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Wang Q, Mao K, Si M, Cao X. Thoracoscopic resection of pulmonary alveoli formed by pulmonary metastases of placental site trophoblastic tumors: A case report. Asian J Surg 2024:S1015-9584(24)00684-5. [PMID: 38641527 DOI: 10.1016/j.asjsur.2023.12.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/25/2023] [Indexed: 04/21/2024] Open
Affiliation(s)
- Qin Wang
- Department of Reproductive Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
| | - Kaiyun Mao
- First Clinical Medical College, Gannan Medical University, Ganzhou, China.
| | - Maoyan Si
- Department of Thoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
| | - Xiying Cao
- Department of Thoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
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Cao X, Zhong X, Yu W, Xiong J. Ultrasonography of pericardial synovial sarcoma: A rare case report. Asian J Surg 2023; 46:5889-5890. [PMID: 37709617 DOI: 10.1016/j.asjsur.2023.08.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Affiliation(s)
- Xiying Cao
- Department of Thoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
| | - Xiangkun Zhong
- The First People's Hospital of Nankang District, Ganzhou, China.
| | - Wenbo Yu
- Gannan Medical University, Ganzhou, China.
| | - Jianxian Xiong
- Department of Cardiovascular Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
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梅 松, 吴 姁, 杨 杰, 余 中, 蒋 亚, 薛 宇, 杜 春. [Application of Precision Nursing Based on Multidisciplinary Collaboration Model in Older Patients Undergoing Thoracoscopic Surgery for Lung Cancer]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:1052-1057. [PMID: 37866968 PMCID: PMC10579088 DOI: 10.12182/20230960508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Indexed: 10/24/2023]
Abstract
Objective To examine the application effect of precision nursing strategies based on multidisciplinary collaboration model in older patients undergoing thoracoscopic surgery for lung cancer. Methods A total of 100 patients who were admitted to our hospital for thoracoscopic surgery for lung cancer between July 2022 and March 2023 were prospectively enrolled for the study. They were assigned, with a random number table, to two groups, a control group receiving routine nursing care and an experimental group receiving nursing care based on multidisciplinary collaborative precision nursing strategies. Their lung function, anxiety and depression scores, and quality of life were assessed at three points of time, including upon admission, one week after surgery, and one month after surgery, and comparison was made between the two groups. Results There were significant differences in forced expiratory volume in one second (FEV1) at the three time points ( F=156.787, P<0.001) and the ratio of FEV1 to forced vital capacity (FVC) (FEV1/FVC%) at the three time points ( F=25.587, P<0.001) between two groups. There were significant difference between the findings for FEV1, FEV1/FVC%, FVC, and maximum voluntary ventilation (MVV) indexes at 1 week and those at 1 month after surgery in the experimental group ( P<0.05). After the surgery, the pulmonary function of the experimental group was better than that of the control group. The anxiety and depression scores of the experimental group were lower than those of the control group, with the difference being statistically significant ( P<0.05), which suggested that the experimental group showed improvement in anxiety and depression in comparison with the control group. Regarding the quality of life, there were significant differences between the two groups in the scores for the functional dimension ( F=109.798, P<0.001), the symptom dimension ( F=106.936, P<0.001), other items ( F=78.798, P<0.001), and overall health dimensions ( F=174.307, P<0.001). At 1 week and 1 month after surgery, the experimental group had higher scores for the functional dimension and lower scores for the symptom dimension than the control group did, with the differences being statistically significant ( P<0.05). The overall health status of the experimental group was better than that of the control group. Conclusion Precision nursing strategies based on multidisciplinary collaboration model can effectively help improve the lung function, the mood, and the quality of life of patients in the short term, showing considerable promise for wide clinical application.
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Affiliation(s)
- 松利 梅
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 姁怿 吴
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 杰 杨
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 中华 余
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 亚芸 蒋
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 宇 薛
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
| | - 春萍 杜
- 四川大学华西医院 康复医学中心/四川大学华西护理学院 (成都 610041)Rehabilitation Medicine Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 肺癌中心/四川大学华西护理学院 (成都 610041)Lung Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
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Jiang J, Wang L, Xia H, Liu Y. Watch out for the lung tissue trapped by fractured ribs: a case report. Interdiscip Cardiovasc Thorac Surg 2023:7180279. [PMID: 37233210 DOI: 10.1093/icvts/ivad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/04/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
A 52-year-old woman was injured in an accident, emergency tests showed rib fracture and pleural effusion. However, lung incarceration was found during thoracic exploration which was not detected in preoperative imaging findings. Although rare, Clinicians should be careful of this possible pitfall, which may bring about poor prognosis after rib fracture.
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Affiliation(s)
- Jipeng Jiang
- Department of Thoracic Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Linghui Wang
- Department of Thoracic Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hui Xia
- Department of Thoracic Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang Liu
- Department of Thoracic Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing, China
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Zhang J, Liu Y. Efficacy of single- and double-hole thoracoscopic lobectomy for treatment of non-small cell lung cancer: a meta-analysis. Am J Transl Res 2023; 15:3013-3025. [PMID: 37303678 PMCID: PMC10251010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/17/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To compare the effectiveness of single-port and double-port thoracoscopic lobectomy in the treatment of non-small cell lung cancer (NSCLC) using meta-analysis. METHODS We systematically searched Pubmed, Embase, and Cochrane Library databases to collect literature on single-hole and double-hole thoracoscopic lobectomy for NSCLC with the end date of August 2022. Keywords included "thoracoscopy", "lobectomy", and "non-small cell lung cancer". Two authors independently conducted literature screening, data extraction, and quality evaluation. The quality evaluation tools were the Cochrane bias risk assessment tool and the Newcastle-Ottawa scale. Meta-analysis was performed using RevMan5.3 software. The odds ratio (OR), weighted mean difference (WMD), and 95% Cl were calculated using a fixed-effects model or random-effect model as appropriate. RESULTS Ten studies were included. These included two randomized controlled studies and eight cohort studies. 1800 sick persons were included in the survey. Among them, 976 sick people underwent single-hole thoracoscopic lobectomy (single-hole group), and 904 had double-hole thoracoscopic lobectomy (double-hole group). The results of the meta-analysis are as follows. The intraoperative bleeding volume [WMD = -13.75, 95% CI (-18.47, -9.03), P < 0.001], postoperative 24 h VAS score [WMD = -0.60, 95% CI (-0.75, -0.46), P < 0.001], and postoperative hospital stay time [WMD = -0.33, 95% CI (-0.54, -0.11), P = 0.0003] in the single-hole group was less than that in the double-hole group. The amount of dissected lymph nodes in the double-hole group was more than that in the single-hole group [WMD = 0.50, 95% CI (0.21, 0.80), P = 0.0007]. In both groups, operative time [WMD = 1.00, 95% CI (-9.62, 11.62), P = 0.85], intraoperative conversion rate [OR = 1.07, 95% CI (0.55, 2.08), P = 0.85], postoperative drainage time [WMD = -0.18, 95% CI (-0.52, -0.17), P = 0.32], and postoperative complications rate [OR = 0.89, 95% CI (0.65, 1.22), P = 0.46] had no statistical significance. CONCLUSION Single-hole thoracoscopic lobectomy has advantages in reducing intraoperative bleeding volume, alleviating early postoperative pain, and shortening postoperative hospital stay time. Double-hole thoracoscopic lobectomy has advantages in lymph node dissection. Both methods are equally safe and feasible for NSCLC.
