scholarly journals Modified technique of closing the port site after multiport thoracoscopic surgery using the shingled suture technique: a single centre experience

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haitao Xu ◽  
Shuai Ren ◽  
Tianyu She ◽  
Jingyu Zhang ◽  
Lianguo Zhang ◽  
...  
Keyword(s):  
Chest Tube ◽  
Traditional Method ◽  
Thoracoscopic Surgery ◽  
Wound Dehiscence ◽  
Suture Technique ◽  
Port Site ◽  
Modified Technique ◽  
Mediastinal Disease ◽  
Postoperative Drainage ◽  
Method Group

Abstract Background Due to improvements in operative techniques and medical equipment, video-assisted thoracoscopic surgery has become a mainstay of thoracic surgery. Nevertheless, in multiport thoracoscopic surgery, there have been no substantial advances related to the improvement of the esthetics of the site of the chest tube kept for postoperative drainage of intrathoracic fluid and decompression of air leak after thoracoscopic surgery. Leakage of fluid and air around the site of the chest tube can be extremely bothersome to patients. Methods From March 2019 to April 2020, we used a modified technique of closing the port site in 67 patients and the traditional method in 51 patients undergoing multiport thoracoscopic surgery due to lung disease or mediastinal disease. We recorded patients’ age, gender, body mass index, surgical method, postoperative drainage time, and postoperative complications.The NRS pain scale was used to score the pain in each patient on the day of extubation.The PSAS and the OSAS were used for the assessment of scars one month after surgery. Results In the modified technique group, only one patient (1.49%) had pleural effusion leakage, compared with five patients (9.80%) in the traditional method group (P < 0.05). There were no significant differences in the pain of extubating and wound dehiscence between the two groups. However,the incidence rates of wound dehiscence in the modified technique group were lower than in the traditional method group. There were no post-removal pneumothorax and wound infection in either of the groups. Significant differences in the PSAS and OSAS were observed between the groups,where the modified technique group was superior to the traditional method group. Conclusions The modified technique of port site closure is a leak-proof method of fixation of the chest tube after multiport thoracoscopic surgery. Moreover, it is effective and preserves the esthetic appearance of the skin.

scholarly journals Modified technique of closing the port site after multiport thoracoscopic surgery using the shingled suture technique: a single centre experience

2020 ◽  
Author(s):  
Haitao Xu ◽  
Shuai Ren ◽  
Tianyu She ◽  
Jingyu Zhang ◽  
Lianguo Zhang ◽  
...  
Keyword(s):  
Subcutaneous Emphysema ◽  
Chest Tube ◽  
Traditional Method ◽  
Thoracoscopic Surgery ◽  
Suture Technique ◽  
Port Site ◽  
Skin Closure ◽  
Modified Technique ◽  
Aesthetic Appearance ◽  
Mediastinal Disease

Abstract Background: Due to improvements in operative techniques and medical equipment, video-assisted thoracoscopic surgery has become a mainstay of thoracic surgery. Nevertheless, in multiport thoracoscopic surgery,there have been no substantive improvements in how to improve the aesthetics of the site of the chest tube left for postoperative drainage of intrathoracic fluid and decompression of air leak after the thoracoscopic surgery. Leakage of fluid and air around the site of the chest tube can be extremely bothersome to the patient. Methods: From March 2019 to April 2020, we used modified technique of closing the port site in 67 patients and traditional method in 51 patients who underwent multiport thoracoscopic surgery due to lung disease or mediastinal disease. With our modified technique, the muscle and fat layers are sutured separately and a removal-free, absorbable, continuous intradermal suture is used for the skin closure to assure both a tight closure and a better aesthetic appearance. The traditional method of fixation of the chest tube use two sutures to close the skin on each side of the chest tube.Results: The chest tubes were removed 2–13 days after the thoracoscopic procedure. In the modified technique group,one patients (1.49%) had fluid extravasation, which was better than five patients (9.80%) in the traditional method group (P<0.05).There were no significant differences in subcutaneous emphysema and wound dehiscenc between the two groups.However,the incidence of subcutaneous emphysema and wound dehiscenc in the modified technique group were lower than in the traditional method group.There were no post-removal pneumothorax and wound infection in either groups.Conclusions: This modified technique of port site closure is a leak-proof method of fixation of the chest tube after multiport thoracoscopic surgery and effective with aesthetic appearance of the skin.

