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anatomic segmentectomy

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
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
Tokio Higaki, Tadatoshi Takayama, Yutaka Midorikawa
BACKGROUND: Resection of hepatocellular carcinoma located in the caudate lobe is challenging because this anatomical location is difficult to approach, especially the caval portion. METHODS: We performed resection of the caval portion of the caudate lobe using a ventral approach combined with the resection of segment IV, VII, or VIII for hepatocellular carcinoma in 41 patients (extended segmentectomy group). As a control group, 138 patients with hepatocellular carcinoma who underwent segmentectomy for IV, VII, or VIII (segmentectomy group) were studied...
February 21, 2018: Surgery
Takamasa Onuki, Masato Kanzaki, Hideyuki Maeda, Kei Sakamoto, Tamami Isaka, Kunihiro Oyama, Masahide Murasugi
BACKGROUND: Because left upper division resection is similar to right upper lobectomy, this procedure is frequently employed. Few studies have used the anatomic courses of veins evaluated on preoperative computed tomography (CT) imaging to determine what types of patients are at the highest risk for hemorrhagic pulmonary infarction. CASE: We describe our experience with a patient in whom hemorrhagic pulmonary infarction occurred at 6 days after transecting two superior branches (V1 and V3 ) of the three branches of the left superior pulmonary vein...
February 20, 2018: Annals of Thoracic and Cardiovascular Surgery
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
Fei Yao, Jian Wang, Ju Yao, Lei Xu, Junling Qian, Yongke Cao
BACKGROUND: Anatomic segmentectomy for stage I nonsmall cell lung cancer (NSCLC) has potential advantages such as preserving pulmonary function and reducing postoperative complications. However, many surgeons are deterred from this procedure for its anatomical complexity. Therefore, we presented our early experience with video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy compared with our most recent VATS lobectomy cases. PATIENTS AND METHODS: Forty patients with cT1aN0M0 (ground-glass opacity [GGO] rate >50%) NSCLC underwent VATS segmentectomy from January 2015 to December 2016...
February 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Davor Stamenovic, Antje Messerschmidt
Anatomical segment resections are often technically more demanding than lobectomies. Anterior segment of the left upper lobe (S3) is usually removed within the standard resection of the upper three segments.    Our patient in this case was a 56-year-old with a known oropharyngeal carcinoma, otherwise amenable to curative treatment, who was admitted to our clinic with  a 1-cm nodule in the anterior segment of the left upper lobe.  Distant metastases were excluded, and a decision was made to proceed with a uniportal video-assisted thoracoscopic segmentectomy and lymphadenectomy...
January 11, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Benjamin Smood, Asem Ghanim, Benjamin Wei, Robert J Cerfolio
The objectives of this study are to review the complicated and often confusing technical changes required when converting from the Si robotic system to the Xi when performing pulmonary lobectomy and segmentectomy. We reviewed a prospective database of a consecutive series of patients who intended to undergo robotic lobectomy or segmentectomy by one surgeon. There were 101 lobectomies and 25 segmentectomies performed on the Si robot in 2015-2016, and 95 lobectomies and 28 segmentectomies in 2016 on the Xi robot...
January 23, 2018: Journal of Robotic Surgery
Ahmed G Elkhouly, Benedetto Cristino, Eugenio Pompeo
Optimal identification of the intersegmental plane can be challenging during thoracoscopic anatomical segmentectomy for lung cancer. We describe a simple new method of infrared-fluorescence-enhanced thoracoscopy with selected injection of indocyanine green into the bronchi not targeted for resection, which allows us to clearly identify the intersegmental plane in thoracoscopic segmentectomy.
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Hiroaki Kuroda, Tatsuya Yoshida, Yukinori Sakao
We used the powered vascular staple (PVS) instead of the conventional staple technique [the utilization of the powered linier cutter (PLC)] or ligation for total 23 segmental or subsegmental bronchi with less than 10 mm in the bronchial luminal size on computed tomography (CT) in thoracoscopic segmentectomy. Our results suggested that the availability of the PVS represents a novel advance in the armamentarium and may have a possibility of being pervasive widely however, more observative periods and further sample accumulation are needed...
December 2017: Journal of Thoracic Disease
Davor Stamenovic, Korkut Bostanci, Antje Messerschmidt
Background: The acceptance of uniportal video-assisted thoracoscopic surgery (uVATS) for anatomical lung resections has been growing in recent years. This study presents the first case-series in the literature with posterior uVATS (puVATS) technique for specific anatomical lung resections. Methods: The first 20 consecutive patients who underwent an anatomical lung resection by a single surgeon, by means of puVATS technique were evaluated in terms of pre-, peri- and post-operative results...
December 2017: Journal of Thoracic Disease
Xiao-Wei She, Yun-Bin Gu, Chun Xu, Chang Li, Cheng Ding, Jun Chen, Jun Zhao
BACKGROUND: Compared to the pulmonary lobe, the anatomical structure of the pulmonary segment is relatively complex and prone to variation, thus the risk and difficulty of segmentectomy is increased. We compared three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with 3D video-assisted thoracic surgery (3D-VATS) to perform segmentectomy to conventional two-dimensional (2D)-VATS for the treatment of non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the data of randomly selected patients who underwent 3D-CTBA combined with 3D-VATS (3D-CTBA-VATS) or 2D-VATS at the Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University Hospital, from January 2014 to May 2017...
