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.

Comparison of Postoperative Pain and Recovery between Single-Port and Two-Port Thoracoscopic Lobectomy for Lung Cancer

2018 ◽  
Vol 67 (02) ◽  
pp. 142-146 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Feng Shao
Keyword(s):  
Postoperative Pain ◽  
Single Port ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Perioperative Outcomes ◽  
Vats Lobectomy ◽  
Video Assisted ◽  
Incision Size ◽  
Wound Pain ◽  
Video Assisted Thoracoscopic Surgery

Objective To investigate whether the single-port (SP) technique had more favorable postoperative outcomes than had the two-port (TP) technique. Methods One hundred sixty-six single-port video-assisted thoracoscopic surgery (SP-VATS) lobectomy and 162 two-port video-assisted thoracoscopic surgery (TP-VATS) lobectomy had been successfully completed between August 2015 and September 2016. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes and the safety between SP-VATS and TP-VATS lobectomy for NSCLC was compared. Results In the SP-VATS group, incision size was kept to a minimum, with a median of 3 cm; mediastinal lymph node dissection was performed in all patients with malignancy. Overall, median operative time was 89 minutes, and median chest tube duration was 3.1 days. The VAS on postoperative days 3, 7, and 14 was less in the SP-VATS group than that in the TP-VATS group. The VAS on days 1, 30, 60, 90, 180, and 360 did not differ significantly between the two groups. The number of days of use of analgesic agents after surgery was less in the SP-VATS group. The pathological symptoms of wound pain were significantly less in the SP-VATS group. Conclusions Compared with the multiport approach, SP VATS lobectomy might reduce postoperative pain and lead to faster recovery.

scholarly journals Video-assisted thoracoscopic surgery under non-intubated spontaneous breathing anesthesia using laryngeal mask

2015 ◽  
Vol 10 (S1) ◽  
Author(s):  
Premjithlal Bhaskaran ◽  
Antonios Katsipoulakis ◽  
Francesca Caliandro ◽  
Niall McGonigle ◽  
Nikolaos Anastasiou
Keyword(s):  
Spontaneous Breathing ◽  
Thoracoscopic Surgery ◽  
Laryngeal Mask ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Uniportal video-assisted thoracoscopic carinal resections: technical aspects and outcomes

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i58-i64
Author(s):  
Dmitrii Sekhniaidze ◽  
Diego Gonzalez-Rivas ◽  
Pavel Kononets ◽  
Alejandro Garcia ◽  
Vladimir Shneider ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Thoracoscopic Surgery ◽  
Morbidity Rate ◽  
Surgical Time ◽  
Technical Aspects ◽  
Video Assisted ◽  
The Mean ◽  
Clinic Hospital ◽  
Blood Loss Volume ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES Important benefits in uniportal video-assisted thoracoscopic surgery (VATS) for lung cancer have recently been achieved. However, the use of this technique for complex sleeve procedures is limited. We describe the technical aspects of and patient outcomes following carinal resections using uniportal VATS. METHODS Since 2015, 16 sleeve carinal resections, including 11 right pneumonectomies, 4 right upper lobectomies and 1 lung-sparing carinal resection, have been performed at the Regional Clinic Hospital, Tyumen, Russia. RESULTS The mean surgical time was 215.9 ± 67.2 min (range 125–340 min). The mean blood loss volume was 256.3 ± 284.5 ml (range 50–1200 ml). There was 1 case of conversion to thoracotomy. The morbidity rate was 25%, and the mortality rate was 0%. The median overall survival was 38.6 ± 3.5 months. CONCLUSIONS The use of uniportal VATS for carinal resections in certain patients allows for radical resections with low rates of morbidity and mortality.

A Video-Assisted Thoracoscopic Approach to Transaxillary First Rib Resection

2015 ◽  
Vol 10 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Harmik J. Soukiasian ◽  
Daniel Shouhed ◽  
Derek Serna-Gallgos ◽  
Robert McKenna ◽  
Vahak J. Bairamian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Thoracoscopic Surgery ◽  
Invasive Approach ◽  
Thoracoscopic Approach ◽  
Rib Resection ◽  
Video Assisted ◽  
First Rib ◽  
The Mean ◽  
First Rib Resection ◽  
Video Assisted Thoracoscopic Surgery

