scholarly journals Thoracoscopic versus open resection for symptomatic congenital pulmonary airway malformations in neonates: a decade-long retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jintao Zheng ◽  
Huajian Tang ◽  
Huiyu Xu ◽  
Jiequan Li ◽  
Xiangming Mao ◽  
...  
Keyword(s):  
Wedge Resection ◽  
Lower Lobe ◽  
Volume Ratio ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Lesion Size ◽  
Open Resection ◽  
Thoracoscopic Resection ◽  
Resection Group ◽  
Pulmonary Airway

Abstract Purpose The purpose of this study is to evaluate the potential advantages of thoracoscopic versus open resection for symptomatic congenital pulmonary airway malformation (CPAM) in neonates. Methods A retrospective review of the medical records of neonates (age ≤ 28 days) who underwent surgery for symptomatic CPAM from 2010 to 2020. Results Of the 24 patients, 14 patients underwent thoracoscopic resection and 10 patients underwent open resection. 4 patients with CPAM located in the upper or middle lobes underwent lobectomy, and 20 underwent lung-preserving wedge resection in the lower lobe. Between the two groups, there were no statistically significant differences in related preoperative variables, including gestational age at birth, body weight, head circumference, lesion size, cystic adenomatoid malformation volume ratio (CVR), and age at operation (P > .05). The differences in intraoperative variables were statistically significant. The length of the surgical incision was significantly shorter in thoracoscopic resection group than in open resection group (1.4 cm [1.3–1.8] vs. 6.0 cm [5.0–8.0], P = .000), along with significantly less operative blood loss (3 ml [1–6] vs. 5 ml [2–10], P = .030) but significantly longer operation time (159 min [100–220] vs. 110 min [70–170], P = .003). Regarding postoperative variables, ventilator days, duration of chest tube use and length of hospital stay were not statistically significant (P > .05). Conclusion Both thoracoscopic and open resection for symptomatic CPAM achieve good clinical outcomes, even in neonates. Thoracoscopic resection has minimal aesthetic effects and does not increase the risk of surgical or postoperative complications. Lung-preserving resection may be feasible for neonatal CPAM surgery.

scholarly journals Can Awake Thoracoscopy Procedure be Performed with the Help of Thoracic Paravertebral Anesthesia?

2018 ◽  
Vol 17 (4) ◽  
pp. 576-582
Author(s):  
Fazli Yanik ◽  
Yekta Altemur Karamustafaoglu ◽  
Elif Copuruoglu ◽  
Gonul Sagiroglu
Keyword(s):  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Medical Science ◽  
Oral Intake ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Early Mobilization ◽  
Talc Pleurodesis ◽  
The Mean

Aim:The aim of this study was to present our experience with 11 patients who were spontaneously breathing with Awake Video Thoracoscopy (AVATS) procedure with the help of TPB because of rareness in the literature.Materials and Methods: Between December 2015 and December 2017, a total of 125 VATS cases were performed; 11 cases underwent VATS operation with the help of TPB; age, gender, operation performed, duration of operation, time of onset of mobilization-oral intake, duration of hospital stay, Visual Analogue Scale (VAS) scores were evaluated retrospectively.Results: All cases were treated with uniportal AVATS procedure with the help of TPB. The mean age was 40,3 ± 17,4 years (range 18-64 years ), nine (82%) of the pateints were male and two (18%) were female. Operation procedures included wedge resection in eight (73 %) patients (six of them for pneumothorax, two of them for diagnosis), in three (27%) patients pleural biopsy (one of them used talc pleurodesis).There were no perioperative events. The mean operation time was 27,7 ± 6,4 minutes (range, 20-40 min) and the mean anesthesia time was 25 ± 3,8 minutes (range 20-30 min).The mean time of mobilizitation, oral intake opening time and length of hospital stay was 1,1 ± 0,4 hours (1-2 hours), 3,5 ± 0,5 hours (3-4 hours), 2,6 ± 0,5 days (2-3 days), respectively.Conclusion:Awake Video Asssited Thoracoscopic Surgery with the help of TPB has less side effects and less complication risks than other awake procedures with the help of other regional anesthesia techniques. We conclude that; although AVATS with the help of TPB has some minor complications, it has advantages such as early discharge, early mobilization and early oral intake, low pain levels in well-selected patient groups.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.576-582

scholarly journals Feasibility Analysis and Advantages of Wedge Resection Plus Transverse Suture Applied to Closure of Loop Ileostomy

2021 ◽  
Author(s):  
Hai-Quan Qin ◽  
Jian-Kun Liao ◽  
Wen-Tao Wang ◽  
Ling-Hou Meng ◽  
Zi-Gao Huang ◽  
...  
Keyword(s):  
Diagnosis Related Groups ◽  
Wedge Resection ◽  
Loop Ileostomy ◽  
Operation Time ◽  
Ileostomy Closure ◽  
Resection Group ◽  
Significant Difference ◽  
Surgical Data ◽  
Suture Group ◽  
Research Standards

