scholarly journals Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

2019 ◽  
Author(s):  
Yang Gu ◽  
Ruowang Duan ◽  
Jiong Song ◽  
Xin Lv
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Perioperative Period ◽  
Radical Resection ◽  
Double Lumen ◽  
Intubation Technique ◽  
Video Assisted ◽  
Double Lumen Endobronchial Tube ◽  
The Right ◽  
Left Pneumonectomy

Abstract Background Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special ventilation strategy. Case presentation A 48-year-old woman was going to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS) who had left pneumonectomy two years ago. A 32-French left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff’s inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the promotion of the operation could be solved.

scholarly journals Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

2019 ◽  
Author(s):  
Yang Gu ◽  
Ruowang Duan ◽  
Xin Lv ◽  
Jiong Song
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Perioperative Period ◽  
Radical Resection ◽  
Double Lumen ◽  
Intubation Technique ◽  
Video Assisted ◽  
Double Lumen Endobronchial Tube ◽  
The Right ◽  
Left Pneumonectomy

Abstract Background Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special ventilation strategy. Case presentation A 48-year-old woman was going to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS) who had left pneumonectomy two years ago. A 32-French left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff’s inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the promotion of the operation could be solved.

scholarly journals Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

2019 ◽  
Author(s):  
Yang Gu ◽  
Ruowang Duan ◽  
Jiong Song ◽  
Xin Lv
Keyword(s):  
Airway Management ◽  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Perioperative Period ◽  
Double Lumen ◽  
Intubation Technique ◽  
Video Assisted ◽  
Double Lumen Endobronchial Tube ◽  
The Right ◽  
Left Pneumonectomy

Abstract Background: Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special airway management strategy. Case presentation: A 48-year-old woman was going to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS) who had left pneumonectomy two years ago. A 32-French left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff’s inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion: Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the promotion of the operation could be solved.

scholarly journals Diagnostic and Therapeutic Performance of Video-Assisted Thoracoscopic Surgery (Vats) in Investigation and Management of Pleural Exudates

2008 ◽  
Vol 90 (7) ◽  
pp. 597-600 ◽  
Author(s):  
ARL Medford ◽  
YM Awan ◽  
A Marchbank ◽  
J Rahamim ◽  
J Unsworth-White ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Thoracoscopic Surgery ◽  
Good Practice ◽  
National Standards ◽  
Postoperative Fever ◽  
Video Assisted ◽  
The Right ◽  
Culture Negative ◽  
Video Assisted Thoracoscopic Surgery ◽  
Fluid Culture

INTRODUCTION Video-assisted thoracoscopic surgery (VATS) is the gold standard investigation for diagnosis of pleural exudates. It is invasive and it is important to ensure that it is performed to acceptable national standards. We assumed that VATS empyema fluid culture would not contribute further to microbiological diagnosis in referred culture-negative empyemas. PATIENTS AND METHODS Eighty-six consecutive external referrals for VATS for diagnosis of a cytology-negative pleural exudate (or for further management of the exudate) were studied retrospectively. Diagnostic yield, pleurodesis efficacy and complications were compared to national standards and good practice recommendations. VATS empyema fluid microbiological culture results were compared to pre-VATS empyema fluid culture results. RESULTS VATS was performed well within national standards with a diagnostic yield of 82.3% for cytology-negative exudates, 100% pleurodesis efficacy, 5.8% postoperative fever, with only one significant complication (1.2% rate) and no deaths. Compliance with good practice pleural fluid documentation points was greater than 70%. VATS empyema fluid culture positivity (84.6%) was significantly higher than pre-VATS fluid culture (35%). CONCLUSIONS VATS was performed to acceptable standards. These data confirm the utility and safety of VATS in the right context but also suggest the potential diagnostic utility of VATS empyema fluid culture. Further studies are required to investigate this latter possibility further.

