scholarly journals Can a standardised Ventilation Mechanical Test for quantitative intraoperative air leak grading reduce the length of hospital stay after video-assisted thoracoscopic surgery lobectomy?

2017 ◽  
Vol 3 ◽  
pp. 179-179 ◽  
Author(s):  
Francesco Zaraca ◽  
Maurizio Vaccarili ◽  
Gino Zaccagna ◽  
Pio Maniscalco ◽  
Giampiero Dolci ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Mechanical Test ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Air Leak ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Outcome Comparison between Video Assisted Thoracoscopic Surgery and Open Thoracotomy on Primary Spontaneous Pneumothorax in a Tertiary Hospital in Thailand

2021 ◽  
Vol 104 (1) ◽  
pp. 100-104
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Open Thoracotomy ◽  
Video Assisted ◽  
Operative Outcome ◽  
Video Assisted Thoracoscopic Surgery

Objective: To assess recurrence, complication after surgery, hospital stay, and cost-effective in primary spontaneous pneumothorax (PSP) patients of Thai urban population that underwent video assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). Materials and Methods: The present study was a retrospective cohort between 2006 and 2019. Seventy-five patients were diagnosed as PSP. All medical records were collected from Vajira Hospital. All various factors were analyzed to evaluate an outcome between the two groups. Results: Fifty-four patients were treated by VATS, whereas 21 patients were treated by OT. The mean follow-up time was 26 months. There was no difference in term of gender, indication of surgery, and cost during hospital stay between the two groups. Length of hospital stay were shorter in VATS groups (9.5 days versus 15 days, p=0.006). The operative time was longer and more blood loss in OT groups compared to VATS groups (180 minutes versus 70 minutes, p<0.001 and 100 mL versus 30 mL, p<0.001). In post-operative outcome, there was no difference in terms of recurrence, pneumonia, and re-operation. Conclusion: VATS is associated with shorter length of hospital stay and less blood loss with no difference of cost effective, recurrence, and post-operative outcome in PSP patients. Keywords: Video assisted thoracoscopic surgery, Pneumothorax, Open thoracotomy

Video-Assisted Thoracic Surgery in Early Stage of Pediatric Pleural Empyema Improves Outcome

2020 ◽  
Author(s):  
Zenon Pogorelić ◽  
Dora Bjelanović ◽  
Ružica Gudelj ◽  
Miro Jukić ◽  
Jasna Petrić ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Pleural Empyema ◽  
Stage Iii ◽  
Surgical Time ◽  
Postoperative Fever ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objectives The aim of this study was to observe outcomes of early decortication in a treatment of pleural empyema using video-assisted thoracoscopic surgery (VATS). Methods The case records of 21 pediatric patients who underwent VATS for empyema between 2009 and 2019 were retrospectively reviewed. Patients were observed based on demographic, laboratory, and clinical data, as well as treatment outcomes. Results Out of a total of 59 patients treated for pleural empyema, 21 (10 male and 11 female) children with a median age of 5 years (interquartile range [IQR] 2.8; 6.0) received VATS. The empyema was classified as stage I in 2 patients (9.5%), stage II in 4 patients (19%), and stage III in 15 patients (71.5%). Median surgical time was 60 minutes (IQR 50; 90). There were 2 (9.5%) postoperative complications and 1 recurrence (4.8%). Children treated in stages I and II showed significantly better postoperative results compared with the children treated in stage III. Length of hospital stay (8 vs. 10 days; p = 0.01), length of intensive care unit stay (1 vs. 5 days; p < 0.001), duration of chest tube drainage (4 vs. 6 days; p = 0.043), duration of postoperative fever (1.5 vs. 4 days; p = 0.001), and surgical time (40 vs. 70 minutes; p < 0.001) were significantly shorter in children operated in stages I and II than in stage III. Conclusion Early decortication using a VATS is a successful, effective, and easily performed surgical method in the treatment of pediatric pleural empyema, as well as a method that significantly improves recovery time and shortens the hospital stay.

scholarly journals Study of diagnostic and therapeutic utility of video assisted thoracoscopic surgery

2018 ◽  
Vol 5 (8) ◽  
pp. 2751
Author(s):  
Nilesh P. Mangam ◽  
Aashish R. Chavan ◽  
Ritesh Bodade ◽  
Asmita Dhurve
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Postoperative Bleeding ◽  
Intraoperative Complication ◽  
Video Assisted ◽  
Significant Difference ◽  
Prolonged Air Leak ◽  
Video Assisted Thoracoscopic Surgery ◽  
Therapeutic Utility

