Management of Pleural Empyema with Single-Port Video-Assisted Thoracoscopy

2012 ◽  
Vol 7 (5) ◽  
pp. 338-345 ◽  
Author(s):  
Alessandro Marra ◽  
Christoph Huenermann ◽  
Bernd Ross ◽  
Ludger Hillejan
Keyword(s):  
Chest Tube ◽  
Pleural Cavity ◽  
Single Port ◽  
Intraoperative Complications ◽  
Operation Time ◽  
Pleural Empyema ◽  
Metastatic Colon Cancer ◽  
Invasive Treatment ◽  
Female Ratio ◽  
Video Assisted

Objective The aim of this study was to evaluate the safety and efficacy of an original technique of single-port video-assisted thoracoscopy (S-VATS) for the minimally invasive treatment of pleural empyema in fibrinopurulent stage. Methods Single-port video-assisted thoracoscopy was performed under general anesthesia and single-lung ventilation using a 2-cm incision after ultrasound localization of the projected midpoint of the pleural effusion. Through the single access, a video scope and standard thoracoscopy instruments were simultaneously introduced to perform debridement and lavage of the pleural cavity. Postoperatively, patients underwent continuous or intermittent pleural irrigation through the chest tube until microbiological confirmation of sterility of the pleural fluid. Results Between November 2004 and December 2009, a total of 61 patients underwent S-VATS for pleural empyema in stage I(7%) or II (93%). Median age was 63.5 years (range, 22–94 years). Male-to-female ratio was 4.2. Surgery was performed 3 to 60 days after the onset of symptoms. Macroscopically complete debridement of the pleural cavity was achieved in most (98%) cases. Median operation time was 53 minutes (range, 29–90 minutes). No intraoperative complications occurred. In-hospital mortality and morbidity rates were 3% and 16%, respectively. Deaths were caused by diffuse metastatic colon cancer in one case and severe apoplectic insult in the other. Chest tube was removed after a median time of 12 days (range, 4–64 days). Four (6.5%) patients experienced a relapse of empyema; this was caused by complicated residual pleural space (two cases), persistent pleuropulmonary fistula (one case), or both (one case). Conclusions It seems that S-VATS is a safe and effective procedure for the treatment of pleural empyema in fibrinopurulent stage.

scholarly journals Video-assisted thoracic surgery ( conventional and single-port ) - place and role in the improved management of malignant pleural effusions: review article

2018 ◽  
Vol 16 (3) ◽  
pp. 242-248
Author(s):  
D. Valchev ◽  
E. Obretenov ◽  
D. Petrov
Keyword(s):  
Survival Time ◽  
Single Port ◽  
Performance Status ◽  
Pleural Empyema ◽  
Radical Change ◽  
Technological Advancement ◽  
Cancer Disease ◽  
Video Assisted ◽  
Surgical Methods ◽  
Improved Performance

MPE management has been changing over the years as this is due both to the technological advancement of mini-invasive surgical methods and to the change in our knowledge about this manifestation of oncology disorder. Advanced cancer disease and poor general condition in most cases do not allow large-volume and duration of surgical procedures. VATS is becoming an increasingly large share of the operating methods of treatment of spontaneous pneumothorax, thoracic trauma, acute pleural empyema, pleural effusion, benign pleural and pulmonary lesions, secondary metastatic and primary malignant lesions - pleural, pulmonary, mediastinal and bilateral location. Diagnostic and therapeutic capabilities of VATS for simultaneous diagnosis and palliative surgical treatment make it the optimal procedure in MPE management. It should be noted that the preliminary assessment of the patient’s condition and local status with an estimate of survival time often undergoes a radical change after the video-assisted surgical procedure. Improvement is reported with an increase of predetermined survival time and improved performance status, which supports the application of more minimally invasive, non-intubated, “awake” single-port VATS.

scholarly journals Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Resection of Solitary Pulmonary Nodules and Influencing Factors in the Diagnosis of Benign and Malignant Nodules

