scholarly journals Case Report: Discontinuous Spontaneous Ventilating Anesthesia for McKeown Esophagectomy by Laryngeal Mask: A Case Series—A Novel Approach of Discontinuous Spontaneous Ventilating Anesthesia for Esophagectomy

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiaoqiao Xu ◽  
Xuan Mo ◽  
Juan Xiong ◽  
Yi Zhang
Keyword(s):  
Esophageal Cancer ◽  
Enhanced Recovery ◽  
Thoracoscopic Surgery ◽  
Muscle Relaxation ◽  
Case Series ◽  
Laryngeal Mask ◽  
Double Lumen ◽  
Regional Analgesia ◽  
Post Surgery ◽  
Mckeown Esophagectomy

Double lumen endobronchial ventilation in McKeown esophagectomy is common for esophageal cancer. In spite of most patients could be extubated immediately after surgery under adequate multimodal analgesia, still some patients require extended mechanical ventilation or airway support post-surgery because of pain or difficult respiration. The present study reported a novel challenge for McKeown esophagectomy with discontinuous spontaneous ventilating anesthesia by the laryngeal mask. Three esophageal cancer patients underwent McKeown esophagectomy under discontinuous spontaneous ventilating anesthesia with local and regional analgesia and appropriate sedation. Two of them were accomplished under non-intubated video-assisted thoracoscopic surgery (NIVATS), and then, the abdominal and neck surgery was managed under laryngeal mask airway with appropriate muscle relaxation. One patient was endured high PetCO2 level, and converted to regular double lumen endobronchial intubation for safety. However, from the two successful cases, we still proved that the discontinuous spontaneous ventilating anesthesia achieved the same anesthetic effect as bronchial intubation under general anesthesia for McKeown esophagectomy, which reduced the postoperative pharyngeal discomfort, might be beneficial to the patients for enhanced recovery after surgery (ERAS).

Thoracoscopic Surgery for Esophageal Cancer in Line with Microanatomy

2014 ◽  
Vol 65 (2) ◽  
pp. 134-134
Author(s):  
S. Lee ◽  
S. Kishida ◽  
Y. Fujiwara ◽  
R. Hashiba ◽  
Y. Matsuda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracoscopic Surgery

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 Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy

Esophagus ◽  
2021 ◽  
Author(s):  
Yuichiro Tanishima ◽  
Katsunori Nishikawa ◽  
Masami Yuda ◽  
Yoshitaka Ishikawa ◽  
Keita Takahashi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Enhanced Recovery ◽  
Enhanced Recovery Protocol ◽  
Mckeown Esophagectomy

scholarly journals Surgical management of Encapsulating Peritoneal Sclerosis (EPS) in children: international case series and literature review

2021 ◽  
Author(s):  
Videha Sharma ◽  
Zia Moinuddin ◽  
Angela Summers ◽  
Mohan Shenoy ◽  
Nicholas Plant ◽  
...  
Keyword(s):  
Case Series ◽  
Wound Management ◽  
Supplementary Information ◽  
Operative Morbidity ◽  
Post Surgery ◽  
Paediatric Patients ◽  
Stoma Formation ◽  
Gut Function ◽  
Health And Development ◽  
Secondary Closure

