Video-assisted thoracoscopic surgery for the treatment of primary pneumothorax: talc pleurodesis or pleural abrasion? Retrospective multicentre study

2011 ◽  
Vol 1 (1) ◽  
pp. 9 ◽  
Author(s):  
Jon Zabaleta ◽  
Borja Aguinagalde ◽  
Carlos Alvarez ◽  
Marta G. Fuentes ◽  
Nerea Bazterargui ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Nonparametric Tests ◽  
Postoperative Hospital Stay ◽  
Talc Pleurodesis ◽  
Video Assisted ◽  
Pleural Abrasion ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

In the treatment of primary spontaneous pneumothorax (PSP) the latest guidelines recommend video-assisted thoracoscopy, but do not specify the best technique for performing pleurodesis. Indeed, there are no clinical trials comparing the effectiveness of talc pleurodesis, mechanical pleurodesis and pleurectomy. Our objective was to compare outcomes in patients who underwent surgery for primary pneumothorax with the talc procedure or with pleural abrasion using dry gauze. Patients undergoing video-assisted thoracoscopic surgery for PSP in two hospitals were retrospectively recruited between 2007 and 2008, and followed-up until December 2010. The variables measured to compare the outcomes were: recurrence, complications, and mortality, as well as the duration of air leaks and of drainage and the length of postoperative hospital stay (in days). Statistical analysis: The two groups were compared using the Chi square test for qualitative variables and nonparametric tests for continuous variables. A total of 106 interventions were carried out in 104 patients (74 in group A: pleural abrasion with dry gauze; 32 in group B: chemical pleurodesis with talc), with a mean age of 28 years (median 25) and 85.6% were male. Complications were observed in nine patients (8.5%) and there were no deaths in the 30 days after surgery; there were, however, four cases of recurrence (3.8%). The mean air leak duration was 0.78 days (median 0), the mean drainage duration 1.95 days (median 1) and the mean length of postoperative hospital stay 2.68 days (median 2). In 74 cases (69.8%), mechanical pleurodesis was performed, while 32 cases were treated with talc (30.2%). Comparing the two groups, we did not find statistically significant differences in recurrence (4.1% vs 3.1%, P=0.82), complications (6.8% vs 12.5%, P=0.45) or mortality (no cases of death). On the other hand, the mean postoperative hospital stay was lower in the mechanical pleurodesis group than in the talc group (2.2 vs 3.8 days, P=0.005). Video-assisted surgery in the treatment of PSP is a safe technique. In the mechanical pleurodesis group, we observed the same rate of recurrence, half the number of complications and a shorter hospital stay. We consider it necessary that well-designed multicentre clinical trials be carried out to compare these techniques and determine which produces the best outcomes, providing stronger scientific evidence given that the data available to date are not conclusive.

scholarly journals Video assisted thoracoscopic surgery in the management of acute fibrinopurulent empyema in paediatric patients

2020 ◽  
Vol 7 (6) ◽  
pp. 1847
Author(s):  
Arti S. Mitra ◽  
Nilesh G. Nagdeve ◽  
Simran R. Khatri ◽  
Unmed A. Chandak
Keyword(s):  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Bronchopleural Fistula ◽  
Tertiary Care ◽  
Pleural Empyema ◽  
Care Hospital ◽  
Age Group ◽  
Video Assisted ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background: Empyema is the presence of pus in the pleural space that usually follows an episode of pneumonia in pediatric age group. The aim of this study was to assess the efficacy of management of acute fibrinopurulent stage of empyema by early video assisted thoracoscopic surgery (VATS) in paediatric patients.Methods: The study was carried out at a tertiary care hospital in India. It was a prospective interventional observational study. The study included 40 children between age group 0-12 years attending the surgery in-patient department referred for further management of parapneumonic effusions who had clinical and radiological evidence of empyema and thoracocentesis confirmed purulent exudate in pleural cavity, were subjected to early VATS after thorough pre-operative workup.Results: The mean age was 7.22 years. Average operative time was 135.5 minutes. The mean duration of hospital stay was 7.5 days. Few complications were bleeding, superficial wound infection, bronchopleural fistula, pneumothorax, recurrence of empyema and incomplete expansion of lung.Conclusions: VATS facilitates the management of fibrinopurulent and organised pyogenic pleural empyema with less post-operative discomfort and complications and reduced hospital stay. However larger sample size study is required to come to a definitive conclusion.