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Affiliation(s)
- Jie Zhang
- Cardio-Thoracic Surgery, Yantai Montain Hospital Yantai 264000, Shandong, China
| | - Yongchang Liu
- Cardio-Thoracic Surgery, Yantai Montain Hospital Yantai 264000, Shandong, China
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Liu L, Zhang F, Wu Z, Tu S, Li Y. Diagnostic challenge and management of thymic cavernous hemangioma: a case report and review of the literature. Curr Med Imaging 2023:CMIR-EPUB-128654. [PMID: 36624647 DOI: 10.2174/1573405619666230109121128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/28/2022] [Accepted: 11/22/2022] [Indexed: 01/11/2023]
Abstract
Objective Thymic cavernous hemangioma (CH) as a benign lesion is extremely rare, and it is very difficult to distinguish it from other anterior mediastinal tumors on imaging. Case Presentation We treated a 63-year-old woman with thymic CH that was incidentally found by chest computed tomography (CT). Contrast-enhanced chest CT described an anterior superior mediastinal mass, approximately 2.5cm in diameter, with centripetal enhancement and an increased range of enhancement in the delayed period. The tumor and thymus were completely resected by video-assisted thoracic surgery (VATS) to provide a definitive diagnosis and precise treatment. Postoperative pathology suggested that the tumor was a thymus cavernous hemangioma. Conclusion We reported an extremely uncommon case of CH in the thymus and reviewed the previously published literature. CH can occur at any age and body tissue, and there is no significant difference between males and females. Most patients are asymptomatic, often found by chest CT. Enhanced chest CT suggested that an increased area of venous enhancement at a prolonged duration may be a feature of CH. Complete surgical resection is a safe and effective method for CH in the thymus.
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Affiliation(s)
- Li Liu
- Department of Cardiothoracic Surgery, Zhejiang University, Lishui Hospital, Lishui Municipal Central Hospital, Lishui, Zhejiang, 323000, P.R. China
| | - Fangbiao Zhang
- Department of Cardiothoracic Surgery, Zhejiang University, Lishui Hospital, Lishui Municipal Central Hospital, Lishui, Zhejiang, 323000, P.R. China
| | - Zhijun Wu
- Department of Cardiothoracic Surgery, Zhejiang University, Lishui Hospital, Lishui Municipal Central Hospital, Lishui, Zhejiang, 323000, P.R. China
| | - Shaosong Tu
- Department of Cardiothoracic Surgery, Zhejiang University, Lishui Hospital, Lishui Municipal Central Hospital, Lishui, Zhejiang, 323000, P.R. China
| | - Yan Li
- Department of Cardiothoracic Surgery, Zhejiang University, Lishui Hospital, Lishui Municipal Central Hospital, Lishui, Zhejiang, 323000, P.R. China
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Lu Y, Ding H, Shao C, Wang N, Shi J, Lian C, Wu J, Shangguan W. Effect of lidocaine perioperative infusion on chronic postsurgical pain in patients undergoing thoracoscopic radical pneumonectomy. BMC Anesthesiol 2022; 22:255. [PMID: 35945486 PMCID: PMC9361613 DOI: 10.1186/s12871-022-01795-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thoracoscopic radical pneumonectomy is associated with a high incidence of postoperative chronic pain. Studies on the benefits of lidocaine intravenous infusion during the perioperative period were still controversial in thoracoscopic surgery. METHODS Sixty-four lung cancer patients scheduled for thoracoscopic radical pneumonectomy were randomly divided into two groups: normal saline group (control group) or lidocaine group. In the lidocaine group, 1.5 mg/kg lidocaine was administered during the anesthesia induction, and 2 mg·kg-1·h-1 lidocaine was continuously intravenous infused until the end of the surgery. After the surgery, a mixture of 2 μg/kg sufentanil and 10 mg/kg lidocaine was continuously intravenous infused by postoperative patient-controlled intravenous analgesia pump (100 ml). In the control group, the same volume of normal saline was administered according to the calculation of lidocaine during anesthesia induction, maintenance and postoperative patient-controlled intravenous analgesia. The primary outcome was the incidence of chronic postoperative pain at 3 months after the surgery. The secondary outcomes include the incidence of chronic postoperative pain at 6 months after the surgery; the effect of lidocaine on postoperative pain within the first 24 and 48 h; total amount of sufentanil administered during entire procedure and the number of PCA triggers within 48 h after surgery. RESULTS Compared with the control group, the incidence of chronic pain at 3 months after the surgery was significantly lower (13 cases, 46.4% vs. 6 cases, 20.7%, p < 0.05), but no significant difference at 6 months between two group. The cumulative dosage of sufentanil in perioperative period was significantly lower (149.64 ± 18.20 μg vs. 139.47 ± 16.75 μg) (p < 0.05), and the number of PCA triggers (8.21 ± 4.37 vs. 5.83 ± 4.12, p < 0.05) was significantly greater in the control group. The NRS pain scores at 24 h (1.68 ± 0.72 vs. 1.90 ± 0.86) and 48 h (1.21 ± 0.42 vs. 1.20 ± 0.41) after the operation were no significant difference. CONCLUSION Perioperative infusion lidocaine significantly reduced the number of PCA triggers and the incidence of chronic postoperative pain at 3 months after the thoracoscopic radical pneumonectomy. TRIAL REGISTRATION http://www.chictr.org.cn : ChiCTR1900024759, frist registration date 26/07/2019.
