scholarly journals Surgery in congenital lung malformations: the evolution from thoracotomy to VATS, 10-year experience in a single center

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kenan C. Ceylan ◽  
Güntuğ Batihan ◽  
Ahmet Üçvet ◽  
Soner Gürsoy
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
Thoracoscopic Surgery ◽  
Pathological Examination ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Simple Cyst ◽  
Cyst Excision ◽  
Congenital Lung Malformation ◽  
First Choice ◽  
Congenital Lung Malformations

Abstract Background Congenital lung malformation is an umbrella term and consist of various kind of parenchymal and mediastinal pathologies. Surgical resection is often required for diagnosis and curative treatment. We aimed to review our experience in surgical treatment for congenital lung disease and present the role of minimally invasive surgery. Methods Surgical resections performed for benign lesions of the lung and mediastinum between January 2009 and May 2019 were retrospectively analyzed. Patients who were found to have congenital lung malformation as a result of pathological examination were included in our study. Distribution characteristics of the patients according to congenital lung malformation subtypes, differences in surgical approach and postoperative results were investigated. Results A total of 94 patients who underwent surgical resection and were diagnosed with the bronchogenic cyst, sequestration, bronchial atresia, congenital cystic adenomatoid malformation (CCAM), or enteric cyst as a result of pathological examination were included the study. There were no significant differences between pathological subtypes in the postoperative length of hospital stay and drainage duration however, perioperative complication rate was higher in the sequestration group. In addition, in the first three days postoperatively, the mean pain score was found to be lower in the VATS group compared to thoracotomy. Conclusions Congenital lung malformations consist of a heterogeneous group of diseases and the surgical treatment in these patients can range from a simple cyst excision to pneumonectomy. Video-assisted thoracoscopic surgery should be considered as the first choice in the surgical treatment of these patients in experienced centers.

scholarly journals Surgery in Congenital Lung Malformations: The Evolution From Thoracotomy to Minimally Invasive Surgery, 10-year Experience in a Single Center

2020 ◽  
Author(s):  
Kenan Can Ceylan ◽  
Güntuğ Batıhan ◽  
Ahmet ÜÇVET ◽  
Soner Gürsoy
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Clinical Results ◽  
First Choice ◽  
Significant Difference ◽  
Congenital Lung Malformations

Abstract BackgroundCongenital lung malformation is an umbrella term and consist of various kind of parenchymal and mediastinal pathologies. Surgical intervention is often necessary for diagnosis and treatment for these pathologies. We aimed to review our experience in surgical treatment for congenital lung disease and present the role of minimally invasive surgery. Methods From January 2009 to May 2019, a total of 94 patients fitted the criteria for inclusion in this retrospective study. We investigated the clinical results obtained retrospectively.Results There were no significant differences between pathological subtypes in the postoperative length of hospital stay and drainage duration. There wasn't a significant difference between VATS and thoracotomy group in perioperative complicationsConclusions Congenital lung malformations consist of a heterogeneous group of diseases and video-assisted thoracoscopic surgery should be considered as the first choice in the surgical treatment of these patients.

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

scholarly journals Impact of Surgical Resection and Reasons for Poor Prognosis of Pelvic Osteosarcoma Based on the Bone Tumor Registry in Japan

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3320
Author(s):  
Satoshi Takenaka ◽  
Hironari Tamiya ◽  
Toru Wakamatsu ◽  
Sho Nakai ◽  
Yoshinori Imura ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Propensity Score ◽  
Surgical Resection ◽  
Bone Tumor ◽  
Poor Prognosis ◽  
Propensity Score Analysis ◽  
The Elderly ◽  
Tumor Stage ◽  
Tumor Registry ◽  
Score Analysis

Pelvic osteosarcoma has a poor prognosis compared to osteosarcomas in other locations, and the reasons for this remain unknown. Surgical resection of pelvic osteosarcoma is technically demanding and often results in dysfunction and complications. In this study, we investigated the reasons underlying the poor prognosis of pelvic osteosarcoma by comparing it to femoral osteosarcoma using data from the Bone Tumor Registry in Japan. We used propensity score analysis to determine whether surgical resection of pelvic osteosarcoma improved its prognosis. We demonstrated that pelvic osteosarcoma had a poor prognosis because it occurred more often in the elderly, often had larger tumor size, and had metastasis at presentation more often in comparison to femoral osteosarcoma. These three factors were also associated with the non-surgical treatment of pelvic osteosarcoma, which also led to a poor outcome. The overall survival rate was only comparable in pelvic osteosarcoma and femoral osteosarcoma in cases treated with surgical resection. Propensity score analysis revealed that surgical treatment improved the prognosis of pelvic osteosarcoma. As such, we propose that surgical resection should be considered based on tumor stage and patient age in order to improve the prognosis of pelvic osteosarcoma.

scholarly journals Fluorescence-Guided Surgery in the Surgical Treatment of Gliomas: Past, Present and Future

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3508
Author(s):  
Rosa Sun ◽  
Hadleigh Cuthbert ◽  
Colin Watts
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
Patient Outcomes ◽  
Aminolevulinic Acid ◽  
Guided Surgery ◽  
Improved Outcomes ◽  
Fluorescence Guided Surgery ◽  
Central Nervous Systems ◽  
Extent Of Surgical Resection ◽  
Disease Free