Modified Suture Technique to Improve Cosmetic Appearance and Wound Dehiscence in Upper Blepharoplasty

2021 ◽  
pp. 074880682110100
Author(s):  
Nabil Fakih-Gomez ◽  
Roshini Manay ◽  
Andres Bastidas ◽  
Ibrahim Fakih-Gomez
Keyword(s):  
Wound Dehiscence ◽  
Suture Technique ◽  
Skin Closure ◽  
Modified Technique ◽  
Suturing Technique ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Upper Blepharoplasty ◽  
The Right ◽  
Split Face

The objective of the study was to compare wound dehiscence in upper blepharoplasty between the traditional suturing technique and the modified suturing technique in split-face study. A prospective, intrapatient split-face study was conducted from October 2019 to August 2020 in 40 patients who underwent upper blepharoplasty. The incision was made on both eyes, where the left eye received 3 subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure (modified technique), and the right eye underwent skin closure only (traditional technique). At 3 months, the aesthetic results using Hollander wound scale were evaluated by patients and an independent surgeon blinded to the method of closure. The study included 40 patients with an average age of 45 years. At 3 months, 39 patients (97.5%) recorded lateral wound dehiscence on the right eye and 0 patients (0%) on the left eye. The patient was scored 2 on the right eye and 5 on the left eye by the surgeon, whereas the patient scored 3 on right eye and 5.5 on left eye on Hollander wound scale. The modified technique in upper blepharoplasty proved to be a more aesthetically appealing and effective method to achieve a better scar in inverted canoe-shaped incisions with high-tension closure in well-positioned eyebrow.

Pre-embedding subcutaneous suture technique for chest-tube insertion

ASVIDE ◽  
2017 ◽  
Vol 4 ◽  
pp. 475-475
Author(s):  
Chieh-Ni Kao ◽  
Chao-Wei Chang ◽  
Meng-Chien Hsieh ◽  
Yu-Wei Liu ◽  
Shah-Hwa Chou
Keyword(s):  
Chest Tube ◽  
Suture Technique ◽  
Tube Insertion ◽  
Chest Tube Insertion

scholarly journals Making the transition from video-assisted thoracoscopic surgery to chest tube with fibrinolytics for empyema in children: Any change in outcomes?

2016 ◽  
Vol 59 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Michael H. Livingston ◽  
Sara Colozza ◽  
Kelly N. Vogt ◽  
Neil Merritt ◽  
Andreana Bütter
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Salvage for Unsuccessful Aspiration of Primary Pneumothorax: Thoracoscopic Surgery or Chest Tube Drainage?

2008 ◽  
Vol 85 (6) ◽  
pp. 1908-1913 ◽  
Author(s):  
Jin-Shing Chen ◽  
Hsao-Hsun Hsu ◽  
Kung-Tsao Tsai ◽  
Ang Yuan ◽  
Wen-Jone Chen ◽  
...  
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Chest Tube Drainage ◽  
Tube Drainage

scholarly journals Two-port versus three-port video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: feasibility, postoperative outcome and long-term recurrence rates

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephen Fung ◽  
Hany Ashmawy ◽  
Sami Safi ◽  
Anja Schauer ◽  
Alexander Rehders ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Postoperative Outcome ◽  
Primary Spontaneous Pneumothorax ◽  
Recurrence Rates

Abstract Background Two-port VATS (2-P-VATS) and three-port VATS (3-P-VATS) are well-established techniques for surgical therapy of primary spontaneous pneumothorax (PSP). However, comparisons of both techniques in terms of postoperative outcome and recurrence are limited. Methods From January 2010 to March 2020, we retrospectively reviewed data of 58 PSP patients who underwent VATS in our institution. For statistical analysis, categorical and continuous variables were compared by chi-square test or Fisher’s exact test and the Student´s t-test, respectively. Twenty-eight patients underwent 2-P-VATS and 30 were treated with 3-P-VATS. Operation time, length of hospital stay (LOS), total dose of analgesics per stay (opioids and non-opioids), duration of chest tube drainage, pleurectomy volume (PV), postoperative complications and recurrence rates were compared between both groups. Results Clinical and surgical characteristics including mean age, gender, Body-Mass-Index (BMI), pneumothorax size, smoking behaviour, history of contralateral pneumothorax, side of pneumothorax, pleurectomy volume and number of resected segments were similar in both groups. The mean operation time, LOS and total postoperative opioid and non-opioid dose was significantly higher in the 3-P-VATS group compared with the 2-P-VATS group. Despite not being statistically significant, duration of chest tube was longer in the 3-P-VATS group compared with the 2-P-VATS group. In terms of postoperative complications, the occurrence of hemothorax was significantly higher in the 3-P-VATS group (3-P-VATS vs. 2-P-VATS; p = 0.001). During a median follow-up period of 61.6 months, there was no significant statistical difference in recurrence rates in both groups (2/28 (16.7%) vs. 5/30 (7.1%); p = 0.274). Conclusion Our data demonstrate that 2-P-VATS is safer and effective. It is associated with reduced length of hospital stay and decreased postoperative pain resulting in less analgesic use.

scholarly journals Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: a systematic review and meta-analysis

2019 ◽  
Vol 56 (5) ◽  
pp. 819-829
Author(s):  
Jean H T Daemen ◽  
Pieter W J Lozekoot ◽  
Jos G Maessen ◽  
Michiel H M Gronenschild ◽  
Gerben P Bootsma ◽  
...  
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Tube Drainage ◽  
Recurrence Rates ◽  
Tube Drainage ◽  
Ipsilateral Recurrence ◽  
Length Of Hospitalization

