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https://www.readbyqxmd.com/read/27900328/blunt-traumatic-tension-chylothorax-case-report-and-mini-review-of-the-literature
#1
Kamal Idris, Michael Sebastian, Ashraf F Hefny, Navidul Haq Khan, Fikri M Abu-Zidan
Tension chylothorax following blunt thoracic trauma is an extremely rare condition. Here we report such a case and review its management. A 31-year-old man was involved in a road traffic collision. The car rolled over and the patient was ejected from the vehicle. On arrival at the Emergency Department the patient was conscious and haemodynamically stable. Clinical examination of the chest and abdomen was normal. The patient had sustained fractures of the sixth cervical vertebra and the tenth thoracic vertebra, left pleural effusion, haematoma around the descending aorta and fracture of the right clavicle...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#2
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27894764/thoracoscopic-bilateral-t3-sympathectomy-for-primary-focal-hyperhidrosis-in-children
#3
Pablo Laje, Kali Rhodes, Leanne Magee, Mary Kate Klarich
AIM OF THE STUDY: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients. METHODS: Retrospective chart review of all patients operated between 2013 and 2015. RESULTS: We operated and included in the study 28 patients, 22 females and 6 males. Mean age was 14 (6-21) years. All patients had previously tried at least one form of medical therapy with no success...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27894759/pancreaticoduodenectomy-for-pediatric-and-adolescent-pancreatic-malignancy-a-single-center-retrospective-analysis
#4
Erika B Lindholm, Abdulaziz K Alkattan, Sara J Abramson, Anita P Price, Todd E Heaton, Vinod P Balachandran, Michael P La Quaglia
PURPOSE: While pancreaticoduodenectomy (PD) has been extensively studied in adults, there are few data pertaining specifically to pediatric patients. We retrospectively analyzed PD-associated morbidity and mortality in pediatric patients. METHODS: Our analytic cohort included all consecutive patients ≤18years of age treated at our institution from 1993 to 2015 who underwent PD. Patient data (demographics, disease characteristics, surgical and adjuvant treatment, length of hospital stay, and postoperative course) were extracted from the medical records...
November 16, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27884332/thoracostomy-tube-function-not-trajectory-dictates-reintervention
#5
Nathan W Kugler, Thomas W Carver, Paul Knechtges, David Milia, Lawrence Goodman, Jasmeet S Paul
BACKGROUND: Hemothorax and/or pneumothorax can be managed successfully managed with tube thoracostomy (TT) in the majority of cases. Improperly placed tubes are common with rates near 30%. This study aimed to determine whether TT trajectory affects the rate of secondary intervention. METHODS: A retrospective review of all adult trauma patients undergoing TT placement over a 4-y period was performed. TT trajectory was classified as ideal, nonideal, or kinked-based on anterior-posterior chest x-ray...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27867567/influence-of-old-pulmonary-tuberculosis-on-the-management-of-secondary-spontaneous-pneumothorax-in-patients-over-the-age-of-70-years
#6
Sang Cjeol Lee, Deok Heon Lee
BACKGROUND: This study aimed to investigate the treatment outcomes and influence of old pulmonary tuberculosis (TB) in elderly patients (over 70 years) with secondary spontaneous pneumothorax (SSP). METHODS: A retrospective analysis was performed on patients with SSP between January 2002 and December 2014. Treatment outcomes including chest tube duration (CTD), type and complication of surgery, recurrence and survival rate were obtained from the review of medical records and analyzed statistically...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#7
José M Porcel, Horacio Valencia, Silvia Bielsa
PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas. METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven...
