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Neonate thoracoscopy

Mario Lima, Michela Maffi, Tommaso Gargano, Giovanni Ruggeri, Michele Libri, Francesca Destro
We report the case of a neonate affected by prenatally diagnosed congenital diaphragmatic hernia (CDH), treated by thoracoscopy. During the procedure, we detected an associated extralobar pulmonary sequestration (EPS), which was preoperatively undiagnosed, and we removed it. EPS has been shown to be associated with CDH in up to 15 to 40% of cases. A possible explanation hypothesized is that pulmonary sequestration, which develops at 4 to 5 weeks of gestation, can disturb the fusion of the diaphragm and closure of the pleuroperitoneal canal...
December 2016: European Journal of Pediatric Surgery Reports
Satoshi Makita, Kenitiro Kaneko, Yasuyuki Ono, Hiroo Uchida
PURPOSE: We aimed to identify the risk factors for thoracic and spinal deformities following lung resection during childhood and to elucidate whether thoracoscopic surgery reduces the risk of complications after lung resection. METHODS: We retrospectively examined the medical records of all pediatric patients who underwent lung resection for congenital lung disease at our institution between 1989 and 2014. RESULTS: Seventy-four patients underwent lung resection during the study period and were followed-up...
October 25, 2016: Surgery Today
Hemanshoo Sudhir Thakkar, Jonathan Durell, Subhasis Chakraborty, Bianca-Lea Tingle, Arnwald Choi, Darren J Fowler, Steve J Gould, Lawrence Impey, Kokila Lakhoo
Congenital airway pulmonary malformations are increasingly being diagnosed, but their management continues to remain controversial. Our approach has been to offer surgery to mitigate the risk of infection and possible malignancy. All patients routinely undergo a CT scan of the chest postnatally and once the diagnosis is confirmed, minimal access surgery is offered. Our anesthetists provide single-lung ventilation to enhance the operative view. We conducted a retrospective review over a 10-year period, during which 91 patients were prenatally suspected to have a cystic lung lesion...
October 10, 2016: European Journal of Pediatric Surgery
Kazuo Oshima, Hiroo Uchida, Takahisa Tainaka, Akihide Tanano, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Ryo Shirotsuki, Kosuke Chiba, Akinari Hinoki
A right aortic arch (RAA) is found in 5% of neonates with tracheoesophageal fistulae (TEF) and may be associated with vascular rings. Oesophageal repairs for TEF with an RAA via the right chest often pose surgical difficulties. We report for the first time in the world a successful two-stage repair by left-sided thoracoscope for TEF with an RAA and a vascular ring. We switched from right to left thoracoscopy after finding an RAA. A proximal oesophageal pouch was hemmed into the vascular ring; therefore, we selected a two-stage repair...
January 2017: Journal of Minimal Access Surgery
Tariq Altokhais, Mohammad Aqil Soomro, Abdulmonem Gado, Abdulrahman Albassam
Objectives This study aims to evaluate the feasibility, safety, limitations, and outcomes of performing different surgical approaches and techniques for the bedside repair of congenital diaphragmatic hernia (CDH) in critically ill patients who cannot be transferred to the operating room. Study Design Between December 1997 and July 2013, medical charts of all neonates operated on at the bedside for CDH while on high-frequency oscillatory ventilation (HFOV) and nitric oxide were reviewed. Demographic data; contributing antenatal, perinatal, and postnatal factors; clinical presentation; associated anomalies; respiratory and hemodynamic status; operative details; complications, and outcome were analyzed...
July 2016: American Journal of Perinatology
Subramanian Hari Rao, Saravanan Natarajan, Vyapaka Pallavi
Congenital eventration of the diaphragm is a rare disorder, the perioperative management of which is challenging. The introduction of thoracoscopic repair of these defects has considerably reduced the perioperative morbidity and mortality in these patients. In spite of the advantages of thoracoscopy which include smaller chest incisions, reduced postoperative pain, and more rapid postoperative recovery compared with thoracotomy, it is still inherent with complications unique to it. A clear understanding of the pathophysiologic changes, potential complications and institution of appropriate monitoring and good planning is essential for the safe conduct of thoracoscopic procedures in neonates...
January 2016: Anesthesia, Essays and Researches
So Hyun Nam, Min Jeong Cho, Dae Yeon Kim
PURPOSE: The aim of this study is to present our experience with minimally invasive surgery (MIS) for congenital cystic adenomatoid malformations (CCAMs). METHODS: The medical records of infants under 2 years of age who underwent operation for a CCAM from 2009 to 2014 were retrospectively reviewed. RESULTS: MIS (9 of thoracoscopy and 1 of laparoscopy) was performed for 10 infants (male:female = 7:3) with CCAM. CCAM were discovered prenatally around gestational age of 24...
