Feasibility Investigation of Ipsilateral Reoperations by Thoracoscopy for Major Lung Resection

2019 ◽  
Vol 68 (03) ◽  
pp. 241-245 ◽  
Author(s):  
Weiyan Sun ◽  
Lei Zhang ◽  
Zeyao Li ◽  
Donglai Chen ◽  
Gening Jiang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Intraoperative Blood Loss ◽  
Drainage Time ◽  
The Mean ◽  
Room Time ◽  
Video Assisted Thoracoscopic Surgery ◽  
Operating Room Time

Abstract Background Video-assisted thoracoscopic surgery (VATS) has become the preferred approach for minimizing harm from thoracic operations. There is no report, however, which has discussed the feasibility of VATS in ipsilateral reoperation of major lung resection. Methods The present study included patients who had undergone ipsilateral reoperation of major lung resection by VATS from October 2009 to May 2017. Referring clinical data were recruited for analysis. Results Fourteen patients were recruited in the present study, including nine patients who underwent lobectomy and five who underwent segmentectomy during the second operation. Different hila were found in 6 patients, and pleural adhesions appeared in 10 patients. The average intraoperative blood loss was 203.6 ± 121.7 mL, and the mean operating room time was 2.2 ± 0.5 hours. There were no intraoperative deaths, and only one patient required conversion to thoracotomy. The average drainage time was 5.9 ± 4.6, and the mean hospital stay was 6.7 ± 4.2 days. Conclusion Though it is technically demanding to safely handle the changed hilum structure caused by the last operation, major lung resection by VATS is feasible for ipsilateral reoperation in appropriate candidates.

Video-assisted thoracoscopic surgery for the treatment of primary pneumothorax: talc pleurodesis or pleural abrasion? Retrospective multicentre study

2011 ◽  
Vol 1 (1) ◽  
pp. 9 ◽  
Author(s):  
Jon Zabaleta ◽  
Borja Aguinagalde ◽  
Carlos Alvarez ◽  
Marta G. Fuentes ◽  
Nerea Bazterargui ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Nonparametric Tests ◽  
Postoperative Hospital Stay ◽  
Talc Pleurodesis ◽  
Video Assisted ◽  
Pleural Abrasion ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

In the treatment of primary spontaneous pneumothorax (PSP) the latest guidelines recommend video-assisted thoracoscopy, but do not specify the best technique for performing pleurodesis. Indeed, there are no clinical trials comparing the effectiveness of talc pleurodesis, mechanical pleurodesis and pleurectomy. Our objective was to compare outcomes in patients who underwent surgery for primary pneumothorax with the talc procedure or with pleural abrasion using dry gauze. Patients undergoing video-assisted thoracoscopic surgery for PSP in two hospitals were retrospectively recruited between 2007 and 2008, and followed-up until December 2010. The variables measured to compare the outcomes were: recurrence, complications, and mortality, as well as the duration of air leaks and of drainage and the length of postoperative hospital stay (in days). Statistical analysis: The two groups were compared using the Chi square test for qualitative variables and nonparametric tests for continuous variables. A total of 106 interventions were carried out in 104 patients (74 in group A: pleural abrasion with dry gauze; 32 in group B: chemical pleurodesis with talc), with a mean age of 28 years (median 25) and 85.6% were male. Complications were observed in nine patients (8.5%) and there were no deaths in the 30 days after surgery; there were, however, four cases of recurrence (3.8%). The mean air leak duration was 0.78 days (median 0), the mean drainage duration 1.95 days (median 1) and the mean length of postoperative hospital stay 2.68 days (median 2). In 74 cases (69.8%), mechanical pleurodesis was performed, while 32 cases were treated with talc (30.2%). Comparing the two groups, we did not find statistically significant differences in recurrence (4.1% vs 3.1%, P=0.82), complications (6.8% vs 12.5%, P=0.45) or mortality (no cases of death). On the other hand, the mean postoperative hospital stay was lower in the mechanical pleurodesis group than in the talc group (2.2 vs 3.8 days, P=0.005). Video-assisted surgery in the treatment of PSP is a safe technique. In the mechanical pleurodesis group, we observed the same rate of recurrence, half the number of complications and a shorter hospital stay. We consider it necessary that well-designed multicentre clinical trials be carried out to compare these techniques and determine which produces the best outcomes, providing stronger scientific evidence given that the data available to date are not conclusive.

scholarly journals Video assisted thoracoscopic surgery in the management of acute fibrinopurulent empyema in paediatric patients