Background: Video-assisted thoracoscopic surgery (VATS) is rapidly becoming a popular method for diagnostic and therapeutic purposes. Many diseases of the chest can now be diagnosed by VATS due to ease of look and biopsy. Hence the present study was undertaken to determine diagnostic and therapeutic utility of VATS in different chest pathologies.Methods: In this prospective study, total 36 patients of different age group were subjected to VATS procedure, to measured operative time, intra and post- operative complications, post-operative pain and hospital stay. Then patient was followed up at 15 days, at 1 month, 3 month and at 6 months.Results: VATS was successfully carried out in 28 patients as the only procedure whereas 8 patients required conversion to thoracotomy. Average operative time for patients operated by VATS only was 94.9 minute and for patients operated by VATS converted to thoracotomy was 175.5 minute. Most common intraoperative complication was bleeding (16.66 %) followed by anaphylactic shock observed in only one patient. Most common postoperative complication was prolonged air leak (5.55%) followed by port site infection (2.77%) and postoperative bleeding (2.77%). At 24 hours postoperatively, average pain score observed in VATS group was 3.73 and in thoracotomy group was 6.28. The mean postoperative hospital stay for patients operated by VATS was 7.28 days and for patients operated by VATS converted to thoracotomy was 10.36 days. There was significant difference observed in diagnosis of various chest pathologies by radiological investigations and VATS.Conclusions: VATS should be offered as the first approach to various chest pathologies requiring surgical intervention and preferred over thoracotomy when feasible. 

Video-assisted thoracoscopic surgery for the treatment of primary pneumothorax: talc pleurodesis or pleural abrasion? Retrospective multicentre study

2011 ◽  
Vol 1 (1) ◽  
pp. 9 ◽  
Author(s):  
Jon Zabaleta ◽  
Borja Aguinagalde ◽  
Carlos Alvarez ◽  
Marta G. Fuentes ◽  
Nerea Bazterargui ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Nonparametric Tests ◽  
Postoperative Hospital Stay ◽  
Talc Pleurodesis ◽  
Video Assisted ◽  
Pleural Abrasion ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

In the treatment of primary spontaneous pneumothorax (PSP) the latest guidelines recommend video-assisted thoracoscopy, but do not specify the best technique for performing pleurodesis. Indeed, there are no clinical trials comparing the effectiveness of talc pleurodesis, mechanical pleurodesis and pleurectomy. Our objective was to compare outcomes in patients who underwent surgery for primary pneumothorax with the talc procedure or with pleural abrasion using dry gauze. Patients undergoing video-assisted thoracoscopic surgery for PSP in two hospitals were retrospectively recruited between 2007 and 2008, and followed-up until December 2010. The variables measured to compare the outcomes were: recurrence, complications, and mortality, as well as the duration of air leaks and of drainage and the length of postoperative hospital stay (in days). Statistical analysis: The two groups were compared using the Chi square test for qualitative variables and nonparametric tests for continuous variables. A total of 106 interventions were carried out in 104 patients (74 in group A: pleural abrasion with dry gauze; 32 in group B: chemical pleurodesis with talc), with a mean age of 28 years (median 25) and 85.6% were male. Complications were observed in nine patients (8.5%) and there were no deaths in the 30 days after surgery; there were, however, four cases of recurrence (3.8%). The mean air leak duration was 0.78 days (median 0), the mean drainage duration 1.95 days (median 1) and the mean length of postoperative hospital stay 2.68 days (median 2). In 74 cases (69.8%), mechanical pleurodesis was performed, while 32 cases were treated with talc (30.2%). Comparing the two groups, we did not find statistically significant differences in recurrence (4.1% vs 3.1%, P=0.82), complications (6.8% vs 12.5%, P=0.45) or mortality (no cases of death). On the other hand, the mean postoperative hospital stay was lower in the mechanical pleurodesis group than in the talc group (2.2 vs 3.8 days, P=0.005). Video-assisted surgery in the treatment of PSP is a safe technique. In the mechanical pleurodesis group, we observed the same rate of recurrence, half the number of complications and a shorter hospital stay. We consider it necessary that well-designed multicentre clinical trials be carried out to compare these techniques and determine which produces the best outcomes, providing stronger scientific evidence given that the data available to date are not conclusive.

scholarly journals Robotic video-assisted thoracoscopic surgery using multiport triangular trocar configuration: initial experience at a single center

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Vu Huu Vinh ◽  
Nguyen Viet Dang Quang ◽  
Dang Dinh Minh Thanh ◽  
Truong Van Le Phong
Keyword(s):  
Hospital Stay ◽  
Mediastinal Tumor ◽  
Thoracoscopic Surgery ◽  
Tumor Resection ◽  
Initial Experience ◽  
Single Center ◽  
Video Assisted ◽  
Duration Of Surgery ◽  
Video Assisted Thoracoscopic Surgery ◽  
Surgical Operations

