Laser enucleation of a renal cell carcinoma (RCC) lung metastasis. This video demonstrates a metastasis enucleation using a laser fiber with a power of 60 W. The 64-year-old former heavy smoker male with a history of RCC 18 months prior, was admitted with undefined pulmonary nodules. The procedure started with a uniportal video-assisted thoracic surgery (VATS) wedge resection from segment S1. Frozen section confirmed a 10-mm clear cell RCC lung metastasis. Through anterolateral thoracotomy five further nodu

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 94-94
Author(s):  
Stefan Welter ◽  
Varun Gupta
Keyword(s):  
Lung Metastasis ◽  
Clear Cell ◽  
Frozen Section ◽  
Wedge Resection ◽  
Pulmonary Nodules ◽  
Heavy Smoker ◽  
Anterolateral Thoracotomy ◽  
History Of ◽  
Laser Enucleation ◽  
Vats Wedge Resection

scholarly journals Advances in Minimally Invasive Surgery for Lung Cancer

2020 ◽  
Author(s):  
Rachit Shah ◽  
Nils-Tomas Delagar McBride
Keyword(s):  
Lung Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Wedge Resection ◽  
Surgical Techniques ◽  
Robotic Assisted ◽  
Current State ◽  
Chest Disease ◽  
History Of ◽  
Vats Wedge Resection

Over the last 25 years, improvement in instrumentation and surgical techniques has led to widespread adaptation of thoracoscopic (VATS) surgery in the field of thoracic oncology. What once was a niche operation like VATS wedge resection to now hybrid VATS chest wall resections, and advanced surgeries like bronchoplasty and sleeve resections are done with VATS. This has led to improved surgical outcomes for our patients and increased use of surgery in the treatment of chest disease. We review the history of VATS and its current state with most recent changes and upgrades in the technique in this chapter. We review the advancement in uniportal VATS, robotic assisted resection, complex VATS resection, and awake lung surgery with VATS.

Combined Hookwire and Methylene Blue Localization of Pulmonary Nodules

2018 ◽  
Vol 13 (3) ◽  
pp. 184-189 ◽  
Author(s):  
John Joseph Brady ◽  
Christie Hirsch Reilly ◽  
Robert Guay ◽  
Uday Dasika
Keyword(s):  
Computed Tomography ◽  
Methylene Blue ◽  
Thoracic Surgery ◽  
Wedge Resection ◽  
Pulmonary Nodules ◽  
Tactile Sensation ◽  
Wire Localization ◽  
Pathologic Diagnosis ◽  
History Of ◽  
The Mean

Objective Because of decreased tactile sensation with thoracoscopic approaches to biopsy, localization preoperatively and intraoperatively is important for successful biopsy. Our study evaluated the technique of combined computed tomography-guided hookwire and methylene blue localization. Methods Seventy-five patients from November 2007 to August 2013 who underwent combined Hawkins hookwire and methylene blue localization of 76 total pulmonary nodules before video-assisted thoracic surgery-guided wedge resection were retrospectively reviewed. Multiple patient, nodule, and procedural characteristics were analyzed for correlation with successful wire localization and wire dislodgement. Successful wire localization was defined as absence of lesions requiring re-resection, wire dislodgement necessitating re-resection, or conversion to thoracotomy for localization. Results Seventy-four patients were included in the study (75 pulmonary nodules - 1 patient had 2 lesions localized) and mean ± SD patient age was 65.8 ± 12.1 years and 50% were male. The mean ± SD largest nodule diameter was 14.6 ± 7.4 mm and 29.3% of these were subcentimeter pulmonary nodules. Increased age and history of malignancy were associated with malignant diagnoses ( P = 0.037 and 0.009, respectively) Successful wire localization was present in 86.4% of patients. Lesions with lower mean distance to the pleura correlated with successful localization ( P = 0.002). Wire dislodgement was present in 9.3% (7 patients) with 4 (5.3%) of these necessitating need for re-resection to establish pathologic diagnosis. Albeit wire dislodgement, 57.4% (4/7) still had successful thoracoscopic localization. Conclusions This study demonstrates that utilization of Hawkins hookwire in combination with methylene blue injection is an effective method to successfully localize pulmonary nodules for thoracoscopic wedge resection and should prompt further investigation for its utilization.

scholarly journals Late Lung Metastasis in a Patient with a Clear Cell Chondrosarcoma: An Indication for a Life-Long Follow-Up?