2020 ◽  
Vol 7 (6) ◽  
pp. 1847
Author(s):  
Arti S. Mitra ◽  
Nilesh G. Nagdeve ◽  
Simran R. Khatri ◽  
Unmed A. Chandak
Keyword(s):  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Bronchopleural Fistula ◽  
Tertiary Care ◽  
Pleural Empyema ◽  
Care Hospital ◽  
Age Group ◽  
Video Assisted ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background: Empyema is the presence of pus in the pleural space that usually follows an episode of pneumonia in pediatric age group. The aim of this study was to assess the efficacy of management of acute fibrinopurulent stage of empyema by early video assisted thoracoscopic surgery (VATS) in paediatric patients.Methods: The study was carried out at a tertiary care hospital in India. It was a prospective interventional observational study. The study included 40 children between age group 0-12 years attending the surgery in-patient department referred for further management of parapneumonic effusions who had clinical and radiological evidence of empyema and thoracocentesis confirmed purulent exudate in pleural cavity, were subjected to early VATS after thorough pre-operative workup.Results: The mean age was 7.22 years. Average operative time was 135.5 minutes. The mean duration of hospital stay was 7.5 days. Few complications were bleeding, superficial wound infection, bronchopleural fistula, pneumothorax, recurrence of empyema and incomplete expansion of lung.Conclusions: VATS facilitates the management of fibrinopurulent and organised pyogenic pleural empyema with less post-operative discomfort and complications and reduced hospital stay. However larger sample size study is required to come to a definitive conclusion.

Outcome Comparison between Video Assisted Thoracoscopic Surgery and Open Thoracotomy on Primary Spontaneous Pneumothorax in a Tertiary Hospital in Thailand

2021 ◽  
Vol 104 (1) ◽  
pp. 100-104
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Open Thoracotomy ◽  
Video Assisted ◽  
Operative Outcome ◽  
Video Assisted Thoracoscopic Surgery

Objective: To assess recurrence, complication after surgery, hospital stay, and cost-effective in primary spontaneous pneumothorax (PSP) patients of Thai urban population that underwent video assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). Materials and Methods: The present study was a retrospective cohort between 2006 and 2019. Seventy-five patients were diagnosed as PSP. All medical records were collected from Vajira Hospital. All various factors were analyzed to evaluate an outcome between the two groups. Results: Fifty-four patients were treated by VATS, whereas 21 patients were treated by OT. The mean follow-up time was 26 months. There was no difference in term of gender, indication of surgery, and cost during hospital stay between the two groups. Length of hospital stay were shorter in VATS groups (9.5 days versus 15 days, p=0.006). The operative time was longer and more blood loss in OT groups compared to VATS groups (180 minutes versus 70 minutes, p<0.001 and 100 mL versus 30 mL, p<0.001). In post-operative outcome, there was no difference in terms of recurrence, pneumonia, and re-operation. Conclusion: VATS is associated with shorter length of hospital stay and less blood loss with no difference of cost effective, recurrence, and post-operative outcome in PSP patients. Keywords: Video assisted thoracoscopic surgery, Pneumothorax, Open thoracotomy

Endoscopic resection of intrathoracic tumors: experience with and long-term results for 26 patients

2011 ◽  
Vol 14 (3) ◽  
pp. 377-381 ◽  
Author(s):  
Francisco A. Ponce ◽  
Brendan D. Killory ◽  
Scott D. Wait ◽  
Nicholas Theodore ◽  
Curtis A. Dickman
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Long Term Results ◽  
Invasive Approach ◽  
Horner Syndrome ◽  
Neurogenic Tumors ◽  
Presenting Symptoms ◽  
The Mean

Object Thoracoscopy may be used in place of thoracotomy to resect intrathoracic neoplasms such as paraspinal neurogenic tumors. Although these tumors are rare, they account for the majority of tumors arising in the posterior mediastinum. Methods A database was maintained of all patients undergoing thoracoscopic surgery for tumors. The authors analyzed the presenting symptoms, pathological diagnoses, and outcomes of 26 patients (7 males and 19 females, mean age 37.2 years) who were treated for intrathoracic tumors via thoracoscopy between January 1995 and May 2009. Fourteen patients were diagnosed incidentally (54%). Five patients (19%) presented with dyspnea or shortness of breath, 4 (15%) with pain, 1 (4%) with pneumonia, 1 (4%) with hoarseness, and 1 (4%) with Horner syndrome. Results Pathology demonstrated schwannomas in 20 patients (77%). Other diagnoses included ganglioneurofibroma, paraganglioma, epithelioid angiosarcoma, benign hemangioma, benign granular cell tumor, and infectious granuloma. One patient required conversion to open thoracotomy due to pleural scarring to the tumor. One underwent initial laminectomy due to intraspinal extension of the tumor. Gross-total resection was obtained in 25 cases (96%). The remaining patient underwent biopsy followed by radiation therapy. The mean surgical time was 2.5 hours, and the mean blood loss was 243 ml. The mean duration of chest tube insertion was 1.3 days, and the mean length of hospital stay was 3.0 days. Cases that were treated in the second half of the cohort were more often diagnosed incidentally, performed in less time, and had less blood loss than those in the first half of the cohort. There was 1 case of permanent treatment-related morbidity (mild Horner syndrome). All previously employed patients were able to return to work (mean clinical follow-up 43 months). There were no recurrences (mean imaging follow-up 54 months). Conclusions Endoscopic transthoracic approaches can reduce approach-related soft-tissue morbidity and facilitate recovery by preserving the normal tissues of the chest wall, by avoiding rib retraction and muscle transection, and by reducing postoperative pain. This less invasive approach thus shortens hospital stay and recovery time.

