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VATS in Lung

Marcin Zieliński, Tomasz Nabialek, Juliusz Pankowski
Background: The aim of the study is a description of surgical technique of uniportal transcervical video-assisted thoracoscopic surgery (VATS) for pulmonary lobectomy. Methods: We used a collar neck incision (transcervical) of an average length 5-8 centimeters. The manubrium of the sternum is elevated with a hook connected to the Zakopane II frame (Aesculap-Chifa, B. Braun, Nowy Tomyśl, Poland). The first step is a transcervical extended mediastinal lymphadenectomy (TEMLA), for improved staging and possible improved survival...
2018: Journal of Visualized Surgery
Federico Davini, Sara Ricciardi, Carmelina Cristina Zirafa, Ilenia Cavaliere, Gaetano Romano, Franca Melfi
Background: The incidental detection of solitary pulmonary nodule (SPN) is currently increasing due to the widespread use of computed tomography (CT) during the follow up in oncological patients or in screening trials. A quick and definitive histological diagnosis of these nodes is mandatory as, in case of primitive lung cancer, an early detection could improve both surgical results and prognosis. The minimally invasive pulmonary resection (MIPR) is the gold standard procedure for diagnosis and treatment of small lung nodules, but it can be difficult to localize deep nonpalpable nodes that lie in the lung parenchyma...
2018: Journal of Visualized Surgery
Massimo Osvaldo Jaus, Annarita Forcione, Alessandro Gonfiotti, Francesco Carleo, Alessia Raffaella De Massimi, Luigi Carbone, Marco Di Martino, Giuseppe Cardillo
Nowadays the treatment of patients with non-small cell lung cancer (NSCLC) that invades the chest wall is still questioned. The classic approach is a lobectomy that requires chest wall resection through thoracotomy, but thanks to the progress in the field of thoracoscopic surgery, this procedure can be performed by video-assisted thoracoscopic surgery (VATS). Major advances have been made in recent years both in the surgical technique associated with thoracoscopy and in the instrumentation available today. This has allowed the use of thoracoscopic technique even in advanced disease...
2018: Journal of Visualized Surgery
Robert Dziedzic, Tomasz Marjanski, Franciszek Binczyk, Joanna Polanska, Wioletta Sawicka, Witold Rzyman
OBJECTIVES: The video-assisted thoracoscopic surgery (VATS) approach has become a standard for the treatment of early-stage non-small-cell lung cancer (NSCLC). Recently published meta-analyses proved the benefit of VATS versus thoracotomy for overall survival (OS) and reduction of postoperative complications. The aim of this study was to compare early outcomes, long-term survival and rate of postoperative complications of the VATS approach versus thoracotomy. METHODS: In this retrospective cohort study, we analysed 982 individuals who underwent surgical resection for Stage I-IIA NSCLC between 2007 and 2015...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Shuangjiang Li, Zhiqiang Wang, Kun Zhou, Yan Wang, Yanming Wu, Pengfei Li, Guowei Che
Background: To evaluate the clinical significance of degree of pulmonary fissure completeness (PFC) on major in-hospital outcomes following video-assisted thoracoscopic (VATS) lobectomy for non-small-cell lung cancer (NSCLC). Materials and methods: We carried out a single-center retrospective analysis on the prospectively maintained database at our unit between August 2014 and October 2015. Patients were divided into two groups based on their fissure sum average (FSA)...
2018: Therapeutics and Clinical Risk Management
Haruhiko Shiiya, Yasuhiro Suzuki, Shigeo Yamazaki, Kichizo Kaga
BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) can be associated with life-threatening complications such as paradoxical embolization, cerebral abscess, and hemothorax. Therefore, all adults with PAVMs should be offered treatment. Percutaneous transcatheter embolization is the first-line treatment, but 5-25% of cases require further treatment due to persistence after embolization. Recently, the role of minimally invasive thoracic surgery as a definitive treatment has been evaluated...
March 12, 2018: Surgical Case Reports
Rizwana Yasmin, Dorte R Stærk, Anna Kalhauge, Henrik J Hansen, Tina E Olsen, Lisa L Maroun
Bilateral pulmonary sequestration (PS) is a very rare congenital malformation. We describe a case of bilateral intralobar pulmonary sequestration (ILS) in a newborn. Both sequestrations received arterial supply from separate branches of the descending aorta and venous drainage was into ipsilateral inferior pulmonary veins. Prenatal ultrasonography showed cystic changes in the lungs. Computed tomography angiography (CTA) with supplemental two-dimensional (2D) and three-dimensional (3D) images was performed to clearly define the pathology and revealed bilateral intralobar pulmonary sequestration with aberrant blood supply...
