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Thoracic surgery complications anesthesia

Marcello Migliore, Francesco Borrata, Marco Nardini, Alessandra Criscione, Damiano Calvo, Mariapia Gangemi, Francesco Scalieri
Since 1998, we started a clinical program for awake video-assisted thoracic surgery in our unit using four-step local anesthesia and sedation. Throughout the years, we experienced several difficult cases, three of them had complications postpneumonectomy. The aim of this paper is to report these three cases.
October 17, 2016: Future Oncology
Mineto Kamata, Corey Stiver, Aymen Naguib, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: The objectives of this study were to evaluate the effect of ventricular morphology on perioperative outcomes during Fontan surgery. DESIGN: Retrospective cohort study. SETTING: Single standing, not-for-profit pediatric hospital. PARTICIPANTS: A total of 72 patients who underwent Fontan surgery using cardiopulmonary bypass without aortic cross-clamp between January 1, 2009 and December 31, 2014. INTERVENTIONS: None...
July 19, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mingxiang Feng, Miao Lin, Yaxin Shen, Hao Wang
A 62-year-old female was admitted to our hospital after computed tomography (CT) revealed a 2.5 cm × 2.1 cm mass in the left upper lobe. PET/CT scan diagnosed as malignant lesion with no signs of metastasis. Under general anesthesia, the patient was placed in right lateral decubitus position. A 4cm incision was made in the 4th intercostal space with plastic protector. The camera was placed in the upper part of the incision and the instruments were inserted below the camera. Left upper lobectomy along with systematic lymphadenectomy was performed...
August 2016: Journal of Thoracic Disease
Fei Cui, Jun Liu, Shuben Li, Weiqiang Yin, Xu Xin, Wenlong Shao, Jianxing He
BACKGROUND: To assess the feasibility and safety of tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of a chest tube postoperatively compared with VATS under intubated anesthesia with single-lung mechanical ventilation. METHODS: A total of 91 patients undergoing tubeless VATS (60 sympathectomies, 22 bullae resections, and 9 mediastinal tumor resections) between December 2012 and December 2015 were included...
August 2016: Journal of Thoracic Disease
Yuu Tanaka, Masahiko Kawaguchi, Yoshinori Noguchi, Kenji Yoshitani, Mikito Kawamata, Kenichi Masui, Takeo Nakayama, Yoshitugu Yamada
Motor evoked potential (MEP) monitoring has been used to prevent neurological complications such as paraplegia in patients who underwent thoracic or thoracoabdominal aortic aneurysm (TAA/TAAA) surgery. The object of this study was making a systematic review to survey the performance of MEP monitoring during TAA/TAAA open repair surgery. We searched electronic databases for relevant studies. We summarized the diagnostic data with summary sensitivity, summary specificity and forest plots of pooled sensitivity, and conducted sub-group analysis...
September 9, 2016: Journal of Anesthesia
Mingkwan Wongyingsinn, Annisa Anuwongjaroen
BACKGROUND: Epidural analgesia is the recommended analgesic technique in patients having surgery with moderate to severe postoperative pain. Inadequate pain control in patients receiving epidural analgesia frequently occurred in clinical practice but the number of the success rate or the failure rate have not been reported in our university hospital. OBJECTIVE: The aim of the prospective descriptive study is to examine various data related to and evaluate the effectiveness of the postoperative epidural analgesia in Siriraj Hospital, a university hospital in Thailand...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Murali Chakravarthy, Muralimanohar Veerappa, Vivek Jawali, Nischal Pandya, Jayaprakash Krishnamoorthy, Geetha Muniraju, Antony George, Jitumoni Baishya
BACKGROUND: Minimal invasive surgeries are carried out to benefit the patient with less pain, blood loss, mechanical ventilation and hospital stay; a smaller scar is not the aim. Minimal invasive cardiac surgeries are carried out via small sternotomy, small thoracotomy and via robotic arms. Subxiphoid route is a novel method and avoids sternotomy. AIM: This case series is an attempt to understand the anesthetic modifications required. Secondly, whether it is feasible to carry out subxiphoid coronary artery bypass surgery...
