Subxiphoid Video-Assisted Thoracoscopic Surgery for Lung Resection Under Spontaneous Ventilation: Case Report

2021 ◽  
Vol 104 (11) ◽  
pp. 1847-1849
Keyword(s):  
Case Report ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Foley Catheter ◽  
Spontaneous Ventilation ◽  
Chest Drain ◽  
Arterial Line ◽  
Video Assisted ◽  
Subxiphoid Approach ◽  
Video Assisted Thoracoscopic Surgery

This case report describes two patients that underwent successful video-assisted thoracoscopic surgery (VATS) lung resections under spontaneous ventilation using the uniportal subxiphoid approach. The authors performed lung wedge resection in both patients under local anesthesia without using of a Foley catheter, arterial line, or intercostal chest drain. Only intravenous drugs and an oxygen mask with reservoir bag were used. The postsurgical course for both patients was uneventful. Both were discharged on postoperative day 2 and were doing well at 1- and 3-month follow-ups. Keywords: Subxiphoid approach; Pulmonary resection; Lung cancer

scholarly journals Is tubeless uniportal video-assisted thoracic surgery for pulmonary wedge resection a safe procedure?

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i70-i76 ◽  
Author(s):  
Chao-Yu Liu ◽  
Po-Kuei Hsu ◽  
Ka-I Leong ◽  
Chien-Kun Ting ◽  
Mei-Yung Tsou
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Chest Drain ◽  
Safe Procedure ◽  
X Rays ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Clinically Significant ◽  
Pulmonary Wedge Resection

Abstract OBJECTIVES Tubeless uniportal video-assisted thoracic surgery (VATS), using a uniportal approach and non-intubated anaesthesia while avoiding postoperative chest drain insertion, for patients undergoing thoracoscopic surgery has been demonstrated to be feasible in selected cases. However, to date, the safety of the procedure has not been studied. METHODS We reviewed consecutive patients undergoing non-intubated uniportal VATS for pulmonary wedge resection at 2 medical centres between August 2016 and October 2019. The decision to avoid chest drain insertion was made in selected candidates. For those candidates in whom a tubeless procedure was performed, postoperative chest X-rays (CXRs) were taken on the day of the surgery [operation (OP) day], on postoperative day 1 and 1–2 weeks later. The factors associated with abnormal CXR findings were studied. RESULTS Among 135 attempts to avoid chest drain insertion, 13 (9.6%) patients ultimately required a postoperative chest drain. Among 122 patients in which a tubeless procedure was performed, 26 (21.3%) and 47 (38.5%) had abnormal CXR findings on OP day and postoperative day 1, respectively. Among them, 3 (2.5%) patients developed clinically significant abnormal CXRs and required intercostal drainage. Primary spontaneous pneumothorax was independently associated with a higher risk of postoperative abnormal CXRs. CONCLUSIONS Tubeless uniportal VATS for pulmonary wedge resection can be safely performed in selected patients. Most patients with postoperative abnormal CXRs presented subclinical symptoms that spontaneously resolved; only 2.5% of patients with postoperative abnormal CXRs required drainage.

scholarly journals Thoracic Paravertebral Block with Adjuvant Dexmedetomidine in Video-Assisted Thoracoscopic Surgery: A Randomized, Double-Blind Study

2019 ◽  
Vol 8 (3) ◽  
pp. 352 ◽  
Author(s):  
Boohwi Hong ◽  
ChaeSeong Lim ◽  
Hyemin Kang ◽  
Hongsik Eom ◽  
Yeojung Kim ◽  
...  
Keyword(s):  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Paravertebral Block ◽  
P Value ◽  
Double Blind Study ◽  
Thoracic Paravertebral Block ◽  
Video Assisted ◽  
Fentanyl Consumption ◽  
Video Assisted Thoracoscopic Surgery