Gliomas are central nervous systems tumours which are diffusely infiltrative and difficult to treat. The extent of surgical resection is correlated with improved outcomes, including survival and disease-free progression. Cancerous tissue can be directly visualised intra-operatively under fluorescence by administration of 5-aminolevulinic acid to the patient. The adoption of this technique has allowed surgeons worldwide to achieve greater extents of resection, with implications for improved prognosis. However, there are practical limitations to use of 5-aminolevulinic acid. New adjuncts in the field of fluorescence-guided surgery aim to improve recognition of the interface between tumour and brain with the objective of improving resection and patient outcomes.

Enthesopathy of the Bicipital Tuberosity of the Radius Treated Under Intraoperative Computed Tomography

2021 ◽  
Author(s):  
Ryosuke Ikeguchi ◽  
Takashi Noguchi ◽  
Maki Ando ◽  
Koichi Yoshimoto ◽  
Diachi Sakamoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Surgical Resection ◽  
Tendon Rupture ◽  
Computed Tomography Scan ◽  
Forearm Rotation ◽  
Elbow Pain ◽  
Intraoperative Computed Tomography ◽  
Tomography Scan ◽  
Bicipital Tuberosity

Abstract There is no report of the application of intraoperative computed tomography to the extremities, and its usefulness is not mentioned. We present a case of a patient with the elbow pain and loss of the forearm rotation due to the prominent bicipital tuberosity of the radius, which was diagnosed as enthesopathy. Surgical treatment to excise the prominent part of the bicipital tuberosity of the radius was recommended. However, it is difficult to perform the appropriate excision of the abnormal prominent part because of complications such as bicipital tendon rupture. The patient was successfully treated by surgical resection under the control of intraoperative computed tomography. Intraoperative computed tomography scan is a useful tool to assess the remaining volume of the abnormal bones.

scholarly journals Robotic pulmonary lobectomy for lung cancer treatment: program implementation and initial experience

2016 ◽  
Vol 42 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Ricardo Mingarini Terra ◽  
Pedro Henrique Xavier Nabuco de Araujo ◽  
Leticia Leone Lauricella ◽  
José Ribas Milanez de Campos ◽  
Herbert Felix Costa ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Sao Paulo ◽  
Pathological Examination ◽  
São Paulo ◽  
Pulmonary Lobectomy ◽  
Video Assisted ◽  
Tertiary Teaching ◽  
Video Assisted Thoracoscopic Surgery

ABSTRACT Objective: To describe the implementation of a robotic thoracic surgery program at a public tertiary teaching hospital and to analyze its initial results. Methods: This was a planned interim analysis of a randomized clinical trial aimed at comparing video-assisted thoracoscopic surgery and robotic surgery in terms of the results obtained after pulmonary lobectomy. The robotic surgery program developed at the Instituto do Câncer do Estado de São Paulo, in the city of São Paulo, Brazil, is a multidisciplinary initiative involving various surgical specialties, as well as anesthesiology, nursing, and clinical engineering teams. In this analysis, we evaluated the patients included in the robotic lobectomy arm of the trial during its first three months (from April to June of 2015). Results: Ten patients were included in this analysis. There were eight women and two men. The mean age was 65.1 years. All of the patients presented with peripheral tumors. We performed right upper lobectomy in four patients, right lower lobectomy in four, and left upper lobectomy in two. Surgical time varied considerably (range, 135-435 min). Conversion to open surgery or video-assisted thoracoscopic surgery was not necessary in any of the cases. Intraoperative complications were not found. Only the first patient required postoperative transfer to the ICU. There were no deaths or readmissions within the first 30 days after discharge. The only postoperative complication was chest pain (grade 3), in two patients. Pathological examination revealed complete tumor resection in all cases. Conclusions: When there is integration and proper training of all of the teams involved, the implementation of a robotic thoracic surgery program is feasible and can reduce morbidity and mortality.

scholarly journals Management of Cardiac Tamponade: A Comperative Study between Echo-Guided Pericardiocentesis and Surgery—A Report of 100 Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Hasan Ali Gumrukcuoglu ◽  
Dolunay Odabasi ◽  
Serkan Akdag ◽  
Hasan Ekim
Keyword(s):  
Surgical Treatment ◽  
Cardiac Tamponade ◽  
Total Mortality ◽  
Invasive Procedure ◽  
Mortality Rates ◽  
Pericardial Fluid ◽  
Complication Rates ◽  
Optimal Method ◽  
First Choice ◽  
Group A

