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

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.

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Anh Hải Vũ ◽  

Tóm tắt Mục tiêu: Nhận xét chỉ định và kết quả ứng dụng phẫu thuật nội soi (PTNS) trong điều trị mủ màng phổi. Đối tượng và phương pháp: 44 người bệnh mủ màng phổi giai đoạn bán cấp và mạn tính được PTNS điều trị tại khoa phẫu thuật lồng ngực - Bệnh viện Quân Y 103, thời gian từ 01/2017 đến 04/2019. Nghiên cứu tiến cứu, mô tả và theo dõi dọc. Kết quả: Tuối trung bình 54,6 ± 14,2; tỷ lệ nam/nữ là 21/1; điểm Karnofsky 68,6 ± 6,9; bệnh lý kết hợp gồm: đái tháo đường (36,4%), suy thận giai đoạn cuối (2,3%), xơ gan (2,3%). Cấy khuẩn mủ màng phổi xác định được vi khuẩn gây bệnh ở 12/44 trường hợp (tỷ lệ 27,3%); PTNS điều trị mủ màng phổi giai đoạn bán cấp tính chiếm 77,3%, mạn tính 22,7%. Phương pháp xử lý gồm: bóc vỏ phổi (56,8%) và gỡ dính, hút mủ, rửa màng phổi, dẫn lưu kín (43,2%); Biến chứng sau mổ 9,1%. Kết quả tốt tại thời điểm 1 và 3 tháng sau phẫu thuật lần lượt là 43,2% và 81,8%. Kết luận: Ứng dụng PTNS điều trị mủ màng phổi (MMP) giai đoạn bán cấp và đầu mạn tính khả thi. Biến chứng tỷ lệ thấp (9,1%). Kết quả tốt khả quan tại thời điểm tháng thứ 3 sau phẫu thuật (81,8%). Abstract Objectives: Remarks on indication and results of Video - Assisted - Thoracoscopic Surgery (VATS) for management of empyema. Materials and Methods: 44 patients with fibrinopurulent and empyema phases were treated by VATS at the Department of thoracic surgery of Military Hospital 103, from 01/2017 to 04/2019. Descriptive, longitudinal and prospective study. Results: The mean of age was 54.6 ± 14.2; male/female was 21/1; Karnofsky score was 68.6 ± 6.9; Comorbidity diseases include: diabetes (36.4%), end-stage renal failure (2.3%), cirrhosis (2.3%). Results of pleural pus culture with 12/44 (27,3%) were identified pathogenic bacteria. VATS performed for fibrinopurulent and chronic empyema (77.3% and 22.7%, respectively). The techniques performed were: decortication (56.8%) and empyemectomy and debridement (43.2%). The rate of postoperative complication was relative low (9.1%). The good results at the 1st and 3rd month after surgery were 43.2% and 81.8%, respectively. Conclusion: Application of VATS for fibrinopurulent and chronic empyema was feasibility. Low-rate of complication was only 9,1%. The good results at the 3rd month after surgery was as high as 81,8%. Keywords: Empyema; Video-Assisted-Thoracoscopic Surgery


2021 ◽  
Vol 44 (1) ◽  
pp. 369-373
Author(s):  
Truong Giang Nguyen ◽  
Ngoc Trung Nguyen ◽  
Van Nam Nguyen ◽  
Trung Kien Nguyen ◽  
Duc Thang Vu ◽  
...  

2015 ◽  
Vol 68 (6) ◽  
pp. 219-224
Author(s):  
Aurél Ottlakán ◽  
Tibor Géczi ◽  
Balázs Pécsy ◽  
Bernadett Borda ◽  
Judit Lantos ◽  
...  

