An Accidental Discovery of Tracheobronchomegaly: a Case Report

Abstract Tracheobronchomegaly is a rare disease with congenital abnormal change in respiratory tract; its image features are also very special. In this case, we described a 57-year-old male with cough, expectoration, chest pain, and dyspnea. In our institution, the result of chest CT scan is highly extraordinary, which showed obvious dilation of the trachea and main bronchi, emphysema, and a number of pulmonary bullae, and there was a big bulla with air-fluid level on the lower lobe of the right lung. Fortunately, after wedge resection for the big bulla on the lower lobe of right lung under video-assisted thoracoscopic surgery, this patient’s symptoms were significantly relieved. The clinical manifestations of tracheobronchomegaly lack specificity; this disease has freakish image features. At present, there are no effective treatments for tracheobronchomegaly, which just was an accidental discovery in this patient; we just mainly take surgical measures to treat the big bulla for relieving symptoms.

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Posterior uniportal video-assisted thoracoscopic surgery for resection of the apical segment of the right lower lobe followed by completion lobectomy

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivw405 ◽

2017 ◽

pp. ivw405

Author(s):

Davor Stamenovic ◽

Antje Messerschmidt

Keyword(s):

Thoracoscopic Surgery ◽

Lower Lobe ◽

Apical Segment ◽

Video Assisted ◽

The Right ◽

Completion Lobectomy ◽

Video Assisted Thoracoscopic Surgery

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Postoperative cavitating infarction following lobectomy: the importance of variant pulmonary anatomy

BMJ Case Reports ◽

10.1136/bcr-2020-238138 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238138

Author(s):

William John Hunter Brown ◽

Vidan Masani ◽

Tim Batchelor ◽

Jonathan C L Rodrigues

Keyword(s):

Pulmonary Artery ◽

Thoracoscopic Surgery ◽

Vascular Complications ◽

Lower Lobe ◽

Lung Abscess ◽

Preoperative Imaging ◽

Pulmonary Vasculature ◽

The Right ◽

Video Assisted Thoracoscopic Surgery ◽

Safe Working

A 75-year-old woman was admitted to hospital with haemoptysis, fever and shortness of breath. She had undergone a right video-assisted thoracoscopic surgery upper lobectomy for an apical lung cancer 4 weeks earlier, and had been treated with antibiotics for 1 week prior to admission for a suspected postoperative lung abscess. Review of preoperative imaging found that she possessed a lobar pulmonary artery variant, with postoperative imaging confirming that the right lower lobe segmental pulmonary artery had been divided alongside the upper lobe vessels. The diagnosis of a lung abscess was thus revised to a cavitating pulmonary infarct. There are numerous variations of the pulmonary vasculature, all of which have the potential to cause a range of serious vascular complications if not appreciated preoperatively. Measures to mitigate the risk of complications resulting from vascular anomalies should be considered by both radiologists and surgeons, with effective lines of communication essential to safe working.

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Non-smoking woman with adenocarcinoma of the lung, IV stage with ROS1 mutation and acquired thrombophilia

Journal of Pulmonology and Respiratory Research ◽

10.29328/journal.jprr.1001027 ◽

2021 ◽

Vol 5 (1) ◽

pp. 064-072

Author(s):

Taivans Immanuels ◽

Senterjakova Natalja ◽

Kozirovskis Viktors ◽

Strazda Gunta ◽

Nazarovs Jurijs ◽

...

Keyword(s):

Protein Tyrosine Kinase ◽

Kinase Inhibitors ◽

Palliative Chemotherapy ◽

Thoracoscopic Surgery ◽

Lower Lobe ◽

Adenocarcinoma Of The Lung ◽

Supraclavicular Lymph Nodes ◽

History Of ◽

The Right ◽

Video Assisted Thoracoscopic Surgery

Despite the fact, that lung cancer is more common among older smoking men, however it may also develop among young women without a smoking anamnesis. We report here a history of a non-smoking woman, 40 years old, with a diagnosis of lung adenocarcinoma at IV stage. Despite the fact, the woman received three lines of palliative chemotherapy, the disease progressed. After the sample of the tumor was tested by genetic approach, ROS1 mutation was detected, and the patient was treated with a ROS1 inhibitor, Crizotinib. Sharp improvement was observed already after the first week of treatment. After one-month adenocarcinoma shrink, and specific supraclavicular lymph nodes disappeared. Unfortunately, due to problems with financing the treatment was stopped, after what the disease began to progress rapidly, and the patient died after a month due to brain metastasis. This case is noteworthy also because the patient was first diagnosed a thrombophilia with thrombi present in deep calf veins, left heart ventricle and lungs Adenocarcinoma was discovered occasionally when during video-assisted thoracoscopic surgery biopsy specimen was taken from suspicious mass in the lower lobe of the right lung. This story reminds us that lung carcinoma may start with a paraneoplastic syndrome, like thrombophilia as in this case and finding of adenocarcinoma of the lung in young, non-smoking persons is indicative for possible ROS1 gene mutation. In such cases early treatment with ROS1 protein-tyrosine kinase inhibitors should be started as soon as possible.

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Uniportal video-assisted thoracoscopic surgery for right lower lobe pulmonary wedge resection of metastasis associated with primary rhabdomyosarcoma

Journal of Pediatric Endoscopic Surgery ◽

10.1007/s42804-020-00069-3 ◽

2020 ◽

Cited By ~ 1

Author(s):

Kenan Karavdić ◽

Ilijaz Pilav ◽

Amira Mešić ◽

Meliha Sakić ◽

Borko Rajič ◽

...

