scholarly journals Thoracoscopic resection of bilateral multiple superior mediastinal neurofibromas

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yoko Azuma ◽  
Naobumi Tochigi ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Akira Iyoda
Keyword(s):  
Thoracoscopic Surgery ◽  
Thoracoscopic Resection ◽  
Case Presentation ◽  
Postoperative Course ◽  
Superior Mediastinum ◽  
Chest Cavity ◽  
Video Assisted ◽  
First Case ◽  
Video Assisted Thoracoscopic Surgery ◽  
Multiple Nodules

Abstract Background The indications for surgical resection concerning multiple bilateral neurofibromas in the superior mediastinum remain controversial, because vascular injury or development of postoperative Horne syndrome are concerned. Case presentation A 60-year-old woman presented with multiple nodules in her right neck and bilateral chest cavity tops which indicated neurofibromatosis. The thoracic masses grew slowly over 9 years, and she then underwent a 2-stage resection starting with the left to right side. Bilateral tumors were completely removed via video-assisted thoracic surgery. The patient’s postoperative course was uneventful, without postoperative Horner syndrome. Conclusions To the best of our knowledge, this is the first case of multiple bilateral superior mediastinal neurofibromas resected from the pulmonary apices via thoracoscopy. We selected a minimally invasive pure video-assisted thoracoscopic surgery approach and enucleated some tumors to avoid nerve injury. This approach may be safe and useful for multiple neurofibromas in patients with neurofibromatosis.

scholarly journals Thoracoscopic Resection of Bilateral Multiple Superior Mediastinal Neurofibromas

2020 ◽  
Author(s):  
Yoko Azuma ◽  
Naobumi Tochigi ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Satoshi Koezuka ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Thoracoscopic Resection ◽  
Case Presentation ◽  
Postoperative Course ◽  
Superior Mediastinum ◽  
Chest Cavity ◽  
Video Assisted ◽  
First Case ◽  
Video Assisted Thoracoscopic Surgery ◽  
Multiple Nodules

Abstract Background: The indications for surgical resection concerning multiple bilateral neurofibromas in the superior mediastinum remain controversial, because vascular injury or development of postoperative Horne syndrome are concerned.Case presentation: A 60-year-old woman presented with multiple nodules in her right neck and bilateral chest cavity tops which indicated neurofibromatosis. The thoracic masses grew slowly over 9 years, and she then underwent a 2-stage resection starting with the left to right side. Bilateral tumors were completely removed via video-assisted thoracic surgery. The patient’s postoperative course was uneventful, without postoperative Horner syndrome. Conclusions: To the best of our knowledge, this is the first case of multiple bilateral superior mediastinal neurofibromas resected from the pulmonary apices via thoracoscopy. We selected a minimally invasive pure video-assisted thoracoscopic surgery approach and enucleated some tumors to avoid nerve injury. This approach may be safe and useful for multiple neurofibromas in patients with neurofibromatosis.

scholarly journals Anesthetic Substitute of Intraoperative Regional Anesthesia of Nonintubated or Endotracheal-intubated Video-assisted Thoracoscopic Surgery With Thoracoscopic Multilevel Intercostal Nerve Blocks: a Randomized Study

2021 ◽  
Author(s):  
Kuang-Cheng Chan ◽  
Li-Lin Wu ◽  
Su-Chuan Han ◽  
Jin-Shing Chen ◽  
Ya-Jung Cheng
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Surgical Stress ◽  
Thoracoscopic Surgery ◽  
Intercostal Nerve ◽  
General Anesthetics ◽  
Nerve Blocks ◽  
Video Assisted ◽  
First Case ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background:A reduced need for general anesthetics and enhanced effectiveness of postoperative analgesia have been reported for multimodal anesthesia, which involves combining regional and general anesthesia. Ideal regional anesthesia to combine with general anesthesia should match but not overdo with the surgical stress from corresponding operations. However, as thoracic operation becomes less invasive, the substitute effects on intraoperative analgesia or consciousness by regional anesthesia such as with thoracoscopic intercostal nerve blocks (TINBs) for managing corresponding surgical stress in intubated or non-intubated video-assisted thoracoscopic surgery (VATS) have been inadequately studied. The goals of this study is to investigate the substituve of TINBs on analgesia and consciousness for intubated and non-intubated uniport VATS operations.Methods:Sixty patients who received VATS with target-controlled infusions of propofol and remifentanil were recruited. Patients were randomized into intubated and nonintubated groups. Intraoperative multilevel (T3–T8) TINBs were performed after artificial pneumothorax and before VATS operations. The effects of substitute on analgesia by TINBs for VATS operations were indicated by changes on blood pressure and the Ce of remifentanil to maintain normotension. EEG data with a density spectral array (DSA) and data on the effect-site concentration (Ce) of propofol goaled with bispectral index (BIS) levels between 40-60were compared to determine whether TINBs affect consciousness. Results:TINBs with 0.5% bupivacaine provide substitute more than required on analgesia for intubated and non-intubated uniport VATS operations. The Ce of remifentanil was significantly decreased beginning 10 min after TINBs in both groups (p < 0.001). In the nonintubated VATS (NIVATS) group, a significantly lower mean arterial pressure after introducing TINBs persisted for 20 min. TINBs demonstrated a DSA smoothing effect despite the subsequent VATS. The Ce of the propofol infusion decreased 5 min after TINBs in both NIVATS (p < 0.001) and intubated VATS (IVATS; p = 0.252) groups. The Ce of remifentanil was significantly higher in parallel for the IVATS group than for the NIVATS group (p < 0.001).Conclusions:Intraoperative TINBs with 0.5 % bupivacaine provides substitutes on analgesia and hyponosis more than required for uniportal intubated or non-intubated VATS operations. Situations involving endotracheal tubes required more analgesia but does not affect the substitute effects of TINBs.Trial registration: ClinicalTrials. gov, NCT03874403. This study was approved by the Research Ethics Committee of National Taiwan University Hospital, Taipei, Taiwan (201712125RINB) on February 2, 2018. We then enrolled our first case on November 1, 2018 - Retrospective registered on February 28, 2019, https://clinicaltrials.gov/ct2/show/record/NCT03874403

