scholarly journals Case Report: Surgical Therapy for Left Innominate Vein Aneurysm Under Thoracoscopy

2021 ◽  
Vol 8 ◽  
Author(s):  
Yan Hu ◽  
Siying Ren ◽  
Chao Zeng ◽  
Jina Li ◽  
Min Zou ◽  
...  
Keyword(s):  
Mediastinal Mass ◽  
Thoracoscopic Surgery ◽  
Median Sternotomy ◽  
Innominate Vein ◽  
Anterior Mediastinal Mass ◽  
Health Examination ◽  
Thoracoscopic Approach ◽  
First Case ◽  
First Choice ◽  
Left Innominate Vein

Left innominate vein aneurysm is extremely rare, with a limited number of case reports present in the literature. Herein, we report a case of a 50-year-old female patient presenting with an incidental finding of an anterior mediastinal mass on chest radiography during a routine health examination. Contrast-enhanced computerized tomography (CT) of the chest showed a 4.8 × 4.6 cm anterior mediastinal mass with significant homogenous enhancement after injection of the contrast medium, suggesting a diagnosis of Castleman's disease, but not excluding thymoma. The patient underwent surgical resection of the anterior mediastinal mass under a thoracoscopic approach. Postoperative pathology confirmed the diagnosis of a left innominate vein aneurysm. This is the first case reporting a left innominate vein aneurysm resected under thoracoscopy. Despite this successful treatment experience, we need to emphasize that open thoracotomy or median sternotomy should be chosen as the first choice for surgeons who lack experience in thoracoscopic surgery, with the aim of avoiding intraoperative accidents.

Totally Thoracoscopic Versus Open Surgery for Closure of Atrial Septal Defect: Propensity-Score Matched Comparison

2014 ◽  
Vol 17 (4) ◽  
pp. 227 ◽  
Author(s):  
Zhe Zheng ◽  
Hua Kun ◽  
Xu Xuezeng ◽  
Chen Yunge ◽  
Ma Zengshan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Propensity Score ◽  
Atrial Septal Defect ◽  
Open Surgery ◽  
Septal Defect ◽  
Thoracoscopic Surgery ◽  
Median Sternotomy ◽  
Robotic Assistance ◽  
Thoracoscopic Approach ◽  
Significant Difference

<p>The purpose of this study is to compare early clinical outcomes of surgical repair for isolated atrial septal defect (ASD) with a totally thoracoscopic approach without robotic assistance versus a conventional open procedure.</p><p>Between September 2010 and June 2012, 254 consecutive patients with isolated ASD underwent totally thoracoscopic surgery without robotic assistance in seven institutions participating in the nationwide multi-centered registry in China. During the same period, these patients were matched using propensity score methodology with 254 patients who had accepted conventional open surgery through a median sternotomy. The early in-hospital results between the two groups were analyzed and compared.</p><p>The patient age was 26.8 � 14.0 years and weight was 52.9 � 16.9 kg in the totally thoracoscopic group. The totally thoracoscopic surgery required longer aortic clamp time (32.1 � 17.3 minutes versus 28.3 � 16.7 minutes, <i>P</i> = .01); shorter length of stay in the intensive care unit (25.3 � 12.2 hours versus 34.8 � 24.4 hours, <i>P</i> = .001); shorter length of stay in hospital (6.5 � 6.3 days versus 7.9 � 6.4 days, <i>P</i> = .008); and shorter mechanical ventilation time (8.3 � 5.0 hours versus 11.4 � 14.8 hours, <i>P</i> = .04). The cardiopulmonary bypass (CPB) time (62.7 � 29.3 minutes versus 61.5 � 28.0 minutes, <i>P</i> = .64) showed no significant difference between the two groups. The totally thoracoscopic group had significantly less postoperative chest tube drainage (322.1 � 213.7 mL versus 462.8 � 398.4 mL, <i>P</i> = .001). The intraoperative (35.4% versus 38.6%, <i>P</i> = .46) and postoperative blood products usage (20.9% versus 21.3%, <i>P</i> = .91) showed no significant difference between the two groups.</p><p>There also was no significant difference in mortality and major in-hospital complications between the two groups. The early outcomes for treatment of isolated ASD were similar between the totally thoracoscopic group conventional open operation performed through median sternotomy, despite a longer aortic clamp time in the totally thoracoscopic group.</p>

