scholarly journals Anesthetic management of thoracoscopic pulmonary wedge resection with a giant tracheal diverticulum in the carina: a case report and review of the literature

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110328
Author(s):  
Xiao Huang ◽  
Yuan Sun ◽  
Dandan Lin ◽  
Changewi Wei ◽  
Anshi Wu ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Wedge Resection ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Thoracic Computed Tomography ◽  
Tracheal Diverticulum ◽  
Intraoperative Management ◽  
Key Factor ◽  
Difficult Ventilation ◽  
Pulmonary Wedge Resection

A tracheal diverticulum (TD) is a rare disease that is usually diagnosed as an incidental finding on thoracic computed tomography or bronchoscopy. TDs can be classified as congenital or acquired. In patients undergoing surgery, TDs can result in difficult intubation, difficult ventilation, pneumothorax, and other complications. We herein report a case of anesthetic management of thoracoscopic pulmonary wedge resection in a patient with a giant TD in the carina. Intraoperative double-lumen intubation and single-lung ventilation were challenging to perform. Fiberoptic-guided intubation was helpful, and intraoperative management was tailored to avoid diverticulum rupture. In this report, we also review complications related to TD in surgical patients undergoing mechanical ventilation. Ventilation is one of the most prominent anesthetic challenges. The close collaboration of the entire medical team was a key factor in the successful management of this rare case.

scholarly journals Anesthetic management of a patient with situs inversus totalis undergoing coronary artery bypass grafting surgery: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chigusa Nakasone ◽  
Masafumi Kanamoto ◽  
Wataru Tatsuishi ◽  
Tomonobu Abe ◽  
Shigeru Saito
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Situs Inversus ◽  
Anesthetic Management ◽  
Artery Bypass ◽  
Situs Inversus Totalis ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Intraoperative Management

Abstract Background Anesthetic management of coronary artery bypass grafting surgery (CABG) in a dextrocardia patient with situs inversus totalis is rarely encountered and seldom reported in the literature. Case presentation A 76-year-old Japanese female patient had been diagnosed with situs inversus totalis and coronary artery disease of 3 vessels, and she subsequently underwent elective CABG. A preoperative examination showed almost normal results. ECG showed right deviation with the normal lead position. In the operating room, ECG leads were applied in reverse. Pulmonary artery catheterization was performed via the left internal jugular vein. A transesophageal echocardiography (TEE) probe was introduced without difficulty. A different angle was needed to acquire the desired views because of her atypical anatomy. Conclusion Careful perioperative evaluation, intraoperative management, and inspection of multiplane angle and probe adjustments in TEE are needed for anatomically abnormal patients.

scholarly journals Multiple Tracheal Diverticula in a COVID-19 Positive Patient

2021 ◽  
pp. 014556132110346
Author(s):  
Konstantinos Garefis ◽  
Konstantinos Tarazis ◽  
Konstantinos Gkiouzelis ◽  
Anastasia Kipriotou ◽  
Iordanis Konstantinidis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Incidental Finding ◽  
Positive Patient ◽  
Computed Tomography Scan ◽  
Tracheal Diverticulum ◽  
Tomography Scan ◽  
Paratracheal Air Cyst

A tracheal diverticulum is a type of paratracheal air cyst and is usually an incidental finding after a computed tomography scan of the neck and thorax. With an incidence between 1% and 4% in adults, tracheal diverticula are rare entities that can be symptomatic in certain cases. We present a case of a COVID-19 positive patient who presented to our hospital and was diagnosed with multiple tracheal diverticula during his hospitalization.

Trauma: The Burn Patient

2018 ◽  
pp. 81-86
Author(s):  
Ethan Kim ◽  
Ruchir Gupta
Keyword(s):  
Carbon Monoxide ◽  
Fluid Therapy ◽  
Muscle Relaxation ◽  
Anesthetic Management ◽  
Preoperative Evaluation ◽  
Initial Assessment ◽  
Area Burned ◽  
Intraoperative Management ◽  
Parkland Formula ◽  
Burn Patient

In this chapter the essential aspects of anesthetic management of the burn patient are discussed. Subtopics include use of the Parkland formula for calculating fluid requirements, airway considerations, and carbon monoxide toxicity. The differences between first-, second-, and third-degree burns are also discussed. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Issues discussed that are related to preoperative evaluation include initial assessment, calculating percentage of body area burned, and airway evaluation. Topics related to intraoperative management include muscle relaxation, monitoring, and fluid therapy. Postoperative issues involve extubation criteria and treatment to induce muscle relaxation.