Abstract Background Recent developments in robotic technology have brought significant changes in robotic video-assisted thoracoscopic surgery (r-VATS) worldwide, particularly including the treatment in the thorax for the mediastinal, esophagus, and pulmonary lesions. Currently, there are only a few reports describing the procedural experience and outcomes with r-VATS. The objective of this study is to provide our initial experience using r-VATS at a single center, with specific attention to safety, efficacy, and procedural details. Methods We retrospectively reviewed patients who underwent a newly modified r-VATS procedure for various surgical operations at the thoracic department of our hospital, from July 2018 to January 2020. Multiport trocars were placed in the classic triangular arrangement as in conventional VATS (c-VATS) but with modifications based on the type of surgery. The peri- and postoperative outcomes such as duration of surgery, complications, and duration of hospital stay for these patients were reported. Results Overall, 142 patients underwent r-VATS for lobectomy (66), wedge resection (15), thymectomy (22), mediastinal tumor resection (30), pneumonectomy (4), transthoracic esophagectomy (1), esophageal tumor resection or esophageal diverticulum repair (2), diaphragm plication (1), and mediastinal tumor resection plus thymectomy (1). For the entire cohort, the median operative time was 110 min, and the median length of hospital stay was 5 days. Conversion to open thoracic surgery was reported only in a total of 3 (2.1%) patients of pneumonectomy (1.4%) and mediastinal tumor resection (0.70%). All our patients were managed successfully with no postoperative complications and mortality. Conclusion Our method of r-VATS was found to be safe and effective and may be applied to different surgical operations. Adequate and proper training of thoracic surgeons is immediately needed for the transition from c-VATS to r-VATS. The utility and advantages of triangular trocar configuration for r-VATS require further refinement and research before it can be routinely adopted in clinical practice. Trial registration Retrospectively registered.

scholarly journals Video assisted thoracoscopic surgery in the management of acute fibrinopurulent empyema in paediatric patients

2020 ◽  
Vol 7 (6) ◽  
pp. 1847
Author(s):  
Arti S. Mitra ◽  
Nilesh G. Nagdeve ◽  
Simran R. Khatri ◽  
Unmed A. Chandak
Keyword(s):  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Bronchopleural Fistula ◽  
Tertiary Care ◽  
Pleural Empyema ◽  
Care Hospital ◽  
Age Group ◽  
Video Assisted ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background: Empyema is the presence of pus in the pleural space that usually follows an episode of pneumonia in pediatric age group. The aim of this study was to assess the efficacy of management of acute fibrinopurulent stage of empyema by early video assisted thoracoscopic surgery (VATS) in paediatric patients.Methods: The study was carried out at a tertiary care hospital in India. It was a prospective interventional observational study. The study included 40 children between age group 0-12 years attending the surgery in-patient department referred for further management of parapneumonic effusions who had clinical and radiological evidence of empyema and thoracocentesis confirmed purulent exudate in pleural cavity, were subjected to early VATS after thorough pre-operative workup.Results: The mean age was 7.22 years. Average operative time was 135.5 minutes. The mean duration of hospital stay was 7.5 days. Few complications were bleeding, superficial wound infection, bronchopleural fistula, pneumothorax, recurrence of empyema and incomplete expansion of lung.Conclusions: VATS facilitates the management of fibrinopurulent and organised pyogenic pleural empyema with less post-operative discomfort and complications and reduced hospital stay. However larger sample size study is required to come to a definitive conclusion.

scholarly journals Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jian Zhou ◽  
Chuan Li ◽  
Quan Zheng ◽  
Chenglin Guo ◽  
Mengyuan Lyu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Air Leak ◽  
Chest Drainage ◽  
Video Assisted ◽  
Matched Study ◽  
Water Seal ◽  
Persistent Air Leak ◽  
Video Assisted Thoracoscopic Surgery

BackgroundUniportal video-assisted thoracoscopic surgery (UniVATS) was utilized with a rapid growth. The evidence is sparse, however, on whether to add external suction to water-seal drainage for chest drainage after UniVATS. This retrospective propensity score-matched study aimed to identify the necessity of adding external suction to chest drainage after UniVATS.MethodsPatients with lung cancer who underwent UniVATS were included from our prospectively maintained database. Patients were divided into two cohorts based on the addition of external suction to postoperative water-seal drainage or not. Propensity score-matched analysis was performed to identify the impact of suction on chest tube duration, incidence of persistent air leak, hospital stay, and hospitalization cost. Multivariable model with interaction terms was constructed to identify impact of covariables on effect of suction.ResultsThe two cohorts matched well on baseline characteristics (nonsuction: 173; suction: 96). Compared with nonsuction group, suction group showed longer median chest tube duration (3 vs. 2 days, p = 0.003), higher incidences of persistent air leak (9.4% vs. 1.2%, p = 0.003), persistent drainage (16.8% vs. 5.8%, p = 0.007), and reduced drainage volume within first 3 postoperative days (386.90 vs. 504.78 ml, p = 0.011). Resection extent was identified to mediate the relationship between suction and chest tube drainage.ConclusionsThese findings discouraged adding external suction to water-seal drainage after UniVATS regarding longer chest tube duration and more persistent air leak. Patients undergoing lobectomy would benefit more from water-seal drainage without external suction compared with those doing sublobectomy.

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