Objective Thoracic outlet syndrome (TOS) can be associated with neurologic, arterial, or venous deficiencies. When nonsurgical treatment has failed to adequately palliate TOS, surgical intervention is indicated. The supraclavicular and transaxillary approaches are currently the most commonly used approaches for first rib resection, yet little has been reported to date on outcomes of minimally invasive procedures, such as video-assisted thoracoscopic surgery (VATS). The purpose of this article was to describe a minimally invasive approach to TOS and the associated outcomes. Methods This study is a retrospective analysis of a prospectively maintained database. Patients who failed nonsurgical therapy for TOS were referred to our practice for evaluation of surgery with a VATS minimally invasive first rib resection. Between 2001 and 2010, 66 VATS procedures were performed on 58 patients (41 women, 17 men). Patients were followed postoperatively for a mean time of 13.5 months. Results Forty-one patients were women (70.7%), and the mean age was 40.5 years, with a patient age range of 17 to 59 years. The mean length of hospital stay was 2.47 days; median length of stay was 2 days. There were a total of eight complications (12.1%). There were no mortalities. Conclusions Video-assisted thoracoscopic surgery first rib resection for TOS is another feasible option for TOS, which can be added to the armamentarium of the thoracic surgeon. The outcomes associated with our technique are comparable with the outcomes related to other current standards of care.

Comparison of Subxiphoid and Intercostal Uniportal Thoracoscopic Thymectomy for Nonmyasthenic Early-Stage Thymoma: A Retrospective Single-Center Propensity-Score Matching Analysis

2020 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Disease Stage ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Video Assisted ◽  
Drainage Time ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective The aim of this study was to compare early outcome between intercostal uniportal video-assisted thoracoscopic surgery (IU-VATS) versus subxiphoid uniportal video-assisted thoracoscopic surgery (SU-VATS) in thymectomy for non-myasthenic early-stage thymoma. Method Retrospective analysis of 76 cases completed in our hospital from May 2018 to September 2019 with subxiphoid uniportal thoracoscopic thymectomy; a single incision of ∼3 cm was made ∼1 cm under the xiphoid process. The control group included 213 patients who received intercostal uniportal thoracoscopic thymectomy from August 2015, and propensity score matching was conducted. All patients who were clinically diagnosed with thymic tumor before surgery were treated with thymectomy. Perioperative outcomes between SU-VATS (n = 76) and IU-VATS, n = 76 were compared. Result After propensity score matching, there were no statistically significant differences between the two groups in terms of age, gender, disease stage, maximal tumor size, or other baseline demographic and clinical variables. All operation was successfully completed; there were no significant differences in the operative time (88 vs. 81 minutes, p = 0.63), intraoperative blood loss (55 vs. 46 mL, p = 0.47), postoperative drainage time (2.2 vs. 2.5 days, p = 0.72), and postoperative hospital stay (3.2 vs. 3.4 days, p = 0.78) between the two groups. The visual analog scale (VAS) on postoperative days 1, 3, 7, and 30 was less in the SU-VATS group than that in the IU-VATS group. The VAS on days 60 and 180 did not differ significantly between the two groups. Conclusion Thymectomy using SU-VATS is a feasible procedure; it might reduce early postoperative pain and lead to faster recovery.

Nonintubated Thoracoscopic Pulmonary Nodule Resection under Spontaneous Breathing Anesthesia with Laryngeal Mask

2014 ◽  
Vol 9 (4) ◽  
pp. 276-280 ◽  
Author(s):  
Marcello C. Ambrogi ◽  
Olivia Fanucchi ◽  
Stylianos Korasidis ◽  
Federico Davini ◽  
Raffaello Gemignani ◽  
...  
Keyword(s):  
Spontaneous Breathing ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Lung Nodule ◽  
Carbon Dioxide Tension ◽  
Technical Feasibility ◽  
End Tidal Carbon Dioxide ◽  
The Mean ◽  
End Tidal ◽  
Video Assisted Thoracoscopic Surgery

Objective During the past 20 years, the use of video-assisted thoracoscopic surgery has increased as an important minimally invasive tool. To further reduce its invasiveness, after a preliminary experience, we decided to use a nonintubated spontaneous breathing general anesthesia, for video-assisted thoracoscopic surgery resection of lung nodule, using a laryngeal mask (LMA). This study aimed to verify the safety and the feasibility of this technique. Methods Twenty consecutive patients who underwent thoracoscopic wedge of lung nodule under spontaneous breathing general anesthesia with LMA are the subjects of this study. Clinical data, American Society of Anesthesiologists status, Adult Comorbidity Evaluation-27 score, and Revised Cardiac Risk Index score were recorded for each patient. General inhalatory anesthesia (sevoflurane) was given in all cases through an LMA, without muscle relaxants, thus allowing spontaneous breathing. All procedures were performed in the lateral decubitus position. The maximum and minimum values of end-tidal carbon dioxide tension and oxygen saturation were recorded during the procedure. The level of technical feasibility was stratified by the operating surgeon according to four levels: excellent, good, satisfactory, and unsatisfactory. Results There were 13 men and 7 women (mean age, 57 years). The mean induction anesthesia time was 6 minutes, whereas the mean operative time was 38 minutes. The values of oxygen saturation as well as minimum and maximum end-tidal carbon dioxide tension were 99.1%, 33.6 mm Hg, and 39.1 mm Hg, respectively. No mask displacement occurred. The mean operative time was 38 minutes (range, 25–90 minutes). The level of technical feasibility was defined as excellent in 19 cases and good in 1 case. No mortality occurred. Morbidity consisted of pleural effusion (one case), which was medically resolved. The mean postoperative stay was 3.5 days. Histopathologic results were one squamous cell lung cancer (lung primary), one adenocarcinoma (lung primary), five metastasis from colon cancer, four metastasis from breast cancer, three metastasis from renal cancer, three sarcoidosis, two amartocondroma, and one tuberculosis. Conclusions Our experience suggests that thoracoscopic wedge resection of lung nodule is safe and feasible under spontaneous breathing anesthesia with LMA. This technique permits a confident manipulation of lung parenchyma and a safe stapler positioning, without cough, pain, or panic attack described for awake epidural anesthesia, avoiding the risks related to tracheal intubation and mechanical ventilation.

