scholarly journals Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

2020 ◽  
Author(s):  
Yungang Sun ◽  
Feng Shao ◽  
Qiang Zhang ◽  
Zhao Wang
Keyword(s):  
Lung Resection ◽  
Pulmonary Sequestration ◽  
Perioperative Period ◽  
Massive Hemorrhage ◽  
Perioperative Outcomes ◽  
Invasive Technique ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Aberrant Artery ◽  
The Mean

Abstract Background: Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration. Methods: A total of 24 patients with PS including fifteen males and nine females with the mean age of 40 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Related clinical data were retrieved from hospital records and analyzed. Results: All 24 patients had been treated with the UAVTS approach successfully without aberrant artery ruptured or massive hemorrhage, and no patients died during the perioperative period. Overall median surgery time was 102 mins (range, 55-150mins), the mean blood loss was 94 ml (range, 10-300ml), the mean days of chest tube maintained were 4 days (range,1-10days), and the mean postoperative hospitalization days was 6 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, associated with PS, occurring during the average follow-up of 17 months (range, 3-35months). Conclusions: Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

scholarly journals Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

2020 ◽  
Author(s):  
Yungang Sun ◽  
Feng Shao ◽  
Qiang Zhang ◽  
Zhao Wang
Keyword(s):  
Lung Resection ◽  
Pulmonary Sequestration ◽  
Perioperative Period ◽  
Massive Hemorrhage ◽  
Perioperative Outcomes ◽  
Invasive Technique ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Aberrant Artery ◽  
The Mean

Abstract Background Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration. Methods A total of 24 patients with PS including fifteen males and nine females with the mean age of 40 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Related clinical data were retrieved from hospital records and analyzed. Results All 24 patients had been treated with the UAVTS approach successfully without aberrant artery ruptured or massive hemorrhage, and no patients died during the perioperative period. Overall median surgery time was 102 mins (range, 55-150mins), the mean blood loss was 94 ml (range, 10-300ml), the mean days of chest tube maintained were 4 days (range,1-10days), and the mean postoperative hospitalization days was 6 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, associated with PS, occurring during the average follow-up of 17 months (range, 3-35months). Conclusions Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

scholarly journals Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

2019 ◽  
Author(s):  
Yungang Sun ◽  
Feng Shao ◽  
Qiang Zhang ◽  
Zhao Wang
Keyword(s):  
Lung Resection ◽  
Pulmonary Sequestration ◽  
Perioperative Period ◽  
Massive Hemorrhage ◽  
Perioperative Outcomes ◽  
Invasive Technique ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Aberrant Artery ◽  
The Mean

Abstract Background Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration.Methods A total of 24 patients with PS including fifteen males and nine females with the mean age of 40.54±14.49 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Referring clinical data were retrieved from hospital records and analyzed.Results All 24 patients had been treated with the UAVTS approach successfully with no aberrant artery ruptured and no massive hemorrhage occurred, and no patients died during the perioperative period. Overall median surgery time was 102.21 ±28.00 mins (range, 55-150mins), the mean blood loss was 94.17±78.90 ml (range, 10-300ml), the mean days of chest tube maintained were 4.21±2.21 days (range,1-10days), and the mean postoperative hospitalization days was 5.79 ±2.35 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, occurring during the average follow-up of 17.42 ±2.00 months (range, 3-35months).Conclusions Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun
Keyword(s):  
Thoracoscopic Surgery ◽  
Anterior Mediastinum ◽  
Laryngeal Mask ◽  
Double Lumen Tube ◽  
Perioperative Outcomes ◽  
Video Assisted ◽  
Incision Size ◽  
The Mean ◽  
End Tidal ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

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.

The Bronchus First and Vessels Simultaneously Stapled Technique: A Safe and Simple Method for Video-Assisted Right Upper Lobe Lobectomy

2018 ◽  
Vol 67 (02) ◽  
pp. 131-136
Author(s):  
Hao Xu ◽  
Linyou Zhang
Keyword(s):  
Invasive Procedure ◽  
Distant Recurrence ◽  
Massive Hemorrhage ◽  
Simple Method ◽  
Video Assisted ◽  
Novel Approach ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Right

Objective Video-assisted thoracic surgery lobectomy is a minimally invasive procedure for major pulmonary resection. The purpose of this study was to present a novel approach with a thoracoscope in the right upper lobe and to compare different lobectomy methods at our institution. Methods We reviewed the medical records of patients who underwent a thoracoscopic right upper lobectomy for lung cancer between September 2015 and September 2016. We performed 128 thoracoscopic right upper lobectomies: group A (n = 50) was treated with the bronchus-first and vessels simultaneously stapled method and group B (n = 78) was treated with the conventional isolation–ligation method. Preoperative mediastinal staging and lymphadenectomy followed the National Comprehensive Cancer Network guidelines. The intra- and postoperative outcomes were recorded and statistically compared. Results All patients underwent successful thoracoscopic right upper lobectomies. No significant differences in mean intraoperative blood loss, massive hemorrhage (>500 mL), and postoperative complications were observed between the two groups (p < 0.05). The mean operative time of group A was less than that of group B (110.80 ± 34.74 versus 167.01 ± 48.38 minutes, p = 0.000). The mean duration of chest drainage in group A was 4.34 ± 2.06 days, which was shorter than that of group B (5.85 ± 3.13 days, p = 0.017). No significant differences were observed in the local recurrence and distant recurrence between the two groups during the postoperative follow-up. Conclusions Thoracoscopic right upper lobectomy with the lobectomy bronchus-first and vessels simultaneously stapled method is a safe and efficient procedure that leads to better recovery.

