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https://www.readbyqxmd.com/read/29600064/national-adoption-of-video-assisted-thoracoscopic-surgery-vats-lobectomy-the-italian-vats-register-evaluation
#1
Duilio Divisi, Luca Bertolaccini, Mirko Barone, Dario Amore, Desideria Argnani, Gino Zaccagna, Piergiorgio Solli, Gaetano Di Rienzo, Carlo Curcio, Roberto Crisci
Background: The expertise curve of video-assisted thoracoscopic surgery (VATS) lobectomies still stirs debate and controversy both because of the number of procedures to carry out and of the evaluation of the learning threshold. The purpose of our study was the examination of the variables related to the learning curve of the video-assisted approach, to establish what may be an expression of the technical maturity of the surgeon. Methods: The National Register for VATS lobectomy built in 2013 was used to collect data from 65 Thoracic Surgery Units...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29579185/safety-of-lymphadenectomy-during-video-assisted-thoracic-surgery-lobectomy-analysis-from-a-national-database
#2
Alessandro Gonfiotti, Alessandro Bertani, Mario Nosotti, Domenico Viggiano, Stefano Bongiolatti, Luca Bertolaccini, Andrea Droghetti, Piergiorgio Solli, Roberto Crisci, Luca Voltolini
OBJECTIVES: The Italian VATS Group database was accessed to evaluate whether preoperative and intraoperative factors may affect the safety of lymphadenectomy (LA) during video-assisted thoracic surgery lobectomy. METHODS: All video-assisted thoracic surgery lobectomy procedures performed between 1 January 2014 and 30 March 2017 for non-small-cell lung cancer with cN0 or cN1 disease were identified in the database. LA safety was evaluated based on intraoperative (operative time, bleeding and conversion rate) and postoperative (30-day morbidity and mortality, chest drain duration and length of stay) outcomes and was correlated with the number of resected lymph nodes and the rates of nodal upstaging...
March 20, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29553480/real-time-chest-wall-motion-tracking-by-a-single-optical-fibre-grating-a-prospective-method-for-ventilator-triggering
#3
Marija D Ivanovic, Jovana Petrovic, Andrej Savic, Goran Gligoric, Marjan Miletic, Miodrag Vukcevic, Bosko Bojovic, Ljupco Hadzievski, Tom D P Allsop, David J Webb
The ventilators involved in non-invasive mechanical ventilation commonly provide ventilator support via a facemask. The interface of the mask with a patient promotes air leaks that cause errors in the feedback information provided by a pneumatic sensor and hence patient-ventilator asynchrony with multiple negative consequences. Our objective is to test the possibility of using chest-wall motion measured by an optical fibre-grating sensor as a more accurate non-invasive ventilator triggering mechanism.
 Approach: The basic premise of our approach is that the measurement accuracy can be improved by using a triggering signal that precedes pneumatic triggering in the neuro-ventilatory coupling sequence...
March 19, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29498941/ultrasound-guided-laryngeal-air-column-width-difference-as-a-new-predictor-for-postextubation-stridor-in-children
#4
Doaa El Amrousy, Mohamed Elkashlan, Nagat Elshmaa, Ahmed Ragab
OBJECTIVES: To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. DESIGN: Prospective observational study. SETTING: Single, tertiary care pediatric hospital. PATIENTS: This study was carried out at PICU and surgical ICU, Tanta University Hospital on 400 ventilated children between January 2015 and May 2017. Patients who received mechanical ventilation and met criteria for a weaning trial were included...
March 1, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29480071/use-of-endo-bronchial-end-tidal-co-2-test-for-location-of-the-pleural-air-leakage-in-patients-with-intractable-pneumothorax
#5
Yi-Ming Zeng, Yun-Feng Chen, Hui-Huang Lin, Xiao-Bin Zhang
BACKGROUND: Location of the affected bronchus of pleural air leaks is the most important step of trans-bronchoscopic bronchial occlusion for the treatment of intractable pneumothorax. The balloon occlusion test is the most commonly used technique, but has failed in some cases. The aim of the present study was: (1) to determine if endo-bronchial end-tidal CO2 (EtCO2 ) measurement can identify the affected bronchus that is the source of a persistent pleural air leak; and (2) to establish a methodology for endo-bronchial EtCO2 testing in locating affected bronchus in intractable pneumothorax...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29422335/comparison-of-three-continuous-positive-airway-pressure-cpap-interfaces-in-healthy-beagle-dogs-during-medetomidine-propofol-constant-rate-infusions
#6
Carolina Meira, Fabiola B Joerger, Annette P N Kutter, Andreas Waldmann, Simone K Ringer, Stephan H Böehm, Samuel Iff, Martina Mosing
OBJECTIVE: To compare the efficacy of three continuous positive airway pressure (CPAP) interfaces in dogs on gas exchange, lung volumes, amount of leak during CPAP and rebreathing in case of equipment failure or disconnection. STUDY DESIGN: Randomized, prospective, crossover, experimental trial. ANIMALS: Ten purpose-bred Beagle dogs. METHODS: Dogs were in dorsal recumbency during medetomidine-propofol constant rate infusions, breathing room air...