Floating left innominate vein neoplastic thrombus: A rare case of mediastinal extension of follicular thyroid carcinoma

2013 ◽  
Vol 30 (2) ◽  
pp. 140-144 ◽  
Author(s):  
IF Franco ◽  
A Gurrado ◽  
G Lissidini ◽  
G Di Meo ◽  
A Pasculli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Superior Vena ◽  
Vena Cava ◽  
Innominate Vein ◽  
En Bloc ◽  
First Case ◽  
Thyroid Mass ◽  
Retrosternal Goiter ◽  
Arm Swelling ◽  
Left Innominate Vein

Objective We report a case of advanced follicular thyroid cancer with innominate vein involvement. To our knowledge, this seems to be the first case treated in emergency surgery, reported in literature. Method A 59-year-old woman with a five-year history of a large and mainly right-sided cervical mass presented with dyspnea, unilateral arm swelling, facial flushing, and venous congestion. An emergency computed tomography scan revealed a thyroid mass extending into the upper mediastinum with displacement and compression of the right jugular vein and carotid artery and apparent adherence to the superior vena cava and left innominate vein. Results An emergency total thyroidectomy was performed by means of a sternotomy. The lower portion of the retrosternal goiter projected directly into the left innominate vein, with tumor floating in its lumen. Removal of the neoplastic thrombus was performed, through an incision in the vein, en bloc with the thyroid mass. Both goiter and thrombus were completely replaced by follicular carcinoma. Conclusions Accurate preoperative assessment through contrast-enhanced computed tomography is strongly suggested in the presence of enlarged thyroid gland extending into the mediastinum whenever angioinvasion is suspected. This could prevent blinded maneuvers such as digital externalization of the thoracic component of the gland, which can be fatal in cases of cervico-mediastinal goiter extending into great cervical or mediastinal veins.

scholarly journals Primary Lymphoepithelioma-like Hepatocellular Carcinoma With Hepatic Cyst: a Case Report and Review of Literature

2021 ◽  
Author(s):  
Zhiqiang Yang ◽  
Shengwei Li ◽  
Junbo Li ◽  
Xinglang Wu ◽  
Jin Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Histopathological Examination ◽  
Lateral Lobe ◽  
Good Prognosis ◽  
Hepatic Cyst ◽  
Health Examination ◽  
Lymphocyte Infiltration ◽  
Ki 67 ◽  
First Case ◽  
First Choice

Abstract Background: Lymphoepithelioma-like hepatic carcinoma is a rare malignant tumor. It includes lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) and lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC). we report the first case of hepatic cyst and LEL-HCC, which is extremely rare among hepatocellular carcinoma.Case presentation: A 47-year-old female was admitted to our hospital with an unexpected health examination finding of liver nodules. Subsequently, the Computerized tomography (CT) revealed a tumor and a cyst. The Magnetic resonance imaging (MRI) found a 23×18 mm hepatic cyst in the right lobe of the liver and a 21×17 mm nodule in the left lateral lobe of the liver, and the nodule imaging was likely liver cancer. The patient underwent laparoscopic left lateral hepatectomy, and the histopathological examination revealed undifferentiated heterogeneous glandular epithelial cells with obvious lymphocyte infiltration. The Immunohistochemistry study CD3, CD20, Ki-67, CK, and CK19 results were positive, while CD10, P53, and CEA were negative in tumor tissues. Epstein-Barr virus (EBV) was negative in situ hybridization. For this patient, the LEL-HCC diagnostic was made according to the histopathological result. Surgical resection is the first choice for this kind of patients, but immunotherapy may be more promising for them in the future. Conclusion: LEL-HCC is a rare variant of HCC, characterized by dense lymphocyte infiltration and a good prognosis. We report the first patient with hepatic cysts and LEL-HCC, which is distinctly uncommon in the HCC patients. Because the hepatic cyst and tumor are similar in certain imaging studies, our work can provide information for clinical diagnosis.

scholarly journals Brachiocephalic artery to left innominate vein fistula following median sternotomy