scholarly journals Impact of resection margin length and tumor depth on the local recurrence after thoracoscopic pulmonary wedge resection of a single colorectal metastasis

2019 ◽  
Vol 11 (5) ◽  
pp. 1879-1887 ◽  
Author(s):  
Jae Ho Chung ◽  
Sung Ho Lee ◽  
Eunjue Yi ◽  
Ju Yong Lim ◽  
Jae Seung Jung ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Resection Margin ◽  
Wedge Resection ◽  
Colorectal Metastasis ◽  
Tumor Depth ◽  
Pulmonary Wedge Resection

scholarly journals Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI/BSCCT and BSTI

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200894
Author(s):  
Michelle Claire Williams ◽  
Ausami Abbas ◽  
Erica Tirr ◽  
Shirjel Alam ◽  
Edward Nicol ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Artery Calcification ◽  
Consensus Statement ◽  
Incidental Finding ◽  
Aortic Valve Calcification ◽  
Thoracic Ct ◽  
Thoracic Computed Tomography ◽  
Valve Annulus ◽  
Artery Disease

Incidental coronary and cardiac calcification are frequent findings on non-gated thoracic CT. We recommend that the heart is reviewed on all CT scans where it is visualised. Coronary artery calcification is a marker of coronary artery disease and it is associated with an adverse prognosis on dedicated cardiac imaging and on non-gated thoracic CT performed for non-cardiac indications, both with and without contrast. We recommend that coronary artery calcification is reported on all non-gated thoracic CT using a simple patient-based score (none, mild, moderate, severe). Furthermore, we recommend that reports include recommendations for subsequent management, namely the assessment of modifiable cardiovascular risk factors and, if the patient has chest pain, assessment as per standard guidelines. In most cases, this will not necessitate additional investigations. Incidental aortic valve calcification may also be identified on non-gated thoracic CT and should be reported, along with ancillary findings such as aortic root dilation. Calcification may occur in other parts of the heart including mitral valve/annulus, pericardium and myocardium, but in many cases these are an incidental finding without clinical significance.

scholarly journals Platypnea–orthodeoxia syndrome after pulmonary wedge resection in a patient with severe scoliosis

2020 ◽  
Vol 30 (5) ◽  
pp. 790-791
Author(s):  
Stefano Maria Donghi ◽  
Giulia Sedda ◽  
Juliana Guarize ◽  
Lorenzo Spaggiari
Keyword(s):  
Wedge Resection ◽  
Upright Position ◽  
Unique Case ◽  
Severe Scoliosis ◽  
Rare Syndrome ◽  
Arterial Desaturation ◽  
The Subject ◽  
Pulmonary Wedge Resection

Abstract Platypnea–orthodeoxia is a rare syndrome characterized by dyspnoea and arterial desaturation, exacerbated by an upright position and relieved when the subject is recumbent. We report on a unique case of a patient with severe scoliosis who presented with several episodes of arterial desaturation after right pulmonary wedge resection.

Transsphenoidal/Pituitary Surgery

2018 ◽  
Author(s):  
Vaia T. Abatzis ◽  
Edward C. Nemergut
Keyword(s):  
Pituitary Gland ◽  
Anesthetic Management ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
Pituitary Surgery ◽  
Anesthetic Care ◽  
Anesthetic Agents ◽  
Intraoperative Management ◽  
Transsphenoidal Pituitary Surgery ◽  
Early Diagnosis Of Diabetes

Patients with tumors of the pituitary gland represent a heterogeneous yet commonly encountered neurosurgical population. Optimal anesthetic care requires an understanding of the complex pathophysiology secondary to each patient’s endocrine disease. Although patients presenting with Cushing’s disease and acromegaly have unique manifestations of endocrine dysfunction, all patients with tumors of the pituitary gland require meticulous preoperative evaluation and screening. There are many acceptable strategies for optimal intraoperative anesthetic management; however, the selection of anesthetic agents should be tailored to facilitate surgical exposure, preserve cerebral perfusion and oxygenation, and provide for rapid emergence and neurological assessment. Postoperatively, careful monitoring of fluid balance and serum sodium is essential to the early diagnosis of diabetes insipidus (DI). DI is most often transient but can require medical therapy. A thorough understanding of the preoperative assessment, intraoperative management, and potential complications are fundamental to successful perioperative patient care and avoidance of morbidity and mortality.

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.

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