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Affiliation(s)
- Yi Lu
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China
| | - Hehe Ding
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China.,Department of Anesthesiology, People's Hospital of Ruian, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, 325200, Zhejiang, People's Republic of China
| | - Caiqun Shao
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China
| | - Ning Wang
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China
| | - Junhua Shi
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China
| | - Chaohui Lian
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China
| | - Junzheng Wu
- Department of Anesthesia and Pediatrics, Cincinnati Children Hospital Medical Center, Cincinnati, OH, USA
| | - Wangning Shangguan
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China.
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Chang CY, Hung CC, Liu JM, Chiu CD. Tension pneumocephalus following endoscopic resection of a mediastinal thoracic spinal tumor: A case report. World J Clin Cases 2022; 10:725-732. [PMID: 35097100 PMCID: PMC8771397 DOI: 10.12998/wjcc.v10.i2.725] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/12/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pneumocephalus is a rare complication presenting in the postoperative period of a thoracoscopic operation. We report a case in which tension pneumocephalus occurred after thoracoscopic resection as well as the subsequent approach of surgical management.
CASE SUMMARY A 66-year-old man who received thoracoscopic resection to remove an intrathoracic, posterior mediastinal, dumbbell-shaped, pathology-proven neurogenic tumor. The patient then reported experiencing progressively severe headaches, especially when in an upright position. A brain computed tomography scan at a local hospital disclosed extensive pneumocephalus. Revision surgery for resection of the pseudomeningocele and repair of the cerebrospinal fluid leakage was thus arranged for the patient. During the operation, we traced the cerebrospinal fluid leakage and found that it might have derived from incomplete endoscopic clipping around the tumor stump near the dural sac at the T3 level. After that, we wrapped and sealed all the possible origins of the leakage with autologous fat, tissue glue, gelfoam, and duraseal layer by layer. The patient recovered well, and the computed tomography images showed resolution of the pneumocephalus.
CONCLUSION This report and literature review indicated that the risk of developing a tension pneumocephalus cannot be ignored and should be monitored carefully after thoracoscopic tumor resection.
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Affiliation(s)
- Chao-Yuan Chang
- Department of Neurosurgery, China Medical University Hospital, Taichung 40447, Taiwan
| | - Cheng-Che Hung
- Department of Neurosurgery, China Medical University Hospital, Taichung 40447, Taiwan
| | - Ju-Mien Liu
- Department of Pathology, Puli Christian Hospital, Nantou 54041, Taiwan
| | - Cheng-Di Chiu
- Department of Neurosurgery, China Medical University Hospital, Taichung 40447, Taiwan
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Hernández-Rodríguez RA, Rosell Echevarría MJ, Ravelo Díaz FD, Villamil V, Pérez-Etchepare Figueroa EL. Mid- to long-term results of SuPerLap single-port treatment in inguinal hernia. Cir Pediatr 2022; 35:14-17. [PMID: 35037435 DOI: 10.54847/cp.2022.01.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Laparoscopic treatment of inguinal hernia is gaining popularity in many hospitals, but the use of working channel scopes is not as widely extended. We present our long-term experience with the SuPerLap (laparoscopic-assisted percutaneous suture) technique described by Rosell et al.(1) for epigastric hernia repair in the percutaneous, single-port treatment of inguinal hernia using working channel scopes. MATERIALS AND METHODS A retrospective analysis of a series of male patients with congenital inguinal hernia undergoing surgery from February 2017 to December 2020 was carried out. A 5 mm-0º pleuroscope with a 3.5 mm working channel, a 20 G epidural needle, a 36 cm/3.5 mm laparoscopic Maryland dissector, and 3-0 polypropylene and polyester sutures were used. RESULTS 384 inguinal hernia repairs using the SuPerLap technique were performed in 295 male patients - 206 unilateral repairs and 89 bilateral repairs. In 24 bilateral cases (26.95%), preoperative diagnosis had been unilateral. Mean age was two years (2 weeks-13 years). Mean operating time was 14 minutes (6-50 min) for unilateral repair, and 27 minutes (14-80 min) for bilateral repair. There were two cases of epigastric vessel damage, and one case of early recurrence in a newborn, who successfully underwent re-intervention using the SuPerLap technique. No late complications were recorded after a mean follow-up of 1-36 months. CONCLUSIONS Working channel scopes using the SuPerLap technique avoid additional ports in inguinal hernia repair. They allow for excellent functional results, without visible scars, and minimize spermatic cord manipulation. Laparoscopy allows previously undiagnosed defects to be concomitantly treated.