December 5, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29414895/a-case-of-spontaneous-pneumomediastinum-with-subcutaneous-emphysema-in-children
#7
Said Benlamkaddem, Mohamed Adnane Berdai, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum is defined as free air or gas contained within the mediastinum, which almost invariably originates from the alveolar space or the conducting airways. It is rare in pediatric patients; however, occasional cases are reported to result from forced Valsalva's maneuver due to cough, emesis, a first attack of wheeze, or asthma exacerbations. We report the case of a 7-year-old previously healthy girl, with a history of persistent dry cough one day before, who was brought to our unit with face, neck and chest swelling...
February 7, 2018: Children
https://www.readbyqxmd.com/read/29386215/tension-pneumoperitoneum
#8
Giovanni Ferrara, Venkata Satish Kolli, Stefan Arnaudov, Graham Whiteley
A 35-year-old man stopped breathing after injecting a large dose of heroin. He subsequently received cardiopulmonary resuscitation from friends. He arrived to accident and emergency department with Glasgow Coma Scale of 13. On examination, he had distended and tense abdomen. CT Thorax, Abdomen, and Pelvis confirmed massive tension pneumoperitoneum. A 14 Fr intravenous cannula was inserted through the umbilicus to relieve the intra-abdominal pressure. An emergency laparotomy showed petechia along the anterior gastric wall, haematoma of lesser omentum but showed no evidence of gastrointestinal perforation or organ injury...
January 31, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29384486/buoyancy-disorders-in-pet-axolotls-ambystoma-mexicanum-three-cases
#9
Yoshinori Takami, Yumi Une
As far as we are aware, there are no previous reports on the pathologic conditions of buoyancy disorders in Ambystoma mexicanum. Herein, we describe various clinical test results, clinical outcomes, and the pathological findings of an experimental pneumonectomy procedure in 3 A. mexicanum exhibiting abnormal buoyancy. The 3 pet A. mexicanum were adults, and their respective ages and body weights were 1, 5, and 6 yr and 48, 55, and 56 g. Two of these cases were confirmed via radiographic examination to have free air within the body cavity, and all 3 cases were found via ultrasonography to have an acoustic shadow within the body cavity and were diagnosed with pneumocoelom...
January 31, 2018: Diseases of Aquatic Organisms
https://www.readbyqxmd.com/read/29383943/complications-of-surgery-for-infectious-lung-cavities
#10
Gildardo Cortés-Julián, Luis C Valencia, Silviano Ríos-Pascual, Marco A de la Rosa-Abarroa, Enrique Guzmán-de Alba
Background Infectious lung cavities are a common entity for the respiratory physician. Sometimes these lesions require surgical treatment, but surgery is challenging, and complications are common. Methods Patients with infectious lung cavities amenable to surgical treatment were included in a case-control study. The control group included patients with no complications. The cases group comprised patients with any of the following complications up to 90 days after surgery: death, persistence of hemoptysis, empyema, operative blood loss > 500 mL, vascular lesion requiring repair, massive transfusion (>5 units of packed red blood cells per 48 h) or reoperation for bleeding, postoperative mechanical ventilation, intensive care unit stay > 48 h, prolonged air leak, and persistent atelectasis...
February 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29372629/chest-tube-drainage-of-the-pleural-space-a-concise-review-for-pulmonologists
#11
REVIEW
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
January 24, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29346253/an-innovative-solution-for-prolonged-air-leaks-the-customized-endobronchial-silicone-blocker
#12
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rakesh Godara, Chakravarthi Lokanath, Michael Cutaia
BACKGROUND: Prolonged air leak (PAL) is a life-threatening condition that can present either as bronchopleural fistula, or alveolar-pleural fistula (APF). Although numerous bronchoscopic treatments are described, they are either expensive, not widely available in the developing world or have limited success. We describe our experience with a novel customized endobronchial silicone blocker (CESB) for PAL treatment. METHODS: This is a retrospective study of PAL patients who underwent CESB placement...
April 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29278753/intraoperative-endoscopy-prevents-technical-defect-related-leaks-in-laparoscopic-roux-en-y-gastric-bypass-a-randomized-control-trial
#13
Carlos Valenzuela-Salazar, Martin E Rojano-Rodríguez, Sujey Romero-Loera, Mario E Trejo-Ávila, Joseph Bañuelos-Mancilla, Roberto Delano-Alonso, Mucio Moreno-Portillo
BACKGROUND: Postoperative anastomotic leaks, bleeding and stenosis are major causes of morbidity after laparoscopic Roux-en-Y gastric bypass (LRYGB). Retrospective studies suggest that intraoperative endoscopy reduces the incidence of these complications. METHODS: We conducted a prospective randomized controlled trial in a single institution between March 2013 and January 2016. Patients were assigned to one of two groups: LRYGB with Intraoperative Endoscopy (IOE) or LRYGB without IOE...