January 3, 2018: Thoracic Cancer
Rafael Santiago Andrade, Ilitch Diaz-Gutierrez, Jacob Hutchins, Alexander Kaizer, Joseph Small, Madhuri Rao
OBJECTIVE: We describe laparoscopic transdiaphragmatic (LTD) chest surgery without intercostal incisions and focus on technique and safety. The goal of LTD is to minimize postoperative pain. METHODS: We reviewed all patients undergoing LTD chest surgery (September 8, 2010-April 4, 2017). We place 4 abdominal ports with the patient in semilateral decubitus, make 2 diaphragmatic openings, and advance 2 ports into the chest. The intrathoracic operation is standard video-assisted thoracoscopic surgery (VATS), and diaphragmatic openings are closed at the end...
November 10, 2017: Journal of Thoracic and Cardiovascular Surgery
Kazuya Takamochi, Shuko Nojiri, Shiaki Oh, Takeshi Matsunaga, Kota Imashimizu, Mariko Fukui, Kenji Suzuki
OBJECTIVE: The objective of this study was to evaluate whether a digital thoracic drainage system (group D) is clinically useful compared with a traditional thoracic drainage system (group T) in chest tube management following anatomic lung resection. METHODS: Patients scheduled to undergo segmentectomy or lobectomy were prospectively randomized before surgery to group D or T. A stratification randomization was performed according to the following air leak risk factors: age, sex, smoking status, and presence of emphysema and/or chronic obstructive pulmonary disease...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
Liang Xue, Yunfeng Yuan
A ground-glass opacity (GGO) lesion was discovered in a 64-year-old female 1 year ago. One month before administration, a follow-up CT showed the lesion in the apical segment of left upper lobe had increased from 8 to 11 mm in diameter. The lesion was diagnosed to be cT1aN0M0 non-small cell lung cancer (NSCLC) and a 3-port video-assisted thoracic surgery (VATS) anatomic segmentectomy was performed. Intraoperative frozen sections revealed a microinvasive adenocarcinoma. Systematic lymph node dissection was then carried out...
September 2017: Journal of Thoracic Disease
Anna Cantarutti, Carlotta Galeone, Giovanni Leuzzi, Elena Bertocchi, Giovanna Pomponi, Martin Langer, Vincenzo Mazzaferro, Gustavo Galmozzi, Giovanni Apolone, Giovanni Corrao, Ugo Pastorino
BACKGROUND: Accurate measurement of outcomes is essential to monitor the effectiveness of public health policies. In Italy, the Ministry of Health has chosen 30-day mortality after major surgical or medical procedures as the main outcome measure, pooling all pulmonary resections for malignancy in a single category. The present audit evaluated all pulmonary resections performed over a 13-year period in a single institution to assess the immediate (30-day mortality) and long-term (5-year survival) outcomes according to type and stage of disease and extent of surgery...
November 21, 2017: Tumori
Paolo Scanagatta, Lara Girelli
Pulmonary metastasectomy has become a standard procedure for pediatric patients with certain types of solid tumors. Surgeons, expert pediatric oncologists and radiation oncologists contribute with their different skills to the management of pulmonary metastases. Patients are usually scheduled for surgery in case of primary tumor control, in absence of metastases in other organs and when a complete resection is achievable. Nodules are removed through precision resections using electrocautery or laser methods in order to ensure radical surgery with adequate margins...
October 2017: Journal of Thoracic Disease
Shun-Mao Yang, Wen-Ting Wu, Yu-Hsuan Liu, Huan-Jang Ko
BACKGROUND: Pulmonary segmentectomy can be an oncologic equivalent of lobectomy for small non-small cell lung cancer. Uniportal video-assisted thoracoscopic surgery (VATS) has recently showed favorable surgical outcomes, but remains technical demanding, especially in a complex procedure like anatomic segmentectomy. This manuscript demonstrates the surgical techniques for uniportal VATS segmentectomies with the assistance of additional needlescopic instruments. METHODS: Data of 22 consecutive patients who underwent 24 needlescopic-assisted uniportal VATS segmentectomies between December 2016 and June 2017 was analyzed...
2017: Journal of Visualized Surgery
Chi-Fu Jeffrey Yang, Zachary W Fitch, S Scott Balderson, John Z Deng, Thomas A D'Amico
Over the past 20 years, there have been significant advancements in thoracoscopic surgical techniques as well as in lung cancer screening protocols, which have identified greater numbers of smaller lung tumors (<2 cm) that are more frequently operable and curable. These advancements have led to new interest in the thoracoscopic (VATS) approach to segmentectomy. This article will discuss the outcomes and technical considerations associated with VATS segmentectomy.
2017: Journal of Visualized Surgery
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