Non-intubated subxiphoid uniportal video-assisted thoracoscopic thymectomy

2019 ◽  
Vol 29 (5) ◽  
pp. 742-745 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun
Keyword(s):  
Surgical Approach ◽  
Anterior Mediastinum ◽  
Laryngeal Mask ◽  
Lower Edge ◽  
Fast Recovery ◽  
Transverse Incision ◽  
Video Assisted ◽  
Potential Benefits ◽  
Safety Precaution ◽  
Ventilatory Management

Abstract This report describes a non-intubated, subxiphoid, uniportal approach to video-assisted thoracoscopic thymectomy. A laryngeal mask was used as a safety precaution for ventilatory management, and thymectomy was accomplished through a single transverse incision below the lower edge of the xiphoid. Patients were uneventfully discharged with fast recovery. This novel surgical approach may merge the potential benefits of a subxiphoid incision for treatment of anterior mediastinum lesion and adoption of a non-intubated anaesthesia protocol.

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 Non-Intubated Uniportal Subxiphoid Thoracoscopic Extended Thymectomy for Thymoma Associated with Myasthenia Gravis

2021 ◽  
Author(s):  
Jian Zhong ◽  
Yang Sun ◽  
Zhengcheng Liu
Keyword(s):  
Chest Tube ◽  
Operative Time ◽  
Early Stage ◽  
Postoperative Hospital Stay ◽  
Fast Recovery ◽  
Transverse Incision ◽  
Extended Thymectomy ◽  
Xiphoid Process ◽  
Potential Benefits

Abstract Background: To describe a technique of non-intubated uniportal subxiphoid thoracoscopic extended thymectomy.Methods: Data were collected retrospectively. A single 3-cm transverse incision was made below the xiphoid process. This method for extended thymectomy entails adoption of uniportal subxiphoid VATS combined with use of non-intubated anaesthesia for thymoma associated with myasthenia gravis.Results: 10 consecutive patients underwent this procedure successfully. Mean operative time was 102.5 minutes. Conversion to intubated ventilation or thoracotomy was not required. Mean chest tube duration was 3.5 days. Mean postoperative hospital stay was 4.7 days. Histologic examination showed early-stage thymomas. Complications were rare. Quantitative MG scores decreased during follow-up. Conclusions: Patients were uneventfully discharged with fast recovery. This technique may merge the potential benefits of a subxiphoid incision and the non-intubated anesthesia protocol.

scholarly journals Non-intubated uniportal subxiphoid thoracoscopic extended thymectomy for thymoma associated with myasthenia gravis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhengcheng Liu ◽  
Louqian Zhang ◽  
Weifeng Tang ◽  
Rusong Yang
Keyword(s):  
Myasthenia Gravis ◽  
Operative Time ◽  
Early Stage ◽  
Postoperative Hospital Stay ◽  
Fast Recovery ◽  
Transverse Incision ◽  
Extended Thymectomy ◽  
Xiphoid Process ◽  
Potential Benefits

Abstract Background To describe a technique of non-intubated uniportal subxiphoid thoracoscopic extended thymectomy. Methods Data were collected retrospectively. A single 3-cm transverse incision was made below the xiphoid process. This method for extended thymectomy entails adoption of uniportal subxiphoid VATS combined with using of non-intubated anesthesia for thymoma associated with myasthenia gravis. Results Ten consecutive patients underwent this procedure successfully. Mean operative time was 102.5 min. Conversion to intubated ventilation or thoracotomy was not required. Mean chest tube duration was 3.5 days. Mean postoperative hospital stay was 4.7 days. Histologic examination showed early-stage thymomas. Side effects were rare. Quantitative MG scores decreased during follow-up. Conclusions Patients were uneventfully discharged with fast recovery. This technique may merge the potential benefits of a subxiphoid incision and the non-intubated anesthesia protocol.

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

Difficult Pediatric Airway Management: A Randomized Trial Comparing Laryngeal Mask Airway, Video-Assisted, and Direct Laryngoscopy

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P101-P101
Author(s):  
Art A. Ambrosio ◽  
Colleen Perez ◽  
Chelsie Byrnes ◽  
Cory Gaconnet ◽  
Christopher Cornelissen ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Randomized Trial ◽  
Direct Laryngoscopy ◽  
Laryngeal Mask ◽  
Pediatric Airway ◽  
Video Assisted

MANAGEMENT OF DESCENDING NECROTIZING MEDIASTINITIS WITH VIDEO-ASSISTED THORACOSCOPIC SURGICAL APPROACH

CHEST Journal ◽  
2006 ◽  
Vol 130 (4) ◽  
pp. 270S
Author(s):  
Michael K. Hsin ◽  
Innes Y. Wan ◽  
Tak W. Lee ◽  
Kin H. Thung ◽  
Norihisha Shigemura ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Descending Necrotizing Mediastinitis ◽  
Video Assisted

scholarly journals Pediatric Trainees Managing a Difficult Airway: Comparison of Laryngeal Mask Airway, Direct, and Video-Assisted Laryngoscopy

OTO Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. 2473974X1770791 ◽  
Author(s):  
Art Ambrosio ◽  
Kastley Marvin ◽  
Colleen Perez ◽  
Chelsie Byrnes ◽  
Cory Gaconnet ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Direct Laryngoscopy ◽  
Training Session ◽  
Laryngeal Mask ◽  
Normal Infant ◽  
Difficult Airway Management ◽  
Video Assisted ◽  
Advanced Airway

Objective Difficult airway management is a key skill required by all pediatric physicians, yet training on multiple modalities is lacking. The objective of this study was to compare the rate of, and time to, successful advanced infant airway placement with direct laryngoscopy, video-assisted laryngoscopy, and laryngeal mask airway (LMA) in a difficult airway simulator. This study is the first to compare the success with 3 methods for difficult airway management among pediatric trainees. Study Design Randomized crossover pilot study. Setting Tertiary academic medical center. Methods Twenty-two pediatric residents, interns, and medical students were tested. Participants were provided 1 training session by faculty using a normal infant manikin. Subjects then performed all 3 of the aforementioned advanced airway modalities in a randomized order on a difficult airway model of a Robin sequence. Success was defined as confirmed endotracheal intubation or correct LMA placement by the testing instructor in ≤120 seconds. Results Direct laryngoscopy demonstrated a significantly higher placement success rate (77.3%) than video-assisted laryngoscopy (36.4%, P = .0117) and LMA (31.8%, P = .0039). Video-assisted laryngoscopy required a significantly longer amount of time during successful intubations (84.8 seconds; 95% CI, 59.4-110.1) versus direct laryngoscopy (44.9 seconds; 95% CI, 33.8-55.9) and LMA placement (36.6 seconds; 95% CI, 24.7-48.4). Conclusions Pediatric trainees demonstrated significantly higher success using direct laryngoscopy in a difficult airway simulator model. However, given the potential lifesaving implications of advanced airway adjuncts, including video-assisted laryngoscopy and LMA placement, more extensive training on adjunctive airway management techniques may be useful for trainees.

An extrapleural approach to the anterior mediastinum using video-assisted thoracic surgery (VATS)

2003 ◽  
Vol 17 (11) ◽  
pp. 1851-1851 ◽  
Author(s):  
T. Morikawa ◽  
S. Ohtake ◽  
M. Kaji ◽  
S. Okushiba ◽  
S. Kondo ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Anterior Mediastinum ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Extrapleural Approach
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