scholarly journals Is tubeless uniportal video-assisted thoracic surgery for pulmonary wedge resection a safe procedure?

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i70-i76 ◽  
Author(s):  
Chao-Yu Liu ◽  
Po-Kuei Hsu ◽  
Ka-I Leong ◽  
Chien-Kun Ting ◽  
Mei-Yung Tsou
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Chest Drain ◽  
Safe Procedure ◽  
X Rays ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Clinically Significant ◽  
Pulmonary Wedge Resection

Abstract OBJECTIVES Tubeless uniportal video-assisted thoracic surgery (VATS), using a uniportal approach and non-intubated anaesthesia while avoiding postoperative chest drain insertion, for patients undergoing thoracoscopic surgery has been demonstrated to be feasible in selected cases. However, to date, the safety of the procedure has not been studied. METHODS We reviewed consecutive patients undergoing non-intubated uniportal VATS for pulmonary wedge resection at 2 medical centres between August 2016 and October 2019. The decision to avoid chest drain insertion was made in selected candidates. For those candidates in whom a tubeless procedure was performed, postoperative chest X-rays (CXRs) were taken on the day of the surgery [operation (OP) day], on postoperative day 1 and 1–2 weeks later. The factors associated with abnormal CXR findings were studied. RESULTS Among 135 attempts to avoid chest drain insertion, 13 (9.6%) patients ultimately required a postoperative chest drain. Among 122 patients in which a tubeless procedure was performed, 26 (21.3%) and 47 (38.5%) had abnormal CXR findings on OP day and postoperative day 1, respectively. Among them, 3 (2.5%) patients developed clinically significant abnormal CXRs and required intercostal drainage. Primary spontaneous pneumothorax was independently associated with a higher risk of postoperative abnormal CXRs. CONCLUSIONS Tubeless uniportal VATS for pulmonary wedge resection can be safely performed in selected patients. Most patients with postoperative abnormal CXRs presented subclinical symptoms that spontaneously resolved; only 2.5% of patients with postoperative abnormal CXRs required drainage.

scholarly journals Robotic video-assisted thoracoscopic surgery using conventional thoracoscopic access

2020 ◽  
Vol 28 ◽  
pp. 93-100
Author(s):  
Vu Huu Vinh ◽  
Dang Dinh Minh Thanh ◽  
Nguyen Viet Dang Quang ◽  
Truong Cao Nguyen
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Operation Time ◽  
Tumour Resection ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Tube Removal ◽  
Conventional Open Surgery ◽  
Video Assisted Thoracoscopic Surgery

Video assisted thoracic surgery (VATS) has been widely used and confirmed to be effective and less invasive compared with conventional open surgery. Robotic video-assisted thoracic surgery (R-VATS) is VATSusing a surgeon-controlled robotic system. R-VATS has been increasingly performed worldwide but not in Vietnam. Wehave started implementing r-VATS since July 2018, using conventional thoracoscopic accesses (trocars) and reported our initial results after 18 months of implementation with 116 cases. 57 cases of lobectomy, 9 cases of wedge resection,19 cases of thymectomy, 28 cases of mediastinal tumour resection, 1 case of esophagectomy, 1 case of oesophageal leiomyoma resection, and 1 case of diaphragm plication. 110 cases had good outcomes with no complications, 5 cases suffered from haemothorax that lasted for more than 5 days. Onepatient died after 35 days due to pneumonia. The operation time was comparable to that ofc- VATS. Average time to chest tube removal was 2 days. Time from surgery to discharge was comparable to that ofc-VATS.

Subxiphoid Video-Assisted Thoracoscopic Surgery for Lung Resection Under Spontaneous Ventilation: Case Report

2021 ◽  
Vol 104 (11) ◽  
pp. 1847-1849
Keyword(s):  
Case Report ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Foley Catheter ◽  
Spontaneous Ventilation ◽  
Chest Drain ◽  
Arterial Line ◽  
Video Assisted ◽  
Subxiphoid Approach ◽  
Video Assisted Thoracoscopic Surgery

This case report describes two patients that underwent successful video-assisted thoracoscopic surgery (VATS) lung resections under spontaneous ventilation using the uniportal subxiphoid approach. The authors performed lung wedge resection in both patients under local anesthesia without using of a Foley catheter, arterial line, or intercostal chest drain. Only intravenous drugs and an oxygen mask with reservoir bag were used. The postsurgical course for both patients was uneventful. Both were discharged on postoperative day 2 and were doing well at 1- and 3-month follow-ups. Keywords: Subxiphoid approach; Pulmonary resection; Lung cancer

Video-Assisted Thoracic Surgery

2016 ◽  
Author(s):  
Scott J. Swanson ◽  
Abby White
Keyword(s):  
Thoracic Surgery ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Wedge Resection ◽  
Hospital Length Of Stay ◽  
Port Placement ◽  
Video Assisted ◽  
Trocar Placement ◽  
Video Assisted Thoracoscopic Surgery