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 Uniportal video-assisted thoracoscopic carinal resections: technical aspects and outcomes

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i58-i64
Author(s):  
Dmitrii Sekhniaidze ◽  
Diego Gonzalez-Rivas ◽  
Pavel Kononets ◽  
Alejandro Garcia ◽  
Vladimir Shneider ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Thoracoscopic Surgery ◽  
Morbidity Rate ◽  
Surgical Time ◽  
Technical Aspects ◽  
Video Assisted ◽  
The Mean ◽  
Clinic Hospital ◽  
Blood Loss Volume ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES Important benefits in uniportal video-assisted thoracoscopic surgery (VATS) for lung cancer have recently been achieved. However, the use of this technique for complex sleeve procedures is limited. We describe the technical aspects of and patient outcomes following carinal resections using uniportal VATS. METHODS Since 2015, 16 sleeve carinal resections, including 11 right pneumonectomies, 4 right upper lobectomies and 1 lung-sparing carinal resection, have been performed at the Regional Clinic Hospital, Tyumen, Russia. RESULTS The mean surgical time was 215.9 ± 67.2 min (range 125–340 min). The mean blood loss volume was 256.3 ± 284.5 ml (range 50–1200 ml). There was 1 case of conversion to thoracotomy. The morbidity rate was 25%, and the mortality rate was 0%. The median overall survival was 38.6 ± 3.5 months. CONCLUSIONS The use of uniportal VATS for carinal resections in certain patients allows for radical resections with low rates of morbidity and mortality.

A Video-Assisted Thoracoscopic Approach to Transaxillary First Rib Resection

2015 ◽  
Vol 10 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Harmik J. Soukiasian ◽  
Daniel Shouhed ◽  
Derek Serna-Gallgos ◽  
Robert McKenna ◽  
Vahak J. Bairamian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Thoracoscopic Surgery ◽  
Invasive Approach ◽  
Thoracoscopic Approach ◽  
Rib Resection ◽  
Video Assisted ◽  
First Rib ◽  
The Mean ◽  
First Rib Resection ◽  
Video Assisted Thoracoscopic Surgery

Objective Thoracic outlet syndrome (TOS) can be associated with neurologic, arterial, or venous deficiencies. When nonsurgical treatment has failed to adequately palliate TOS, surgical intervention is indicated. The supraclavicular and transaxillary approaches are currently the most commonly used approaches for first rib resection, yet little has been reported to date on outcomes of minimally invasive procedures, such as video-assisted thoracoscopic surgery (VATS). The purpose of this article was to describe a minimally invasive approach to TOS and the associated outcomes. Methods This study is a retrospective analysis of a prospectively maintained database. Patients who failed nonsurgical therapy for TOS were referred to our practice for evaluation of surgery with a VATS minimally invasive first rib resection. Between 2001 and 2010, 66 VATS procedures were performed on 58 patients (41 women, 17 men). Patients were followed postoperatively for a mean time of 13.5 months. Results Forty-one patients were women (70.7%), and the mean age was 40.5 years, with a patient age range of 17 to 59 years. The mean length of hospital stay was 2.47 days; median length of stay was 2 days. There were a total of eight complications (12.1%). There were no mortalities. Conclusions Video-assisted thoracoscopic surgery first rib resection for TOS is another feasible option for TOS, which can be added to the armamentarium of the thoracic surgeon. The outcomes associated with our technique are comparable with the outcomes related to other current standards of care.

scholarly journals Study of diagnostic and therapeutic utility of video assisted thoracoscopic surgery