scholarly journals Non-intubated spontaneous ventilation in video-assisted thoracoscopic surgery: a meta-analysis

2019 ◽  
Author(s):  
Yaokai Wen ◽  
Hengrui Liang ◽  
Guanping Qiu ◽  
Zhichao Liu ◽  
Jun Liu ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Perioperative Outcomes ◽  
Postoperative Rehabilitation ◽  
Video Assisted ◽  
Thoracic Diseases ◽  
Feasible Alternative ◽  
Hospital Stays ◽  
Video Assisted Thoracoscopic Surgery ◽  
Rehabilitation Time

Abstract It remains unclear whether non-intubated video-assisted thoracoscopic surgery (VATS) is comparable or advantageous compared with conventional intubated VATS. Thus, we systematically assessed the feasibility and safety of non-intubated VATS compared with intubated VATS perioperatively for the treatment of different thoracic diseases. An extensive search of literature databases was conducted. Perioperative outcomes were compared between 2 types of operations. The time trend of the overall results was evaluated through a cumulative meta-analysis. Subgroup analyses of different thoracic diseases and study types were examined. Twenty-seven studies including 2537 patients were included in the analysis. A total of 1283 patients underwent non-intubated VATS; intubated VATS was performed on the other 1254 patients. Overall, the non-intubated VATS group had fewer postoperative overall complications [odds ratios (OR) 0.505; P < 0.001]; shorter postoperative fasting times [standardized mean difference (SMD) −2.653; P < 0.001]; shorter hospital stays (SMD −0.581; P < 0.001); shorter operative times (SMD −0.174; P = 0.041); shorter anaesthesia times (SMD −0.710; P < 0.001) and a lower mortality rate (OR 0.123; P = 0.020). Non-intubated VATS may be a safe and feasible alternative to intubated VATS and provide a more rapid postoperative rehabilitation time than conventional intubated VATS.

scholarly journals Conversion from video-assisted thoracic surgery (VATS) to thoracotomy during major lung resection: how does it affect perioperative outcomes?

2020 ◽  
Vol 32 (1) ◽  
pp. 55-63
Author(s):  
Joseph Seitlinger ◽  
Anne Olland ◽  
Sophie Guinard ◽  
Gilbert Massard ◽  
Pierre-Emmanuel Falcoz
Keyword(s):  
Risk Factors ◽  
Thoracic Surgery ◽  
Conversion Rate ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
High Risk Population ◽  
Technical Failure ◽  
Perioperative Mortality ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Abstract OBJECTIVES Since video-assisted thoracic surgery (VATS) was first performed in the early 1990s, there have been many developments, and the conversion rate has decreased over the years. This article highlights the specific outcomes of patients undergoing conversion to thoracotomy despite initially scheduled VATS lung resection. METHODS We retrospectively reviewed 501 patients who underwent thoracoscopic anatomic lung resection (i.e. lobectomy, segmentectomy or bilobectomy) between 1 January 2012 and 1 August 2017 at our institution. We explored the risk factors for surgical conversion and adverse events occurring in patients who underwent conversion to thoracotomy. RESULTS A total of 44/501 patients underwent conversion during the procedure (global rate: 8.8%). The main reasons for conversion were (i) anatomical variation, adhesions or unexpected tumour extension (37%), followed by (ii) vascular causes (30%) and (iii) unexpected lymph node invasion (20%). The least common reason for conversion was technical failure (13%). We could not identify any specific risk factors for conversion. The global complication rate was significantly higher in converted patients (40.9%) than in complete VATS patients (16.8%) (P = 0.001). Postoperative atrial fibrillation was a major complication in converted patients (18.2%) [odds ratio (OR) 5.09, 95% confidence interval (CI) 1.80–13.27; P = 0.001]. Perioperative mortality was higher in the conversion group (6.8%) than in the VATS group (0.2%) (OR 33.3, 95% CI 3.4–328; P = 0.003). CONCLUSIONS Through the years, the global conversion rate has dramatically decreased to &lt;10%. Nevertheless, patients who undergo conversion represent a high-risk population in terms of complications (40.9% vs 16.8%) and perioperative mortality (6.8% vs 0.2%).

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 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.

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