Since the early 1990s, video-assisted thoracoscopic surgery (VATS) has revolutionized surgical care. The era of VATS is sufficiently mature that enough data have accrued to compare the efficacy of VATS with that of open procedures. In this regard, anatomic pulmonary resection by VATS has led to significant reductions in morbidity, mortality, and hospital length of stay, allowing patients a more expeditious return to regular activities. VATS has been used in the treatment of both benign and malignant diseases of the chest. Furthermore, VATS may be used in selected patients with early-stage lung cancer without breaching oncologic surgical principles. This review covers the case for VATS technology; operative planning; basic thoracoscopy operative technique; VATS procedures for pleural disease, pulmonary wedge resection, spontaneous pneumothorax and bullous disease, lung volume reduction surgery, lobectomy, mediastinal lymph node dissection, pericardial window, mediastinal masses, management of thoracic trauma, sympathectomy and splanchnicectomy; and cost considerations. Figures show preoperative evaluation; proper patient position in the operating room, with the patient propped on pontoons; triangulation technique for port placement in relation to intrathoracic structures and targets; thoracoscope and trocar placement; video and monitors; wedge resection with lung compression clamp; tissue-reinforced stapler  inserted into the chest; endoleader looped around the superior pulmonary vein; endoleader looped around the truncus anterior and its branch; and division of the upper lobe bronchus. Tables list indications and relative contraindications for VATS procedures, basic instruments and equipment used for VATS procedures, and operative steps for VATS lobectomy.   This review contains 10 highly rendered figures, 3 tables, and 35 references Key words: Video-assisted thoracoscopic surgery; VATS; Minimally invasive thoracic surgery; Thoracoscopy; Rigid thoracoscope; Flexible thoracoscope; Thoracoport

Video-Assisted Thoracic Surgery Lobectomy versus Lobectomy by Thoracotomy for Lung Cancer: Pilot Study

2013 ◽  
Vol 8 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Michael Papiashvilli ◽  
Lior Sasson ◽  
Sharbel Azzam ◽  
Henri Hayat ◽  
Letizia Schreiber ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Hospital Stay ◽  
Propensity Scores ◽  
Early Stage ◽  
Small Cell Lung Carcinoma ◽  
Safe Procedure ◽  
Cell Lung Carcinoma ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Objective Video-assisted thoracic surgery lobectomy (VATS-L) has become accepted as a safe and effective procedure to treat early-stage non–small cell lung carcinoma (NSCLC). However, the advantages of VATS-L compared with lobectomy by thoracotomy (TL) remain controversial. The aim of this study was to compare the outcomes of patients who underwent VATS-L with those who underwent TL. Methods We studied 103 patients who underwent surgery for operable NSCLC between October 2009 and March 2012. All operations were performed by a single surgeon. The inclusion and exclusion criteria for VATS-L and TL were formulated before the study was initiated. Data on age, sex, preoperative comorbidities, intraoperative and postoperative complications, hospital stay, morbidity, mortality, and other characteristics were recorded preoperatively, in real time intra-operatively, and during hospitalization and were statistically compared. Comorbidities were scaled according to the Charlson Comorbidity Index, and propensity scores between the patients who underwent TL and VATS-L were compared. Results Sixty-three VATS-L operations and 40 TL operations were performed. There were no postoperative complications in 39 patients (61.9%) who underwent VATS-L compared with 25 patients (62.5%) who underwent TL. The patients who underwent TL were significantly younger than the patients who underwent VATS-L (mean ± SD, 64.7 ± 12.6 vs 70.9 ± 8.4; P = 0.003). Hospital stay was not found to be related to the type of surgery (mean ± SD, 8.43 ± 3.15 days vs 8.32 ± 4.13 days; P = 0.888). There were no significant differences when comparing postoperative complications. Conclusions Our initial data suggest that VATS-L is a safe procedure in patients with resectable IA/IB NSCLC and may be the preferred strategy for treatment of the older patient population.

scholarly journals Video-Assisted Thoracic Surgery for Tubercular Spondylitis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Roop Singh ◽  
Paritosh Gogna ◽  
Sanjeev Parshad ◽  
Rajender Kumar Karwasra ◽  
Parmod Kumar Karwasra ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Bone Graft ◽  
Thoracoscopic Surgery ◽  
Spinal Tuberculosis ◽  
Neurological Involvement ◽  
Graft Placement ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Duration Of Surgery ◽  
Final Followup

The present study evaluated the outcome of video-assisted thoracic surgery (VATS) in 9 patients (males = 6, females = 3) with clinico-radiological diagnosis of tubercular spondylitis of the dorsal spine. The mean duration of surgery was 140.88 ± 20.09 minutes, mean blood was 417.77 ± 190.90 mL, and mean duration of postoperative hospital stay was 5.77 ± 0.97 days, Seven patients had a preoperative Grade A neurological involvement, while at the time of final followup the only deficit was Grade D power in 2 patients. In patients without bone graft placement (n= 6), average increase in Kyphosis angle was 16°, while in patients with bone graft placement (n= 3) the deformity remained stationary. At the time of final follow up, fusion was achieved in all patients, the VAS score for back pain improved from a pretreatment score of 8.3 to 2, and the function assessment yielded excellent (n= 4) to good (n= 5) results. In two patients minithoracotomy had to be resorted due to extensive pleural adhesions (n= 1) or difficulty in placement of graft (n= 1). Videoassisted thoracoscopic surgery provides a safe and effective approach in the management of spinal tuberculosis. It has the advantages of decreased blood loss and post operative morbidity with minimal complications.

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