intercostal space with plastic protector. The camera was placed in the upper part of the incision and the instruments were inserted below the camera. Left upper lobectomy along with systematic lymphadenectomy was performed...
August 2016: Journal of Thoracic Disease
Qianli Ma, Deruo Liu
BACKGROUND: The aim of this study is to discuss video-assisted thoracic surgery (VATS) sleeve bronchial lobectomy when handling the locally advanced central lung cancer (involving the trachea and/or main bronchus). METHODS: A 2.5 cm × 1.0 cm mass was found in the right upper lobe. Bronchoscopy demonstrated the tumor obstructing the right upper lobe bronchus and involved the right main bronchus and bronchus intermedius. Interrupted sutures were chosen for bronchial anastomosis...
August 2016: Journal of Thoracic Disease
Jun-Qiang Fan, Jie Yao, Zhi-Bo Chang, Qi Wang
Uniportal video-assisted thoracic surgery (VATS) anatomical pulmonary resection, with only one small incision for surgery instruments and camera insertion, requires higher operative skills, especially in the cases of the enlarged pulmonary hilar lymph nodes. With improved technology and increased experiences in VATS lobectomy, uniportal VATS lobectomy has been applied in major medical centers recently. A 67-year-old male patient with left upper peripheral lung cancer and enlarged hilar lymph nodes underwent unipotal VATS lobectomy and systemic mediastinal lymph node dissection...
August 2016: Journal of Thoracic Disease
Zongwu Lin, Junjie Xi, Songtao Xu, Qun Wang
A 63-year-old male was referred to our hospital with two existing lesions in bilateral lungs. Computed tomography (CT) showed a 15-mm ground-glass opacity (GGO) in the superior segment of left lower lung (S6) and a 5-mm GGO in the center of the right upper lobe. The preoperative clinical diagnosis was stage I primary lung cancer for the left lesion while the right lesion needed follow-up. Uniportal video-assisted thoracic surgery (VATS) left superior segmentectomy in the semiprone position was performed in this case and the right upper lobe was kept untouched...
August 2016: Journal of Thoracic Disease
Kenji Tsuboshima, Machiko Nagata, Teppei Wakahara, Yasumi Matoba, Yoshimasa Maniwa
We reported the feasibility of single-incision thoracoscopic surgery bullectomy using a chest wall pulley for lung excision (PulLE) in patients with primary spontaneous pneumothorax (PSP). PulLE has many merits including comfort of manipulation, cosmetic advantages, etc., compared to other procedures. However, our method was utilized for relatively straightforward cases. The PulLE was contraindicated for PSPs with multiple or comprehensive bullae. Therefore, we developed the modified PulLE (mPulLE) to treat such cases in February 2015...
September 6, 2016: Annals of Thoracic and Cardiovascular Surgery
Nkem Aziken, Maria Evasovich, Rafael S Andrade, Eitan Podgaetz
Mediastinal parathyroid adenomas are rare. Surgical resection is recommended. Traditionally median sternotomy has been the preferred approach; newer less invasive techniques have been described. The aim is to describe an innovative technique for thymectomy via a laparoscopic transdiaphragmatic approach avoiding any thoracic incisions and potentially chronic postoperative intercostal pain in a patient with a well localized mediastinal parathyroid adenoma. No intraoperative complications, parathyroid hormone essay normalized and the patient was discharged home on the second day...
September 1, 2016: European Journal of Cardio-thoracic Surgery
Paweł Nachulewicz, Anna Golonka, Tomasz Żądkowski, Paweł Osemlak, Joanna Nużyńska-Flak, Agnieszka Brodzisz, Elżbieta Pac-Kożuchowska
BACKGROUND: We report a 16-year-old patient with a massive left-sided chylothorax after chemotherapy due to mixed germinal tumor of the testis with massive metastases located in the retroperitoneal space and posterior mediastinum. Chemotherapy resolved the metastases in the mediastinum but evoked a huge pleural effusion in the left pleural cavity, requiring surgical intervention.Left-sided access was used. The 5-mm camera and 3 5-mm working ports were inserted. The parietal pleura was incised and the esophagus located and protected...
August 2016: Medicine (Baltimore)
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