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Affiliation(s)
- R A Hernández-Rodríguez
- Pediatric Surgery Department. Nuestra Señora de Candelaria University Hospital. Santa Cruz de Tenerife (Spain)
| | - M J Rosell Echevarría
- Pediatric Surgery Department. Nuestra Señora de Candelaria University Hospital. Santa Cruz de Tenerife (Spain)
| | - F D Ravelo Díaz
- Pediatric Surgery Department. Nuestra Señora de Candelaria University Hospital. Santa Cruz de Tenerife (Spain)
| | - V Villamil
- Pediatric Surgery Department. Nuestra Señora de Candelaria University Hospital. Santa Cruz de Tenerife (Spain)
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Tan Z, Lijun-Yang, Zou C, Yu JG, Li JH, Liang L, Shu Q. The application of virtual segmentectomy based on three-dimensional computed tomography and angiography in thoracoscopic segmentectomy for children and infants. Pediatr Surg Int 2021; 37:1207-1214. [PMID: 33821327 DOI: 10.1007/s00383-021-04899-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this retrospective study was to evaluate the efficacy of anatomic thoracoscopic pulmonary segmentectomy performed based on three-dimensional computed tomography bronchography and angiography (3D-CTBA) in children and infants. METHODS Totally, 22 patients received thoracoscopic segmentectomy from October 2019 to February 2020. The procedures were performed virtual segmentectomy based on 3D-CTBA. The preoperative planning depended on the 3D-CTBA result. RESULTS All of the 22 cases ( 1 left S1, 1 right S3, 1 left S1 + 2, 1 left S1 + 2 + 3, 1 left S4 + 5, 1 right S6, 1 right S10, 1 left S10, 2 right S9 + 10, 3 left S9 + 10, 1 right S7 + 8 + 9 + 10, 8 left S7 + 8 + 9 + 10) were received thoracoscopic segmentectomy successfully. The mean procedure length was 76.6 ± 17.2 min, and the intraoperative blood loss was 16.5 ± 2.8 ml. The mean duration of chest tube insertion was 3.2 ± 0.7 days, and the mean hospital stay was 8.2 ± 2.8 days. Postoperative complications included infection (n = 1), atelectasis (n = 1), hydropneumothorax (n = 1) and pneumothorax (n = 1). No recurrence or mortality was observed during the short-term follow-up period of 3 months. CONCLUSIONS Based on the 3D-CTBA technique, the specific pulmonary segments invaded by the lesions and the relationship between the corresponding pulmonary vessels and bronchi can be acknowledged before the operation, which is of positive significance for the resection of complex pulmonary segments and good preoperative surgical planning. It's worth popularizing in the pediatric population.
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Affiliation(s)
- Zheng Tan
- Department of Thoracic Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, China.
| | - Lijun-Yang
- Department of Extracorporeal Circulation and Extracorporeal Life Support, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Chen Zou
- Department of Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jian-Gen Yu
- Department of Thoracic Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, China
| | - Jian-Hua Li
- Department of Thoracic Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, China
| | - Liang Liang
- Department of Thoracic Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, China
| | - Qiang Shu
- Department of Thoracic Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang, China
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Wu YY, He ZL, Lu ZY. Thoracoscopic diagnosis of traumatic pericardial rupture with cardiac hernia: A case report. World J Clin Cases 2021; 9:4001-4006. [PMID: 34141759 PMCID: PMC8180212 DOI: 10.12998/wjcc.v9.i16.4001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/26/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pericardial rupture caused by blunt chest trauma is rare in clinical practice. Because of its atypical clinical symptoms, and because surgeons are often unfamiliar with the clinical and radiological manifestations of the injury, preoperative diagnosis is difficult; it is easily misdiagnosed and causes serious consequences.
CASE SUMMARY A 60-year-old man, previously healthy, was transported to the emergency room after falling from a great height. Upon arrival, his vital signs were stable. Electrocardiography and echocardiography were performed, and there was no sign of cardiac injury or ischemia. Chest and abdomen computerized tomography revealed pneumopericardium, hemopneumothorax, lung contusion, multiple rib fractures on the right side (Figure 1), and right scapula and clavicle fractures. He was admitted to the inpatient department for further observation after tube thoracostomy. The next day, the patient suddenly experienced rapid arrhythmia (the ventricular rate reached 150-180 beats/min) when turning onto his right side, accompanied by a blood pressure drop to 70/45 mm Hg and a chief complaint of palpitation. Thoracoscopy was performed urgently, and a large vertical tear (8 cm × 6 cm) was found in the pericardium. The defect was successfully repaired using a heart Dacron patch. His postoperative condition was uneventful without any fluctuations in vital signs, and he was transferred to the orthopedics department for further surgery on postoperative day 8.
CONCLUSION Although the possibility of pericardial rupture combined with cardiac hernia is extremely low, it is one of the causes of cardiogenic shock following blunt trauma. Therefore, clinicians need to be more familiar with its characteristic manifestations and maintain a high degree of vigilance against such injuries to avoid disastrous consequences.
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Affiliation(s)
- Yong-Yong Wu
- Department of Cardiothoracic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
| | - Zhong-Liang He
- Department of Cardiothoracic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
| | - Zi-Ying Lu
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
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Zhao F, Chen Q, Guo Z, Jiang N. Thoracoscopic assistance in tricuspid valvuloplasty in an unarrested state: a case report and literature review. Ann Transl Med 2020; 8:1607. [PMID: 33437806 PMCID: PMC7791200 DOI: 10.21037/atm-20-6995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Tricuspid regurgitation, a common tricuspid lesion, consists of organic and functional tricuspid insufficiency (FTI). FTI is usually secondary to the valvular heart disease in left atrium. Pulmonary hypertension may result in right ventricular and tricuspid annular enlargement. This report documents our findings of tricuspid valve surgery under cardiac arrest with telescopic assistance. A 65-year-old female patient referred to our department received thoracoscope-associated tricuspid valvuloplasty. The patient exhibited a history of intermittent dyspnea and shortness of breath for 20 years, together with edema in the lower limbs for 3 months. A small incision was made, prior to an additional incision of about 3 cm in length before localization was performed at the lateral side of the 4th midclavicular line. The satellite hole was localized at the 5th midaxillary line. The operation was completed under cardiopulmonary bypass with a beating heart. Echocardiogram (ECG) analysis 10 days post-surgery indicated no clinically significant findings. Finally, the patient was discharged with slight tricuspid regurgitation .Thoracoscopy-associated heart surgery reduces postoperative pain and shortens postoperative recovery time. It is in line with the concept of rapid recovery and beauty needs. Our data confirmed that thoracoscope-assisted tricuspid valvuloplasty in an unarrested state was effective for the treatment of patients with tricuspid insufficiency, secondary to post-cardiac surgery.