2018 ◽  
Vol 5 (8) ◽  
pp. 2751
Author(s):  
Nilesh P. Mangam ◽  
Aashish R. Chavan ◽  
Ritesh Bodade ◽  
Asmita Dhurve
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Postoperative Bleeding ◽  
Intraoperative Complication ◽  
Video Assisted ◽  
Significant Difference ◽  
Prolonged Air Leak ◽  
Video Assisted Thoracoscopic Surgery ◽  
Therapeutic Utility

Background: Video-assisted thoracoscopic surgery (VATS) is rapidly becoming a popular method for diagnostic and therapeutic purposes. Many diseases of the chest can now be diagnosed by VATS due to ease of look and biopsy. Hence the present study was undertaken to determine diagnostic and therapeutic utility of VATS in different chest pathologies.Methods: In this prospective study, total 36 patients of different age group were subjected to VATS procedure, to measured operative time, intra and post- operative complications, post-operative pain and hospital stay. Then patient was followed up at 15 days, at 1 month, 3 month and at 6 months.Results: VATS was successfully carried out in 28 patients as the only procedure whereas 8 patients required conversion to thoracotomy. Average operative time for patients operated by VATS only was 94.9 minute and for patients operated by VATS converted to thoracotomy was 175.5 minute. Most common intraoperative complication was bleeding (16.66 %) followed by anaphylactic shock observed in only one patient. Most common postoperative complication was prolonged air leak (5.55%) followed by port site infection (2.77%) and postoperative bleeding (2.77%). At 24 hours postoperatively, average pain score observed in VATS group was 3.73 and in thoracotomy group was 6.28. The mean postoperative hospital stay for patients operated by VATS was 7.28 days and for patients operated by VATS converted to thoracotomy was 10.36 days. There was significant difference observed in diagnosis of various chest pathologies by radiological investigations and VATS.Conclusions: VATS should be offered as the first approach to various chest pathologies requiring surgical intervention and preferred over thoracotomy when feasible. 

Video-assisted thoracoscopic thymectomy for thymoma: a single-center experience

2018 ◽  
Vol 26 (3) ◽  
pp. 207-211 ◽  
Author(s):  
Giang Truong Nguyen ◽  
Trung Ngoc Nguyen ◽  
Nam Van Nguyen ◽  
Kien Trung Nguyen ◽  
Anh Viet Le
Keyword(s):  
Myasthenia Gravis ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Military Hospital ◽  
Video Assisted ◽  
Single Center Experience ◽  
Early Results ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background Thymoma is a primary tumor derived from the epithelial cells of the thymus, which is commonly seen in the mediastinum. Surgical thymectomy is the radical treatment for thymoma. The recent introduction of video-assisted thoracoscopic surgery has improved the quality of thymectomy surgery. The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. The objectives of this study were to investigate the clinical and laboratory characteristics of thymoma and to evaluate the early results of video-assisted thoracoscopic thymectomy for thymoma in Vietnamese patients. Methods All 53 thymoma patients with or without myasthenia gravis who underwent video-assisted thoracoscopic thymectomy in Military Hospital 103, Vietnam, from October 2013 to July 2017 were included. Results The mean age was 46.5 7.1 years, and the female/male ratio was 1.2:1. Myasthenia gravis, mostly stage IIA, was present in 84.9% of patients. There was no hospital mortality or major postoperative complication. The mean operative time was 65 min, intensive care unit stay was 22 ± 5 h, and postoperative hospital stay was 7.5 ± 1.7 days. Conclusion Thoracoscopic thymectomy for thymoma in Vietnamese patients achieved improved cosmesis and was safe for both non-myasthenia gravis and myasthenia gravis patients.

scholarly journals Can Awake Thoracoscopy Procedure be Performed with the Help of Thoracic Paravertebral Anesthesia?

