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Video-assisted thoracic surgery

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
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
Jessica Gates, Akhilesh Sharma, Arunesh Kumar
We present the case of a 34-year-old Nigerian woman who was referred to the Respiratory team with a 12-month history of breathlessness. She was concurrently being investigated for an abdominal mass and rectal and vaginal bleeding. Consequently, she underwent cross-sectional imaging of her chest, abdomen and pelvis, revealing a small right-sided pneumothorax and right lower lobe pleural-based lesion. Shortly thereafter, she was admitted to the hospital with chest pain and required chest drain insertion. This partially treated her pneumothorax but she required referral to a cardiothoracic centre for definitive diagnosis and to manage her non-resolving pneumothorax...
March 9, 2018: BMJ Case Reports
Timothy L Surman, Robert G Stuklis, Justin C Chan
BACKGROUND: Multiple case studies have suggested that video-assisted thoracoscopic sympathectomy (VATS) reduces the occurrence and frequency of symptoms in long QT syndrome (LQTS) [1,2,3]. To date there has not been a literature review to report on the short-term and long-term outcomes of this procedure. Our primary aims are to review the literature findings on the clinical outcomes of VATS sympathectomy for long QT and present a local centre case report on the outcomes of T2-T5 sympathectomy...
February 13, 2018: Heart, Lung & Circulation
Daisuke Nakamura, Kentaro Miura, Hirotaka Kumeda, Hiroyuki Agatsuma, Akira Hyogotani, Kazutoshi Hamanaka, Tomonobu Koizumi, Hiroshi Yamamoto, Hisashi Tamada, Ken-Ichi Ito
We report a case of pleomorphic carcinoma with exon 18 mutation (G719X) of the epidermal growth factor receptor (EGFR), which showed good response to afatinib and resulted in successful resection. To our knowledge, this is the first report on the use of afatinib for pleomorphic carcinoma followed by the surgical resection. The patient was a 59-year-old woman, who visited our hospital because chest computed tomography showed a 28 × 28-mm nodule in the left upper lobe. Bronchoscopy was performed and the histological findings of transbronchial biopsy revealed adenosquamous carcinoma positive for G719X mutation in exon 18 of the EGFR...
September 2017: Case Reports in Oncology
Ching Feng Wu, Ricardo Fernandez, de la Torre Mercedes, Maria Delgado, Eva Fieira, Ching Yang Wu, Ming Ju Hsieh, Marina Paradela, Yun-Hen Liu, Diego Gonzalez-Rivas
OBJECTIVES: Single-port video-assisted thoracoscopic surgery (SPVATS) anatomical resection has been shown to be a feasible technique for lung cancer patients. Whether SPVATS has equivalent or better oncological outcomes for lung cancer patients remains controversial. The purpose of this study was to evaluate the perioperative and mid-term survival outcomes of SPVATS in 2 different medical centres. METHODS: We retrospectively reviewed patients who underwent SPVATS anatomical resections between January 2014 and February 2017 in Coruña University Hospital's Minimally Invasive Thoracic Surgery Unit (Spain) and Chang Gung Memorial Hospital (Taiwan)...
March 3, 2018: European Journal of Cardio-thoracic Surgery
Linda Martin, Bethany Sarosiek, Meredith Harrison, Traci Hedrick, James Isbell, Alexander Krupnick, Christine Lau, Hunter Mehaffey, Robert Thiele, Dustin Walters, Randal Blank
BACKGROUND: To minimize the stress of surgery, improve the patient experience, reduce variability and optimize resource utilization, we implemented a thoracic Enhanced Recovery After Surgery (ERAS) protocol and evaluated progress after one year. METHODS: Two protocols were developed: video assisted thoracic surgery (ERAS-VATS) and thoracotomy (ERAS-T). Each incorporated preoperative patient education, carbohydrate loading, opioid-sparing analgesia, conservative fluid management, and early ambulation...
March 3, 2018: Annals of Thoracic Surgery
Brittany N Burton, Swapnil Khoche, Alison M A'Court, Ulrich H Schmidt, Rodney A Gabriel
OBJECTIVE: Postoperative respiratory failure requiring reintubation is associated with a significant increase in mortality. However, perioperative risk factors and their effects on unplanned 30-day reintubation and postoperative outcomes after unplanned reintubation following lung resection are not described well. The aim of this study was to determine whether certain comorbidities, demographic factors, and postoperative outcomes are associated with 30-day reintubation after thoracic surgery...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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
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
Vesna D Dinic, Milena Dragisa Stojanovic, Danica Markovic, Vladan Cvetanovic, Anita Zoran Vukovic, Radmilo J Jankovic
The main goal of enhanced recovery program after thoracic surgery is to minimize stress response, reduce postoperative pulmonary complications, and improve patient outcome, which will in addition decrease hospital stay and reduce hospital costs. As minimally invasive technique, video-assisted thoracoscopic surgery represents an important element of enhanced recovery program in thoracic surgery. Anesthetic management during preoperative, intraoperative and postoperative period is essential for the enhanced recovery...
2018: Frontiers in Medicine
Xiaoli Luo, Weibin Shi, Xiaoqun Zhang, Xiaoli Yang, Wei Wang, Chunyu Zeng, Hongyong Wang
An elderly male patient with coronary heart disease underwent coronary angiography, which revealed bilateral severe coronary artery stenosis. Four stents were implanted, and at 5 h post-surgery, typical hemorrhagic shock appeared. Echocardiography verified heavy bleeding in the right thoracic cavity. Emergency angiography excluded injury or perforation of the coronary artery, aorta, right subclavian artery and brachiocephalic artery. Considering the patient's history of chronic obstructive pulmonary disease and severe cough during the operation, it was suspected that hemothorax was induced by a blood vessel rupture in the pleura...
March 2018: Experimental and Therapeutic Medicine
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
Ching Yeung, Sebastien Gilbert
Background: In recent years, there has been an exponential growth in the research and development of uniportal video-assisted thoracoscopic surgery (VATS). In the context of the 2017 Annual Asian Single-Port VATS Symposium held in Shanghai, China, we sought to describe current the state of uniportal VATS in North America and explore factors that could influence future adoption. Methods: In March 2017, a five-question survey was distributed to North American Thoracic Surgeons in order to obtain their opinion regarding the uniportal VATS approach to pulmonary resection...
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
Elisa Meacci, Dania Nachira, Maria Teresa Congedo, Marco Chiappetta, Leonardo Petracca Ciavarella, Stefano Margaritora
In the era of lung cancer screening and early detection of lung lesions, pulmonary segmentectomy has gained wide acceptance between thoracic community reducing the need of lobectomy for diagnostic purpose and treatment in case of centrally located benign, multiple or undetermined lesions. In rigorously selected patients with stage I non-small cell lung cancer (NSCLC), segmentectomies seem to offer similar survival outcomes rather than lobectomies, but associated with a better conservation of lung function. However, segmentectomy is a more challenging procedure to be performed compared to lobectomy, especially by video-assisted thoracic surgery (VATS)...
2018: Journal of Visualized Surgery
Aris Koryllos, Erich Stoelben
Bronchus sleeve resection for operative treatment of non-small cell lung cancer (NSCLC) is a gold standard in modern thoracic surgery in cases of centrally located tumors or hilär lymph node metastases. Advanced instruments and growing surgical experience allowed surgeons to reduce the required incisions (from 3-port to uniportal) and to resect larger and more centrally located malignancies minimal invasively. It is a logical and expected advance in thoracic surgery that video-assisted thoracoscopic surgery (VATS) would be ultimately used also for complex bronchial resections...
2018: Journal of Visualized Surgery
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