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Affiliation(s)
- Feng Zhao
- Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China
| | - Qingliang Chen
- Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China
| | - Zhigang Guo
- Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China
| | - Nan Jiang
- Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China
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13
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Li CR, Yu QL, Yang B, Zhang B, Liu Y. [Clinical value of holographic multimodal real-time three-dimensional navigation technology in the surgical location of pulmonary lesions]. Zhonghua Yi Xue Za Zhi 2020; 100:2452-2456. [PMID: 32819062 DOI: 10.3760/cma.j.cn112137-20200207-00214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical value of holographic multimodal real-time three-dimensional navigation (3D-HMRN) technology for navigation and localization of pulmonary micro lesions. Methods: A total of 152 patients who underwent thoracoscopic partial resection of small pulmonary nodules in the Department of Thoracic Surgery of the First Medical Center of Chinese PLA General Hospital from June 2017 to December 2019 were retrospectively collected and were divided into two groups by computer random number. The experimental group consists of 76 patients (31 males and 45 females) with a mean age of (47±17) years. CT scan in lateral position navigation mode and 3D reconstruction of the surgical area were performed on all patients. Before the operation, holographic multimodal real-time 3D navigation technology was used to guide the puncture of the lesion. After the operation was completed, the intraoperative CT was used to verify the location of the puncture and determine the accuracy and error rang of the puncture. The control group consists of 76 patients (34 males and 42 females) with a mean age of (50±19) years. Intraoperative CT positioning was directly subjected to the patients. And then, the localization data of the two groups were compared and statistically analyzed. Results: Seventy-six cases of positioning puncture using navigation technology, the first success rate was 97.4%, the error was (3.9±0.9) mm, and the average operation time was (4.4±1.2) min; while the success rate of one-time CT positioning during routine surgery was 98.7%, the error was (3.5±1.0) mm, and the average operating time was (10.7±2.6) min. Compared with intraoperative CT positioning, the success rate and positioning accuracy of 3D-HMRN were not statistically significant (both P>0.05), however the operation time was significantly shortened (P<0.01). Conclusion: The holographic multi-modal real-time 3D navigation technology saves time and has accurate positioning, which may be used as an effective method for localization of pulmonary micro nodules during surgical treatment.
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Affiliation(s)
- C R Li
- Department of Thoracic Surgery, the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China
| | - Q L Yu
- the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China
| | - B Yang
- Department of Thoracic Surgery, the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China
| | - B Zhang
- Department of Thoracic Surgery, the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China
| | - Y Liu
- Department of Thoracic Surgery, the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China
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14
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Zhou X, Zhang D, Xie Z, Chen M, Yang Y, Liang Z, Zhang G. 3D printing and thoracoscopy assisted MIPO in treatment of long-range comminuted rib fractures, a case report. J Cardiothorac Surg 2019; 14:83. [PMID: 31036030 PMCID: PMC6489358 DOI: 10.1186/s13019-019-0892-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background To investigate the application of 3D printing technology combined with percutaneous Minimally Invasive Plate Oseoynthesis (MIPO) and thoracoscopic techniques in the treatment of long comminuted rib fractures. Case presentation One case of multiple rib fractures with abnormal respiratory disease (including rib 3 and 4 of long comminuted fractures) due to a fall injury was selected. The 3D model of comminuted rib fracture was reconstructed and printed according to the thin-layer CT scan results. After the fracture model was restored to the normal rib anatomy, the metal plate was accurately shaped according to the 3D rib shape. Conclusions 3D printing technology combined with MIPO technology under thoracoscopy in the minimally invasive treatment of long-range comminuted rib fractures, greatly reduced the time and improved the accuracy of intraoperative fixation, reduced the difficulty of surgery, patient injury, and perfectly reconstructed the chest wall. Application of the 3D printing technique to make the rib model and pre-mold the metal plate combined the thoracoscopic MIPO technology provides less invasive and accurate individualized treatment for complex rib fractures.
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Affiliation(s)
- Xuetao Zhou
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Dongsheng Zhang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China.
| | - Zexin Xie
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Menghui Chen
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Yang Yang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Zheng Liang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Guoliang Zhang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
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15
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Han L, Gao S, Tan F, Zhao Z, Song P. [Experience and Progress Processing Policy of Simultaneous Multiple Primary
Lung Cancer]. Zhongguo Fei Ai Za Zhi 2018; 21:180-184. [PMID: 29587936 PMCID: PMC5973046 DOI: 10.3779/j.issn.1009-3419.2018.03.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Simultaneity multiple primary lung cancer always is a rare disease, but in recent years due to the progress of the diagnosis and treatment means detection rate increased. This study summarized the clinical data of 31 cases of synchronous multiple primary lung cancer (sMPLC) analysis, further to explore the diagnosis, treatment and prognosis of MPLC. METHODS Sum up the clinical data of 31 cases of simultaneous multiple primary lung cancer, the diagnostic method, surgical methods, pathology, were retrospectively analyzed. RESULTS All the patients are thoracoscope surgery, no deaths. Thin high resolution computed tomography (CT) in preoperative found multiple lung nodules. Lesions located in the same side of the same period surgical treatment, the operation method is given priority to with under the thoracoscope lung + the lobectomy; Lesions located in bilateral, all staged operation, the time interval for 3 months-4 months. CONCLUSIONS Thin layer distinguish CT preoperative diagnosis is the best way to simultaneous multiple primary lung cancer. Multiple primary lung cancer incidence of ipsilateral lung at the same time higher than that of bilateral lung (23:8), type, around 94%, the most common histology to adenocarcinoma, 80.6% (25/31). Primary lesions under thoracoscope lobectomy plus the lobectomy of secondary lesions is the most commonly used.