February 2016: Annals of Surgical Treatment and Research
Stefaan H A J Tytgat, Maud Y A van Herwaarden, Lisanne J Stolwijk, Kristin Keunen, Manon J N L Benders, Jurgen C de Graaff, Dan M J Milstein, David C van der Zee, Petra M A Lemmers
BACKGROUND: Little is known about the effects of carbon dioxide (CO2) insufflation on cerebral oxygenation during thoracoscopy in neonates. Near-infrared spectroscopy can measure perioperative brain oxygenation [regional cerebral oxygen saturation (rScO2)]. AIMS: To evaluate the effects of CO2 insufflation on rScO2 during thoracoscopic esophageal atresia (EA) repair. METHODS: This is an observational study during thoracoscopic EA repair with 5 mmHg CO2 insufflation pressure...
July 2016: Surgical Endoscopy
Mario A Riquelme, Carlos D Guajardo, Marco A Juarez-Parra, Rodolfo A Elizondo, Julio C Cortinas
We present a case of congenital diaphragmatic hernia that was successfully treated with spi-ral tacks using thoracoscopy. A newborn female was diagnosed with a diaphragmatic hernia at 20 weeks of gestation. The defect was surgically repaired by thoracoscopy and primary closure. On postoperative day 25, she developed respiratory distress. Chest x-ray showed a recurrence and was taken to the OR for surgical repair with spiral tacks.
July 2015: Journal of Neonatal Surgery
Tomasz Stankowski, Sleiman Sebastian Aboul-Hassan, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether thoracoscopic patent ductus arteriosus (PDA) closure is superior to conventional surgery. Altogether 821 papers were found using the reported search, 11 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Eleven studies included in the analysis consisted of two prospective and three retrospective, non-randomized studies and six case series...
October 2015: Interactive Cardiovascular and Thoracic Surgery
Hiroaki Fukuzawa, Akihiko Tamaki, Jyunkichi Takemoto, Keiichi Morita, Kosuke Endo, Tamaki Iwade, Okata Yuichi, Yuko Bitoh, Akiko Yokoi, Kosaku Maeda
A large congenital diaphragmatic hernia needing patch repair has a high risk of recurrence. Thus, managing these large congenital diaphragmatic hernias under thoracoscopy has become a problem. Here, a large congenital diaphragmatic hernia that was repaired using Gerota's fascia under thoracoscopy is reported. In the present case, it was impossible to close the hernia directly under thoracoscopy because the hernia was too large. Gerota's fascia was raised up by the left kidney and used for the repair. The left colon adhering to Gerota's fascia was mobilized, and a large space was made under thoracoscopy...
May 2015: Asian Journal of Endoscopic Surgery
Lucile Fievet, Claudia Natale, Xavier-Benoit D'Journo, Stéphanie Coze, Jean-Christophe Dubus, Jean-Michel Guys, Pascal Thomas, Pascal De Lagausie
UNLABELLED: In adults, congenital pulmonary malformations are candidates for surgery due to symptoms. A pre-natal diagnosis is simple and effective, and allows an early thoracoscopic surgical treatment. A retrospective study was performed to assess management in two different populations of adults and children to define the best strategy. SUBJECTS AND METHODS: Pulmonary malformations followed at the University Hospital from 2000 to 2012 were reviewed. Clinical history, malformation site, duration of hospitalisation, complications and pathology examinations were collected...
April 2015: Journal of Minimal Access Surgery
Lisanne J Stolwijk, Stefaan H A J Tytgat, Kristin Keunen, Nutnicha Suksamanapan, Maud Y A van Herwaarden, Floris Groenendaal, Petra M A Lemmers, David C van der Zee
OBJECTIVE: To evaluate the effect of CO2-insufflation with 5 and 10 mmHg on cerebral oxygenation and hemodynamics in neonates. BACKGROUND: An increasing percentage of surgical interventions in neonates are performed by minimal invasive techniques. Recently, concerns have been raised regarding a decrease of cerebral oxygenation in neonates during thoracoscopy as a result of CO2-insufflation. METHODS: This was an animal experimental study. Piglets were anesthetized, intubated, ventilated, and surgically prepared for CO2-insufflation...