Background. Cardiac tamponade (CT) represents a life-threatening condition, and the optimal method of draining accumulated pericardial fluid remains controversial. We have reviewed 100 patients with CT at our institution over a five-year period and compared the results of echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis with regard to functional outcomes.Methods. The study group consisted of 100 patients with CT attending Yuzuncu Yil University from January 2005 to January 2010 who underwent one of the 3 treatment options (echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis). CT was defined by clinical and echocardiographic criteria. Data on medical history, characteristics of the pericardial fluid, treatment strategy, and follow-up data were collected.Results. Echo-guided pericardiocentesis was performed in 38 (38%) patients (Group A), primary surgical treatment was preformed in 36 (36%) patients (Group B), and surgical treatment following pericardiocentesis was performed in 26 (26%) patients (Group C). Idiopathic and malignant diseases were primary cause of tamponade (28% and 28%, resp.), followed by tuberculosis (14%). Total complication rates, 30-day mortality, and total mortality rates were highest in Group C. Recurrence of tamponade before 90 days was highest in Group A.Conclusions. According to our results, minimal invasive procedure echo-guided pericardiocentesis should be the first choice because of lower complication and mortality rates especially in idiopathic cases and in patients with hemodynamic instability. Surgical approach might be performed for traumatic cases, purulent, recurrent, or malign effusions with higher complication and mortality rates.

PS01.184: ESOPHAGEAL CANCER SURGICAL TREATMENT IN BRAZILIAN NATIONAL CANCER INSTITUTE: 25 YEARS EXPERIENCE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 102-102
Author(s):  
Marco Antonio Guimaraes Filho ◽  
Flávio Sabino ◽  
Daniel Fernandes ◽  
Carlos Eduardo Pinto ◽  
Luis Felipe Pinto ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Surgical Treatment ◽  
Surgical Resection ◽  
National Cancer Institute ◽  
Conflicts Of Interest ◽  
Morbidity Rate ◽  
Surgical Mortality ◽  
Surgical Morbidity ◽  
Hospitalization Time

Abstract Background Esophageal cancer is the 8th most common cancer in the world. It is an lethal disease, responsible for almost 400.000 deaths by year. Surgical resection is considered the gold standard in esophageal cancer treatment, with a global 15–40% cure rate. In this study, the results of esophageal cancer surgical treatment at Brazilian National Cancer Institute, Abdominal-pelvic Surgical Section, is analyzed. Methods The medical records of 215 patients with esophageal cancer, treated with surgical resection (esophagectomy), between January 1999 and December 2015, were retrospectively studied. The endpoints analyzed in the study were: hospitalization time, operative complications and mortality, and overall survival. Results Esophageal cancer was predominant in male patients; median age was 58 years (27–78). Primary tumor location varied between 7,5 - 41 cm (median 32cm) and tumor extension 1 - 16cm (median 5cm). Median surgical time was 330 minutes (120–720); transhiatal esophagectomy with gastric tube reconstruction was the most used surgical approach. Tumors histopathological types were equaly distributed. ICU (Intensive Care Unit) stay median time was 5 days (1–87) and median hospitalization time was 15 days (5–166). Most common surgical complications were anastomotic leakage (25,5%) and pneumonia (20%), with a surgical morbidity rate of 61,8%. Surgical mortality rate was 12%, with 61% of these cases occuring in the 30 days after surgery. Median 2-year overall survival was 44,3 months. Conclusion Besides the high surgical morbidity, esophagectomy for esophageal cancer remains the standard treatment for patients with ressectable tumors and without clinical contraindications for surgery. Reduction of surgical mortality depends on rigorous patients selection, surgical team expertise and adequate perioperative and postoperative care. Disclosure All authors have declared no conflicts of interest.

scholarly journals Pleurodesis methods in the surgical treatment of primary spontaneous pneumothorax

2021 ◽  
pp. 77-81
Keyword(s):  
Surgical Treatment ◽  
Recurrence Rate ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Primary Spontaneous Pneumothorax ◽  
High Recurrence Rate ◽  
Parietal Pleura ◽  
Advantages And Disadvantages ◽  
Video Assisted Thoracoscopic Surgery

Pneumothorax is the collection of air in the pleural space. Pneumothorax can be spontaneous, traumatic or iatrogenic. Primary spontaneous pneumothorax mostly occurs in healthy individuals without an apparent cause, probably due to the rupture of subpleural emphysematous bullae located on the apex of the lung. It usually occurs in tall and healthy males younger than 40 years old. Primary spontaneous pneumothorax has a recurrence rate of 20-30% after the first attack, 50% after the second attack, and 80% after the third attack. Surgery is presented as a treatment option to reduce the high recurrence rate after the second attack. It has been reported that recurrence is between 10 and 20% in patients who undergo bullectomy or wedge resection with endoscopic steps alone. Therefore, various pleural pleurodesis methods are applied in addition to bulla resection in order to reduce the recurrence rate after surgery. In mechanical pleurodesis, adhesion between visceral and parietal pleura is achieved by mechanical abrasion of the parietal pleura or by total or partial removal of the parietal pleura. In chemical pleurodesis, the visceral pleura is adhered to the parietal pleura by creating irritation in the pleura with chemical agents. In cases where pleurodesis was added, the recurrence rate was reported to be between 1.7 and 2.8%. Whether the pleurectomy, pleural mechanical or chemical abrasion methods performed with video-assisted thoracoscopic surgery is superior for preventing recurrence is still a matter of debate. In this article, we aimed to discuss the advantages and disadvantages of pleurodesis methods in the surgical treatment of primary spontaneous pneumothorax in the light of the literature.

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