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Affiliation(s)
- Liankui Han
- Department of Thoracic Surgery, Guizhou People's Hospital, Guiyang 550000, China
| | - Shugeng Gao
- Department of Thoracic Surgery, Tumor Hospital of the Chinese Academy of Medical Sciences, Beijing 100021, China
| | - Fengwei Tan
- Department of Thoracic Surgery, Tumor Hospital of the Chinese Academy of Medical Sciences, Beijing 100021, China
| | - Ziran Zhao
- Department of Thoracic Surgery, Tumor Hospital of the Chinese Academy of Medical Sciences, Beijing 100021, China
| | - Peng Song
- Department of Thoracic Surgery, Tumor Hospital of the Chinese Academy of Medical Sciences, Beijing 100021, China
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郭 虹, 刁 亚, 范 黄, 罗 清. [Clinical Value of Four-hole Unilateral Dissecting Lobectomy and Mediastinal Lymph Node Dissection in the Treatment of Early Non-small Cell Lung Cancer]. Zhongguo Fei Ai Za Zhi 2018; 21:578-582. [PMID: 30172263 PMCID: PMC6105359 DOI: 10.3779/j.issn.1009-3419.2018.08.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/02/2018] [Accepted: 04/04/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Thoracoscopic lobectomy combined with mediastinal lymph node dissection has been considered as one of the standard surgical procedures for early lung cancer. After 20 years of development, thoracoscopic lobectomy has reached a consensus on reliability and minimally invasive. At present, thoracoscopic lobectomy has a variety of incisions, which gradually evolve into four holes based on three holes, and two or one hole as the operative approach. The aim of this study was to evaluate the clinical value of four-hole unilateral dissecting lobectomy and mediastinal lymph node dissection in the treatment of non-small cell lung cancer (NSCLC). The aim of this study was to investigate the clinical value of anatomical lobectomy with mediastinal lymphadenectomy under four-hole completely video-assisted thoracoscopic surgery (C-VATS) in the treatment of non-small cell lung cancer. METHODS The patients undergoing lobectomy with mediastinal lymphadenectomy for NSCLC were identified in the Department of Thoracic Surgery, Yangzhou First People's Hospital, Yangzhou University from March 2015 to July 2016. Preoperative clinical diagnosis of peripheral-type early NSCLC. The patients were randomly divided into four-hole monophasic group (experimental group) and three-hole group (control group) according to the number of hospitalization before surgery. According to inclusion and exclusion criteria, the 39 cases assign in experimental group and 34 cases in the control group, including 36 males and 37 females; aged 38 to 84 years. The mean operation time, average blood loss, lymph node dissection group, average drainage, average extubation time and postoperative complications were compared between the two groups for statistical analysis. RESULTS The two groups of patients were successfully completed surgery, no death after surgery. Mean bleeding in the two groups, the number of lymph node dissection group, the average postoperative drainage, the average time of extubation, postoperative complications, with no significant difference. The average operation time of the four-hole unidirectional group was shorter than that of the three-hole group. The difference was statistically significant (P<0.05). CONCLUSIONS The safety and efficacy of a four-hole one-way operation under VATS are satisfactory. The operation is smooth during operation, which shortens the course of operation and deserves the clinical promotion.
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Affiliation(s)
- 虹 郭
- 225000 扬州,扬州大学附属医院扬州市第一人民医院胸外科Department of Thoracic Surgery, Affiliated to Hospital of Yangzhou University, Yangzhou 225000, China
| | - 亚利 刁
- 225000 扬州,扬州大学附属医院扬州市第一人民医院胸外科Department of Thoracic Surgery, Affiliated to Hospital of Yangzhou University, Yangzhou 225000, China
| | - 黄新 范
- 225000 扬州,扬州大学附属医院扬州市第一人民医院胸外科Department of Thoracic Surgery, Affiliated to Hospital of Yangzhou University, Yangzhou 225000, China
| | - 清泉 罗
- 200240 上海,上海交通大学附属胸科医院胸外科Department of Thoracic Surgery, Affiliated to Hospital of Shanghai Jiao Tong University, Shanghai 200240, China
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17
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Lee JY, Sul YH, Ye JB, Ko SJ, Choi JH, Kim JS. Right-sided diaphragmatic rupture in a poly traumatized patient. Ann Surg Treat Res 2018; 94:342-345. [PMID: 29854713 PMCID: PMC5976576 DOI: 10.4174/astr.2018.94.6.342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/20/2017] [Accepted: 08/03/2017] [Indexed: 11/30/2022] Open
Abstract
Traumatic diaphragmatic rupture (TDR) is uncommon, and may be associated with other severe life-threatening injuries after blunt trauma. Recently, we experienced a right-sided TDR patient with other multiple life-threatening injuries. A 59-year-old female inflicted with a right-sided TDR accompanied by herniated liver was treated with thoracoscopic exploration. We successfully managed associated life-threatening injuries such as traumatic brain injury and pelvic bone fractures with bleeding, simultaneously.
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Affiliation(s)
- Jin Young Lee
- Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Young Hoon Sul
- Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Jin Bong Ye
- Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Seung Je Ko
- Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Jung Hee Choi
- Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Joong Suck Kim
- Department of Trauma Surgery, Cheju Halla General Hospital, Jeju, Korea
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Abstract
The main reasons of emergent conversion during thoracoscopic lobectomy included tumor invasion, hilar lymph node (LN) metastasis, and lymphoid tuberculosis. We presented a video which depicted a three-portal thoracoscopic left upper lobectomy with dissection of large LNs. Severe adhesions between a large LN and the first branch of the left pulmonary artery (PA) were found during surgery. For safety reasons, the left main pulmonary artery (LMPA) was clamped with an endoscopic bulldog clamp prior to lymph nodal dissection. The strategy of precontrolling the LMPA during thoracoscopic lobectomy is useful for these patients with complicated hilum, and may assure the safety of the operation.
