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Chest wall resection

Hans Kristian Pilegaard
The Nuss procedure is now the preferred operation for surgical correction of pectus excavatum (PE). It is a minimally invasive technique, whereby one to three curved metal bars are inserted behind the sternum in order to push it into a normal position. The bars are left in situ for three years and then removed. This procedure significantly improves quality of life and, in most cases, also improves cardiac performance. Previously, the modified Ravitch procedure was used with resection of cartilage and the use of posterior support...
September 2016: Annals of Cardiothoracic Surgery
Anton H Schwabegger
Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed...
September 2016: Annals of Cardiothoracic Surgery
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
Edward J Caruana, Pierogiorgio Solli, Aman S Coonar
Chest wall invasion is seen in 5% to 8% of patients presenting with lung cancer. We report a case of complete resection of a 14 cm × 9 cm pT3N0M0 squamous cell carcinoma arising from the right lower lobe and invading the lower chest wall posteriorly, in a 75 years old male, via a hybrid thoracoscopic [video-assisted thoracoscopic surgery (VATS)] approach. Following conventional VATS lobectomy, a targeted 10 cm incision was performed to allow wide resection of the 7(th) to 10(th) ribs and 6(th) to 9(th) transverse processes, with the defect being subsequently reconstructed with a composite rigid prosthesis...
September 2016: Journal of Thoracic Disease
Mitsuhiro Kamiyoshihara, Takashi Ibe, Natsuko Kawatani, Fumi Ohsawa, Ryohei Yoshikawa, Kimihiro Shimizu
BACKGROUND: Computed tomography (CT)-guided lung needle marking is useful to identify pulmonary nodules. However, certain complications sometimes trigger severe after-effects or death. So, we present a convenient and safe method by which small pulmonary nodules can be identified using a particular dye [2% (w/v) gentian violet]. METHODS: A patient is initially placed in the lateral operative position. Under CT guidance, a "magic marker" is used to identify the skin above the pulmonary nodule...
September 2016: Journal of Thoracic Disease
Avas Chandra Ray, Subhra Aditya, Pulak Kumar Jana, Apratim Chatterjee, Anup Sarkar, Jay Mehta, Jotideb Mukhopadhyay
A young male labourer developed pain at the site of blunt trauma over back of chest followed by fever, cough with expectoration, breathlessness and hemorrhagic pleural effusion in the side of injury. What could have been passed as a sequel of trauma turned out to be the consequences of an underlying rare and aggressive malignant tumor of the chest wall known as Askin tumor or Primitive Neuroectodermal Tumor (PNET). CT thorax with guided FNAC, debulking operation, histopathological examination followed by immunohistochemistry of the tumor tissue led to the final diagnosis...
March 2016: Journal of the Association of Physicians of India
Catherine H Davis, Halim Yammine, Puja G Khaitan, Edward Y Chan, Min P Kim
INTRODUCTION: Soft tissue sarcomas of the chest wall are exceptionally rare entities that present as painless slow growing masses. Resection is often precarious due to involvement of vital structures, and patients are left with large chest wall defects postoperatively requiring extensive reconstruction. PRESENTATION OF CASE: We present a case report of a 29 year-old man who presented with a giant soft tissue sarcoma of the chest that had been growing slowly for one year prior to presentation...
October 4, 2016: International Journal of Surgery Case Reports
Xin Jin, Jianfeng Cao, Yong Liu, Fang Bian, Qingqing Zhao, Yan Wang, Xu Lv, Yayong Huang
Primitive neuroectodermal tumors (PNETs) are small, round cell tumors that may be classified as peripheral or central, based on their site of origin. PNETs often arise in the soft tissue or bone of young adults. Although not common, PNETs have been described in other organs, including the gonads, kidneys, myocardium and pancreas, but rarely in the lungs without chest wall or pleural involvement. The present study reports a rare case of peripheral PNET (pPNET), which originated in the lung. A 37-year-old female patient presented at Xuzhou Central Hospital (Xuzhou, China) with a history of a dry cough, mild dyspnea and slight pain in the left chest...