July 2016: Annals of Cardiac Anaesthesia
Ramesh L Narasimhan, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
Intrapleural foreign body is an uncommon condition, usually encountered in the setting of thoracic trauma, but can rarely complicate diagnostic procedures such as thoracentesis. The management involves urgent identification and removal of the foreign body. Although surgical extraction using thoracotomy or video-assisted thoracoscopic surgery under general anesthesia constitutes the primary management strategy, intrapleural foreign body can also be removed using medical thoracoscopy. Herein, we report the successful removal of 2 intrapleural foreign bodies using a rigid thoracoscope under local anesthesia and conscious sedation...
June 30, 2016: Journal of Bronchology & Interventional Pulmonology
Sook Young Lee, Ji Young Yoo, Jong Yeop Kim, Dae Hee Kim, Jung Dong Lee, Go Un Rho, Hyungbae Park, Sung Yong Park
Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled...
June 2016: Medicine (Baltimore)
Kook Nam Han, Hyun Koo Kim, Hyun Joo Lee, Dong Kyu Lee, Heezoo Kim, Sang Ho Lim, Young Ho Choi
BACKGROUND: The development of single-port thoracoscopic surgery and two-lung ventilation reduced the invasiveness of minor thoracic surgery. This study aimed to evaluate the feasibility and safety of single-port thoracoscopic bleb resection for primary spontaneous pneumothorax using two-lung ventilation with carbon dioxide insufflation. METHODS: Between February 2009 and May 2014, 130 patients underwent single-port thoracoscopic bleb resection under two-lung ventilation with carbon dioxide insufflation...
June 2016: Journal of Thoracic Disease
Yaling Liu, Peiying Li, Xinyu Cheng, Weifeng Yu, Liqun Yang, Hui Zhu
Postoperative pulmonary complication (PPC) remains the most common postoperative complication in patients undergoing noncardiac thoracic surgery. We conducted the clinical study to determine the diagnostic role of miRNA-21 in noncardiac thoracic surgery. 368 patients undergoing noncardiac thoracic surgery were recruited. Blood samples were collected before anesthesia and 2 hours after incision during surgery for RT-PCR measurement of miRNA-21. PPC occurrence, extrapulmonary complications, duration of ICU stay, and death within 1 year were evaluated...
2016: Mediators of Inflammation
Xiaotan Dai, Pingping Song, Baijiang Zhang
Tracheal intubation general anesthesia technique is widely used in video-assisted thoracic surgery (VATS) because it can improve the safety of VATS, but the complications of tracheal intubation can not be avoided. How to develop a "minimally invasive" surgery (including micro anesthesia) has become a hot topic in the field of minimally invasive surgery. Along with the progress of the anesthesia management technology and the risk management in the operation, the technology of non-intubated anesthesia was successfully applied to VATS, namely using local anesthesia to maintain patients intraoperative independent ventilation and intraoperative only mild sedation or fully conscious state of implementation of thoracoscope surgery, therefore is also called awake VATS...
May 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Beatrice Beck-Schimmer, John M Bonvini, Julia Braun, Manfred Seeberger, Thomas A Neff, Tobias J Risch, Frank Stüber, Andreas Vogt, Walter Weder, Didier Schneiter, Miodrag Filipovic, Milo Puhan
BACKGROUND: One-lung ventilation during thoracic surgery is associated with hypoxia-reoxygenation injury in the deflated and subsequently reventilated lung. Numerous studies have reported volatile anesthesia-induced attenuation of inflammatory responses in such scenarios. If the effect also extends to clinical outcome is yet undetermined. We hypothesized that volatile anesthesia is superior to intravenous anesthesia regarding postoperative complications. METHODS: Five centers in Switzerland participated in the randomized controlled trial...
August 2016: Anesthesiology
Anis Dizdarevic, Anthony Fernandes
Objective. Primary lateral sclerosis (PLS) is a rare idiopathic neurodegenerative disorder affecting upper motor neurons and characterized by spasticity, muscle weakness, and bulbar involvement. It can sometimes mimic early stage of more common and fatal amyotrophic lateral sclerosis (ALS). Surgical patients with a history of neurodegenerative disorders, including PLS, may be at increased risk for general anesthesia related ventilatory depression and postoperative respiratory complications, abnormal response to muscle relaxants, and sensitivity to opioids, sedatives, and local anesthetics...
