scholarly journals Congenital Pulmonary Airway Malformation in Children: Advantages of an Additional Trocar in the Lower Thorax for Pulmonary Lobectomy

2021 ◽  
Vol 9 ◽  
Author(s):  
Hiroyuki Koga ◽  
Takanori Ochi ◽  
Shunki Hirayama ◽  
Yukio Watanabe ◽  
Hiroyasu Ueno ◽  
...  
Keyword(s):  
Blood Loss ◽  
Chest Tube ◽  
Operative Time ◽  
Pulmonary Veins ◽  
Pulmonary Lobectomy ◽  
Congenital Pulmonary Airway Malformation ◽  
Tube Insertion ◽  
Time Duration ◽  
Chest Tube Insertion ◽  
Pulmonary Airway

Aim: To present the use of an additional trocar (AT) in the lower thorax during thoracoscopic pulmonary lobectomy (TPL) in children with congenital pulmonary airway malformation.Methods: For a lower lobe TPL (LL), an AT is inserted in the 10th intercostal space (IS) in the posterior axillary line after trocars for a 5-mm 30° scope, and the surgeon's left and right hands are inserted conventionally in the 6th, 4th, and 8th IS in the anterior axillary line, respectively. For an upper lobe TPL (UL), the AT is inserted in the 9th IS, and trocars are inserted in the 5th, 3rd, and 7th IS, respectively. By switching between trocars (6th↔8th for the scope, 4th↔6th for the left hand, and 8th↔10th for the right hand during LL and 5th↔7th, 3rd↔5th, and 7th↔9th during UL, respectively), vital anatomic landmarks (pulmonary veins, bronchi, and feeding arteries) can be viewed posteriorly. The value of AT was assessed from blood loss, operative time, duration of chest tube insertion, requirement for post-operative analgesia, and incidence of perioperative complications.Results: On comparing AT+ (n = 28) and AT– (n = 27), mean intraoperative blood loss (5.6 vs. 13.0 ml), operative time (3.9 vs. 5.1 h), and duration of chest tube insertion (2.2 vs. 3.4 days) were significantly decreased with AT (p < 0.05, respectively). Differences in post-operative analgesia were not significant. There were three complications requiring conversion to open/mini-thoracotomy: AT– (n = 2; bleeding), AT+: (n = 1; erroneous stapling).Conclusions: An AT and switching facilitated posterior dissection during TPL in children with congenital pulmonary airway malformation enhancing safety and efficiency.

Hemothorax after chest tube insertion for pneumothorax as a complication of clopidogrel

Open Medicine ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. 406-409 ◽  
Author(s):  
Gen Ohara ◽  
Katsunori Kagohashi ◽  
Koichi Kurishima ◽  
Kunihiko Miyazaki ◽  
Hiroaki Satoh
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Male Patient ◽  
Surgical Procedures ◽  
Chest Tube ◽  
Ischemic Heart ◽  
Tube Insertion ◽  
Chest Tube Insertion ◽  
Hemorrhagic Complications

AbstractHemorrhagic complications are recognized when anti-platelet agents are used during or after surgical procedures. We present a 69-year-old male patient who developed hemothorax after chest tube insertion for pneumothorax as a complication of clopidogrel and aspirin following ischemic heart disease. Hemothorax associated clopidogrel has rarely been reported and this is the first academic publication of this complication type following chest tube insertion shortly after the cessation of clopidogrel. Our case demonstrates the possibility of hemothorax when chest tube insertion is indicated under such conditions.

An intragastric chest tube insertion

2013 ◽  
Vol 39 (12) ◽  
pp. 2207-2208
Author(s):  
Damien Roux ◽  
Georges Surugue ◽  
Stéphane Gaudry ◽  
Michel Wolff
Keyword(s):  
Chest Tube ◽  
Tube Insertion ◽  
Chest Tube Insertion

Pre-embedding subcutaneous suture technique for chest-tube insertion

ASVIDE ◽  
2017 ◽  
Vol 4 ◽  
pp. 475-475
Author(s):  
Chieh-Ni Kao ◽  
Chao-Wei Chang ◽  
Meng-Chien Hsieh ◽  
Yu-Wei Liu ◽  
Shah-Hwa Chou
Keyword(s):  
Chest Tube ◽  
Suture Technique ◽  
Tube Insertion ◽  
Chest Tube Insertion

scholarly journals Simulation training for emergency skills: effects on ICU fellows’ performance and supervision levels

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bjoern Zante ◽  
Joerg C. Schefold
Keyword(s):  
Chest Tube ◽  
Simulation Training ◽  
Skill Training ◽  
Training Methods ◽  
Tube Insertion ◽  
Time Saving ◽  
External Assessment ◽  
Professional Activities ◽  
Chest Tube Insertion ◽  
Skill Performance

Abstract Background The application of manual emergency skills is essential in intensive care medicine. Simulation training on cadavers may be beneficial. The aim of this study was to analyze a skill-training aiming to enhance ICU-fellows´ performance. Methods A skill-training was prepared for chest tube insertion, pericardiocentesis, and cricothyroidotomy. Supervision levels (SL) for entrustable professional activities (EPA) were applied to evaluate skill performance. Pre- and post-training, SL and fellows´ self- versus consultants´ external assessment was compared. Time on skill training was compared to conventional training in the ICU-setting. Results Comparison of pre/post external assessment showed reduced required SL for chest tube insertion, pericardiocentesis, and cricothyroidotomy. Self- and external assessed SL did not significantly correlate for pre-training/post-training pericardiocentesis and post-training cricothyroidotomy. Correlations were observed for self- and external assessment SL for chest tube insertion and pre-assessment for cricothyroidotomy. Compared to conventional training in the ICU-setting, chest tube insertion training may further be time-saving. Conclusions Emergency skill training separated from a daily clinical ICU-setting appeared feasible and useful to enhance skill performance in ICU fellows and may reduce respective SL. We observed that in dedicated skill-training sessions, required time resources would be somewhat reduced compared to conventional training methods.

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