Background: The addition of the adjuvant dexmedetomidine to a nerve block improves the quality of the block and reduces perioperative opioid consumption. The aim of this study was to assess the effect of dexmedetomidine as an adjuvant for the thoracic paravertebral block (TPVB) in postoperative pain control after video-assisted thoracoscopic surgery (VATS). Methods: Sixty-six males, aged 15–40 years, with spontaneous pneumothorax scheduled for VATS wedge resection were enrolled. Following surgery, ultrasound-guided TPVB was performed on the T3 and T5 levels with 30 mL of 0.5% ropivacaine, plus adjuvant dexmedetomidine 50 μg or normal saline. The primary outcome was cumulative fentanyl consumption at 24 h. Pain severity, the requirement for additional rescue analgesics, hemodynamic variations, and side effects were also evaluated. Results: Median postoperative cumulative fentanyl consumption at 24 h was significantly lower in the dexmedetomidine group (122.6 (interquartile range (IQR) 94.5–268.0) μg vs. 348.1 (IQR, 192.8–459.2) μg, p-value = 0.001) with a Hodges–Lehman median difference between groups of 86.2 (95% confidence interval (CI), 4.2–156.4) mg. Coughing numeric rating scale (NRS) was lower in the dexmedetomidine group at postoperative 2, 4, 8, and 24 h. However, resting NRS differed significantly only after 4 h postoperative. Conclusions: Dexmedetomidine as an adjunct in TPVB provided effective pain relief and significantly reduced opioid requirement in VATS.

scholarly journals Fibrinolíticos no Tratamento de Derrames Pleurais Complicados

2016 ◽  
Vol 29 (11) ◽  
pp. 711 ◽  
Author(s):  
Ana Coelho ◽  
Margarida Coelho ◽  
Joana Pereira ◽  
Vasco Lavrador ◽  
Lurdes Morais ◽  
...  
Keyword(s):  
Failure Rate ◽  
Thoracoscopic Surgery ◽  
Therapeutic Option ◽  
Fibrinolytic Therapy ◽  
Chest Drain ◽  
Open Thoracotomy ◽  
Effective Treatment Option ◽  
Therapeutic Success ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Introduction: The treatment of complicated pleural parapneumonic effusions with intrapleural instillation of fibrinolytics, has shown similar results as surgical treatment. The present study aimed to evaluate the results of the use of intrapleural instillation of fibrinolytics in the treatment of complicated pleural parapneumonic effusions, in patients followed in our hospital.Material and Methods: A retrospective review of all the patients (aged between one month and 18 years) diagnosed with complicated parapneumonic effusions, which had chest drain insertion with intrapleural instillation of fibrinolytic, between January 2005 andDecember 2013, was undertaken.Results: A total of 37 patients were identified. Mean duration of hospital stay was 17 ± 7.60 days. Chest drain was placed in the first 48 h of hospital admission in most of the patients (89.2%), with a mean of six days of drainage. Treatment failure was reported in 2.7% of cases and was related with effusion recurrence. This patient underwent video-assisted thoracoscopic surgery with the need to convert to open thoracotomy. A favorable outcome was achieved in 96.9 % of cases.Discussion: In our review, therapeutic success rate was as expected, with a failure rate below those reported in literature. We present intrapleural instillation of fibrinolytics and video-assisted thoracoscopic surgery as part of the same protocol, in which fibrinolytic therapy is the first-line treatment.Conclusion: The therapeutic option presented shows a low failure rate and avoids a more aggressive surgical procedure. We consider this an effective treatment option, with low sequelae rate.

scholarly journals Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

2021 ◽  
Vol 7 ◽  
pp. 32-32
Author(s):  
Marco Mammana ◽  
Giovanni M. Comacchio ◽  
Alessandro Pangoni ◽  
Andrea Zuin ◽  
Samuele Nicotra ◽  
...  
Keyword(s):  
Case Report ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Right Thoracotomy ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

2021 ◽  
Vol 0 ◽  
pp. 0-0
Author(s):  
Marco Mammana ◽  
Giovanni M. Comacchio ◽  
Alessandro Pangoni ◽  
Andrea Zuin ◽  
Samuele Nicotra ◽  
...  
Keyword(s):  
Case Report ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Right Thoracotomy ◽  
Video Assisted Thoracoscopic Surgery
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