March 2018: Acta Radiologica Open
Shaohua Ma, Tiansheng Yan, Keyi Wang, Jingdi Wang, Jintao Song, Tong Wang, Wei He, Jie Bai, Liang Jin, Hailong Liang
BACKGROUND: Segmentectomy can retains more healthy lung tissue than lobectomy, but it remains controversial in oncology for early stage lung cancer. The aim of this study is to discuss the problems of video-assisted thoracic surgery (VATS) segmentectomy in early stage lung cancer, by analyzing the clinical and pathological data of 35 cases and reviewing the literature. METHODS: There were 35 patients who received segmentectomy by complete video-assisted thoracic surgery, from May 2013 to July 2017, in single operation group in the Third Hospital of Peking University...
February 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Christoph Zoeller, Benno M Ure, Jens Dingemann
INTRODUCTION:  Video-assisted thoracoscopic surgery (VATS) has gained broad acceptance among pediatric surgeons. Today, VATS can be regarded as a routine approach for various conditions in neonates and infants. However, there is a lack of information concerning the complications of thoracoscopic pulmonary surgery in neonates and infants. We aimed to review the available data. PATIENTS AND METHODS:  A systematic review of the literature was performed using PubMed...
March 6, 2018: European Journal of Pediatric Surgery
Winnie Hedevang Olesen, Niels Katballe, Jesper Eske Sindby, Ingrid Louise Titlestad, Poul Erik Andersen, Rune Lindahl-Jacobsen, Peter Bjørn Licht
OBJECTIVES: Primary spontaneous pneumothorax frequently recurs after chest tube management. Evidence is lacking whether patients may benefit from surgery following their first episode. METHODS: We performed a multicentre, randomized trial and enrolled young, otherwise healthy patients admitted with their first episode of primary spontaneous pneumothorax and treated using conventional chest tube drainage. Patients underwent high-resolution computed tomography on fully expanded lungs, and using web-based randomization, we assigned patients to continued conservative chest tube treatment or chest tube treatment followed by video-assisted thoracoscopic surgery (VATS) with the resection of bullae/blebs and mechanical pleurodesis...
March 2, 2018: European Journal of Cardio-thoracic Surgery
Sophia Chen, Travis C Geraci, Robert James Cerfolio
Robotic lobectomy is an increasingly common surgical approach for anatomic lung resection. Over the last decade, robotic lobectomy has shown to be safe, with oncologic efficacy similar to lobectomy via thoracotomy or video-assisted thoracoscopic surgery (VATS). Comparative analysis between these modalities is an active area of investigation. While initially expensive, the costs of a robotic platform decrease as the number of operations performed increases, length of stay is shortened, and postoperative morbidity is reduced...
March 5, 2018: Expert Review of Respiratory Medicine
Manraj N Kaur, Feng Xie, Andrea Shiwcharan, Lisa Patterson, Yaron Shargall, Christian Finley, Colin Schieman, Terry Dalimonte, Christine Fahim, Waël C Hanna
BACKGROUND: The objective of this study is to compare robotic portal (RP) to video-assisted thoracoscopic surgery (VATS) pulmonary resections for early stage non-small cell lung cancer with respect to health care resource utilization during the first year of a robotic surgery program in thoracic oncology. METHODS: Patients who underwent anatomic lung resections using RP (n = 42) or VATS (n = 96) for early stage non-small cell lung cancer between April 2014 and March 2015 at a single institution were identified...
March 2, 2018: Annals of Thoracic Surgery
Sai Yendamuri, Athar Battoo, Kris Attwood, Samjot Singh Dhillon, Grace K Dy, Mark Hennon, Anthony Picone, Chukwumere Nwogu, Todd Demmy, Elisabeth Dexter
BACKGROUND: Mediastinoscopy is considered the gold standard for preresectional staging of lung cancer. We sought to examine the effect of concomitant mediastinoscopy on postoperative pneumonia (POP) in patients undergoing lobectomy. METHODS: All patients in our institutional database (2008-2015) undergoing lobectomy who did not receive neoadjuvant therapy were included in our study. The relationship between mediastinoscopy and POP was examined using univariate (Chi square) and multivariate analyses (binary logistic regression)...
