Perioperative Complications of Video-Assisted Thoracoscopic Pulmonary Procedures in Neonates and Infants

2018 ◽  
Vol 28 (02) ◽  
pp. 163-170 ◽  
Author(s):  
Benno Ure ◽  
Jens Dingemann ◽  
Christoph Zoeller
Keyword(s):  
Thoracoscopic Surgery ◽  
Perioperative Complications ◽  
Case Series ◽  
Major Complication ◽  
Infectious Complications ◽  
Nerve Paralysis ◽  
Lung Lobe ◽  
Phrenic Nerve Paralysis ◽  
Video Assisted ◽  
Neonates And Infants

AbstractVideo-assisted thoracoscopic surgery (VATS) has gained broad acceptance among pediatric surgeons. Today, VATS can be regarded as a routine approach for various conditions in neonates and infants. However, there is a lack of information concerning the complications of thoracoscopic pulmonary surgery in neonates and infants. We aimed to review the available data. A systematic review of the literature was performed using PubMed. All publications reporting on VATS for pulmonary procedures in neonates and infants up to the age of 1 year were included. Articles were reviewed in detail for occurrence of perioperative complications and their treatment. Nine case series were eligible for analysis. Entities treated included lung sequestration, congenital pulmonary airway malformation, congenital lobar emphysema, and bronchogenic cyst. Case series reported on a total number of 135 patients. Complications occurred in 14 patients (10.4%). The major complication was an accidental transection of the middle lobar bronchus that concluded in a later resection of a prior unaffected lung lobe. Other relevant complications reported were bleeding in four patients (3.0%) and persistent air leak in four cases (3.0%). Infectious complications were reported in four patients (3.0%). Additionally, iatrogenic phrenic nerve paralysis occurred in one patient. There were no deaths related to the VATS technique. In 11 cases (8.1%), conversion to thoracotomy had been necessary. General recommendations on the treatment of complications could not be derived due to small patient numbers and lack of details of the complications reported. Reports on major complications of pulmonary VATS in neonates and infants below 1 year of age are scarce. As severe complications such as accidental bronchus transection have been described, feasibility of neonatal/infant VATS cannot be unequivocally confirmed. No literature-based recommendation can be given on the treatment of complications.

scholarly journals Excessive intravenous crystalloid infusion after video-assisted thoracoscopic surgery lobectomy is associated with postoperative pneumonia

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Rong Yang ◽  
Chengli Du ◽  
Jinming Xu ◽  
Linpeng Yao ◽  
Siying Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Thoracoscopic Surgery ◽  
Postoperative Pneumonia ◽  
Lung Lobe ◽  
Video Assisted ◽  
Crystalloid Infusion ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Video-assisted thoracoscopic surgery has been widely used in thoracic surgery worldwide. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy. Methods A retrospective analysis of adult patients undergoing video-assisted thoracoscopic surgery lobectomy between 2016 and 05 and 2017–04 was performed. We used univariate analyses and multivariate analyses to examine risk factors for postoperative pneumonia after lobectomy. Results The incidence of postoperative pneumonia was 19.7% (n = 143/727). Patients with postoperative pneumonia had a higher postoperative length of stay and total hospital care costs when compared to those without postoperative pneumonia. Multivariate analysis showed that body mass index grading ≥24.0 kg/m2 (vs. <24.0 kg/m2: odds ratio 1.904, 95% confidence interval 1.294–2.802, P = 0.001) and right lung lobe surgery (vs. left lung lobe surgery: odds ratio 1.836, 95% confidence interval 1.216–2.771, P = 0.004) were independent risk factors of postoperative pneumonia. Total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL was also identified as the risk factors (vs. 1000 to < 1500 mL: odds ratio 2.060, 95% confidence interval 1.302–3.260, P = 0.002). Conclusions Major risk factors for postoperative pneumonia following video-assisted thoracoscopic surgery lobectomy are body mass index grading ≥24.0 kg/m2, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL.

