scholarly journals Novel microwave surgical instrument for use in various lung resection situations

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Atsushi Kamigaichi ◽  
Takeshi Mimura ◽  
Yoshinori Yamashita
Keyword(s):  
Wedge Resection ◽  
Lung Resection ◽  
Lung Parenchyma ◽  
Surgical Instrument ◽  
Microwave Technology ◽  
Energy Device ◽  
Postoperative Course ◽  
Sealing Ability ◽  
Surgical Energy ◽  
Tissue Sealing

AbstractA novel surgical energy device with high sealing ability using microwave technology has been developed. This novel microwave surgical instrument (MSI) is capable of sealing and dissecting a vessel ≤ 5 mm in diameter. The high sealing ability of the MSI enables fine dissection of the lung parenchyma by a scissor-type blade. This device is particularly useful in situations wherein the use of an automatic suturing instrument is difficult. Here, we describe the dissection of the lung parenchyma using this device in three patients (cases 1–3). This device was used for wedge resection of a tumor located close to the pulmonary hilum, for subsegmentectomy, and for dividing incomplete interlobar fissure (cases 1–3, respectively). In all the cases, the postoperative course was uneventful. This MSI is effective for resection of the lung parenchyma, allowing fine tissue dissection and excellent tissue sealing. This technique could assist surgeons in various lung resection cases.

Robotic-Assisted Lung Resection for Malignant Disease

2007 ◽  
Vol 2 (5) ◽  
pp. 254-258 ◽  
Author(s):  
Casandra A. Anderson ◽  
Minia Hellan ◽  
Andres Falebella ◽  
Clayton S. Lau ◽  
Fredric W. Grannis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Robotic Surgery ◽  
Wedge Resection ◽  
Lung Resection ◽  
Resection Margins ◽  
Primary Tumors ◽  
Lymph Node Retrieval ◽  
Estimated Blood Loss ◽  
Lung Malignancies ◽  
Hospital Stays

Objective There have been few reports of the use of robotic surgery to resect lung malignancies. Feasibility and safety of robotic lung resection for malignant lung lesions will be assessed by performing a retrospective analysis. Methods Between September 2004 and November 2006, 21 patients (11 male and 10 female patients) underwent robotic lung resection. Twenty resections were performed for primary nonsmall cell lung cancer and two for metastatic lesions. One patient had bilateral resections for two primary tumors. Fourteen lobectomies, five segementectomies, one wedge resection, and two bilobectomies were performed. Seventy-two percent of operative procedures included mediastinoscopy and/or bronchoscopy at the time of resection. Results Thirty-day mortality and conversion rate was 0%. The median operating room time and estimated blood loss was 3.6 hours and 100 mL, respectively. The median intensive care unit and total length of hospital stays were 2 and 4 days, respectively. Chest tubes were removed after a median of 2.0 days. The complication rate was 27%, which included atrial fibrillation, need for postoperative bronchoscopy, and pneumonia. The median tumor size and number of lymph nodes harvested was 2.3 cm and 16, respectively. All resection margins were negative. Median follow-up time was 9.8 months, with no local recurrences at this time. Conclusion Robotic lung resection appears safe and feasible and allows for significant lymph node retrieval, offers short hospital stays and low morbidity for patients undergoing surgical resection of lung malignancies. Future studies are needed to define the role of robotic surgery in lung cancer treatment.

scholarly journals Functional Preserving Sublobectomy: A Novel Method for Sublobectomy

2021 ◽  
Author(s):  
Min Zhang ◽  
Liang Chen ◽  
Qingchen Wu ◽  
Mingjian Ge
Keyword(s):  
Lung Function ◽  
Wedge Resection ◽  
Lung Parenchyma ◽  
New Method ◽  
Novel Method

AbstractWe introduce a new method for sublobectomy. It utilizes the easiness and rapidity of wedge resection, and the accuracy and functional preserving of anatomical segmentectomy. It can preserve lung function with less sacrifice of lung parenchyma.