October 2016: Oncology Letters
Naohiro Nose, Kazuhiro Higuchi, Eiichi Chosa, Takanori Ayabe, Masaki Tomita, Kunihide Nakamura
A 60-year-old woman was referred to our hospital with an anterior mediastinal tumor measuring 3.5 cm in diameter on computed tomography (CT). We performed tumor resection by video-assisted thoracic surgery (VATS) with three ports. The final diagnosis was Type A Masaoka Stage I thymoma. On follow-up CT performed 36 months after the operation, two pleural tumors were detected at the port sites through which the forceps and ultrasonic scalpel had passed repeatedly during the operation. We therefore performed a second operation and enucleated the tumors while preserving the ribs...
2016: Journal of Surgical Case Reports
James Benjamin Gleason, Basheer Tashtoush, Maria Julia Diacovo
Biphasic malignant pleural mesothelioma is a rare malignant tumor, usually presenting as a pleural-based mass in a patient with history of chronic asbestos exposure. We herein report a case of a 41-year-old man who presented with chest pain and had a chest computed tomography (CT) scan suggestive of a primary skeletal tumor originating from the ribs (chondrosarcoma or osteosarcoma), with no history of asbestos exposure. CT-guided core needle biopsies were diagnosed as malignant sarcomatoid mesothelioma. Surgical resection and chest wall reconstruction were performed, confirming the diagnosis and revealing a secondary histologic component (epithelioid), supporting the diagnosis of biphasic malignant mesothelioma...
2016: Case Reports in Pulmonology
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
Masaki Ikeda, Yoshitake Murata, Ryoko Ohnishi, Tatsuo Kato, Akira Hara, Takuji Fujinaga
Congenital esophagobronchial fistula (EBF) is rarely seen in adults. We report a case of EBF detected in adulthood with a destroyed lung. A 67-year-old man experienced repeated pneumonia during his childhood. Since the age of 38, he had often suffered from bloody phlegm and always had a cough and sputum during oral intake. Before cardiac surgery for atrial fibrillation and valvular disease, computed tomography (CT) detected bronchiectasis, which could cause pulmonary bleeding during heart surgery, and the patient was introduced to our hospital for lung resection...
December 2016: Surgical Case Reports
John E Mullinax, Ricardo J Gonzalez
The management of truncal sarcoma presents unique challenges to the treating physician for reasons specific to this tumor location. First, the reconstruction options after resection of the abdominal or chest wall require a balance between cosmesis and structural integrity due to the multiplanar forces exerted on this region. Second, the histologies that commonly arise in this region are often associated with high local recurrence rates, which often require complex decision making due to prior therapy. Finally, sarcomas of the trunk in the inguinal region involve those organs in the genitourinary system, of which resection can have significant psychosocial implications...
October 2016: Surgical Clinics of North America
Haitham H Khalil, Marco N Malahias, Balapathiran Balasubramanian, Madava G Djearaman, Babu Naidu, Melvin F Grainger, Maninder Kalkat
BACKGROUND: Management of complex thoracic defects post tumor extipiration is challenging because of the nature of pathology, the radical approach, and the insertion of prosthetic material required for biomechanical stability. Wound complications pose a significant problem that can have detrimental effect on patient outcome. The authors outline an institutional experience of a multidisciplinary thoracic oncoplastic approach to improve outcomes. METHODS: Prospectively collected data from 71 consecutive patients treated with chest wall resection and reconstruction were analyzed (2009-2015)...
