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Techniques of lung lobectomy

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https://www.readbyqxmd.com/read/28088426/propensity-matched-comparison-of-video-assisted-thoracoscopic-with-thoracotomy-lobectomy-for-locally-advanced-non-small-cell-lung-cancer
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27828805/aspergilloma-of-the-lung-strategy-to-prevent-endobronchial-spillage
#14
Preety Mittal Roy, Sangeeta Khanna, Yatin Mehta, Ali Zamir Khan
Aspergilloma of the lung eroding into the airway may lead to perioperative endobronchial spillage and contamination of the normal lung. Our aim in this group of patients who are undergoing robotic- or video-assisted thoracoscopic lobectomy is to protect the contralateral lung and, if possible, uninvolved lobes of ipsilateral lung. Double-lumen endobronchial tubes do provide lung protection to the contralateral lung intraoperatively, but there is no protection to the ipsilateral lung lobes not involved by the disease process...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27825690/variation-in-hospital-adoption-rates-of-video-assisted-thoracoscopic-lobectomy-for-lung-cancer-and-the-effect-on-outcomes
#15
Zaid M Abdelsattar, Mark S Allen, K Robert Shen, Stephen D Cassivi, Francis C Nichols, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: This study examined the variation in the adoption of video-assisted thoracoscopic surgery (VATS) for lobectomy across United States hospitals from a population-based national database. METHODS: We used the National Cancer Data Base to identify patients undergoing lobectomy between 2010 and 2012 and used hierarchical regression to estimate case-mix-adjusted VATS lobectomy rates using patient and tumor characteristics. We stratified hospitals into quintiles by adjusted VATS lobectomy rates...
November 5, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27814899/sleeve-lobectomy-may-provide-better-outcomes-than-pneumonectomy-for-non-small-cell-lung-cancer-a-decade-in-a-nationwide-study
#16
Pierre-Benoit Pagès, Pierre Mordant, Stéphane Renaud, Laurent Brouchet, Pascal-Alexandre Thomas, Marcel Dahan, Alain Bernard
INTRODUCTION: Whenever feasible, sleeve lobectomy is recommended to avoid pneumonectomy for lung cancer, but these guidelines are based on limited retrospective series. The aim of our study was to compare outcomes following sleeve lobectomy and pneumonectomy using data from a national database. METHODS: From 2005 to 2014, 941 sleeve lobectomy and 5318 pneumonectomy patients were recorded in the French database Epithor. Propensity score was generated with 15 pretreatment variables and used to create balanced groups with matching (794 matches) and inverse probability of treatment weighting (standardized difference was 0 for matching, and 0...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27794405/robot-assisted-surgery-for-lung-cancer-state-of-the-art-and-perspectives
#17
REVIEW
Giulia Veronesi, Pierluigi Novellis, Emanuele Voulaz, Marco Alloisio
The robotic surgical system is the result of a long process of development aimed at producing a natural extension of the surgeon's eyes and hands via the intermediation of a computer. In this way, the ease of movement obtained with open surgery is summated with the advantages of the minimally invasive technique. Since 2000, when the first robotic system for surgery was introduced, robot-assisted thoracic surgery (RATS) has been adopted by an increasing number of centres around the world, and today is used in ∼10% of lobectomies in the US...
November 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/27776948/-what-place-for-the-thoracostomy-thoracmyoplasty-in-the-management-of-the-chronic-pleural-empyema
#18
M Lakranbi, S Rabiou, L Belliraj, I Issoufou, F Z Ammor, J Ghalimi, Y Ouadnouni, M Smahi
INTRODUCTION: The occurrence of empyema after pneumonectomy or in suites with chronic pleural pocket is a dreaded complication. The management is long and difficult. The authors report their experience before this complication including infection control by an emptying of the pleural pocket percutaneous drainage or thoracostomy which will be complemented by a thoracomyoplasty the aim to erase the pleural pocket. MATERIALS AND METHODS: This is a retrospective study conducted between 2009 and 2015 concerning the records of 9 patients treated for empyema or in the aftermath of a lung resection or as part of a chronic pleural pocket and calcific...
December 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27766782/comparison-of-three-dimensional-and-two-dimensional-visualization-in-video-assisted-thoracoscopic-lobectomy
#19
Song Dong, Xue-Ning Yang, Wen-Zhao Zhong, Qiang Nie, Ri-Qiang Liao, Jun-Tao Lin, Yi-Long Wu
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) lobectomy has emerged as a safe and effective technique for treating early-stage lung cancer. Novel three-dimensional, high-definition (3D HD) imaging has removed this technical obstacle and is increasingly used in laparoscopic surgery. We compared our initial experience of 3D HD VATS with standard two-dimensional (2D) HD VATS to identify the advantages and disadvantages of 3D HD visualization in VATS. METHODS: The data of consecutive patients diagnosed with lung cancer who underwent 2D or 3D thoracoscopic lobectomy or bilobectomy at the Guangdong Lung Cancer Institute from July 2013 to October 2014 were retrospectively analyzed...
September 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/27747037/uniportal-video-assisted-thoracoscopic-right-upper-sleeve-lobectomy-and-tracheoplasty-in-a-10-year-old-patient
#20
Diego Gonzalez-Rivas, Jessica Correa Marin, Juan Pablo Ovalle Granados, Juan David Urrea Llano, Sonia Roque Cañas, Alonso Oviedo Arqueta, Mercedes de la Torre
Tracheobronchial pediatric tumors are very rare and procedures like pneumonectomy are seldomly indicated due to the associated morbidity. If a surgical approach is considered, the ideal oncological technique would be the minimally invasive sleeve resection, allowing preservation of lung parenchyma (very important in pediatric patients). Here we present the first report of a thoracoscopic right upper tracheo-bronchial sleeve lobectomy in a pediatric patient. A 10-year-old female patient, who received multiple antibiotic treatments for recurrent pneumonia without improvement, was diagnosed with a right upper lobe (RUL) carcinoid tumor...
September 2016: Journal of Thoracic Disease
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