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Affiliation(s)
- Lin Ma
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
| | - Jiandong Mei
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
| | - Chengwu Liu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
| | - Lunxu Liu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
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Song N, Zhao DP, Jiang L, Bao Y, Jiang GN, Zhu YM, Ding JA. Subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for lobectomy: a report of 105 cases. J Thorac Dis 2016; 8:S251-7. [PMID: 27014471 DOI: 10.3978/j.issn.2072-1439.2016.02.32] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND To address the feasibility and advantages of subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for lobectomy. METHODS Since August 2014, 105 cases of subxiphoid uniportal VATS lobectomy were successfully performed. The clinical information was retrospectively analyzed. RESULTS 96 cases underwent unilateral operation and 9 underwent bilateral operations. Surgeries were successfully performed with a complication rate of 10.5%. The average pain scores 8 hours, day 1, 2 and 3 after surgery, as well as the day before discharge were 2.39±0.99, 2.06±0.85, 1.68±0.87, 1.29±0.78, and 0.48±0.51, respectively, which were significantly lower than those in the control group (standard intercostal uniportal VATS) (P<0.001). CONCLUSIONS The subxiphoid uniportal VATS lobectomy is safe and reliable, which is appropriate for bilateral lung diseases, and significantly relieves postoperative incision pain.
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Affiliation(s)
- Nan Song
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - De-Ping Zhao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Lei Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Yi Bao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Ge-Ning Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Yu-Ming Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Jia-An Ding
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
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20
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Lee JM, Yang SM, Yang PW, Huang PM. Single-incision laparo-thoracoscopic minimally invasive oesophagectomy to treat oesophageal cancer†. Eur J Cardiothorac Surg 2015; 49 Suppl 1:i59-63. [PMID: 26547093 DOI: 10.1093/ejcts/ezv392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/06/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Single-incision thoracoscopic and laparoscopic procedures have been applied in treating various diseases. However, it is unknown whether such procedures are feasible in treating oesophageal cancer. METHODS Minimally invasive oesophagectomy (MIO) with a single-incision approach in the thoracoscopic and laparoscopic procedures was attempted in 16 patients with oesophageal cancer. RESULTS One patient was converted to laparotomy and a four-port thoracoscopic procedure due to bleeding. Of the patients successfully treated with a single-port MIO, 6 underwent a McKeown procedure and 9 an Ivor Lewis procedure, including 3 cases of total laryngopharyngo-oesophagectomy with cervical pharyngogastrostomy. The mean ventilator usage of the patients after surgery was 0.3 ± 0.6 days, the mean intensive care unit (ICU) stay was 3.8 ± 3.1 days and the mean number of dissected lymph nodes was 28.6 ± 14.6. One delayed anastomotic leakage occurred, and another patient developed a trachea-oesophageal fistula induced by surgical clip-related tissue erosion, both of which were successfully treated by the placement of an oesophageal stent. No pulmonary complications or surgical mortalities occurred in the study. Minor complications developed in 2 patients, 1 experiencing pneumothorax and 1 postoperative delirium. When compared with traditional MIO in our series (n = 315), no statistical difference was found among patients receiving single-port MIO in terms of ventilator usage, ICU stay and the number of dissected lymph nodes. CONCLUSIONS Single-port MIO seems to be a feasible option for treating patients with oesophageal cancer, which requires further evaluation and follow-up in the future.
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Affiliation(s)
- Jang-Ming Lee
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shun-Mao Yang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Wen Yang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Ming Huang
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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21
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Cai K, Feng S, Wu H, Wang Y, Zhao H, Ren P, Zhang Z. Unidirectionally thoracoscopic resection of lingual segment of the left upper pulmonary lobe. J Thorac Dis 2014; 6:1358-63. [PMID: 25276384 DOI: 10.3978/j.issn.2072-1439.2014.08.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/06/2014] [Indexed: 01/15/2023]
Abstract
A patient with adenocarcinoma in situ was reported to undergo unidirectionally thoracoscopic resection of lingual segment of the left upper pulmonary lobe and lymphadenectomy in the order of the lingual segmental vein, the lingual segmental bronchus, the lingual segmental artery, and the pulmonary tissues of the lingual segment in turn. As the concepts of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) are defined in the latest international classification of lung adenocarcinoma, pulmonary segmentectomy has been initially used in some multi-center clinical studies to treat these early lung cancer lesions. Pulmonary segmentectomy is currently one of the most minimally invasive lung surgeries, with its unique technical essentials different from those of pulmonary lobectomy. Some studies have shown that pulmonary segmentectomy for early lung cancer, especially for tumors with a diameter of less than 2 cm can achieve a similar long-term survival rate as pulmonary lobectomy, yet its effectiveness and safety should be confirmed in further large-scale prospective studies.
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Affiliation(s)
- Kaican Cai
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Siyang Feng
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Hua Wu
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yuanyuan Wang
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Hancheng Zhao
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Pengfei Ren
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Ziliang Zhang
- 1 Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 2 Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Ai B, Zhang Z, Liao Y. Laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis for middle or lower esophageal carcinoma. J Thorac Dis 2014; 6:1354-7. [PMID: 25276383 PMCID: PMC4178078 DOI: 10.3978/j.issn.2072-1439.2014.07.38] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 07/23/2014] [Indexed: 01/12/2023]
Abstract
Thoracoscopic mobilization of esophagus and laparoscopic mobilization of stomach with cervical anastomosis is employed widely in minimally invasive esophagectomy (MIE) for esophageal carcinoma. However, it is associated with high incidence of complications, including recurrent laryngeal nerve injury and anastomotic leak. This paper summarizes the key techniques in total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis for MIE in 62 patients of middle or lower esophageal cancer between March 2012 and August 2013. Total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis was performed to treat the middle or lower esophageal cancer. Laparoscopic and thoracoscopic Ivor-Lewis esophagectomy was performed using a circular stapler (Johnson and Johnson) intrathoracically to staple esophagogastric anastomosis and reconstruct the digestive tract. In addition, we performed tension-relieving anastomotic suture and embedded with pedicled omental flap. Compared with the trans-orally inserted anvil (OrVil) approach, the technique reported here is safe, feasible and user-friendly. Total thoracoscopic intrathoracic anastomosis can be performed with a circular stapler (Johnson and Johnson).