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Paulien West ◽  
Celine Jacobs ◽  
Michael Saerens ◽  
David Creytens ◽  
Gwen Sys ◽  
...  
Keyword(s):  
Lung Metastasis ◽  
Clear Cell ◽  
Wedge Resection ◽  
Lung Nodule ◽  
Complete Removal ◽  
Good Health ◽  
Ct Guided ◽  
Clear Cell Chondrosarcoma ◽  
Lung Lobe

Background. Clear cell chondrosarcoma (CCCS) is a rare subtype of chondrosarcoma and comprises between 1.6% and 2.5% of all chondrosarcoma. They are known to be chemo- and radiotherapy resistant; surgical resection is therefore the therapy of choice. Methods. We present a 63-year-old woman with a progressive lung nodule 20 years after initial diagnosis and treatment of a clear cell chondrosarcoma of the right os naviculare. Results. On serial CT scans of the chest, an asymptomatic, slowly growing nodule in the left upper lung lobe was detected. CT-guided transthoracic biopsy of this nodule confirmed the diagnosis of a chondrosarcoma lung metastasis. Video-assisted thoracoscopic wedge resection was performed with complete removal of the nodule. The patient recovered well from surgery and remains in good health during further follow-up. Conclusion. Given the tendency of clear cell chondrosarcoma to recur and metastasize after extended periods of time, a long-term, possibly life-long follow-up and clinical surveillance is advisable in these patients.

scholarly journals Clinical and chest CT presentations from 27 patients with COVID-19 pneumonia in Mogadishu, Somalia: a descriptive study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Yahye Garad Mohamed ◽  
Mohamed Farah Yusuf Mohamud ◽  
M. Sabri Medişoğlu ◽  
Ihsan Yavuz Atamaca ◽  
Ibrahim Hussein Ali
Keyword(s):  
Sore Throat ◽  
Pulmonary Nodules ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
First Case ◽  
Abnormal Chest ◽  
Lower Lung ◽  
History Of ◽  
Normal Chest ◽  
Bilateral Lung

Abstract Background Coronavirus disease 2019 (COVID-19) is an acute viral pneumonia that had recently been found in humans. The first case was discovered in Wuhan, Hubei province, China, in December 2019. In this article, we aimed to demonstrate the clinical and radiological characteristics of COVID-19 patients in Somalia from 20 March 2020 to 20 April 2020. Results Twenty-seven patients that had a positive RT-PCR test between 20 March 2020 and 20 April 2020 were retrospectively observed. This study included 19 (70.4%) males and 8 (29.6%) females, and the mean age and range were 43 years (SD ± 14.0) and 27–70 years, respectively. The majority (59.3%) of COVID-19-infected patients had no obvious history of exposure to infected patients. The participants of our study mostly presented with dry cough 24 (88.9%) patients, fever 19 (70.4%), myalgia 18 (66.6%), and sore throat 16 (59.3%). Twenty-five of 27 patients had abnormal chest CT, while 2 (7.4%) patients had normal chest CT. The most common patterns of abnormality seen on chest CT in patients with COVID-19 were ground-glass opacity (GGO) 74.1%, crazy paving pattern 18.5%, consolidation 14.8%, and mixed GCO 11.1%. Also, the most common predominant lesion distributions were bilateral lung involvement (88.9%), peripheral distribution (77.8%), and lower lung predominance (63%). Particularly, lung cavitation, discrete pulmonary nodules, pleural effusion, and underlying pulmonary fibrosis or emphysema had not been observed. Conclusion Dry cough, fever, myalgia, and sore throat were the most clinical presentations. GGO, crazy paving pattern, patchy consolidation, and mixed GCO were the typical chest CT manifestations.