Absztrakt Célkitűzés: A myasthenia gravis (MG) kezelésében számos nyitott, illetve minimálisan invazív thymectomia ismert. A tanulmány ugyanazon intézeten belül a transsternalis (TS), illetve kétféle minimálisan invazív thymectomia (video-assisted thoracoscopic extended thymectomy – VATET; unilateral video-assisted thoracoscopic surgery – UL-VATS) eredményeit hasonlítja össze. Anyag és módszerek: Három különböző időintervallumban 71 betegnél történt thymectomia MG miatt (60 nő, 11 férfi): 23 transsternalis thymectomia (1995. január–2004. szeptember), 22 VATET (2004. szeptember – 2009. augusztus) és 26 UL-VATS thymectomia (2009. szeptember – 2011. december). Az eredmények értékelésénél a műtéti idő, MG-hez társuló neurológiai és a műtét utáni sebészi szövődmények, valamint az MG státuszában az egyéves utánkövetéskor észlelt neurológiai változások szerepeltek. Eredmények: Perioperatív mortalitás nem fordult elő. A műtéti idő 112, 211, 116 perc (p = 0,001), a kórházi napok száma: 8,9, 5,6 és 4 nap (p = 0,001) volt a TS-, VATET- és UL-VATS-csoportban. Az MG-hez kapcsolódó postoperativ neurológiai szövődmények 21,7%, 18,2% és 7,7% (p = 0,365) értékeket mutattak. A sebészi szövődmény 4,3%, 13,7%, 0% (p = 0,118) volt. Az MG tüneteinek javulása 91,3%, 94,7%, 87,5% (p = 0,712), míg komplett remisszió 13%, 10,5%, 11,5% (p = 0,917) volt a TS-, VATET- és UL-VATS-csoportokban. Következtetések: A műtéti idő, valamint a kórházban eltöltött napok száma UL-VATS esetében volt a legrövidebb. A kisebb sebészi beavatkozáshoz alacsonyabb sebészi, illetve MG-s neurológiai szövődmények társultak. Az MG-tünetek javulásában mindhárom módszernél kiváló eredményt értek el.


2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun

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.


2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i58-i64
Author(s):  
Dmitrii Sekhniaidze ◽  
Diego Gonzalez-Rivas ◽  
Pavel Kononets ◽  
Alejandro Garcia ◽  
Vladimir Shneider ◽  
...  

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.


Author(s):  
Harmik J. Soukiasian ◽  
Daniel Shouhed ◽  
Derek Serna-Gallgos ◽  
Robert McKenna ◽  
Vahak J. Bairamian ◽  
...  

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.


2018 ◽  
Vol 5 (8) ◽  
pp. 2751
Author(s):  
Nilesh P. Mangam ◽  
Aashish R. Chavan ◽  
Ritesh Bodade ◽  
Asmita Dhurve

Background: Video-assisted thoracoscopic surgery (VATS) is rapidly becoming a popular method for diagnostic and therapeutic purposes. Many diseases of the chest can now be diagnosed by VATS due to ease of look and biopsy. Hence the present study was undertaken to determine diagnostic and therapeutic utility of VATS in different chest pathologies.Methods: In this prospective study, total 36 patients of different age group were subjected to VATS procedure, to measured operative time, intra and post- operative complications, post-operative pain and hospital stay. Then patient was followed up at 15 days, at 1 month, 3 month and at 6 months.Results: VATS was successfully carried out in 28 patients as the only procedure whereas 8 patients required conversion to thoracotomy. Average operative time for patients operated by VATS only was 94.9 minute and for patients operated by VATS converted to thoracotomy was 175.5 minute. Most common intraoperative complication was bleeding (16.66 %) followed by anaphylactic shock observed in only one patient. Most common postoperative complication was prolonged air leak (5.55%) followed by port site infection (2.77%) and postoperative bleeding (2.77%). At 24 hours postoperatively, average pain score observed in VATS group was 3.73 and in thoracotomy group was 6.28. The mean postoperative hospital stay for patients operated by VATS was 7.28 days and for patients operated by VATS converted to thoracotomy was 10.36 days. There was significant difference observed in diagnosis of various chest pathologies by radiological investigations and VATS.Conclusions: VATS should be offered as the first approach to various chest pathologies requiring surgical intervention and preferred over thoracotomy when feasible. 


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