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hongxu Yue ◽  
Kaijie Fan ◽  
Zhimin Zhang ◽  
Yang Liu
Keyword(s):  
Single Port ◽  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Operation Time ◽  
Maximum Diameter ◽  
Imaging Features ◽  
Solitary Pulmonary Nodules ◽  
Serious Adverse Events ◽  
Video Assisted ◽  
Surgical Methods

Purpose. This is a retrospective research comparing the clinical outcomes of single-hole versus multi-hole video-assisted thoracoscopic surgical (VATS) resection for solitary pulmonary nodules (SPN) and examining the factors influencing the diagnosis of benign and malignant pulmonary nodules. Method. We collected the clinical data, surgical status, outcomes, and corresponding imaging features of 317 patients with SPN who were surgically resected by VATS and diagnosed as benign or malignant by pathology in our hospital from January 2019 to December 2021. Result. Among the 317 patients, 124 (39.12%) underwent single-port VATS and 193 (60.88%) underwent multiple-hole VATS. All patients were grouped according to the different surgical methods, and their postoperative indicators were statistically analyzed. The results showed that neither the single-port VATS group nor the multi-port VATS group had any serious adverse events such as death during the perioperative period. The average operation time, intraoperative blood loss, drainage tube indwelling time, and postoperative hospital stay were significantly lower in the two groups. Statistics of postoperative pathological diagnosis showed that 98 cases (30.91%) of all nodules were benign nodules and 219 cases (69.09%) were malignant nodules, and a further single-multivariate analysis showed that age, nodule maximum diameter, lobular sign, burr sign, vascular cluster sign, and pleural depression sign were independent relevant factors for the diagnosis of benign and malignant nodules. Conclusion. VATS is less invasive and has fewer complications and is of great clinical value for both diagnosis and treatment of benign and malignant SPN. Age, maximum nodal diameter, lobar sign, burr sign, vascular set sign, and pleural depression sign were independent correlates affecting the diagnosis of benign and malignant SPN, which reminds that great attention should be paid to patients who are older and have risk factors on imaging, and early and timely active treatment or close follow-up should be carried out.

PS01.130: VIDEO-ASSISTED THORACOSCOPE 3D AND 2D MODE COMPARATIVE ANALYSIS FOR ESOPHAGEAL CHEST SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 86-87
Author(s):  
Jie Jiang ◽  
Xiuyi Yu ◽  
Guojun Geng ◽  
Hongming Liu
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Lymph Nodes ◽  
Chest Tube ◽  
Statistical Difference ◽  
Statistical Significance ◽  
Operation Time ◽  
Intraoperative Bleeding ◽  
Advantages And Disadvantages ◽  
Video Assisted

Abstract Background To study the advantages and disadvantages of 3D and 2D thoracoscope in the thoracic surgery of esophageal carcinoma. Methods Retrospectively analyze esophageal cancer cases between July 2013 and July 2017 of the first affiliated hospital to Xiamen University, depending on the different mode of Video-Assisted Thoracoscopic, which can be divided into 3D-VATS group 353 cases (observation group) and 2D-VATS group 351 cases (control group). Comparing the difference in operation time, intraoperative bleeding, lymph node transmission, volume of the drain by the first 24 hours, total volume of the drain, chest tube time and postoperative complications. Results All the 704 patients with esophageal cancer were performed under the video-assisted thoracoscope. In terms of surgery time, 3D-VATS group (51.4 ± 13.3min) was shorter than 2D-VATS group (65.7 ± 9.1min), with statistical significance (t = -9.751, P = 0.013); on blood loss, 3D-VATS group (34.1 ± 10.5ml) was less than 2D-VATS group (50.2 ± 9.4ml) with statistical significance (t = -9.274, P = 0.009); about lymph nodes transmission, 3D-VATS group (16.8 ± 3.2) was more than 2D-VATS group (13.1 ± 3.7), with statistical significance (t = 5.213, P = 0.007); in volume of the drain by the first 24 hours, 3D-VATS group (171.2.15 ± 20.2ml) was less slightly than 2D-VATS group (180.3 ± 35.2ml), no statistical difference (t = -1.347, P = 0.281); about total volume of the drain, 3D-VATS group (530.2 ± 53.4ml) was less slightly than 2D-VATS group (553.8 ± 57.5ml), no statistical difference (t = -1.911, P = 0.093); on chest tube time, 3D-VATS group (4.2 ± 0.7d) was less slightly than 2D-VATS group (4.9 ± 1.1d), no statistical difference (t = -1.806, P = 0.069); Postoperative complications in two groups including the incidence of arrhythmia, pulmonary infection, anastomotic leakage and recurrent laryngeal nerve injury has no obvious difference (P > 0.05). Conclusion Video-assisted thoracoscopic surgery of esophagectomy under 3D-mode has certain advantages in operation time, intraoperative bleeding and lymph nodes transmission over 2D-mode. While in the item of volume of the drain by 24 hours, total volume of the drain, chest tube time and postoperative complications, they have no obvious difference. Disclosure All authors have declared no conflicts of interest.