scholarly journals Cleft lip: The historical perspective

2009 ◽  
Vol 42 (S 01) ◽  
pp. S4-S8
Author(s):  
S. Bhattacharya ◽  
V. Khanna ◽  
R. Kohli
Keyword(s):  
19Th Century ◽  
Historical Perspective ◽  
Cleft Lip ◽  
Wedge Resection ◽  
Surgical Correction ◽  
Bilateral Cleft Lip ◽  
History Of ◽  
Evil Spirits ◽  
The 19Th Century ◽  
Two Sides

ABSTRACTThe earliest documented history of cleft lip is based on a combination of religion, superstition, invention and charlatanism. While Greeks ignored their existence, Spartans and Romans would kill these children as they were considered to harbour evil spirits. When saner senses prevailed Fabricius ab Aquapendente (1537–1619) was the first to suggest the embryological basis of these clefts. The knowledge of cleft lip and the surgical correction received a big boost during the period between the Renaissance and the 19th century with the publication of Pierre Franco's Petit Traité and Traité des Hernies in which he described the condition as “lièvre fendu de nativitè” (cleft lip present from birth). The first documented Cleft lip surgery is from China in 390 BC in an 18 year old would be soldier, Wey Young-Chi. Albucasis of Arabia and his fellow surgeons used the cautery instead of the scalpel and Yperman in 1854 recommended scarifying the margins with a scalpel before suturing them with a triangular needle dipped in wax. The repair was reinforced by passing a long needle through the two sides of the lip and fixing the shaft of the needle with a figure-of-eight thread over the lip. Germanicus Mirault can be credited to be the originator of the triangular flap which was later modified by C.W. Tennison in 1952 and Peter Randall in 1959. In the late 50s, Ralph Millard gave us his legendary ‘cut as you go’ technique. The protruding premaxilla of a bilateral cleft lip too has seen many changes throughout the ages OE from being discarded totally to being pushed back by wedge resection of vomer to finally being left to the orthodontists.

Frozen Section Diagnoses of Small Pulmonary Nodules: Accuracy and Clinical Implications

2004 ◽  
Vol 78 (5) ◽  
pp. 1755-1759 ◽  
Author(s):  
Alberto M. Marchevsky ◽  
Chanikarn Changsri ◽  
Indu Gupta ◽  
Clark Fuller ◽  
Ward Houck ◽  
...  
Keyword(s):  
Frozen Section ◽  
Pulmonary Nodules ◽  
Clinical Implications ◽  
Small Pulmonary Nodules

Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity

2021 ◽  
pp. 205141582098766
Author(s):  
Harshit Garg ◽  
Brusabhanu Nayak ◽  
Tripti Nakra ◽  
Prabhjot Singh ◽  
Seema Kaushal
Keyword(s):  
Urinary Bladder ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Rare Entity ◽  
Level Of Evidence ◽  
History Of ◽  
Carcinoma Of The Bladder

Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.

scholarly journals Miliary tuberculosis in a paediatric patient with psoriasis

2021 ◽  
Vol 14 (3) ◽  
pp. e237580
Author(s):  
Jacob Kilgore ◽  
Jonathon Pelletier ◽  
Bradford Becken ◽  
Stephen Kenny ◽  
Samrat Das ◽  
...  
Keyword(s):  
Brain Mri ◽  
Miliary Tuberculosis ◽  
Pulmonary Nodules ◽  
Chronically Ill ◽  
Community Acquired Pneumonia ◽  
Oral Antibiotic ◽  
Cavitary Lesion ◽  
Oral Antibiotic Therapy ◽  
History Of ◽  
Chest X Ray

We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed.

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