Intermediate-term Experience With the STAR Total Ankle in the United States

2018 ◽  
Vol 40 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Evan M. Loewy ◽  
Thomas H. Sanders ◽  
Arthur K. Walling
Keyword(s):  
United States ◽  
Perioperative Complications ◽  
Case Series ◽  
Major Complication ◽  
The United States ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Patient Reported ◽  
The Mean

Background: Limited intermediate and no real long-term follow-up data have been published for total ankle arthroplasty (TAA) in the United States. This is a report of clinical follow-up data of a prospective, consecutive cohort of patients who underwent TAA by a single surgeon from 1999 to 2013 with the Scandinavian Total Ankle Replacement (STAR) prosthesis. Methods: Patients undergoing TAA at a single US institution were enrolled into a prospective study. These patients were followed at regular intervals with history, physical examination, and radiographs; American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale scores were obtained and recorded. Primary outcomes included implant survivability and functional outcomes scores. Secondary outcomes included perioperative complications such as periprosthetic or polyethylene fracture. Between 1999 and 2013, a total of 138 STAR TAAs were performed in 131 patients; 81 patients were female. The mean age at surgery was 61.5 ± 12.3 years (range, 30-88 years). The mean duration of follow-up for living patients who retained both initial components at final follow-up was 8.8±4.3 years (range 2-16.9 years). Results: The mean change in AOFAS Ankle-Hindfoot scores from preoperative to final follow-up was 36.0 ± 16.8 ( P < .0001). There were 21 (15.2%) implant failures that occurred at a mean 4.9 ± 4.5 years postoperation. Ten polyethylene components in 9 TAAs (6.5%) required replacement for fracture at an average 8.9 ± 3.3 years postoperatively. Fourteen patients died with their initial implants in place. Conclusion: This cohort of patients with true intermediate follow-up after TAA with the STAR prosthesis had acceptable implant survival, maintenance of improved patient-reported outcome scores, and low major complication rates. Level of Evidence: Level IV, case series.

scholarly journals Image-guided video-assisted thoracoscopic surgery for small ground glass opacities: a case series

2017 ◽  
Vol 3 ◽  
pp. 142-142 ◽  
Author(s):  
Hsin-Yueh Fang ◽  
Yin-Kai Chao ◽  
Ming-Ju Hsieh ◽  
Chih-Tsung Wen ◽  
Pei-Hsuan Ho ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Case Series ◽  
Ground Glass ◽  
Image Guided ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Video-Assisted Thoracoscopic Surgery for Patent Ductus Arteriosus in Low Birth Weight Neonates and Infants

PEDIATRICS ◽  
1999 ◽  
Vol 104 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Redmond P. Burke ◽  
Jeffrey P. Jacobs ◽  
Wen Cheng ◽  
Alfredo Trento ◽  
Gregory P. Fontana
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Thoracoscopic Surgery ◽  
Ductus Arteriosus ◽  
Video Assisted ◽  
Neonates And Infants ◽  
Video Assisted Thoracoscopic Surgery ◽  
Patent Ductus

scholarly journals Uniportal thoracoscopic surgery for difficult late stage empyema: Case series

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Klein Dantis
Keyword(s):  
Methicillin Resistant Staphylococcus Aureus ◽  
Thoracoscopic Surgery ◽  
Case Series ◽  
Open Approach ◽  
Open Thoracotomy ◽  
Invasive Approach ◽  
Video Assisted ◽  
Chronic Empyema ◽  
Clinical Scenarios ◽  
Video Assisted Thoracoscopic Surgery

Early, aggressive, and minimally invasive approach is an advanced surgical approach for chronic empyema management. The traditional video-assisted technique is considered superior over open thoracotomy for empyema management; however, with further modification, the uniportal video-assisted thoracoscopic surgery (UVATS) has greater advantage for surgeons, providing better anatomical view of target tissues, allowing bimanual instrumentation similar to open approach, and nullifying the creation of dihedral angle by instruments that are not favorable in traditional VATS. The present case series describes different clinical scenarios including chronic empyema secondary to traumatic hemothorax, recurrent tubercular empyema following postoperative open decortication, and methicillin-resistant staphylococcus aureus chronic empyema in pediatric patient, which are effectively managed with UVATS approach.

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