Keyword(s):

Thoracoscopic Surgery ◽

Wedge Resection ◽

Lower Lobe ◽

Video Assisted ◽

Pulmonary Wedge Resection ◽

Video Assisted Thoracoscopic Surgery

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Diagnostic and Therapeutic Performance of Video-Assisted Thoracoscopic Surgery (Vats) in Investigation and Management of Pleural Exudates

Annals of The Royal College of Surgeons of England ◽

10.1308/003588408x318246 ◽

2008 ◽

Vol 90 (7) ◽

pp. 597-600 ◽

Cited By ~ 14

Author(s):

ARL Medford ◽

YM Awan ◽

A Marchbank ◽

J Rahamim ◽

J Unsworth-White ◽

...

Keyword(s):

Diagnostic Yield ◽

Thoracoscopic Surgery ◽

Good Practice ◽

National Standards ◽

Postoperative Fever ◽

Video Assisted ◽

The Right ◽

Culture Negative ◽

Video Assisted Thoracoscopic Surgery ◽

Fluid Culture

INTRODUCTION Video-assisted thoracoscopic surgery (VATS) is the gold standard investigation for diagnosis of pleural exudates. It is invasive and it is important to ensure that it is performed to acceptable national standards. We assumed that VATS empyema fluid culture would not contribute further to microbiological diagnosis in referred culture-negative empyemas. PATIENTS AND METHODS Eighty-six consecutive external referrals for VATS for diagnosis of a cytology-negative pleural exudate (or for further management of the exudate) were studied retrospectively. Diagnostic yield, pleurodesis efficacy and complications were compared to national standards and good practice recommendations. VATS empyema fluid microbiological culture results were compared to pre-VATS empyema fluid culture results. RESULTS VATS was performed well within national standards with a diagnostic yield of 82.3% for cytology-negative exudates, 100% pleurodesis efficacy, 5.8% postoperative fever, with only one significant complication (1.2% rate) and no deaths. Compliance with good practice pleural fluid documentation points was greater than 70%. VATS empyema fluid culture positivity (84.6%) was significantly higher than pre-VATS fluid culture (35%). CONCLUSIONS VATS was performed to acceptable standards. These data confirm the utility and safety of VATS in the right context but also suggest the potential diagnostic utility of VATS empyema fluid culture. Further studies are required to investigate this latter possibility further.

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Suspected Pulmonary Metastasis of Actinic Cutaneous Squamous Cell Carcinoma

Case Reports in Surgery ◽

10.1155/2017/4176071 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Monet E. Meter ◽

David J. Nye ◽

Christian R. Galvez

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Actinic Keratosis ◽

Uv Light ◽

Light Exposure ◽

Thoracoscopic Surgery ◽

Wedge Resection ◽

Lung Lesion ◽

The Right

Introduction. It is rare for actinic or squamous cell carcinoma (SCC) in situ to metastasize. Case Presentation. A 67-year-old male had a significant medical history including severe psoriatic arthritis treated with UVB, methotrexate, and rapamycin. He had twenty-five different skin excisions of actinic keratosis four of which were invasive SCC. Our patient developed shortness of breath necessitating a visit to the emergency department. A CT scan of his chest revealed a mass in the right lower lung. A subsequent biopsy of the mass revealed well-differentiated SCC. He underwent thoracoscopic surgery with wedge resection of the lung lesion. Discussion. Actinic keratosis (AK) is considered precancerous and associated with UV exposure. It exists as a continuum of progression with low potential for malignancy. The majority of invasive SCCs are associated with malignant progression of AK, but only 5–10% of AKs will progress to malignant potential. Conclusion. In this case, a new finding of lung SCC in the setting of multiple invasive actinic cutaneous SCC associated with a history of extensive UV light exposure and immunosuppression supports a metastatic explanation for lung cancer.

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Pleurodesis methods in the surgical treatment of primary spontaneous pneumothorax

Journal of Surgical Arts ◽

10.14717/jsurgaerts-210205 ◽

2021 ◽

pp. 77-81

Keyword(s):

Surgical Treatment ◽

Recurrence Rate ◽

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Wedge Resection ◽

Primary Spontaneous Pneumothorax ◽

High Recurrence Rate ◽

Parietal Pleura ◽

Advantages And Disadvantages ◽

Video Assisted Thoracoscopic Surgery

Pneumothorax is the collection of air in the pleural space. Pneumothorax can be spontaneous, traumatic or iatrogenic. Primary spontaneous pneumothorax mostly occurs in healthy individuals without an apparent cause, probably due to the rupture of subpleural emphysematous bullae located on the apex of the lung. It usually occurs in tall and healthy males younger than 40 years old. Primary spontaneous pneumothorax has a recurrence rate of 20-30% after the first attack, 50% after the second attack, and 80% after the third attack. Surgery is presented as a treatment option to reduce the high recurrence rate after the second attack. It has been reported that recurrence is between 10 and 20% in patients who undergo bullectomy or wedge resection with endoscopic steps alone. Therefore, various pleural pleurodesis methods are applied in addition to bulla resection in order to reduce the recurrence rate after surgery. In mechanical pleurodesis, adhesion between visceral and parietal pleura is achieved by mechanical abrasion of the parietal pleura or by total or partial removal of the parietal pleura. In chemical pleurodesis, the visceral pleura is adhered to the parietal pleura by creating irritation in the pleura with chemical agents. In cases where pleurodesis was added, the recurrence rate was reported to be between 1.7 and 2.8%. Whether the pleurectomy, pleural mechanical or chemical abrasion methods performed with video-assisted thoracoscopic surgery is superior for preventing recurrence is still a matter of debate. In this article, we aimed to discuss the advantages and disadvantages of pleurodesis methods in the surgical treatment of primary spontaneous pneumothorax in the light of the literature.

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