September 2015: Surgical Endoscopy
Quentin Ballouhey, Thierry Villemagne, Jérôme Cros, Virginie Vacquerie, Daniel Bérenguer, Karim Braik, Caroline Szwarc, Bernard Longis, Hubert Lardy, Laurent Fourcade
OBJECTIVES: Many studies have reported that robotic-assisted surgery is safe and feasible for paediatric cases. However, very few paediatric thoracic robotic cases have been described. The aim of this study was to share our preliminary experience with robot-assisted thoracic surgery (RATS). METHODS: We reviewed our first, consecutive thoracic robotic procedures between January 2008 and December 2013. Data describing the perioperative and intraoperative periods were prospectively collected in two surgical paediatric centres and then retrospectively analysed...
March 2015: Interactive Cardiovascular and Thoracic Surgery
J S Huang, C T Lau, W Y Wong, Q Tao, Kenneth K Y Wong, P K H Tam
INTRODUCTION: Congenital diaphragmatic hernia is a potentially life-threatening neonatal condition which required surgical intervention. With the advances in endosurgical instruments and techniques, thoracoscopic approach is gaining popularity as a standard procedure in the treatment of this condition. In this study, we reviewed our two centres' experience with thoracoscopic repair of congenital diaphragmatic hernia in recent years. METHODS: All patients who underwent thoracoscopic repair of congenital diaphragmatic hernia between 2010 and 2013 at the two tertiary referral centres were identified...
February 2015: Pediatric Surgery International
Christopher W Snyder, N Elizabeth Walford, Paul D Danielson, Nicole M Chandler
PURPOSE: Existing minimal-access surgical approaches for correction of symptomatic diaphragmatic eventration may be technically difficult in neonates and infants. We report technical details and initial outcomes of a novel, simple thoracoscopic repair technique. METHODS: The technique uses one 3-mm camera port, a 3-mm instrument incision without a port, and an 18-gauge spinal needle, which is passed through the chest wall into the pleural space. The excess diaphragm is first plicated over the needle, after which a non-absorbable suture is passed through the needle and tied extracorporeally...
October 2014: Pediatric Surgery International
Masaya Yamoto, Naoto Urusihara, Koji Fukumoto, Go Miyano, Hiroshi Nouso, Keiichi Morita, Hiromu Miyake, Masakatsu Kaneshiro
PURPOSE: The potential benefits of thoracoscopic repair (TR) of esophageal atresia and tracheoesophageal fistula (EA/TEF) in newborns are still unclear. Our aim was to define the criteria, perioperative outcome after undergoing TR versus open repair (OR) for EA/TEF. PATIENTS AND METHODS: A retrospective chart review was conducted of 36 consecutive neonates who underwent EA/TEF repair between 2001 and 2012 in Shizuoka Children's Hospital. Patients in this study were birth weight >2,000 g, and did not have severe cardiac malformations or chromosomal aberrations...
September 2014: Pediatric Surgery International
Iu A Kozlov, V A Novozhilov, I V Ezhova, V N Medvedev, A V Medvedev, A V Iaroshevich, N I Mikheeva, N V Syrkin, M I Kononenko, N N Kuznetsova
BACKGROUND: Thoracoscopic clipping of the patent ductus arteriosus is an alternative to conventional surgical closure via thoracotomy in low birth weight infants. The aim of this study is to compare of these two groups of patients for the last 11 years. METHODS: We reported the data of 127 small children's who underwent standard transaxillary thoracotomy (101 patients - Group I) and video-assisted thoracoscopic surgery for patent ductus arteriosus clipping (26 patients - Group II)...
2014: Khirurgiia
Christine Burgmeier, Felix Schier
INTRODUCTION: Thoracoscopic repair of esophageal atresia (EA) and congenital diaphragmatic hernia (CDH) repair is increasing in popularity. However, minimally invasive surgery is avoided in infants with heart defects. The aim of this study was to clarify whether cardiac anomalies are a reasonable contraindication to thoracoscopic surgery in term and preterm neonates. PATIENTS AND METHODS: In this retrospective, single-institution study 15 neonates (8 boys and 7 girls) with cardiac anomalies underwent thoracoscopic repair of either EA or CDH...
April 2014: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Arvind Kumar, Belal Bin Asaf, Krishan Chugh, Neetu Talwar
Spontaneous chylothorax, without a predisposing factor is an uncommon cause of pleural effusion beyond the neonatal period. We present a case of left sided spontaneous chylothorax in a 20-month-old boy. We report successful management of this difficult problem with thoracoscopic ligation of thoracic duct after a failed trial with conservative management.
August 2013: Indian Pediatrics
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