February 27, 2018: Annals of Surgical Oncology
Davor Stamenovic, Antje Messerschmidt, Thomas Schneider
BACKGROUND: The prevalence of lung cancer and other tumors is increasing among the elderly people. The purpose of this study was to examine the influence of advanced age (80 + years) on the immediate perioperative outcome as well as to define potential risk factors that may lead to increasing morbidity and mortality after lung resections. METHODS: A retrospective cohort analysis of the data from an electronic database of 208 elderly patients (165 patients ≥70 years, 45 patients ≥80 years) undergoing pulmonary anatomical resection for lung tumors during January 2013-December 2016 was conducted...
February 24, 2018: International Journal of Surgery
Eun Kyung Choe, Hae Yeon Kang, Young Lee, Seung Ho Choi, Hee Joung Kim, Joo Sung Kim
Obesity, particularly abdominal obesity, might be related to decreased lung function. We aimed to investigate whether obesity indices are associated with forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in asymptomatic non-smokers through a longitudinal cohort study. The clinical records of 1,145 subjects (428 males, mean age 52.3 years) who underwent a comprehensive health evaluation, including spirometry and abdominal fat computed tomography, at least twice between 2007 and 2014 were retrospectively reviewed and analysed...
2018: PloS One
G Leschber
More than 200 years ago the first attempts at thoracoscopy were made but only after its introduction 25 years ago has video-assisted thoracoscopic surgery (VATS) experienced rapid progress. Due to worldwide cooperation and international networking tremendous progress of the technique was made by thoracic surgeons on all continents developing the technique into a less invasive operating procedure on the thorax. For patients this meant improvement in the quality of life and ultimately better survival rates following lung cancer surgery...
February 21, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Patricia A Thistlethwaite, Jonathan R Gower, Moises Hernandez, Yu Zhang, Andrew C Picel, Anne C Roberts
BACKGROUND: Lung nodules that are small and deep within lung parenchyma, and have semisolid characteristics are often challenging to localize with video-assisted thoracoscopic surgery (VATS). We describe our cumulative experience using needle localization of small nodules before surgical resection. We report procedural tips, operative results, and lessons learned over time. METHODS: A retrospective review of all needle localization cases between July 1, 2006, and December 30, 2016, at a single institution was performed...
January 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Francesco Guerrera, Pier Luigi Filosso, Cecilia Pompili, Stefania Olivetti, Matteo Roffinella, Andrea Imperatori, Alessandro Brunelli
Background: The presence of air leak following lung resection remains a frequent problem, which may prolong hospital stay and increase hospital costs. In the past, some studies documented the efficacy of soft and flexible chest tube in patients who underwent thoracic surgery. Nevertheless, safety in case of post-operative large air or liquid leak remains questionable. The objective of this study was to verify through a multicentre study the safety and the effectiveness of the coaxial chest tube in a consecutive series of selected patients who underwent anatomical pulmonary resection and with an active and large air leak...
2018: Journal of Visualized Surgery
Mirko Barone, Giuseppe Cipollone, Felice Mucilli
The effects of immunomodulation processes in patients undergoing video-assisted thoracic surgery (VATS) lobectomy are still debated; although, the reduced surgical stress of minimally invasive surgery is evident. The immunological repercussions could also influence the evolution of the disease and the prognosis of patients. The article aims to raise some points of reflection by considering available evidences and reiterating, once again, the prognostic utility of a minimally invasive procedure rather than classical approach...
2018: Journal of Visualized Surgery
Benedetta Bedetti, Davide Patrini, Luca Bertolaccini, Roberto Crisci, Piergiorgio Solli, Joachim Schmidt, Marco Scarci
Uniportal video-assisted thoracoscopic surgery (VATS) is the most advanced evolution of the minimally invasive technique, which allows often the possibility to include patients in enhanced recovery programs in order to optimize the therapeutic pathway, shorten the length of stay and reduce hospital costs. Non-intubated VATS procedures allow the performance of surgeries with minimal sedation without general anesthesia, maintaining throughout the operation spontaneous breathing. The principle is to create an iatrogenic spontaneous pneumothorax, which can provide a good lung isolation without the need of a double lumen tube...
2018: Journal of Visualized Surgery
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