2016: Case Reports in Anesthesiology
Togo Seydou, Ouattara Moussa Abdoulaye, Li Xing, Sanogo Zimogo Zi, Koumaré Sekou, Yang Shang Wen, Sankare Ibrahim, Toure Cheik Ahmed Sekou, Maiga Ibrahim Boubacar, Jacque Saye, Dakouo Dodino Jerome, Toure Ousmane Dantoumé, Yena Sadio
INTRODUCTION: The aim of this work was to present the contribution of the endoscopy in the management of esophageal dilatation for caustic esophageal stenosis (CES). METHODS: This was a descriptive and prospective study in the thoracic surgery department at the Hospital of Mali. A total of 46 cases of CES is recorded and divided into 4 groups according to the topography of the esophageal lesions. For the different methods of dilatation the number of performed endoscopic support was determined to understand the contribution of endoscopic means in the success of dilatation for CES...
2016: Pan African Medical Journal
Karsten Ridderbusch, Martin Rupprecht, Philip Kunkel, Christian Hagemann, Ralf Stücker
BACKGROUND: Growth-sparing techniques for the treatment of early onset scoliosis (EOS) have developed significantly over the last years. Traditional growing rods (GRs) require repeated surgical lengthening under anesthesia. Since June 2011 we have been using the magnetically controlled growing rods (MCGR) to treat patients with progressive EOS. METHODS: Thirty-five patients with EOS of different etiologies underwent treatment with MCGR. We record about our preliminary results of 24 patients who fulfilled the inclusion criteria of a minimum follow-up (FU) of 12 month and >3 lengthenings...
May 13, 2016: Journal of Pediatric Orthopedics
T Kammerer, E Speck, V von Dossow
Thoracic surgery represents a special challenge for anesthesia and requires a high level of human and material resources. Accurate knowledge of the pathophysiology is essential for selection of the anesthetic procedure, the separation of the lungs, monitoring and treatment of hemodynamics as well as for postoperative follow-up care. The increasing number of thoracic interventions and patients who are often suffering from complex diseases require close interdisciplinary cooperation between surgeons, anesthesiologists and intensive care specialists...
May 2016: Der Anaesthesist
Zhihua Guo, Weiqiang Yin, Hui Pan, Xin Zhang, Xin Xu, Wenlong Shao, Hanzhang Chen, Jianxing He
BACKGROUND: The aim of this study was to reveal the short-term outcomes of video-assisted thoracoscopic surgery (VATS) segmentectomy without tracheal intubation compared with intubated general anesthesia with one-lung ventilation (OLV). METHODS: We performed a retrospective review of our institutional database of consecutive 140 patients undergoing VATS anatomical segmentectomy from July 2011 to June 2015. Among them, 48 patients were treated without tracheal intubation using a combination of thoracic epidural anesthesia (TEA), intrathoracic vagal blockade, and sedation (non-intubated group)...
March 2016: Journal of Thoracic Disease
Rosa Klotz, Stefan Hofer, Alexander Schellhaaß, Colette Dörr-Harim, Solveig Tenckhoff, Thomas Bruckner, Christina Klose, Markus K Diener, Markus A Weigand, Markus W Büchler, Phillip Knebel
BACKGROUND: Despite substantial improvements in surgical and anesthesiological practices leading to decreased mortality of less than 5 % at high-volume centers, pancreatic surgery is still associated with high morbidity rates of up to 50 %. Attention is increasingly directed toward the optimization of perioperative management to reduce complications and enhance postoperative recovery. Currently, two different strategies for postoperative pain management after pancreatoduodenectomy are being routinely used: patient-controlled intravenous analgesia and thoracic epidural analgesia...
2016: Trials
Ming-xing Tang, Hong-qi Zhang, Yu-xiang Wang, Chao-feng Guo, Jin-yang Liu
Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited...
February 2016: Orthopaedic Surgery
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