Summary Primary spontaneous pneumothorax affects up to 28 patients per 100 000 population yearly and is commonly resolved by chest tube drainage. However, drainage is also known to be associated with ipsilateral recurrence rates ranging from 25% to 43%. Preventive video-assisted thoracoscopic surgery (VATS) may be an effective alternative to diminish these recurrence rates and its associated morbidity. The aim of this study was to compare the efficacy of chest tube drainage and VATS as first line treatments of an initial episode of primary spontaneous pneumothorax. The MEDLINE, EMBASE, CENTRAL and Clinicaltrials.gov databases were searched through 16 September 2018. Data regarding the ipsilateral recurrence rate and the length of hospitalization were extracted and submitted to meta-analysis using the random-effects model and the I2 test for heterogeneity. Two randomized controlled trials and 2 observational studies were included, enrolling a total of 479 patients. Pairwise analysis demonstrated significantly reduced ipsilateral recurrence rates [odds ratio 0.15, 95% confidence interval (CI) 0.07–0.33; P < 0.00001] and length of hospitalization (standardized mean difference −2.19, 95% CI −4.34 to −0.04; P = 0.046) in favour of VATS. However, a significant level of heterogeneity was detected for the length of hospitalization (I2 = 97%; P < 0.00001). Subgroup analysis that stratified study design found no statistical differences regarding recurrence rate. In conclusion, VATS can be an effective and attractive alternative to standard chest tube drainage, with reduced ipsilateral recurrence rates and length of hospitalization. However, given the low quality of the majority of included studies, more well-designed randomized controlled trials are necessary to strengthen the current evidence.

scholarly journals Reverse puncture device technique: an innovation of esophagojejunostomy in radical laparoscopic total gastrectomy

2019 ◽  
Vol 15 (24) ◽  
pp. 2807-2817 ◽  
Author(s):  
Xiaoxu Huang ◽  
Li Xu ◽  
Hui Peng ◽  
Hao Hu ◽  
Yan Jin ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Odds Ratio ◽  
Outcome Data ◽  
Suture Technique ◽  
Purse String Suture ◽  
Purse String ◽  
Anastomotic Complications ◽  
Drainage Time ◽  
Postoperative Drainage ◽  
Laparoscopic Assisted

Aim: To evaluate the feasibility, safety, short- and long-term efficacy of a reverse puncture device (RPD) technique for esophagojejunostomy in laparoscopic-assisted total gastrectomy. Patients & methods: This retrospective study analyzed outcome data of 104 patients in propensity score matching whom were divided into the RPD and the purse-string suture technique group. Results: The RPD group had a shorter anvil placement time, shorter operative time, longer resected esophageal length, shorter incision length, shorter postoperative drainage time, shorter postoperative hospital stay and anastomotic complications than the purse-string suture technique group (p < 0.05). Multivariate analysis showed that BMI (odds ratio: 6.285, 1.446–27.322) and anvil placement time (odds ratio: 5.645, 1.089–29.321) were independent risk factors for anastomotic complications (p < 0.05). Conclusion: Laparoscopic-assisted total gastrectomy using an RPD technique is feasible, safe and effective.

Supero-Septum Pedicle Mammaplasty: A New Modification for Reduction Mammaplasty

2019 ◽  
Vol 40 (10) ◽  
pp. 1080-1095 ◽  
Author(s):  
Mohammadhossein Hesamirostami ◽  
Leila Sarparast ◽  
Hamed Bateni ◽  
Abbas Kazemi Ashtiani
Keyword(s):  
Reduction Mammaplasty ◽  
Wound Dehiscence ◽  
Modified Technique ◽  
Level Of Evidence ◽  
Superior Pedicle ◽  
Aesthetic Result ◽  
Areola Complex ◽  
The Mean ◽  
The Aesthetic ◽  
A Prospective Study

Abstract Background Many techniques have been introduced for reduction mammaplasty and are utilized in diverse frequencies by different surgeons according to patient needs. Each technique is evaluated based on the aesthetic result, longevity, complication rate, and preservation of the nipple-areola complex (NAC) sensation. Objectives The authors sought to introduce the new modified technique of supero-septum pedicle mammaplasty (SSPM) that utilizes both the septum and superior pedicle and is suitable for macromastia and gigantomastia cases. Methods Between 2015 and 2018, 60 women who underwent SSPM were evaluated in a prospective study after undergoing superior pedicle deepithelialization and resection of the inferior, lateral, and medial segments. In the lateral pillar, a tongue of tissue was preserved for fixation to the medial pectoral fascia through a window created in the superior pedicle at the third intercostal space. Finally, septum pedicle was sutured to the fascia and muscle at the upper border of the sixth rib somewhat medially. Patients were followed up for a minimum of 13 months. Results The mean nipple-to-sternal notch (N-SN) distance was 33.05 cm, and the mean NAC elevation was 10.92 cm. Breast reductions varied from 270 to 2800 g per breast. Complications included wound dehiscence (5%), wound infection (2.5%), and partial NAC necrosis (2.5%). At 6 months postoperation, the NAC sensation was significantly better compared with preoperative values (P &lt; 0.005). Conclusions SSPM is a relatively safe method of reduction mammaplasty, even for very large breasts, that leads to good aesthetic form along with preserving circulation and sensation of the NAC. Level of Evidence: 4

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