scholarly journals VIDEO-ASSISTED RESECTIONS FOR PULMONARY TUBERCULOSIS WITH THE PRESENCE OF PLEURAL CAVITY OBLITERATION

2021 ◽  
Vol 29 (2) ◽  
pp. 53-57
Author(s):  
M. S. Opanasenko ◽  
◽  
V. I. Lysenko ◽  
O. V. Tereshkovych ◽  
B. N. Konik ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Pulmonary Tuberculosis ◽  
Pleural Cavity ◽  
Intraoperative Complications ◽  
Lung Resection ◽  
Parietal Pleura ◽  
Tuberculosis Patients ◽  
Video Assisted ◽  
Regular Open ◽  
Cavity Obliteration

Pulmonary tuberculosis surgery is characterized by a number of aspects associated with adhesions in the pleural cavity, fibrosis of the lung root, destruction of the parenchyma, which contribute to the development of intra- and postoperative complications such as residual pleural cavity and reactivation of tuberculosis in operated lung due to compensatory tissue distortion. Aim: to improve video-assisted lung resection (VATS) in tuberculosis patients with the presence of pleural cavity obliteration. Materials and methods. The developed method of VATS for tuberculosis patients with pleural cavity obliteration is based on separate intubation of right and left main bronchi for mechanical ventilation of one lung, placement of thoracic port, performing revision of pleural cavity using video-assisted thoracoscopy, performing mini-thoracotomy and resection of lung with separate treatment of anatomical structures in required volume by means of disposable stapler or regular open thoracotomy instruments, pleural cavity draining and layered wound closure. Computed tomography of chest is performed during the operation in order to assess the extent and severity of pleural adhesions and to locate safe position of thoracic ports. Hydraulic needle preparation of parietal pleura is performed in severe adhesions area. Hemorrhage is treated using hemostatic plate Surgicel Fibrillar made of restored cellulose. Phrenicotripsy, pleural cavity drainage and, finally, artificial pneumoperitoneum are performed. The proposed method of video-assisted lung resection was used in 41 patients, 25 patients underwent video-assisted resection according to the prototype method. Results. The proposed method reduced duration of the surgical intervention by 52.7 minutes; the frequency of intraoperative complications by 14.4%; the incidence of postoperative complications by 14.2; the duration of patient�s stay at the hospital by 5.8 days and increased of overall treatment efficiency by 14.5%. The proposed method of VATS for patients with pulmonary tuberculosis and pleural cavity obliteration is safe, effective, simple to implement and can be performed at thoracic surgery departments of various pulmonary hospitals of city and regional level. Key words: pulmo