Introduction of the video-assisted thoracoscopic surgery (VATS) port through the subcostal incision to the right pleural cavity

ASVIDE ◽  
2016 ◽  
Vol 3 ◽  
pp. 503-503
Author(s):  
Marcin Zieliński ◽  
Mariusz Rybak ◽  
Katarzyna Solarczyk-Bombik ◽  
Michal Wilkoj ◽  
Wojciech Czajkowski ◽  
...  
Keyword(s):  
Pleural Cavity ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
The Right ◽  
Video Assisted Thoracoscopic Surgery ◽  
Subcostal Incision

Analysis of conversion to thoracotomy during thoracoscopic lung resection

2019 ◽  
Vol 27 (5) ◽  
pp. 381-387 ◽  
Author(s):  
Katsunari Matsuoka ◽  
Tetsu Yamada ◽  
Takahisa Matsuoka ◽  
Shinjiro Nagai ◽  
Mitsuhiro Ueda ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Thoracoscopic Surgery ◽  
Clinical Stage ◽  
Lung Resection ◽  
Open Thoracotomy ◽  
Advanced Clinical Stage ◽  
Video Assisted ◽  
Surgery Group ◽  
Intraoperative Conversion ◽  
Video Assisted Thoracoscopic Surgery

Background Video-assisted thoracoscopic surgery has been widely adopted. However, conversion to open thoracotomy is still necessary when intraoperative complications are encountered. Methods Between January 2009 and December 2014, 1566 patients underwent anatomical lung resection for lung cancer using video-assisted thoracoscopic surgery at our institution. Among these patients, 39 required conversion to open thoracotomy. We retrospectively examined the current status of conversion to thoracotomy during video-assisted thoracoscopic surgery in a single city hospital. Data were compared with those of 89 patients undergoing a scheduled thoracotomy. Results The main reason for conversion was the need for angioplasty for pulmonary artery invasion by silicotic lymph nodes (12 cases), and metastatic lymph nodes or tumors (9 cases). Univariate analysis demonstrated that the risk factors for conversion were male sex, smoking habit, induction therapy, large tumor size, and advanced stage. Multivariate analysis showed that advanced clinical stage was the only significant predictor of intraoperative conversion. Compared to the video-assisted thoracoscopic surgery group, mortality and morbidity in the conversion group were significantly higher, but there was no significant difference in mortality or morbidity between the conversion and scheduled thoracotomy groups. The conversion group showed a significantly higher rate of lethal acute exacerbation of interstitial pneumonitis than the video-assisted thoracoscopic surgery group. Conclusion The main reason for conversion was angioplasty, and advanced clinical stage was a significant predictor of intraoperative conversion. Conversion was safely performed but postoperative complications, although similar in frequency to scheduled thoracotomy cases, were more frequent than those in thoracoscopic surgery cases.

Proctor-guided virtual reality–enhanced three-dimensional video-assisted thoracic surgery: an excellent tutoring model for lung segmentectomy

2020 ◽  
pp. 030089162097217
Author(s):  
Francesco Guerrera ◽  
Samanta Nicosia ◽  
Lorena Costardi ◽  
Paraskevas Lyberis ◽  
Federico Femia ◽  
...  
Keyword(s):  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Three Dimensional ◽  
Resection Margins ◽  
Early Stage Lung Cancer ◽  
Video Assisted ◽  
Tissue Sparing ◽  
The Right ◽  
Colon Rectal Cancer

Objective: Lung segmentectomy using video-assisted thoracoscopic surgery (VATS) is an effective strategy to treat early-stage lung cancer. The objective of this case report is to show the efficacy of Hyper Accuracy 3D™ (HA3D) reconstruction as a tool for trainee surgeons and expert surgeons to perform complex procedures. Methods: An 84-year-old man was treated for colon-rectal cancer. During follow-up, a pulmonary nodule on the right anterior upper lobe suspected for intestinal metastasis was revealed by a computed tomography scan. According to functional tests and radiology, a right anterior upper lobe segmentectomy was planned. HA3D lung reconstruction was used during surgery. Results: Using the HA3D virtual model, the procedure was performed with healthy tissue sparing, ensuring safe resection margins. No postoperative morbidities were noted. The patient referred good pain control. The hospital stay was 6 days. Conclusions: VATS segmentectomy is a technically demanding procedure. HA3D lung reconstruction can help surgeons effectively perform the resection, aiding at individuating intersegmental planes, bronchi, and vessels, guaranteeing oncologic radicality and safe surgical margins, and preserving respiratory function.

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