Video-Assisted Thoracoscopic Resection of Recurrent Intrapulmonary Bronchogenic Cyst after Thoracotomy

2014 ◽  
Vol 9 (2) ◽  
pp. 142-144 ◽  
Author(s):  
Conor F. Hynes ◽  
M. Blair Marshall
Keyword(s):  
Bronchogenic Cyst ◽  
Thoracoscopic Surgery ◽  
Posterolateral Thoracotomy ◽  
Thoracoscopic Resection ◽  
Symptomatic Recurrence ◽  
Video Assisted ◽  
Pathologic Lesion ◽  
Bronchogenic Cysts ◽  
Video Assisted Thoracoscopic Surgery

Intrapulmonary bronchogenic cysts are typically treated surgically by lobectomy to completely excise the cyst to minimize risk for recurrence. Video-assisted thoracoscopic surgery is being used with increasing frequency to manage intrathoracic pathology. We present a patient who underwent resection of a bronchogenic cyst 20 years before. She developed a symptomatic recurrence, and video-assisted thoracoscopic surgery was used to lyse adhesions from her previous posterolateral thoracotomy and perform an intraparenchymal dissection to resect the pathologic lesion while sparing the remaining parenchyma of her right upper lobe. At 2 years of follow-up, the patient is without evidence of recurrence.

scholarly journals Declarations: management of a pulmonary arteriovenous fistulae by uniportal video‐assisted thoracoscopic surgery: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. Li ◽  
Y. Zhou ◽  
S. Kang ◽  
F. Kong ◽  
L. Guan ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Rare Case ◽  
Thoracoscopic Surgery ◽  
Rare Condition ◽  
Preoperative Assessment ◽  
Ct Reconstruction ◽  
Case Presentation ◽  
Lower Lobectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background A pulmonary arteriovenous fistula (PAVF) is a rare condition that is associated with pulmonary arteriovenous malformation (PAVM). Few reports have described managing PAVMs using uniportal video-assisted thoracoscopic surgery (VATS). Case presentation A 13-year-old child with PAVF in the left inferior pulmonary artery was treated by uniportal VATS with left lower lobectomy. After surgery, hemoptysis did not recur and there were no postoperative complications. Six months after the operation, postoperative review of computerized tomography showed no recrudescence of PAVF. Conclusions PAVF is a rare case that should be diagnosed and treated early. 3D- computerized tomography (CT) reconstruction is useful for diagnosis and preoperative assessment. The case shows that PAVF can be managed with uniportal VATS.

scholarly journals Unusual Presentation of Mediastinal Neurogenic Tumours

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Giampiero Negri ◽  
Alessandro Bandiera ◽  
Angelo Carretta ◽  
Armando Puglisi ◽  
Carlo Mandelli ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Surgical Techniques ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Unusual Presentation ◽  
Cervical Region ◽  
Benign Lesions ◽  
Video Assisted ◽  
First Case ◽  
Video Assisted Thoracoscopic Surgery

Mediastinal neurogenic tumours generally arise as single benign lesions and their typical location is the costovertebral sulcus. In about 10% of cases mediastinal neurogenic tumours may extend to the spinal canal; occasionally they may extend to the cervical region and, more rarely, may be multiple or associated with other synchronous mediastinal lesions. The treatment of choice is surgical resection. This report describes three cases of unusual presentation of mediastinal benign schwannomas successfully treated at our Hospital. In the first case multiple simultaneous paravertebral lesions were resected through a posterior approach. In the second case a tumour of the posterior mediastinum extending to the cervical region was excised through a one-stage combined supraclavicular incision followed by left mini-invasive video-assisted thoracoscopic surgical techniques. The third case describes a patient with a posterior neurogenic mediastinal tumour with a synchronous parathyroid adenoma of the anterior mediastinum, which were both successfully resected by video-assisted thoracoscopic surgery.

Myasthenia gravis miatt végzett három különböző típusú csecsemőmirigy-eltávolítás sebészeti és korai neurológiai eredményei

2015 ◽  
Vol 68 (6) ◽  
pp. 219-224
Author(s):  
Aurél Ottlakán ◽  
Tibor Géczi ◽  
Balázs Pécsy ◽  
Bernadett Borda ◽  
Judit Lantos ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Thoracoscopic Surgery ◽  
Extended Thymectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

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.

Sign in / Sign up

Export Citation Format

Share Document