Abstract Objectives: To evaluate the feasibility and advantages of wedge resection plus transverse suture applied to loop ileostomy closure by analyzing the surgical data and the incidence of postoperative complications of patients undergoing this procedure.Methods: We performed a retrospective analysis of the hospitalization data of patients who underwent ileostomy closure surgery and met the research standards from January 2017 to April 2021 in the Guangxi Medical University Cancer Hospital; all surgeries were performed by the same surgeon. The perioperative data were statistically analyzed by grouping.Results: In total, 65 patients were enrolled in this study, with 12 in the wedge resection group, 35 in the stapler group, and 18 in the hand suture group. There was no significant difference in operation time between the wedge resection group and stapler group (P > 0.05), but both groups had shorter operation time than that in the hand suture group (P< 0.05). The postoperative exhaustion time of wedge resection group was earlier than that of the others, and cost of surgical consumables in the wedge resection group was significantly lower than that in the stapler group, all with statistically significant differences (P< 0.05). By contrast, there was no statistically significant difference in postoperative complication incidences among the three groups.Conclusions: The wedge resection plus transverse suture is safe and easy for closure of loop ileostomy, and the intestinal motility recovers rapidly postoperatively. It has less surgical consumables, and is particularly suitable for the currently implemented Diagnosis-Related Groups payment method.

scholarly journals A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure

2021 ◽  
Vol 18 (1) ◽  
pp. 278
Author(s):  
Jahyung Kim ◽  
Sanghyeon Lee ◽  
Jeong Seok Lee ◽  
Sung Hun Won ◽  
Dong Il Chun ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Simple Procedure ◽  
Wedge Resection ◽  
Operation Time ◽  
University Hospital ◽  
Wound Infections ◽  
Germinal Matrix ◽  
One Year ◽  
Ingrown Toenails

(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes.

Meta-Analysis on the Efficacy and Safety of Laparoscopic Surgery for Large Gastric Gastrointestinal Stromal Tumors

2020 ◽  
pp. 000313482095148
Author(s):  
Miao Yu ◽  
Deng-chao Wang ◽  
Jian Wei ◽  
Yue-hua Lei ◽  
Zhao-jun Fu ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Laparoscopic Resection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Operation Time ◽  
Intraoperative Blood Loss ◽  
Open Resection ◽  
Free Survival ◽  
Stromal Tumors ◽  
Disease Free

Background The aim of this study was to conduct a meta-analysis comparing the safety and feasibility of laparoscopic versus open resection for gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm. Method We searched the Cochrane Library, PubMed, and Embase for relevant articles. Randomized and nonrandomized clinical trials were identified and included in this study. Searching for related articles on large GIST (>5 cm) for laparoscopic resection (laparoscopic group [LAPG]) and open resection (open group [OG]), RevMan 5.3 was used for data analysis, comparing 2 groups of operation time, intraoperative blood loss, complications, length of hospital stay, recurrence rate, disease-free survival, and overall survival. Results Seven studies including 440 patients were identified for the meta-analysis. Meta-analysis revealed that LAPG had less bleeding, shorter postoperative hospital stay, and a better 5-year disease-free survival. There was no significant difference between LAPG and OG in operation time, postoperative complications, recurrence rate, and overall survival. Conclusion Laparoscopic resection of large (>5 cm) GIST is safe and feasible and has the advantages of less intraoperative blood loss and fast postoperative recovery, with a good outcome in the recent oncology.

scholarly journals Safety and efficacy of simultaneous colorectal ESD for large synchronous colorectal lesions

2017 ◽  
Vol 05 (07) ◽  
pp. E595-E602 ◽  
Author(s):  
Hideyuki Chiba ◽  
Jun Tachikawa ◽  
Daisuke Kurihara ◽  
Keiichi Ashikari ◽  
Toru Goto ◽  
...  
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Length Of Hospital Stay ◽  
En Bloc Resection ◽  
Lesion Size ◽  
Procedure Time ◽  
Single Group ◽  
Medical Expense ◽  
En Bloc ◽  
Sedative Drug ◽  
Simultaneous Group