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Affiliation(s)
- Bo Ai
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zheng Zhang
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yongde Liao
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Qiao Y, An G, Chen G, Zheng S, Ni L, Wang W, Ma L. Minimally invasive video-assisted double-valve replacement through right anterolateral Minithoracotomy. Heart Lung Circ 2014; 23:847-51. [PMID: 24801447 DOI: 10.1016/j.hlc.2014.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 02/27/2014] [Accepted: 03/09/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to investigate feasibility and safety of minimally invasive video-assisted surgery for double-valve (mitral and aortic) replacement through right anterolateral minithoracotomy. METHODS Between February 2011 and April 2013, 60 patients with combined valvular disease underwent double valve replacement, 26 of them by minimally invasive video-assisted surgery through right anterolateral minithoracotomy (study group) and 34 by median sternotomy (control group). Peripheral cardiopulmonary bypass (CPB) was established through right femoral artery and vein. The incision was made around the right breast approximately 5 cm in length. Pericardiotomy, bicaval occlusion, atriotomy and aortotomy, and double valve replacement were performed with thoracoscope. RESULTS In the study group, times of CPB and aortic cross-clamp were 146.5 ± 40.5 min and 91.5 ± 23.4 min, respectively, which were significantly different from those in the control group, 115.4 ± 26.5 min and 75.4 ± 16.5 min (P<0.05). Thoracic drainage in the study group was significantly lower than the control group, 587 ± 245 ml (study group) versus 756 ± 267 ml (control group) (P<0.05). Length of ICU and postoperative hospital stay were shorter in the study group, 1.9 ± 0.8 and 8.7 ± 4.5 days versus 2.8 ± 1.3 and 11.2 ± 5.6 days in the control group (P<0.05), respectively. There was no statistical difference in the postoperative results of TTE (transthoracic echocardiography) (P>0.05). All patients recovered smoothly with follow-up of six months to two years, with no severe complications. CONCLUSIONS Minimally invasive video-assisted procedure through right anterolateral minithoracotomy is a new promising approach for double valve replacement. Our study suggested that this approach was feasible, safe and had cosmetic effects.
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Affiliation(s)
- Yanli Qiao
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China
| | - Guoying An
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China.
| | - Guoqing Chen
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China
| | - Shanguang Zheng
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China
| | - Liangchun Ni
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China
| | - Weixin Wang
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China
| | - Linfeng Ma
- Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Department of Cardiac Surgery, Jining Medical University Affiliated Hospital, Jining 272029, Shandong, China
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Wang H, Cai K, Wang X, Yang X, Ju Q, Wang J. Radical resection of upper right lung under thoracoscopic guidance. J Thorac Dis 2014; 5:882-5. [PMID: 24409372 DOI: 10.3978/j.issn.2072-1439.2013.11.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 11/22/2013] [Indexed: 11/14/2022]
Abstract
In recent years, thoracoscopic lobectomy has been rapidly developing and applied in China with an ever growing list of indications as the resectable range has been evolving from the peripheral type to the central type, from a diameter less than 3 cm to greater than 5 cm, and from lobectomy to pneumonectomy and segmental lung resection. This technique has become a routine option in our department. This video shows one case of thoracoscopic lobectomy with lymph node dissection for upper right lung cancer of 6 cm in diameter.
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Affiliation(s)
- Haofei Wang
- Department of Cardiothoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Kaican Cai
- Department of Cardiothoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xuelian Wang
- Department of Anesthesiology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - Xiyao Yang
- Department of Cardiothoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Qun Ju
- Department of Cardiothoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Junwu Wang
- Department of Cardiothoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Zeng J, Liu JS. Quality of life after three kinds of esophagectomy for cancer. World J Gastroenterol 2012; 18:5106-13. [PMID: 23049222 PMCID: PMC3460340 DOI: 10.3748/wjg.v18.i36.5106] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 05/08/2012] [Accepted: 05/13/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate quality of life (QOL) following Ivor Lewis, left transthoracic, and combined thoracoscopic/laparoscopic esophagectomy in patients with esophageal cancer.
METHODS: Ninety patients with esophageal cancer were assigned to Ivor Lewis (n = 30), combined thoracoscopic/laparoscopic (n = 30), and left transthoracic (n = 30) esophagectomy groups. The QOL-core 30 questionnaire and the supplemental QOL-esophageal module 18 questionnaire for patients with esophageal cancer, both developed by the European Organization for Research and Treatment of Cancer, were used to evaluate patients’ QOL from 1 wk before to 24 wk after surgery.
RESULTS: A total of 324 questionnaires were collected from 90 patients; 36 postoperative questionnaires were not completed because patients could not be contacted for follow-up visits. QOL declined markedly in all patients at 1 wk postoperatively: preoperative and 1-wk postoperative global QOL scores in the Ivor Lewis, combined thoracoscopic/laparoscopic, and left transthoracic groups were 80.8 ± 9.3 vs 32.0 ± 16.1 (P < 0.001), 81.1 ± 9.0 vs 53.3 ± 11.5 (P < 0.001), and 83.6 ± 11.2 vs 46.4 ± 11.3 (P < 0.001), respectively. Thereafter, QOL recovered gradually in all patients. Patients who underwent Ivor Lewis esophagectomy showed the most pronounced decline in QOL; global scores were lower in this group than in the combined thoracoscopic/laparoscopic (P < 0.001) and left transthoracic (P < 0.001) groups at 1 wk postoperatively and was not restored to the preoperative level at 24 wk postoperatively. QOL declined least in patients undergoing combined thoracoscopic/laparoscopic esophagectomy, and most indices had recovered to preoperative levels at 24 wk postoperatively. In the Ivor Lewis and combined thoracoscopic/laparoscopic groups, pain and physical function scores were 78.9 ± 18.5 vs 57.8 ± 19.9 (P < 0.001) and 59.3 ± 16.1 vs 70.2 ± 19.2 (P = 0.02), respectively, at 1 wk postoperatively and 26.1 ± 28.6 vs 9.5 ± 15.6 (P = 0.007) and 88.4 ± 10.5 vs 95.8 ± 7.3 (P = 0.003), respectively, at 24 wk postoperatively. Scores in the left transthoracic esophagectomy group fell between those of the other two groups.
CONCLUSION: Compared with Ivor Lewis and left transthoracic esophagectomies, combined thoracoscopic/laparoscopic esophagectomy enables higher postoperative QOL, making it a preferable surgical approach for esophageal cancer.
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