Lymphangioleiomyomatosis and Micronodular Pneumocyte Hyperplasia in a Patient With Tuberous Sclerosis Complex

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S50-S50
Author(s):  
An Peter ◽  
Amandeep Aneja
Keyword(s):  
Smooth Muscle ◽  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Wedge Resection ◽  
Premenopausal Women ◽  
Lung Parenchyma ◽  
Nodule Formation ◽  
Radiologic Findings ◽  
Type Ii Pneumocytes ◽  
History Of

Abstract Lymphangioleiomyomatosis (LAM) is a rare progressive disease characterized by proliferation of smooth muscle–like cells in the lung, mediastinum, and abdomen. In the lung, it is seen with cystic destruction of the lung parenchyma, which occurs almost exclusively in premenopausal women. It occurs in about 1% of patients with tuberous sclerosis complex (TSC). MNPH is an extremely rare pulmonary manifestation of TSC, comprising type 2 pneumocytes in a pattern resembling bronchioloalveolar adenocarcinoma. We report a case of both pulmonary LAM and MNPH associated with TSC. A 35-year-old female with a past medical history of TSC with multiple complications was admitted with iatrogenic pneumothorax following nasopharyngeal intubation during a dental procedure. A blebectomy with wedge resection and mechanical pleurodesis was performed. On gross examination, the wedge specimens revealed multiple cysts in a random distribution. Microscopic examination of the lung parenchyma revealed prominent smooth muscle cells with focal nodule formation. Immunohistochemical stains for SMA and HMB-45 were found to be positive and corroborated these findings. Areas of localized nodular proliferation of benign cuboidal type II pneumocytes lining alveolar walls were also identified. These findings are consistent with LAM and MNPH. Clinicopathological correlation with surgical investigation is indispensable in diagnosing LAM and MNPH, especially when radiologic findings are not definitive in these entities.

Differential diagnosis of a rare papillary tumor and mucinous adenocarcinoma

2017 ◽  
Vol 25 (5) ◽  
pp. 391-394 ◽  
Author(s):  
Shunichiro Matsuoka ◽  
Ryoichi Kondo ◽  
Keiko Ishii
Keyword(s):  
Computed Tomography ◽  
Mucinous Adenocarcinoma ◽  
Wedge Resection ◽  
Cytological Diagnosis ◽  
Mucin Secretion ◽  
Papillary Tumor ◽  
Postoperative Course ◽  
Chest Computed Tomography ◽  
Peripheral Lung ◽  
Final Histological Diagnosis

Ciliated muconodular papillary tumors are characterized as rare papillary tumors of the peripheral lung, and involve ciliated, goblet, and basal cell proliferation with mucin secretion. We report the case of a 76-year-old woman who had an irregular solid nodule in the lung on chest computed tomography during a health screening. A wedge resection was performed. Although the intraoperative cytological diagnosis was mucinous adenocarcinoma, the final histological diagnosis was ciliated muconodular papillary tumor. The postoperative course was uneventful, with no recurrence at 24 months after surgery. Cytological diagnosis of ciliated muconodular papillary tumor can be difficult because of its similarity to mucinous adenocarcinoma.

Rare Surgical Lung Biopsy Findings of Metastatic Pulmonary Calcification Associated with Chronic Renal Failure

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S37-S38
Author(s):  
N Ronen ◽  
Y Sheinin
Keyword(s):  
Lung Disease ◽  
Interstitial Fibrosis ◽  
Wedge Resection ◽  
Lung Parenchyma ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Pulmonary Calcification ◽  
Stage Renal Disease ◽  
End Stage ◽  
Metastatic Pulmonary Calcification

Abstract Introduction/Objective Metastatic pulmonary calcification is a metabolic lung disease characterized by depositions of calcium in lung parenchyma. Depositions of calcium salts are usually caused by hypercalcemia and are associated with end-stage renal disease, primary and secondary hyperparathyroidism, and hemodialysis. It is mostly asymptomatic and clinically silent but can lead to life-threatening respiratory failure. Methods We present a case of a 53-year-old woman, with a failed renal transplant and on hemodialysis, admitted with cough and shortness of breath. Computed tomography showed extensive diffuse bilateral groundglass and nodular opacities. Bronchoscopy was unremarkable. BAL results were negative for infection. The initial differential diagnosis included pneumonitis, interstitial lung disease, and chronic obstructive pulmonary disease. VATS lung wedge resection was performed. Results Microscopically there were numerous interstitial, peribronchial and perivascular calcifications highlighted by Van Kossa stain. Calcifications were associated with a marked interstitial fibrosis confirmed by trichrome stain. There was no evidence of significant acute and chronic inflammation, granulomas, fibroblastic foci and vasculitis. Conclusion Metastatic pulmonary calcification is found in 60–80% of autopsies of patients undergoing dialysis treatment. It is rarely diagnosed during their lifetime, because patients are usually asymptomatic, or the imaging findings are negative. The diagnosis of metastatic pulmonary calcification in our patient prompt further evaluation for repeat kidney transplant and the patient is being considered for parathyroidectomy for her tertiary hyperparathyroidism.

