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anatomic segmentectomy

Jia-Ming Chang, Kam-Hong Kam, Yi-Ting Yen, Wei-Li Huang, Wei Chen, Yau-Lin Tseng, Ming-Ho Wu, Wu-Wei Lai, Diego Gonzalez-Rivas
Our study sought to review our experience from biportal to uniportal video-assisted thoracoscopic surgery (VATS) major lung resection. Lessons we learned from the evolution regarding technical aspects were also discussed.We retrospectively reviewed patients who underwent VATS lobectomy or segmentectomies in Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, during January 2012 and December 2014. Patient clinical profiles, surgical indications and procedures, postoperative course, and oncological parameters were analyzed and compared between the biportal and uniportal groups...
October 2016: Medicine (Baltimore)
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
Antonio Mazzella, Anne Olland, Pierre Emmanuel Falcoz, Stephane Renaud, Nicola Santelmo, Gilbert Massard
BACKGROUND: This study evaluates the number of video-assisted thoracic surgery-lobectomies (VATS-lobectomies) required for an experienced consultant thoracic surgeon to obtain competence and to perform standard quality surgery. METHODS: We have analysed the initial VATS-experience (January 2012 to September 2014) of a confirmed senior consultant who has performed 145 consecutive anatomic resections by thoracoscopy. After excluding bilobectomies, segmentectomies, and lobectomies for infectious disease, we have focused into 119 consecutive lobectomies, classified into 4 chronologic groups of 30 each...
September 2016: Journal of Thoracic Disease
Alessandro Brunelli, Michele Salati, Gaetano Rocco, Gonzalo Varela, Dirk Van Raemdonck, Herbert Decaluwe, Pierre Emmanuel Falcoz
OBJECTIVES: To develop models of 30-day mortality and cardiopulmonary morbidity from data on anatomic lung resections deposited in the European Society of Thoracic Surgeons (ESTS) database. METHODS: Retrospective analysis of 47 960 anatomic lung resections from the ESTS database (July 2007-August 2015) (36 376 lobectomies, 2296 bilobectomies, 5040 pneumonectomies and 4248 segmentectomies). Logistic regression analyses were used to test the association between baseline and surgical variables and morbidity or mortality...
October 15, 2016: European Journal of Cardio-thoracic Surgery
Le Xiao, Jian-Wei Li, Shu-Guo Zheng
BACKGROUND: The reported protocol was difficult to expose the hepatic veins for laparoscopic anatomical hepatectomy of segments VII and VIII. We introduce a new, convenient, applicable approach with the hepatic vein exposed from the head side. METHODS: This study included 10 patients who underwent laparoscopic liver resection for HCC in the segments VII and VIII between October, 2014 and November, 2015. Their perioperative course and operative techniques were retrospectively evaluated...
October 14, 2016: Journal of Surgical Oncology
S Bommart, J P Berthet, G Durand, B Ghaye, J L Pujol, C Marty-Ané, H Kovacsik
The major lung resections are the pneumonectomies and lobectomies. The sublobar resections are segmentectomies and wedge resections. These are performed either through open surgery through a thoracotomy or by video-assisted mini-invasive surgery for lobectomies and sublobar resections. Understanding the procedures involved allows the normal postoperative appearances to be interpreted and these normal anatomical changes to be distinguished from potential postoperative complications. Surgery results in a more or less extensive physiological adaptation of the chest cavity depending on the lung volume, which has been resected...
October 2016: Diagnostic and Interventional Imaging
Amaia Ojanguren, Dominique Gossot, Agathe Seguin-Givelet
BACKGROUND: Stapling is becoming the method of choice for dividing the intersegmental plane during thoracoscopic segmentectomies. The technique however is controversial as it can impair re-expansion of preserved segments. We have analyzed the morbidity and lung re-expansion on a series of 175 thoracoscopic segmentectomies. METHODS: A total of 175 patients underwent a thoracoscopic anatomic segmentectomy. Ten patients were excluded due to conversion into thoracotomy...
