Bilateral Lung Transplantation for Patients With Destroyed Lung and Asymmetric Chest Deformity

Background: Destroyed lung can cause mediastinal displacement and asymmetric chest deformity. Reports on bilateral lung transplantation (LT) to treat destroyed lung and asymmetric chest deformity are rare. This study presents our surgical experience of bilateral LT among patients with destroyed lung and asymmetric chest deformity.Methods: Six patients with destroyed lung and asymmetric chest deformity who underwent bilateral LT at our center from 2005 to 2020 were included in the study. Demographic data, technical data, perioperative details, and short-term follow-up data were reviewed.Results: Three patients underwent bilateral LT via anterolateral incisions in the lateral position without sternal transection, while three patients underwent bilateral LT via clam-shell incisions in the supine position with sternal transection. Only one patient required intraoperative extracorporeal membrane oxygenation. Four patients underwent size-reduced LT. In the other two patients, we restored the mediastinum by releasing mediastinal adhesions to ensure maximal preservation of the donor lung function. Patients in the lateral position group had a higher volume of blood loss, longer operation time, and longer postoperative in-hospital stay than those in the supine position group. However, these differences were not statistically significant. Postoperative computed tomography in the supine position group revealed that the donor lungs were well expanded and the mediastina were in their original positions.Conclusions: Although bilateral LT in patients with destroyed lung and asymmetric chest deformity is high risk, with sufficient preoperative preparation and evaluation, it is safe and feasible to perform bilateral LT for selected patients. For patients without severe chest adhesions, releasing the mediastinal adhesions and restoring the mediastinum through a clam-shell incision in the supine position is a simple and effective method to maximally preserve the donor lung function without pneumonectomy or lobectomy.

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Accuracy of SEEG Electrodes Implanted in Lateral Position Versus Supine Position

Neurosurgery ◽

10.1093/neuros/nyz310_427 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Caio M Matias ◽

Sandeep Kandregula ◽

Chengyuan Wu ◽

Ashwini D Sharan

Keyword(s):

Supine Position ◽

Three Dimensional ◽

Major Complication ◽

Lateral Position ◽

Entry Point ◽

Target Point ◽

Robot Assisted ◽

Dimensional Error ◽

Electrode Implantation ◽

Position Group

Abstract INTRODUCTION Accuracy during SEEG implantations is critical as several electrodes will cross narrow corridors between cerebral blood vessels. Previous studies have compared the accuracy of different techniques such as frame-based, frameless, and robot-assisted implantations and overall SEEG has been reported to be quite safe, with a major complication incidence of less than 1%. Typically, the supine position is utilized for implantation; however, the lateral position may be more comfortable and ergonomic for trajectories with a posterior entry point (eg, posterior approach to the insula). To our knowledge, this is the first study to compare the accuracy of SEEG electrodes implanted in supine position vs lateral position. METHODS About 22 patients who underwent SEEG electrode implantation using Leksell frame fixation and Neuromate robot were included in this study and clustered according to the supine (n = 11) or lateral (n = 11) position. A total of 284 electrodes (Supine: n = 139; Lateral: n = 145) were analyzed. Postoperative Oarm images were co-registered with the preoperative plan on Voxim software. Cartesian coordinates of the entry point (EP) and target point (TP) were obtained from the planned trajectory and the implanted electrode. Three-dimensional error (Euclidian distance) and radial error for EP and TP were calculated. Wilcoxon rank sum test was used to compare lateral versus supine group. RESULTS Radial errors were similar between both groups. EP three-dimensional error was higher in the lateral position group (1.3 mm vs 1.7 mm, P = .004), whereas TP three-dimensional error was higher in the supine position group (2.9 mm vs 1.8 mm, P < .001). CONCLUSION SEEG electrode implantation using frame-based fixation and robot-assisted technique in the lateral position has similar accuracy compared to implantation in the supine position.

