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Techniques of lung lobectomy

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https://www.readbyqxmd.com/read/28267978/identification-of-essential-components-of-thoracoscopic-lobectomy-and-targets-for%C3%A2-simulation
#1
Mark K Ferguson, Cathy Bennett
BACKGROUND: Fewer than 50% of lobectomies for lung cancer are performed using thoracoscopic (video-assisted thoracic surgery [VATS]) techniques. This situation could be mitigated through the use of simulation training. Using a Delphi process, this study identified essential components of VATS right upper lobectomy most amenable to focused simulation. METHODS: Experienced VATS surgeons were randomly selected for participation. A custom Internet interface permitted anonymous voting, commenting, and the ability to modify and propose new components...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28262299/high-risk-for-thoracotomy-but-not-thoracoscopic-lobectomy
#2
Laura L Donahoe, Moira de Valence, Eshetu G Atenafu, Waël C Hanna, Thomas K Waddell, Andrew F Pierre, Kazuhiro Yasufuku, Marc de Perrot, Marcelo Cypel, Shaf Keshavjee, Gail E Darling
BACKGROUND: Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28259381/fast-track-pediatric-thoracic-surgery-toward-day-case-surgery
#3
Pauline Clermidi, Myriam Bellon, Alia Skhiri, Olivier Jaby, Christine Vitoux, Michel Peuchmaur, Arnaud Bonnard
PURPOSE: Thoracoscopic lung resection for congenital pulmonary airway malformation (CPAM) is a safe technique for children. Our purpose was to evaluate the feasibility of a fast-track protocol in such cases. METHODS: From September 2007 to May 2016, 101 patients underwent a thoracoscopic pulmonary resection of which 83 for CPAM (lobectomy, wedge resection or sequestrectomy). We retrospectively reviewed the characteristics of surgical procedure, postoperative management and complications through three time periods (September 2007-December 2009: n=14, January 2010-March 2013: n=30, April 2013-May 2016: n=39) corresponding to management protocols modifications introducing fast-track pathways...
February 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28174401/-thoracoscopic-temporary-segmental-bronchus-incision-technique-for-fissureless-lobectomy
#4
Yoshio Tsunezuka, Hideki Fujimori, Nobuyoshi Tanaka, Nobuhiro Tanaka
Several thoracoscopic fissureless lobectomy techniques have been reported;however, the indications for the same remain controversial. One of the reasons for conversion to open lobectomy is the swelling or inflammation of lymph nodes between the lobar bronchus and the adjacent pulmonary artery. In this report, we advocate temporary segmental bronchus incision technique(T-BIT)and describe its application for lung cancer patients with fused fissures. T-BIT involves initial segmental bronchus incision before lobar bronchus stapling to safely dissect the lymph nodes between the lobar bronchus and the pulmonary artery...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28152492/bronchial-mucoepidermoid-carcinoma-a-case-report
#5
Alessandro G Fois, Gabriella Diana, Antonella Arcadu, Viviana Marras, Paola Crivelli, Carlo Putzu, Giorgio C Ginesu, Sara Canu, Pietro Pirina
INTRODUCTION: Bronchial localization of Mucoepidermoid carcinoma (MEC) is rare. The precise nature of these neoplasms is not yet clear and little is known on the histogenesis and pathogenesis of the disease. Here we present a case of a bronchial MEC with a detailed pathological, immunohistochemical, and molecular analysis. PRESENTATION OF A CASE: A 46 years old Caucasian male patient was referred to our Unit for fever, non productive cough and dyspnea lasting for two months...
January 19, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28124480/fissure-last-video-assisted-thoracoscopic-lobectomy-for-non-upper-lobes
#6
Davor Stamenovic, Korkut Bostanci, Antje Messerschmidt, Jahn Tillmann, Marko Kostic, Thomas Schneider
BACKGROUND: Surgical approach into the fissural parenchyma may be an important and modifiable factor for the prevention of air leak after anatomical lung resections. Fissureless fissure-last technique has been described as useful technique to reduce air leak, yet in video-assisted thoracoscopic surgery (VATS) data are limited and mostly on the upper lobes. The purpose of this study is to evaluate the safety and feasibility of fissureless fissure-last VATS 'non-upper' lobectomies and the impact of it on the immediate outcome, especially relating to air leak...
January 26, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#7
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28088426/propensity-matched-comparison-of-video-assisted-thoracoscopic-with-thoracotomy-lobectomy-for-locally-advanced-non-small-cell-lung-cancer
#8
Kezhong Chen, Xun Wang, Fan Yang, Jianfeng Li, Guanchao Jiang, Jun Liu, Jun Wang
OBJECTIVE: We evaluated whether video-assisted thoracoscopic lobectomy for locally advanced non-small cell lung cancer could be performed safely and with acceptable long-term outcomes by our improved technique and compared with standard thoracotomy lobectomy in a well-balanced population. METHODS: Patients with clinical stage II and III A non-small cell lung cancers who received lobectomy were reviewed. Video-assisted thoracoscopic lobectomies were all performed with Wang's technique by the surgeons who had overcome the learning curve and achieved proficiency...
December 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28073573/surgery-for-predominant-lesion-in-nonlocalized-bronchiectasis
#9
Jie Dai, Xinsheng Zhu, Dongliang Bian, Ke Fei, Gening Jiang, Peng Zhang
OBJECTIVE: Patients with nonlocalized bronchiectasis are encountered commonly; however, there is little information regarding surgical intervention in this patient population. The aim of this study was to evaluate symptomatic response and safety of anatomic resection of the predominant lesion via the use of lobectomy for the management of nonlocalized bronchiectasis. METHODS: We reviewed the medical records of 37 consecutive patients who underwent lobectomy via thoracotomy for nonlocalized bronchiectasis between 2010 and 2013...