Management of Pleural Empyema with Single-Port Video-Assisted Thoracoscopy

2012 ◽  
Vol 7 (5) ◽  
pp. 338-345
Author(s):  
Alessandro Marra ◽  
Christoph Huenermann ◽  
Bernd Ross ◽  
Ludger Hillejan
Keyword(s):  
Single Port ◽  
Pleural Empyema ◽  
Video Assisted

scholarly journals Curative Effect Observation and Prognosis Analysis of Video-Assisted Thoracic Surgery and Thoracotomy in Patients with Hemopneumothorax

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Honglei Zhang ◽  
Qian Yang ◽  
Tao Liu ◽  
Yu Liu
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Retention Time ◽  
Chest Tube ◽  
Operation Time ◽  
Postoperative Recovery ◽  
Inflammatory Factor ◽  
Intraoperative Bleeding ◽  
Video Assisted

Currently, the incidence of hemopneumothorax is high in China, and with the continuous improvement of modern medical standards, video-assisted thoracoscopic surgery (VATS) has gradually become the main method of clinical treatment of hemopneumothorax. The aim of this study was to investigate the minimally invasive mechanism and the clinical value of television thoracoscopy in the diagnosis and treatment of traumatic hemopneumothorax and to provide a relevant theoretical basis for the superiority of television thoracoscopy. In this study, total of 98 patients with traumatic hemopneumothorax admitted to three hospitals from January 2017 to December 2019 were selected and divided into 49 cases each in the thoracotomy group and VATS group according to the differences of the surgical method. The surgical situation such as operation time, intraoperative bleeding, and incision length, postoperative recovery such as duration of painkiller use, chest tube retention time, volume of drainage, and hospital stay, levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and other inflammatory factors at different times after admission to hospital, postoperative complications such as pulmonary infection, enveloped effusion, incisional infection, and pressureulcers, and recurrence rate at 12-month follow-up were used as the evaluation indexes to analyze the effect of different surgical treatment modalities in patients with hemopneumothorax and the impact on patient prognosis. The results showed that the operative time, intraoperative bleeding, duration of painkiller use, chest tube retention time, and hospital stay were shorter in the VATS group than in the thoracotomy group. The length of the surgical incision, volume of drainage, and inflammatory factor levels at different postoperative periods were lower in the VATS group than in the thoracotomy group. The incidence of postoperative complications was lower in both groups, and the difference was not statistically significant. The follow-up results showed that there were no recurrent cases in both groups 12 months after discharge. This indicates that VATS is an effective treatment option for hemopneumothorax, which can achieve the same exploration and treatment effect as thoracotomy, and has the advantages of less trauma, less bleeding, shorter operation time, and faster postoperative recovery compared with thoracotomy. The prognosis of patients treated by VTAS is good, which provides a new treatment route for patients who cannot tolerate thoracotomy and are poorly tolerated.

scholarly journals Broken chest tube: a rare complication treated by video-assisted thoracic surgery

2019 ◽  
Vol 6 (9) ◽  
pp. 3443
Author(s):  
Girish D. Bakhshi ◽  
Kushagra Rahul ◽  
Shraddha S. Gangawane ◽  
Ashwini S. Borade ◽  
Dinesh S. Pawar ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
Pleural Cavity ◽  
Rare Complication ◽  
Minimal Invasive ◽  
Chest Drain ◽  
Foreign Body Removal ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Surgical Setting

Intercostal chest drain (ICD) or chest tube is a simple device used very frequently in medical, surgical and critical care specialties to drain air, blood or pus from the pleural cavity. Fracture of ICD and displacement of fractured segment within the pleural cavity is a rare complication. Minimal invasive approaches via video-assisted thoracic surgery (VATS) have been demonstrated predominantly in traumatic thoracic foreign body removal cases in a primary surgical setting. Here we present a case of a broken chest tube in the pleural cavity removed using VATS. A brief case report, review of literature and prevention of this complication is described.

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

2011 ◽  
pp. 114-118
Author(s):  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Van Nghia Tran
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Central Hospital ◽  
Surgical Department ◽  
A New Technique ◽  
Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

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