Video-assisted thoracoscopic thymectomy for thymoma: a single-center experience

2018 ◽  
Vol 26 (3) ◽  
pp. 207-211 ◽  
Author(s):  
Giang Truong Nguyen ◽  
Trung Ngoc Nguyen ◽  
Nam Van Nguyen ◽  
Kien Trung Nguyen ◽  
Anh Viet Le
Keyword(s):  
Myasthenia Gravis ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Military Hospital ◽  
Video Assisted ◽  
Single Center Experience ◽  
Early Results ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background Thymoma is a primary tumor derived from the epithelial cells of the thymus, which is commonly seen in the mediastinum. Surgical thymectomy is the radical treatment for thymoma. The recent introduction of video-assisted thoracoscopic surgery has improved the quality of thymectomy surgery. The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. The objectives of this study were to investigate the clinical and laboratory characteristics of thymoma and to evaluate the early results of video-assisted thoracoscopic thymectomy for thymoma in Vietnamese patients. Methods All 53 thymoma patients with or without myasthenia gravis who underwent video-assisted thoracoscopic thymectomy in Military Hospital 103, Vietnam, from October 2013 to July 2017 were included. Results The mean age was 46.5 7.1 years, and the female/male ratio was 1.2:1. Myasthenia gravis, mostly stage IIA, was present in 84.9% of patients. There was no hospital mortality or major postoperative complication. The mean operative time was 65 min, intensive care unit stay was 22 ± 5 h, and postoperative hospital stay was 7.5 ± 1.7 days. Conclusion Thoracoscopic thymectomy for thymoma in Vietnamese patients achieved improved cosmesis and was safe for both non-myasthenia gravis and myasthenia gravis patients.

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 Simultaneous Bilateral Video-Assisted Thoracoscopic Surgery for the Treatment of Primary Spontaneous Pneumothorax

2014 ◽  
Vol 71 (3) ◽  
pp. 1703-1708 ◽  
Author(s):  
Xin Wang ◽  
Lei Wang ◽  
Huayong Wang ◽  
Hao Zhang
Keyword(s):  
Surgical Procedures ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Primary Spontaneous Pneumothorax ◽  
Intraoperative Bleeding ◽  
Video Assisted ◽  
Second Surgery ◽  
The Mean ◽  
Mean Time ◽  
Video Assisted Thoracoscopic Surgery

Abstract We determined the feasibility and clinical efficacy of simultaneous bilateral video-assisted thoracoscopic surgery (VATS) for treating primary spontaneous pneumothorax (PSP). We performed a retrospective analysis of the efficacy of simultaneous bilateral resection of pulmonary bullae using VATS in 21 PSP patients that were treated at our hospital from February 2010 to August 2013. We found bilateral bullae in all patients through the intraoperative exploration. Surgical procedures were successfully completed in all patients without conversion to thoracotomy. The mean time of surgery was 128.76 ± 13.82 min (range 100–150 min). Total amount of intraoperative bleeding was 80–200 ml. Total drainage of bilateral thoracic ducts was 200–500 ml at the 1st postoperative day with a mean drainage of 321.42 ± 82.66 ml. Bilateral thoracic ducts were removed 4–8 days postoperatively with a mean time of 4.7 days. The duration of postoperative hospitalization was 5–9 days with a mean duration of 7 days. No patient had serious complication(s) and all patients were discharged after full recovery. The patients were followed up for 6–18 months after the surgery and no relapse occurred. In conclusion, treating the unilateral PSP by simultaneous bilateral VATS is safe and effective. It reduces patients’ risk of second surgery and also minimizes patients’ suffering and costs incurred.

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