August 2016: Journal of Thoracic Disease
Thomas Tsitsias, Levon Toufektzian, Tom Routledge, John Pilling
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether there is a specific subgroup of patients that would benefit from pulmonary metastasectomy for colorectal carcinoma (CRC). A total of 524 papers were identified using the reported search, of which 1 meta-analysis, 1 systematic review and 17 retrospective studies represented the best evidence to answer the clinical question. The authors, date, journal, country, study type, population, outcomes and key results are tabulated...
August 29, 2016: Interactive Cardiovascular and Thoracic Surgery
Carlos Galvez, Julio Sesma, Sergio Bolufer, Francisco Lirio, Jose Navarro-Martinez, Maria Galiana, Benno Baschwitz, Maria Jesus Rivera
Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis...
August 2016: Annals of Translational Medicine
Feichao Bao, Chong Zhang, Yunhai Yang, Zhehao He, Luming Wang, Jian Hu
BACKGROUND: Reports of comparison between robotic and thoracoscopic surgery for lung cancer are limited, we aimed to compare the perioperative outcomes of robotic and thoracoscopic anatomic pulmonary resection for lung cancer. METHODS: A total of 184 patients with lung cancer underwent anatomic pulmonary resection by robotics or thoracoscopy. A propensity-matched analysis with incorporated preoperative variables was used to compare the perioperative outcomes between the two procedures...
July 2016: Journal of Thoracic Disease
Nasser K Altorki, Mohamed K Kamel, Navneet Narula, Galal Ghaly, Abu Nasar, Mohamed Rahouma, Paul C Lee, Jeffery L Port, Brendon M Stiles
OBJECTIVES: Sublobar resection is advocated for patients with NSCLC and compromised cardiopulmonary reserve, and for selected patients with early stage disease. Anatomic segmentectomy (AS) has traditionally been considered superior to wedge resection (WR), but well-balanced comparative studies are lacking. We hypothesize that WR and AS are associated with comparable oncologic outcomes for patients with cT1N0 NSCLC. METHODS: A retrospective review of a prospective database was performed (2000-2014) for cT1N0 patients, excluding patients with multiple primary tumors, carcinoid tumors, adenocarcinoma in situ, and minimally invasive adenocarcinoma...
August 3, 2016: Journal of Thoracic Oncology
Shohei Komatsu, Raffaele Brustia, Claire Goumard, Ailton Sepulveda, Fabiano Perdigao, Olivier Soubrane, Olivier Scatton
The objective of this study was to assess the clinical impact of laparoscopic hepatectomy from technical and oncological viewpoints through the consecutive 5-year experience of an expert team. The subjects consisted of 491 consecutive hepatectomies performed over the course of 5 years. A total of 190 hepatectomies (38.6 %) were performed laparoscopically, and the remaining 301 (61.4 %) were open hepatectomies. Chronological trends of operative procedures and their indications were evaluated, and patients with hepatocellular carcinoma (HCC) were analyzed from an oncological viewpoint...
August 5, 2016: Surgical Endoscopy
Shintaro Tarumi, Hiroyasu Yokomise
The maintenance of a good surgical view is mandatory in video-assisted thoracoscopic surgery (VATS). For routine segmentectomy, it is necessary to re-inflate the lung in order to identify the intersegmental borders. However, such re-inflation can occasionally obstruct the surgical view and can lead to prolongation of operation time, particularly in the context of VATS. Infrared thoracoscopy( IRT) with indocyanine green (ICG) is a new method of evaluating lung perfusion. There are 2 methods in IRT. One is based on ICG absorption, and the other is based on ICG fluorescence...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kimihiro Shimizu, Toshiteru Nagashima, Yoichi Ohtaki, Kai Obayashi, Seshiru Nakazawa, Mitsuhiro Kamiyoshihara, Hitoshi Igai, Izumi Takeyoshi, Akira Mogi, Hiroyuki Kuwano
OBJECTIVE: Thoracic surgeons must be erudite pulmonary vein variation when performing anatomical segmentectomy. We used three-dimensional CT (3DCT) to accumulate variations of the pulmonary veins of the right upper lobe (RUL) and created a simplified RUL vein model. METHODS: We reviewed anatomical variations of the RUL pulmonary veins of 338 patients using 3DCT images, and classified them by position related with bronchus. RESULTS: Of the "anterior" and "central" RUL veins, all could be classified into 4 types: 2 Anterior with Central types (Iab and Ib), 1 Anterior type, and 1 Central type...