February 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29246712/selection-of-appropriate-endotracheal-tube-size-using-thoracic-radiography-in-beagle-dogs
#14
Chi Won Shin, Won-Gyun Son, Min Jang, Hyunseok Kim, Hyungjoo Han, Jeesoo Cha, Inhyung Lee
OBJECTIVE: To determine the optimal endotracheal tube size in Beagle dogs using thoracic radiography. STUDY DESIGN: Prospective, randomized, crossover experimental study. ANIMALS: A total of eight healthy adult Beagle dogs. METHODS: Lateral thoracic radiographs were used to measure the internal tracheal diameter at the thoracic inlet. This measurement was multiplied by 60, 70 and 80% to determine the outer diameter of the endotracheal tube for each dog...
January 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29189279/alkalinized-lidocaine-preloaded-endotracheal-tube-cuffs-reduce-emergence-cough-after-brief-surgery-a-prospective-randomized-trial
#15
Papu Nath, Stephan Williams, Luis Fernando Herrera Méndez, Nathalie Massicotte, François Girard, Monique Ruel
BACKGROUND: Alkalinized lidocaine in the endotracheal tube (ETT) cuff decreases the incidence of cough and throat pain on emergence after surgery lasting more than 2 hours. However, alkalinized lidocaine needs 60-120 minutes to cross the ETT cuff membrane; therefore, its usefulness in shorter duration surgery is unknown. This prospective double-blind randomized controlled trial tested the hypothesis that alkalinized lidocaine would reduce the incidence of emergence cough after surgeries lasting <120 minutes...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29172236/what-is-the-optimal-management-of-an-intra-operative-air-leak-in-a-colorectal-anastomosis
#16
J B Mitchem, C Stafford, T D Francone, P L Roberts, D J Schoetz, P W Marcello, R Ricciardi
AIM: An airtight anastomosis on intra-operative leak testing has been previously demonstrated to be associated with a lower risk of clinically significant postoperative anastomotic leak following left-sided colorectal anastomosis. However, to date, there is no consistently agreed upon method for management of an intra-operative anastomotic leak. Therefore, we powered a noninferiority study to determine whether suture repair alone was an appropriate strategy for the management of an intra-operative air leak...
February 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29123439/thoracoscopic-treatment-of-pulmonary-hydatid-cysts-may-have-a-high-morbidity-risk-in-children-retrospective-analysis
#17
Zafer Dokumcu, Serkan Arslan, Emre Divarci, Ata Erdener, Coskun Ozcan
Objective: Thoracoscopic treatment of pulmonary hydatid cyst (PHC) has been considered to be a good treatment option in both children and adults for nearly 25 years. However, there have been very few pediatric studies published during this period. Our goal is to review our results and evaluate the efficiency of thorascopy in pediatric patients. Materials and Methods: The medical records of patients with PHC who were surgically treated between 2005 and 2015 were reviewed...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29117819/role-of-ultrasound-in-confirmation-of-endotracheal-tube-in-neonates-a-review
#18
Deepak Sharma, Seyyed Ahmad Tabatabaii, Nazanin Farahbakhsh
Tracheal intubation (TI) is a commonly done procedure in neonatal intensive care unit and delivery room during resuscitation. The confirmation of endotracheal tube (ETT) position should be done quickly as tube malposition is associated with various serious adverse outcomes like hypoxemia, right upper lobe collapse, atelectasis, air leak syndromes and esophageal intubation. ETT position can be confirmed by various methods like clinical sign, chest radiography, capnography, external digital tracheal palpation, ultrasonography (USG), respiratory function monitor, video-laryngoscope and fiberoptic devices...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28959372/a-decision-theoretic-comparison-of-treatments-to-resolve-air-leaks-after-lung-surgery-based-on-nonparametric-modeling
#19
Yanxun Xu, Peter F Thall, Peter Müller, Reza J Mehran
We propose a Bayesian nonparametric utility-based group sequential design for a randomized clinical trial to compare a gel sealant to standard care for resolving air leaks after pulmonary resection. Clinically, resolving air leaks in the days soon after surgery is highly important, since longer resolution time produces undesirable complications that require extended hospitalization. The problem of comparing treatments is complicated by the fact that the resolution time distributions are skewed and multi-modal, so using means is misleading...
2017: Bayesian Analysis
https://www.readbyqxmd.com/read/28934741/successful-management-of-a-positive-air-leak-test-during-laparoscopic-colorectal-surgery
#20
Kazuhito Sasaki, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Tomomichi Kiyomatsu, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Koji Yasuda, Koji Murono, Toshiaki Watanabe
BACKGROUND/AIMS: Anastomotic leakage remains the most serious complications of colorectal surgery. To prevent colorectal anastomotic leakage (CAL), an air leak test (ALT) with intraoperative colonoscopy (IOCS) is performed to detect mechanically insufficient colorectal anastomoses. The approaches to an intraoperative anastomotic air leak (IOAL) have not been fully investigated. This study aimed to clarify the safe management of an IOAL in laparoscopic colorectal surgery. METHODS: One hundred forty-eight consecutive patients who underwent laparoscopic resection with double-stapling technique (DST) anastomosis for left-sided colorectal cancer between April 2015 and June 2016 were included and retrospectively reviewed...
September 22, 2017: Digestive Surgery
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