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Effect of Favorable Donor Factors on Outcomes After Bilateral Lung Transplantation: Preliminary Prospective Analysis of the University of Minnesota Donor Lung Quality Index (UMN-DLQI)

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2017.01.1515 ◽

2017 ◽

Vol 36 (4) ◽

pp. S314-S315

Author(s):

G. Loor ◽

S. Huddleston ◽

S. Jackson ◽

S. Elde ◽

T. Grabowski ◽

...

Keyword(s):

Lung Transplantation ◽

Quality Index ◽

Prospective Analysis ◽

University Of Minnesota ◽

Bilateral Lung Transplantation ◽

Donor Lung ◽

Donor Factors ◽

Bilateral Lung ◽

The University

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Survival after bilateral lung transplantation depends on the maximum lung function achieved post-transplant and the development of Bronchiolitis Obliterans Syndrome (BOS)

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2004.11.080 ◽

2005 ◽

Vol 24 (2) ◽

pp. S60 ◽

Cited By ~ 1

Author(s):

D. Hadjiliadis ◽

C.S. Berbrayer ◽

O. Hadjiliadis ◽

C. Chaparro ◽

S. Keshavjee

Keyword(s):

Lung Function ◽

Lung Transplantation ◽

Bronchiolitis Obliterans ◽

Bronchiolitis Obliterans Syndrome ◽

Post Transplant ◽

Bilateral Lung Transplantation ◽

Bilateral Lung

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Combined Pancreatic Islet-Lung-Liver Transplantation in a Pediatric Patient with Cystic Fibrosis-Related Diabetes

Hormone Research in Paediatrics ◽

10.1159/000488107 ◽

2018 ◽

Vol 90 (4) ◽

pp. 270-274 ◽

Cited By ~ 2

Author(s):

Philippe Klee ◽

Mirjam Dirlewanger ◽

Vanessa Lavallard ◽

Valerie A. McLin ◽

Anne Mornand ◽

...

Keyword(s):

Cystic Fibrosis ◽

Liver Transplantation ◽

Lung Function ◽

Pancreatic Islet ◽

Sanger Sequencing ◽

High Throughput Sequencing ◽

C Peptide ◽

Bilateral Lung Transplantation ◽

Bilateral Lung ◽

Peptide Secretion

Background: Cystic fibrosis-related diabetes (CFRD) is the most frequent extrapulmonary complication of cystic fibrosis (CF). Methods: We report the first combined pancreatic islet-lung-liver transplantation in a 14-year-old adolescent. CFTR was analyzed by Sanger sequencing. Further genes were analyzed by high-throughput sequencing. Results: The patient was diagnosed with CF at the age of 14 months. Nine years later, after diagnosis of CFRD, the patient’s BMI and lung function began to decline. Bilateral lung transplantation with simultaneous liver transplantation was performed at the age of 14.5 years. The first islet transplantation (IT) was carried out 10 days later. Six months later, C-peptide secretion after arginine stimulation showed peak values of 371 pmol/L (vs. 569 pmol/L before IT) and insulin doses had slightly increased (1.40 vs. 1.11 units/kg/day before IT). A second IT was performed at the age of 15 years, a third at 16 years. Two years after the first IT, arginine-stimulated C-peptide secretion increased to 2,956 pmol/L and insulin doses could be reduced to 0.82 units/kg/day. HbA1c decreased from 7.3% (57.4 mmol/mol) to 5.9% (41.0 mmol/mol). Conclusion: IT following lung and liver transplantation, with injection of islets into a transplanted organ, is feasible. It improves C-peptide secretion, decreases insulin needs, and lowers HbA1c.