October 2016: General Thoracic and Cardiovascular Surgery
Qihong Ni, Haolu Wang, Xiaowen Liang, Yunhe Zhang, Wei Chen, Jian Wang
The combination of hilar cholangiocarcinoma and anatomic variation constitutes a rare and complicated condition. Precise understanding of 3-dimensional position of tumor in the intrahepatic structure in such cases is important for operation planning and navigation. We report a case of a 61-year woman presenting with hilar cholangiocarcinoma. Anatomic variation and tumor location were well depicted on preoperative multidetector computed tomography (MDCT) combined with 3-dimensional reconstruction as the right posterior segmental duct drained to left hepatic duct...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Seiichi Kakegawa, Osamu Kawashima, Yoshio Tomizawa, Masayuki Sugano, Kimihiro Shimizu
The case was 83-year-old man who had complete situs inversus, and was pointed out to have peripheral adenocarcinoma with the size of 1.8 cm at the left upper lobe( S3). Because of severe emphysema and other multiple comorbidities, left S3 segmentectomy with hilar lymph node sampling was performed using video-assisted thoracic surgery (VATS). Preoperatively, the simulation of operation was performed using the 3 dimension computed tomography images of pulmonary arteriovenous and bronchus (3DCTAB). Postoperative course was uneventful...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Robert J Cerfolio, Kyle M Bess, Benjamin Wei, Douglas J Minnich
BACKGROUND: Our objective is to report our incidence, results, and technique for the control of major vascular injuries during minimally invasive robotic thoracic surgery. METHODS: This is a consecutive series of patients who underwent a planned robotic thoracic operation by one surgeon. RESULTS: Between February 2009 and September 2015, 1,304 consecutive patients underwent a robotic operation (lobectomy, n = 502; segmentectomy, n = 130; mediastinal resection, n = 115; Ivor Lewis, n = 103; thymectomy, n = 97; and others, n = 357) by one surgeon...
August 2016: Annals of Thoracic Surgery
Liang Chen, Weibing Wu
Thoracoscopic segmentectomy is technically much more meticulous than lobectomy, due to the complicated anotomical variations of segmental bronchi and vessels. Preoperative three-dimensional computed tomography bronchography and angiography, 3D-CTBA) could reveal the anatomical structures and variations of the segmental bronchi/vessels and locate the pulmonary nodules, which is helpful for surgery planning. Preoperative nodule localization is of vital importance for thoracoscopic segmentectomy. Techniques involved in this procedure include dissection of the targeted arteries, bronchus and intra-segmental veins, retention of the inter-segmental veins, identification of the inter-segmental boarder with the inflation-deflation method and seperation of intra-segmental pulmonary tissues by electrotome and/or endoscopic staplers...
June 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Yuxing Lin, Wei Zheng, Yong Zhu, Zhaohui Guo, Bin Zheng, Chun Chen
BACKGROUND: There are few reports of single-port video-assisted thoracoscopic surgery (S-VATS) anatomic segmentectomy and S-VATS lobectomy for early-stage non-small cell lung cancer (NSCLC) and no comparisons between them have yet been reported. Therefore, the aim of this study was to compare the safety and efficacy of S-VATS anatomic segmentectomy and S-VATS lobectomy for early-stage NSCLC. METHODS: In this retrospective observational study, the outcomes of 79 consecutive patients who had undergone S-VATS anatomic segmentectomy (32 patients) or S-VATS lobectomy (47 patients) for early-stage NSCLC from April 2014 to June 2015 were examined...
June 2016: Journal of Thoracic Disease
Hiroaki Kuroda, Hitoshi Dejima, Tetsuya Mizumo, Noriaki Sakakura, Yukinori Sakao
BACKGROUND: The purpose of this study was to present a new approach to the formation of a segmental plane by LigaSure (Covidien, Mansfield, MA, USA) with indocyanine green (ICG) fluorescence system during thoracoscopic segmentectomy. METHODS: This was a consecutive study that compared 12 patients who underwent a new LigaSure technique (LT) for segmental plane formation during thoracoscopic anatomical segmentectomy with 38 patients who underwent conventional methods using the staple technique (ST)...
June 2016: Journal of Thoracic Disease
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