December 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28066606/lobectomy-and-limited-resection-in-small-sized-peripheral-non-small-cell-lung-cancer
#10
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/28066589/thoracoscopic-anterior-fissure-first-technique-for-left-lung-cancer-with-an-incomplete-fissure
#11
Joji Samejima, Mingyon Mun, Yosuke Matsuura, Masayuki Nakao, Hirofumi Uehara, Ken Nakagawa, Munetaka Masuda, Sakae Okumura
BACKGROUND: Dealing with incomplete lung fissures during thoracoscopic surgery is difficult. Our objective was to evaluate the efficacy and safety of a thoracoscopic anterior 'fissure first' technique for dealing with incomplete left lung fissures. METHODS: One hundred and seventy patients underwent left upper lobectomy or left lower lobectomy between April 2008 and July 2014. Of these, 34 patients underwent surgery using a thoracoscopic anterior 'fissure first' technique for incomplete fissures (group A) and 136 underwent surgery using a conventional thoracoscopic method for unfused fissures (group B)...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28049376/management-of-pleural-space-after-lung-resection-by-cryoneuroablation-of-phrenic-nerve
#12
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/28049169/management-of-stage-i-and-ii-nonsmall-cell-lung-cancer
#13
Fiona McDonald, Michèle De Waele, Lizza E L Hendriks, Corinne Faivre-Finn, Anne-Marie C Dingemans, Paul E Van Schil
The incidence of stage I and II nonsmall cell lung cancer is likely to increase with the ageing population and introduction of screening for high-risk individuals. Optimal management requires multidisciplinary collaboration. Local treatments include surgery and radiotherapy and these are currently combined with (neo)adjuvant chemotherapy in specific cases to improve long-term outcome. Targeted therapies and immunotherapy may also become important therapeutic modalities in this patient group. For resectable disease in patients with low cardiopulmonary risk, complete surgical resection with lobectomy remains the gold standard...
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28043474/is-close-surveillance-indicated-for-indolent-cancers-the-carcinoid-story
#14
Sudish C Murthy, Christopher Bariana, Siva Raja, Usman Ahmad, Daniel P Raymond, Thomas W Rice, Robert Wang, Ponnuthurai Ainkaran, Penny L Houghtaling, Eugene H Blackstone
The objective of this article is to determine the relevance of close postresection surveillance for bronchopulmonary carcinoid. From 2006 to 2013, 57 patients underwent lung resection for bronchopulmonary carcinoid. They were assessed for effects of clinical presentation, subtype, stage, and tobacco use on survival and recurrence. Utility of bronchoscopy and radiographic surveillance was reviewed. Mean follow-up was 2.1 ± 1.7 years. Carcinoid patients presented at a young age (51 ± 15 years) with normal spirometry regardless of smoking status (forced 1-second expiratory volume, 88% ± 19% for never smokers vs 87% ± 16% for smokers)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28005439/early-lung-cancer-detection-by-low-dose-ct-screening-therapeutic-implications
#15
Marjolein A Heuvelmans, Harry J M Groen, Matthijs Oudkerk
Lung cancer screening by low-dose chest computed tomography is currently implemented in the U.S. After implementation of screening, a stage shift may be observed from around 15% stage I non-small cell lung cancers (NSCLCs) in routine clinical practice to up to 70% in screening patients. This indicates a move in treatment options from advanced to early lung cancers, especially in those with small suspected intrapulmonary nodules. Areas covered: We have reviewed the current status of lung cancer screening from the different randomized controlled lung cancer screening studies and the clinical evidence so far for both surgical and non-surgical treatment options for (screen-detected) stage I NSCLC...
December 30, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28000203/comparison-of-continuous-epidural-block-and-continuous-paravertebral-block-in-postoperative-analgaesia-after-video-assisted-thoracoscopic-surgery-lobectomy-a-randomised-non-inferiority-trial
#16
RANDOMIZED CONTROLLED TRIAL
Sylweriusz Kosiński, Edward Fryźlewicz, Michał Wiłkojć, Adam Ćmiel, Marcin Zieliński
BACKGROUND: Video-assisted (VATS) lung lobectomy can be associated with stronger postoperative pain than is commonly believed. It is generally accepted to introduce multimodal analgaesic strategies based on regional blockade, opioids and non-steroidal anti-inflammatory drugs. However, there is still no consensus regarding the optimal regional technique. The aim of this study was to compare the analgaesic efficacy of continuous thoracic epidural block (TEA) and percutaneous continuous paravertebral block (PVB) in patients undergoing video-assisted lung lobectomy...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27924204/combined-use-of-a-double-lumen-tube-and-fogarty-catheter-to-prevent-the-endobronchial-spread-of-infection-a-case-report
#17
Jaewon Kim, Hyelim Lee, Han Park, Chang-Young Jeong
Huntington's disease is a neurodegenerative disorder with an autosomal dominant inheritance pattern. Patients with Huntington's disease show an increased risk of aspiration pneumonia when the pharyngeal muscle is invaded. We report a case of advanced-stage Huntington's disease in which the patient received right middle lobectomy for a lung abscess caused by repeated aspiration. The best lung isolation technique has not yet been established in these patients. We successfully performed selective lobar isolation of the right lower and middle lobes using a double lumen tube and a Fogarty embolectomy catheter...
December 2016: Korean Journal of Anesthesiology
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
#18
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/27865329/management-of-chest-drains-after-thoracic-resections
#19
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/27834025/indocyanine-green-fluorescence-navigated-robotic-segmentectomy
#20
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
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