scholarly journals Locoregional recurrence via mucus-mediated extension following lung resection for mucinous tumors

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yo Kawaguchi ◽  
Jun Hanaoka ◽  
Yasuhiko Ohshio ◽  
Keigo Okamoto ◽  
Ryosuke Kaku ◽  
...  
Keyword(s):  
Risk Factor ◽  
Locoregional Recurrence ◽  
Pulmonary Resection ◽  
Lung Resection ◽  
Tumor Resection ◽  
Lung Parenchyma ◽  
Normal Lung ◽  
Mucinous Tumor ◽  
Sufficient Distance ◽  
Tumor Edge

Abstract Background Clinically, locoregional recurrences following mucinous tumor resection are often experienced. However, it remains unclear whether mucinous tumors directly affect local recurrence or not, and if so, the mechanism is not known. Therefore, we investigated whether mucinous tumors are associated with locoregional recurrence after pulmonary resection and whether mucus extension is a risk factor for locoregional recurrence. Methods The data of 152 patients who underwent pulmonary resection for metastases were reviewed. When mucus was partially or wholly present in the tumor based on macro- or microscopic identification, we assigned the tumor as mucinous. In mucinous tumors, when mucus was identified within the air spaces in the normal lung parenchyma, beyond the edge of the tumor, we assigned the tumor as positive for “mucus extension.” Results The 5-year cumulative incidence of locoregional recurrence in patients with mucinous tumors was 48.1%, which was significantly higher than that observed in those with non-mucinous tumors (14.9%). Within the mucinous tumor, the presence of mucus extension beyond the tumor edge was an independent risk factor for locoregional recurrence after pulmonary resection (hazard ratio, 5.52; P = 0.019). Conclusions During the resection of mucinous cancer, surgeons should maintain sufficient distance from the tumor edge to prevent locoregional recurrences.

Pulmonary Epithelioid Haemangioendothelioma Involving Pleura: A Case Report

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S29-S29
Author(s):  
V Kadam maruthi
Keyword(s):  
Immunohistochemical Staining ◽  
Fusion Gene ◽  
Wedge Resection ◽  
Rare Condition ◽  
Lung Parenchyma ◽  
Shortness Of Breath ◽  
Vascular Proliferation ◽  
History Of ◽  
Pleural Involvement ◽  
Epithelioid Haemangioendothelioma

Abstract Introduction/Objective Pulmonary epithelioid haemangioendothelioma is a rare, low to intermediate grade tumor of endothelial origin. It is more common in middle aged women. In lung, more than 60 % of the cases present as bilateral multiple perivascular nodules on imaging raising the differential of metastasis or inflammatory cause. WWTR1- CAMTA1 fusion gene is characteristic for this entity. Evidence of pleural involvement carries a poor prognosis. Methods Here, we present a case of epithelioid haemangioendothelioma involving pleura in a 52-year-old woman with a long standing history of rheumatoid arthritis. Patient presented with recurrent pleural effusions and shortness of breath. Results A diagnosis of epithelioid haemangioendothelioma was made on her pleural decortication specimen that showed atypical vascular proliferation and confirmed by immunohistochemical staining. Subsequent right lung wedge resection performed later confirmed the presence of epithelioid haemangioendothelioma in lung parenchyma. Conclusion Pathologists should be aware of this rare condition that can clinically present in a very deceptive manner of recurrent effusion.