Abstract Background Encapsulating Peritoneal Sclerosis (EPS) is a rare phenomenon in paediatric patients with kidney failure treated with peritoneal dialysis (PD). This study highlights clinical challenges in the management of EPS, with particular emphasis on peri-operative considerations and surgical technique. Methods Retrospective analysis of all paediatric patients with EPS treated at the Manchester Centre for Transplantation. Results Four patients were included with a median duration of 78 months on PD. All patients had recurrent peritonitis (> 3 episodes), and all had symptoms within three months of a change of dialysis modality from PD to haemodialysis or transplant. In Manchester, care was delivered by a multi-disciplinary team, including surgeons delivering the adult EPS surgical service with a particular focus on nutritional optimisation, sepsis control, and wound management. The surgery involved laparotomy, lavage, and enterolysis of the small bowel + / − stoma formation, depending on intra-abdominal contamination. Two patients had a formal stoma, which were reversed at three and six months, respectively. Two patients underwent primary closure of the abdomen, whereas two patients had re-look procedures at 48 h with secondary closure. One patient had a post-operative wound infection, which was managed medically. One patient’s stoma became detached, leading to an intra-abdominal collection requiring re-laparotomy. The median length of stay was 25 days, and patients were discharged once enteral feeding was established. All patients remained free of recurrence with normal gut function and currently two out of four have functioning transplants. Conclusions This series demonstrates 100% survival and parenteral feed independence following EPS surgery. Post-operative morbidity was common; however, with individualised experience-based decision-making and relevant additional interventions, patients made full recoveries. Health and development post-surgery continued, allowing the potential for transplantation. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

Auricular field nerve stimulation using the NSS-2 BRIDGE® device as an alternative to opioids following kidney donor surgery

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jacques E. Chelly ◽  
Amy L. Monroe ◽  
Raymond M. Planinsic ◽  
Amit Tevar ◽  
Brittany E. Norton
Keyword(s):  
Enhanced Recovery ◽  
Randomized Study ◽  
Cranial Nerves ◽  
Oral Morphine ◽  
Oral Intake ◽  
Control Group ◽  
Hospital Data ◽  
Kidney Donor ◽  
Post Surgery ◽  
Post Operative Nausea

Abstract Objectives The purpose of this study was to investigate the role that the NSS-2 BRIDGE® device, an auricular field nerve stimulator, may play in reducing opioid requirement and pain in kidney donor surgery. It was not a randomized study. Electrophysiologic studies have demonstrated that the stimulation of the cranial nerves produced by the NSS-2 BRIDGE® device modulates the ascending/descending spinal pain pathways, especially at the level of the limbic system. Methods The design compared the effects of the NSS-2 BRIDGE® device (NSS 2-BRIDGE® device group; n=10) to a control group (n=10). In both groups, the surgery was performed using the same standard enhanced recovery after surgery protocol based on the use of a multimodal analgesic approach. For the active treatment group, the NSS-2 BRIDGE® device was placed in the post anesthesia care unit. The primary endpoint was opioid requirement (oral morphine equivalent, OME in mg) at 24 h post-surgery. Secondary endpoints included pain (0–10), at 24 and 48 h, time to discharge from the recovery room, incidence of post-operative nausea and vomiting at 24 h, time to oral intake, time to ambulation, and time to discharge from the hospital. Data was analyzed using unpaired t-test and presented as mean ± standard deviation. Results Compared to control, the use of the NSS-2 BRIDGE® was associated with a 75.4% reduction in OME (33.6 vs. 8.3 mg; p=0.03) and 41.5% reduction in pain (5 vs. 3.28; p=0.06) at 24 h and a 73.3% difference in pain at 48 h (1.6 ± 1.6 vs. 6.0 ± 2.8; p=0.0004). There was no difference in non-opioid analgesics administration between groups. Conclusions The tolerability of NSS-2 BRIDGE® device was reported by most to be excellent. This study suggests that the NSS-2 BRIDGE® device may represent a complementary approach for controlling postoperative opioid consumption and pain in patients undergoing kidney donation.

scholarly journals Use of Double-Lumen Peripherally Inserted Central Catheters for Safer Perioperative Management of Esophageal Cancer Patients

2015 ◽  
Vol 16 (4) ◽  
pp. 338-343 ◽  
Author(s):  
Shuichi Fukuda ◽  
Kiyokazu Nakajima ◽  
Yasuhiro Miyazaki ◽  
Tsuyoshi Takahashi ◽  
Yukinori Kurokawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Perioperative Management ◽  
Double Lumen ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters
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