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Lateral position: a friendly surgical position for intramedullary nailing of tibial shaft fractures via infrapatellar approach

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03883-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jinzhu Zhao ◽

Liang Qu ◽

Peng Li ◽

Changlong Tan ◽

Chunsheng Tao

Keyword(s):

Intramedullary Nailing ◽

Supine Position ◽

Lateral Position ◽

Healing Time ◽

Tibial Shaft ◽

Shaft Fractures ◽

Duration Of Surgery ◽

Surgical Assistants ◽

Tibial Shaft Fractures ◽

Position Group

Abstract Background The conventional infrapatellar approach to intramedullary nailing of tibial fractures adopts the supine high-flexion knee position. However, this has disadvantages including difficulty in obtaining the proximal tibial anteroposterior view during intraoperative fluoroscopy, prolonged duration of fluoroscopy. Accordingly, the present study investigated the utility of the lateral position in the infrapatellar approach to intramedullary nailing of tibial shaft fractures. Methods The present study was a retrospective analysis of 112 patients who sustained closed tibial shaft fractures and treated with intramedullary nailing via the infrapatellar approach. Patients were divided into two groups according to surgical position: lateral or supine. The demographic and clinical data were collected and analyzed. Results There were 54 patients in the lateral and 58 in the supine position groups. The duration of surgery and fluoroscopy was shorter in the lateral group than the supine group (p < 0.05). Blood loss during surgery was lower in the lateral compared with supine position group (p < 0.05). The malunion rate was lower in the lateral position group as compared with the supine position group (p < 0.05); moreover, fewer surgical assistants were needed than in the supine group (p < 0.05). There were no significant differences in fracture healing time, other complications between the two groups (p > 0.05). Conclusions The lateral position was a more convenient choice for intramedullary nailing of tibial shaft fractures via infrapatellar approach.

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Drowned donor lung for bilateral lung transplantation

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(03)00370-2 ◽

2003 ◽

Vol 126 (3) ◽

pp. 910-912 ◽

Cited By ~ 6

Author(s):

C.J McNamee ◽

D.L Modry ◽

D Lien ◽

A.Alan Conlan

Keyword(s):

Lung Transplantation ◽

Bilateral Lung Transplantation ◽

Donor Lung ◽

Bilateral Lung

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Adjustment period in lung function parameters following bilateral lung transplantation

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2004.12.876 ◽

2005 ◽

Vol 115 (2) ◽

pp. S217

Author(s):

S. Park ◽

P. Win ◽

M. Amin ◽

I. Hussain

Keyword(s):

Lung Function ◽

Lung Transplantation ◽

Bilateral Lung Transplantation ◽

Bilateral Lung

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Lateral Position: A Friendly Surgical Position for Intramedullary Nailing of Tibial Shaft Fractures Via Infrapatellar Approach

10.21203/rs.3.rs-72292/v1 ◽

2020 ◽

Author(s):

jinzhu zhao ◽

Liang Qu ◽

Peng Li ◽

Changlong Tan ◽

Chunsheng Tao

Keyword(s):

Intramedullary Nailing ◽

Supine Position ◽

Lateral Position ◽

Healing Time ◽

Tibial Shaft ◽

Shaft Fractures ◽

Duration Of Surgery ◽

Surgical Assistants ◽

Tibial Shaft Fractures ◽

Position Group

Abstract Purpose The purpose of this study was to investigate the utility of the lateral position in intramedullary nailing of tibial shaft fractures via the infrapatellar approach.Methods The present study was a retrospective analysis of 112 patients who sustained closed tibial shaft fractures and treated with intramedullary nailing via the infrapatellar approach. Patients were divided into two groups according to surgical position: lateral or supine. The demographic and clinical data were collected and analyzed. Results There were 54 patients in the lateral and 58 in the supine position groups. The duration of surgery and fluoroscopy was shorter in the lateral group than the supine group (p < 0.05). Blood loss during surgery was lower in the lateral compared with supine position group (p < 0.05). The malunion rate was lower in the lateral position group as compared with the supine position group (p < 0.05); moreover, fewer surgical assistants were needed than in the supine group (p < 0.05). There were no significant differences in fracture healing time, other complications between the two groups (p > 0.05). Conclusions The lateral position was a more convenient choice for intramedullary nailing of tibial shaft fractures via infrapatellar approach.

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