Abstract Background and study aims Multiple large colorectal lesions are sometimes diagnosed during colonoscopy. However, there have been no investigations of the feasibility of simultaneous endoscopic submucosal dissection (ESD) for multiple lesions. This study aims to reveal the strategy of simultaneous ESD for multiple large colorectal lesions. Patients and methods 246 patients who underwent ESD for 274 colorectal lesions were retrospectively evaluated in this study. Fifty-one large colorectal lesions among 23 patients were treated by ESD simultaneously (simultaneous group), and 223 patients were treated with ESD for a single lesion (single group). Results En-bloc resection and curative resection rates did not differ. Compared with the single group, each procedure time was faster (31.8 ± 23.6 min vs. 45.8 ± 44.8, P = 0.002), but total procedure time was significantly longer in the simultaneous group (70.6 ± 33.4 vs. 45.8 ± 44.8 min, P = 0.01). Rates of adverse events including bleeding and perforation were not higher in the simultaneous group but the mean blood pressure, incidence of bradycardia and the amount of sedative drug used during ESD were significantly higher in the simultaneous group. Multiple logistic regression analysis identified non-experienced physician, lesion size ≥ 40 mm and submucosal fibrosis as an independent risk factor for procedure duration (≥ 90 min) (Odds ratio 11.852, 18.280, and 3.672; P < 0.05, respectively). Conclusions Simultaneous ESD for multiple synchronous colorectal lesions is safe and feasible compared with single ESD and can reduce the burden to patients, length of hospital stay and medical expense. These results need to be elucidated by further studies.

scholarly journals Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team.

2015 ◽  
Vol 17 (3) ◽  
pp. 315 ◽  
Author(s):  
Omer Uslukaya ◽  
Metehan Gumus ◽  
Bekir Tasdemir ◽  
Cemil Goya ◽  
Faruk Kilinc ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Parathyroid Adenoma ◽  
Local Anesthesia ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Recurrent Laryngeal Nerve Injury ◽  
Minimally Invasive Parathyroidectomy ◽  
Diagnostic Tools ◽  
Usual Practice ◽  
Invasive Parathyroidectomy

Aims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathy- roidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87±14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of bio- chemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87±3.35 min. Post- operative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.

scholarly journals Surgical treatment to multiple primary lung cancer patients: a systematic review and meta-analysis

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ting-Fei Chen ◽  
Chun-Ying Xie ◽  
Bing-Yu Rao ◽  
Shi-Chao Shan ◽  
Xin Zhang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Wedge Resection ◽  
Meta Analysis ◽  
Primary Lung Cancer ◽  
Systemic Review ◽  
Sublobar Resection ◽  
Resection Group ◽  
Standard Resection ◽  
Multiple Primary

Abstract Background As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and meta-analysis. Methods Relevant literature was obtained from three databases including PubMed, Embase and Web of Science. Inclusion and exclusion criteria were set for the screening of articles to be selected for further conduction of systemic review and meta-analysis. The HRs of OS of the sublobar group compared with standard resection group were extracted directly or calculated indirectly from included researches. Results Ten researches published from 2000 to 2017 were included in this study, with 468 and 445 MPLC cases for the standard resection group and sublobar resection group respectively. The result suggested that OS of MPLC patients underwent sublobar resection (segmentectomy or wedge resection for at least one lesion) was comparable with those underwent standard resection approach (lobectomy or pneumonectomy for all lesions), with HR 1.07, 95% CI 0.67–1.71, p = 0.784. Further analysis found no difference in subgroups of synchronous and metachronous (from second metachronous lesion), different population region and dominant sex type. Conclusions This study may reveal that sublobar resection is acceptable for patients with MPLC at an early stage, because of the equivalent prognosis to the standard resection and better pulmonary function preservation. Further research is needed to validate these findings.

scholarly journals Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

2020 ◽  
pp. 145749692093860
Author(s):  
T. Mönttinen ◽  
H. Kangaspunta ◽  
J. Laukkarinen ◽  
M. Ukkonen
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Time Of Day ◽  
University Hospital ◽  
Patient Comfort ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Clinically Significant

Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

Surgical Management of Bronchobiliary Fistula After Thoracoabdominal Trauma

2020 ◽  
pp. 000313482094526
Author(s):  
Julia M. Coughlin ◽  
Steven Bonomo ◽  
Edie Y. Chan ◽  
Jafar Hasan ◽  
Mark A. Grevious ◽  
...  
Keyword(s):  
Surgical Management ◽  
Conservative Management ◽  
Wedge Resection ◽  
Management Strategies ◽  
Lower Lobe ◽  
Disease Process ◽  
High Morbidity ◽  
Posterolateral Thoracotomy ◽  
Biliary Stenting ◽  
Bronchobiliary Fistula

Bronchobiliary fistulas are exceedingly rare pathological connections between the biliary and the bronchial systems, which result from hepatobiliary neoplasms, abscesses, or thoracoabdominal trauma. Prompt recognition, diagnosis, and intervention is essential in order to prevent the high morbidity and mortality associated with this disease process. Multiple management strategies have been described in the literature; however, the optimal course has not been well defined. We present a case of a 31-year-old male who developed a bronchobiliary fistula 1 month after thoracoabdominal trauma. After conservative management with biliary stenting failed, he successfully underwent latissimus sparing right posterolateral thoracotomy, complete fistulectomy, right lower lobe wedge resection, and diaphragmatic reconstruction with subsequent resolution of his symptoms.

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