2005 ◽  
Vol 28 (2) ◽  
pp. 328-329 ◽  
Author(s):  
Rajnish Duara ◽  
Puthuvassery Raman Suneel ◽  
Thomas Koshy ◽  
Kurur Sankaran Neelakandhan
Keyword(s):  
Median Sternotomy ◽  
Innominate Vein ◽  
Brachiocephalic Artery ◽  
Left Innominate Vein

A rare case of anterior mediastinal mass caused by Brucella infection

2017 ◽  
Vol 25 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Feridoun Sabzi ◽  
Reza Faraji
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Mediastinal Mass ◽  
Surgical Intervention ◽  
Artery Bypass ◽  
Median Sternotomy ◽  
High Fever ◽  
Anterior Mediastinal Mass ◽  
Brucella Infection ◽  
Upper Mediastinum

A previously healthy man, who had undergone coronary artery bypass 10 years earlier and had been diagnosed with brucellosis due to Brucella septicemia after Brucella arthritis, presented with chest pain and high fever. Anti- Brucella antibiotics were started, but after 4 weeks, his high fever remained. An infected mass was confirmed by computed tomography, and surgical intervention was performed via a median sternotomy. A large amount of thick pus gushed from an abscess in the upper mediastinum. The abscess cavity had a thick granulation wall, and cultured pus was positive for Brucella only. The patient responded well to antibiotic therapy.

scholarly journals Totally endoscopic surgical resection for a blood cyst originated from mitral valve: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xin Zhang ◽  
Lin Zhang ◽  
Lianggang Li ◽  
Tong Ren ◽  
Shengli Jiang
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Surgical Resection ◽  
Median Sternotomy ◽  
Cardiac Tumors ◽  
Histopathological Diagnosis ◽  
Thoracoscopic Approach ◽  
Intracardiac Tumor ◽  
First Case ◽  
Local Doctor

Abstract Background Intracardiac blood cysts are very rare primary cardiac tumors. Blood cysts originated from the mitral valve represent a minority of cases, and previous cases have been mainly treated with conventional surgery through median sternotomy. When the tumor involves heart valves and histopathological diagnosis remains unknown preoperatively, minimally invasive surgical resection of an intracardiac tumor can be challenging, especially through an endoscopic approach. We herein present the first case of successful surgical resection for a rare mitral valve originated blood cyst in a minimally invasive, totally thoracoscopic approach. Case presentation An apparently healthy 38-year-old male presented to his local hospital with six months history of palpitation and exertional dyspnea. Transthoracic echocardiography showed a mobile round cystic mass inside the left ventricle, attached to the anterolateral papillary muscle and chordae tendineae of the mitral valve. The local doctor diagnosed an intracardiac tumor and suggested a surgical resection through median sternotomy. However, the patient refused to have a sternotomy. He was then referred to us seeking minimally invasive surgery. We assessed the location, appearance and relationship to nearby structures of the tumor with echocardiography, and made a diagnosis of a suspected primary cystic intracardiac tumor. Since we had enough experience of totally endoscopic mitral surgery, our surgical plan was to resect the tumor in the aid of thoracoscopy, and manage the possible deformation and dysfunction of the cardiac structure if necessary. Using femoro-femoral cannulation and cardiopulmonary bypass, we successfully resected the tumor through a thoracoscopic approach in a closed chest, and well preserved the subvalvular structure and valvular function. Postoperative recovery was quick and uneventful. Pathologic diagnosis confirmed a simple blood cyst. Conclusions Surgical resection is warranted for symptomatic cases of intracardiac blood cysts. With prudent preoperative diagnosis and comprehensive surgical plan, we believe the thoracoscopic approach is a safe, curative and viable alternative for complete resection of cardiac valvular tumors.

Aneurysm Formation of Cervical Aortic Arch Combined with Subaortic Left Innominate Vein: Case Report

2004 ◽  
Vol 50 (1) ◽  
pp. 27
Author(s):  
Young Min Han ◽  
Ja Hong Gu ◽  
Gong Yong Jin ◽  
Hyo Sung Kwak ◽  
Gyung Ho Chung ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Arch ◽  
Innominate Vein ◽  
Aneurysm Formation ◽  
Left Innominate Vein
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