The impact of BMI on operating room time, blood loss, and hospital stay in patients undergoing spinal fusion

2019 ◽  
Vol 179 ◽  
pp. 19-22 ◽  
Author(s):  
Alan Villavicencio ◽  
E. Lee Nelson ◽  
Sharad Rajpal ◽  
Niketna Vivek ◽  
Sigita Burneikiene
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Spinal Fusion ◽  
Operating Room ◽  
The Impact ◽  
Room Time ◽  
Operating Room Time

scholarly journals The Effects of Previous Renal Stone Surgery on Percutaneous Nephrolithotomy Outcomes

2021 ◽  
Author(s):  
Joshgun Hüseynov ◽  
Nadir Kalfazde ◽  
Ekrem Güner
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Intraoperative Blood Loss ◽  
Significant Difference ◽  
History Of ◽  
Renal Stone Surgery ◽  
The Mean ◽  
Free Status

Objective: We aimed to compare outcomes of percutaneous nephrolithotomy (PNL) surgery in patients who had and had not undergone renal stone surgery before PNL. Material and Methods: We retrospectively analyzed the medical records of all patients who underwent PNL in our department between 2010 and 2019. Examined parameters consisted of patient demographics, medical and surgical history, stone size, stone density, stone site, estimated intraoperative blood loss, duration of operation, hospital stay and stone-free status. Results: A total of 193 patients were included the study. The mean age of the patients was 45±13 years. The mean duration of surgery was 69±11.5 minutes. The mean stone area was 720.2±600.4 mm2 and the mean stone attenuation was 982.8±327.7 HU. The mean postoperative hemoglobin decrease was 1.8±1.3 g/dL. 66 patients had previous stone surgery including open stone surgery, PNL and retrograde intrarenal surgery (RIRS). There was no statistically significant difference between patients who had and had not previousşy undergone renal stone surgery in terms of age, gender, body mass index and stone area. Operative time, estimated intraoperative blood loss, postoperative hemoglobin decreases and hospital stay were comparable between patients who had, and hed not undergone previous renal stone surgery. Stone-free rate was significantly higher in primary PNL patients compared to patients with a history of renal stone surgery (92.1% vs 77.3%, p=0.006). Conclusion: PNL has a similar complication rate in patients with and without previous kidney stone surgery. However, achieving stone-free status may be challenging in patients with a history of ipsilateral renal stone surgery.

Role of Minimal Invasive Thoracic Surgery in Thai Lung Cancer Patients

2021 ◽  
Vol 104 (6) ◽  
pp. 916-920
Keyword(s):  
Lung Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Thoracoscopic Surgery ◽  
Minimal Invasive ◽  
Open Thoracotomy ◽  
Lung Cancer Patients ◽  
Operative Outcome ◽  
Video Assisted Thoracoscopic Surgery

Objective: To assess the outcome of minimal invasive surgery in terms of intra and post-operative complication, length of tube duration, hospital stay, and cost-effective in lung resection of Thai urban population that underwent video assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). Materials and Methods: The present study was a retrospective cohort between 2006 and 2019. One hundred seventy-eight patients underwent pulmonary resection. All patients were diagnosed either primary or secondary lung cancer. All medical records were collected at Vajira Hospital. All various factors were analyzed to evaluate an outcome between both groups. Results: One hundred nineteen patients were performed by VATS, whereas 59 patients were performed by OT. Tube duration and length of hospital stay were shorter in VATS groups with five days versus seven days (p=0.001) and six days versus eleven days (p=0.001). The operative time was longer and more blood loss in OT groups compare to VATS groups with 180 minutes versus 70 minutes (p=0.001) and 100 mL versus 20 mL (p=0.001). In post-operative outcome, there was no difference in terms of arrhythmia, pneumonia, and 30 days mortality. However, there were slightly higher cost during hospital stay in VATS compared to OT at 3,329.9 USD versus 2,685.7 USD (p=0.001). Conclusion: VATS is associated with shorter length of tube duration, hospital stay, and less blood loss with no difference of post-operative outcome in lung cancer patients. Keywords: Video assisted thoracoscopic surgery; cancer; open thoracotomy

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun
Keyword(s):  
Thoracoscopic Surgery ◽  
Anterior Mediastinum ◽  
Laryngeal Mask ◽  
Double Lumen Tube ◽  
Perioperative Outcomes ◽  
Video Assisted ◽  
Incision Size ◽  
The Mean ◽  
End Tidal ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

scholarly journals Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098278
Author(s):  
Xing Du ◽  
Yunsheng Ou ◽  
Guanyin Jiang ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Bone Graft ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Operative Time ◽  
Bone Grafts ◽  
Surgical Indications ◽  
Operative Blood Loss ◽  
The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

scholarly journals Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaohe Wang ◽  
Yang Yue ◽  
Wenjie Zhang ◽  
Qiaoyu Liu ◽  
Beicheng Sun ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Hepatic Vein ◽  
Pringle Maneuver ◽  
Caudate Lobe ◽  
Postoperative Hospital Stay ◽  
Dorsal Approach ◽  
Glissonian Approach ◽  
The Mean ◽  
Major Hepatic Vein

Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections.

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