July 2016: Plastic and Reconstructive Surgery. Global Open
Lukas M Nystrom, Nickolas B Reimer, John D Reith, Mark T Scarborough, C Parker Gibbs
BACKGROUND: Extraskeletal osteosarcoma is a rare tumor with a poor prognosis. The purpose of this study is to examine the oncologic outcomes of this disease as they relate to surgical treatment and use of adjuvant therapies. METHODS: We retrospectively analyzed all patients treated at our institution for high-grade extraskeletal osteosarcoma of the limb or chest wall. We recorded demographic data, presenting stage, surgical margin, use of adjuvant chemotherapy or radiation, incidence of local recurrence, metastases, and death...
2016: Iowa Orthopaedic Journal
Jonathan D Spicer, Jitesh B Shewale, Mara B Antonoff, Arlene M Correa, Wayne B Hofstetter, David C Rice, Ara A Vaporciyan, Reza J Mehran, Garrett L Walsh, Jack A Roth, Stephen G Swisher, Boris Sepesi
BACKGROUND: Emerging technologies for prosthetic reconstruction after chest wall resection have yielded a wide variety of reconstructive options for thoracic surgeons. The ideal chest wall reconstruction and its impact on perioperative outcomes has not been well defined. Our goal was to determine whether mesh characteristics such as rigidity or absorbability altered perioperative pulmonary and infectious outcomes. METHODS: Our institutional database was queried for patients who underwent chest wall resection and reconstruction for primary or secondary chest wall tumors between the years 1998 and 2013...
August 12, 2016: Annals of Thoracic Surgery
O Vella, A Bequignon, F Comoz, E Babin
INTRODUCTION: Liposarcoma is a rare malignant mesenchymal tumour. Very few cases of retropharyngeal liposarcoma have been reported in the literature. SUMMARY: A 30-year-old woman with no notable history reported swallowing disorders for the past year associated with dysphonia. Nasal endoscopic examination demonstrated a tumour arising from the left lateral pharyngeal wall, ascending as far as the junction of the free margin of the epiglottis, aryepiglottic fold, and pharyngoepiglottic fold and obliterating the ipsilateral pyriform sinus with preservation of cord mobility...
August 10, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Geoff Frawley, Jacinta Frawley, Joe Crameri
BACKGROUND: Pectus excavatum (PE) is the most common congenital chest wall deformity, occurring in 1 : 1000 children with a male to female ratio of 4 : 1. Several procedures have been described to manage this deformity, including cartilage resection with sternal osteotomy (the Ravitch procedure) and a minimally invasive repair technique (the Nuss procedure). While initially described as a nonthoracoscopic technique, the current surgical approach of the Royal Childrens Hospital involves thoracoscopic assistance...
November 2016: Paediatric Anaesthesia
Addisu Mesfin, Daniel M Sciubba, Nicolas Dea, Anick Nater, Justin E Bird, Nasir A Quraishi, Charles G Fisher, John H Shin, Michael G Fehlings, Naresh Kumar, Michelle J Clarke
STUDY DESIGN: Systematic review. OBJECTIVE: To identify risk factors and preventive methods for wound complications and instrumentation failure after metastatic spine surgery. SUMMARY OF BACKGROUND DATA: We focused on two postoperative complications of metastatic spine tumor surgery: wound complications and instrumentation failure and preventive measures. METHODS: We performed a systematic review of the literature from 1980 to 2015...
October 15, 2016: Spine
Ryo Takahashi, Masatoshi Kurihara, Teruaki Mizobuchi, Hiroki Ebana, Sumitaka Yamanaka
Catamenial pneumothorax (CP) is generally caused by intraperitoneal air leaking from the uterus into the thoracic cavity via a defect in the endometrial tissue of the diaphragm and is usually detected in the right thorax. We report a case of left-sided CP caused by endometriosis in the visceral pleura and with no abnormal findings in the diaphragm. A 33-year-old female patient presented at the end of a course of low-dose contraceptive pills for pelvic endometriosis, with spontaneous pneumothorax in the left chest...
August 10, 2016: Annals of Thoracic and Cardiovascular Surgery
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