2018 ◽  
Vol 17 (4) ◽  
pp. 576-582
Author(s):  
Fazli Yanik ◽  
Yekta Altemur Karamustafaoglu ◽  
Elif Copuruoglu ◽  
Gonul Sagiroglu
Keyword(s):  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Medical Science ◽  
Oral Intake ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Early Mobilization ◽  
Talc Pleurodesis ◽  
The Mean

Aim:The aim of this study was to present our experience with 11 patients who were spontaneously breathing with Awake Video Thoracoscopy (AVATS) procedure with the help of TPB because of rareness in the literature.Materials and Methods: Between December 2015 and December 2017, a total of 125 VATS cases were performed; 11 cases underwent VATS operation with the help of TPB; age, gender, operation performed, duration of operation, time of onset of mobilization-oral intake, duration of hospital stay, Visual Analogue Scale (VAS) scores were evaluated retrospectively.Results: All cases were treated with uniportal AVATS procedure with the help of TPB. The mean age was 40,3 ± 17,4 years (range 18-64 years ), nine (82%) of the pateints were male and two (18%) were female. Operation procedures included wedge resection in eight (73 %) patients (six of them for pneumothorax, two of them for diagnosis), in three (27%) patients pleural biopsy (one of them used talc pleurodesis).There were no perioperative events. The mean operation time was 27,7 ± 6,4 minutes (range, 20-40 min) and the mean anesthesia time was 25 ± 3,8 minutes (range 20-30 min).The mean time of mobilizitation, oral intake opening time and length of hospital stay was 1,1 ± 0,4 hours (1-2 hours), 3,5 ± 0,5 hours (3-4 hours), 2,6 ± 0,5 days (2-3 days), respectively.Conclusion:Awake Video Asssited Thoracoscopic Surgery with the help of TPB has less side effects and less complication risks than other awake procedures with the help of other regional anesthesia techniques. We conclude that; although AVATS with the help of TPB has some minor complications, it has advantages such as early discharge, early mobilization and early oral intake, low pain levels in well-selected patient groups.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.576-582

Video-assisted thoracoscopic surgery with talc pleurodesis in the management of symptomatic hepatic hydrothorax

2002 ◽  
Vol 97 (12) ◽  
pp. 3172-3175 ◽  
Author(s):  
Dino Ferrante ◽  
Miguel R. Arguedas ◽  
Robert J. Cerfolio ◽  
Barry G. Collins ◽  
Dirk J. Leeuwen
Keyword(s):  
Thoracoscopic Surgery ◽  
Hepatic Hydrothorax ◽  
Talc Pleurodesis ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Feasibility Investigation of Ipsilateral Reoperations by Thoracoscopy for Major Lung Resection

2019 ◽  
Vol 68 (03) ◽  
pp. 241-245 ◽  
Author(s):  
Weiyan Sun ◽  
Lei Zhang ◽  
Zeyao Li ◽  
Donglai Chen ◽  
Gening Jiang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Intraoperative Blood Loss ◽  
Drainage Time ◽  
The Mean ◽  
Room Time ◽  
Video Assisted Thoracoscopic Surgery ◽  
Operating Room Time

Abstract Background Video-assisted thoracoscopic surgery (VATS) has become the preferred approach for minimizing harm from thoracic operations. There is no report, however, which has discussed the feasibility of VATS in ipsilateral reoperation of major lung resection. Methods The present study included patients who had undergone ipsilateral reoperation of major lung resection by VATS from October 2009 to May 2017. Referring clinical data were recruited for analysis. Results Fourteen patients were recruited in the present study, including nine patients who underwent lobectomy and five who underwent segmentectomy during the second operation. Different hila were found in 6 patients, and pleural adhesions appeared in 10 patients. The average intraoperative blood loss was 203.6 ± 121.7 mL, and the mean operating room time was 2.2 ± 0.5 hours. There were no intraoperative deaths, and only one patient required conversion to thoracotomy. The average drainage time was 5.9 ± 4.6, and the mean hospital stay was 6.7 ± 4.2 days. Conclusion Though it is technically demanding to safely handle the changed hilum structure caused by the last operation, major lung resection by VATS is feasible for ipsilateral reoperation in appropriate candidates.

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