November 19, 2016: Lung
https://www.readbyqxmd.com/read/27865474/tubeless-uniportal-thoracoscopic-wedge-resection-for-peripheral-lung-nodules
#8
Shun-Mao Yang, Man-Ling Wang, Ming-Hui Hung, Hsao-Hsun Hsu, Ya-Jung Cheng, Jin-Shing Chen
BACKGROUND: Endotracheal intubation and chest tube drainage are considered mandatory for thoracoscopic pulmonary resection. The management of peripheral lung nodules by tubeless uniportal thoracoscopic surgical repair has not been reported previously. METHODS: From October 2015 through January 2016, 30 consecutive patients with peripheral lung nodules underwent uniportal thoracoscopic wedge resection without endotracheal intubation and chest tube drainage (tubeless group)...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27865329/management-of-chest-drains-after-thoracic-resections
#9
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/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#10
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865325/suction-or-nonsuction-how-to-manage-a-chest-tube-after-pulmonary-resection
#11
REVIEW
Gaetano Rocco, Alessandro Brunelli, Raffaele Rocco
Despite several randomized trials and meta-analyses, the dilemma as to whether to apply suction after subtotal pulmonary resection has not been solved. The combination of a poorly understood pathophysiology of the air leak phenomenon and the inadequate quality of the published randomized trials is actually preventing thoracic surgeons from abandoning an empirical management of chest drains. Even digital systems do not seem to have made the difference so far. Based on the evidence of the literature, the authors propose a new air leak predictor score (ALPS) as a contributing step toward appropriateness in using intraoperative sealants, opting for an external suction and managing and chest tubes...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865323/chest-tube-management-after-surgery-for-pneumothorax
#12
REVIEW
Cecilia Pompili, Michele Salati, Alessandro Brunelli
There is scant evidence on the management of chest tubes after surgery for pneumothorax. Most of the current knowledge is extrapolated from studies performed on subjects with lung cancer. This article reviews the existing literature with particular focus on the effect of suction and no suction on the duration of air leak after lung resection and surgery for pneumothorax. Moreover, the role of regulated suction, which seems to provide some benefit in reducing pneumothorax recurrence after bullectomy and pleurodesis, is discussed...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865321/chest-tubes-generalities
#13
REVIEW
Federico Venuta, Daniele Diso, Marco Anile, Erino A Rendina, Ilaria Onorati
Insertion, management, and withdrawal of chest tubes is part of the routine activity of thoracic surgeons. The selection of the chest tube and the strategy for each of these steps is usually built on knowledge, practice, experience, and judgment. The indication to insert a chest tube into the pleural cavity is the presence of air or fluid within it. Various types and sizes of chest tubes are now commercially available.
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27858851/a-comparison-of-a-traditional-endotracheal-tube-versus-etview-sl-in-endotracheal-intubation-during-different-emergency-conditions-a-randomized-crossover-cadaver-trial
#14
Zenon Truszewski, Paweł Krajewski, Marcin Fudalej, Jacek Smereka, Michael Frass, Oliver Robak, Bianka Nguyen, Kurt Ruetzler, Lukasz Szarpak
BACKGROUND: Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27843784/successful-conservative-management-of-tracheal-injury-after-forceful-coughing-during-extubation-a-case-report
#15
Joo Hyeon Oh, Sung Jun Hong, Sang Soo Kang, Sung Mi Hwang
A-56-year-old woman underwent carpal tunnel release surgery under general anesthesia. Thirty minutes after extubation, the patient complained of chest discomfort with dyspnea. Swelling of the neck and upper anterior chest was observed. Computed tomography of the chest showed tracheal rupture at the brachiocephalic trunk level, and bronchoscopy demonstrated a 5 cm linear tracheal defect in the posterior membranous wall, 6 cm proximal to the carina. Surgical repair of the tracheal injury was impossible due to its location...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27834025/indocyanine-green-fluorescence-navigated-robotic-segmentectomy
#16
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/27821828/-primary-spontaneous-pneumothorax-with-an-azygos-lobe
#17
Shoji Nakata, Shin Satake, Yoshitomo Okumura, Satoshi Hara, Kyongyob Min, Keiko Nakayama
A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Chest computed tomography revealed a collapsed lung and floating membrane, which was the lowermost part as a tear-shaped shadow. After the chest tube was inserted and surgical management was performed using a video-assisted thoracoscopic approach. At surgery, the visceral and parietal layers of pleura forming the mesoazygos were not fused, and azygos vein had a partial mobility. There was no adhesion between an upper lobe and visceral pleura...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27805286/accuracy-and-safety-of-ward-based-pleural-ultrasound-in-the-australian-healthcare-system
#18
Gary Hammerschlag, Matthew Denton, Peter Wallbridge, Louis Irving, Daniel Steinfort
BACKGROUND AND OBJECTIVE: Ultrasound has been shown to improve the accuracy and safety of pleural procedures. Studies to date have been performed in large, specialized units, where pleural procedures are performed by a small number of highly specialized physicians. There are no studies examining the safety and accuracy of ultrasound in the Australian healthcare system where procedures are performed by junior doctors with a high staff turnover. METHODS: We performed a retrospective review of the ultrasound database in the Respiratory Department at the Royal Melbourne Hospital to determine accuracy and complications associated pleural procedures...
November 2, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27798792/bleeding-risk-associated-with-eptifibatide-integrilin-bridging-in-thoracic-surgery-patients
#19
Nathan H Waldron, Torijaun Dallas, Loretta Erhunmwunsee, Tracy Y Wang, Mark F Berry, Ian J Welsby
Antiplatelet use for treatment of coronary artery disease (CAD) is common amongst thoracic surgery patients. Perioperative management of antiplatelet agents requires balancing the opposing risks of myocardial ischemia and excessive bleeding. Perioperative bridging with short-acting intravenous antiplatelet agents has shown promise in preventing myocardial ischemia, but may increase bleeding. We sought to determine whether perioperative bridging with eptifibatide increased bleeding associated with thoracic surgery...
October 31, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27718129/the-readiness-of-emergency-and-trauma-care-in-low-and-middle-income-countries-a-cross-sectional-descriptive-study-of-42-public-hospitals-in-albania
#20
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
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