scholarly journals Locoregional Recurrence via Mucus-Mediated Extension Following Lung Resection for Mucinous Tumors

2021 ◽  
Author(s):  
Yo Kawaguchi ◽  
Jun Hanaoka ◽  
Yasuhiko Ohshio ◽  
Keigo Okamoto ◽  
Ryosuke Kaku ◽  
...  
Keyword(s):  
Risk Factor ◽  
Locoregional Recurrence ◽  
Pulmonary Resection ◽  
Lung Resection ◽  
Tumor Resection ◽  
Lung Parenchyma ◽  
Normal Lung ◽  
Mucinous Tumor ◽  
Sufficient Distance ◽  
Tumor Edge

Abstract Background Clinically, locoregional recurrences following mucinous tumor resection are often experienced. However, it is unclear whether mucinous tumors directly affect local recurrence or not, and if so, what the mechanism is. Therefore, we investigated whether mucinous tumors are associated with locoregional recurrence after pulmonary resection and whether mucus extension is a risk factor for locoregional recurrence. Methods The data of 90 patients who underwent pulmonary resection for metastases were reviewed. If mucus was partially or wholly present in the tumor based on macro- or microscopic identification, we assigned the tumor as mucinous. In mucinous tumors, if mucus was identified within the air spaces in the normal lung parenchyma, beyond the edge of the tumor, we assigned the tumor as positive for “mucus extension.” Results The 5-year cumulative incidence of locoregional recurrence in patients with mucinous tumors was 80.3%, which was significantly higher than the 15.5% observed in patients with non-mucinous tumors. Within the mucinous tumor, presence of mucus extension beyond the tumor edge was an independent risk factor for locoregional recurrence after pulmonary resection (hazard ratio, 8.08; P = 0.049). Conclusion During the resection of mucinous cancer, surgeons should maintain sufficient distance from the tumor edge to prevent locoregional recurrences.

scholarly journals Expression of aquaporins in bronchial tissue and lung parenchyma of patients with chronic obstructive pulmonary disease

2019 ◽  
Vol 9 ◽  
Author(s):  
Carmen Calero ◽  
Jose Luis López-Campos ◽  
Lourdes Gómez Izquierdo ◽  
Rocio Sánchez-Silva ◽  
Jose Luis López-Villalobos ◽  
...  
Keyword(s):  
Gene Expression ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Lung Resection ◽  
Lung Neoplasm ◽  
Lung Parenchyma ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Bronchial Tissue

Background: Aquaporins AQP1 and AQP5 are highly expressed in the lung. Recent studies have shown that the expression of these proteins may be mechanistically involved in the airway inflammation and in the pathogenesis of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the expression of AQP1 and AQP5 in the bronchial tissue and the lung parenchyma of patients with COPD and COPD-resistant smokers. Methods: Using a case–control design, we selected a group of 15 subjects with COPD and 15 resistant smokers (smokers without COPD) as a control, all of whom were undergoing lung resection surgery due to a lung neoplasm. We studied the expression of AQP1 and AQP5 in the bronchial tissue and the lung parenchyma by means of immunohistochemistry and reverse-transcription real-time polymerase chain reaction. Tissue expression of AQP1 and AQP5 was semi-quantitatively assessed in terms of intensity and expression by immunohistochemistry using a 4-point scale ranging from 0 (none) to 3 (maximum). Results: There were no significant differences in gene expression between COPD patients and resistant smokers both in the bronchial tissue and in the lung parenchyma. However, AQP1 gene expression was 2.41-fold higher in the parenchyma of smokers with COPD compared to controls, whereas the AQP5 gene showed the opposite pattern, with a 7.75-fold higher expression in the bronchus of smokers with COPD compared with controls. AQP1 and AQP5 proteins were preferentially expressed in endothelial cells, showing a higher intensity for AQP1 (66.7% of cases with an intensity of 3, and 93.3% of subjects with an extension of 3 among patients with COPD). Subtle interstitial disease was associated with type II pneumocyte hyperplasia and an increased expression of AQP1. Conclusions: This study provides pilot observations on the differences in AQP1 and AQP5 expression between COPD patients and COPD-resistant smokers. Our findings suggest a potential role for AQP1 in the pathogenesis of COPD.

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