scholarly journals Large epiphrenic diverticula: a rare case presentation

2015 ◽  
Vol 5 (4) ◽  
Author(s):  
Ajay H. Bhandarwar ◽  
Pravin N. Tungenwar ◽  
Yogesh M. Sawakare ◽  
Amol Nanasaheb Wagh ◽  
Chintan Babubhai Patel ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Esophageal Leak ◽  
Case Presentation ◽  
Hypertensive Lower Esophageal Sphincter ◽  
Wide Mouth ◽  
Epiphrenic Diverticula ◽  
Esophageal Sphincter ◽  
One Year ◽  
Tomography Scan ◽  
Video Assisted Thoracoscopic Surgery

A 70-year old female was admitted to hospital with heartburn and chronic halitosis since 5 years. She was on proton pump inhibitors for the same. Her complaints worsened during the last one-year. Workup comprising of esophagogastro- duodenoscopy, esophageal manometry, 3D computed tomography scan showed rightsided epiphrenic diverticula measuring 10x10 cm with wide mouth about 5 cm with hypertensive lower esophageal sphincter. Patient underwent a video assisted thoracoscopic surgery for esophageal diverticulectomy using two 45 mm staplers. On day 5, the patient developed leak, which was managed by a covered esophageal stent placement. Patient started on oral feeds from day 3 and the esophageal leak healed completely within 2 weeks. Literature suggests that esophageal leaks treated conservatively took approximately 30-40 days on an average for healing. Literature search did not reveal esophageal leak managed by stent with faster recovery (2 weeks). This is one of the largest epiphrenic diverticuli reported in literature.

scholarly journals Unexpected difficult extubation of double lumen bronchial intubation: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xingcai Zhang ◽  
Shumiao Tang ◽  
Zihui Lu ◽  
Yijun Chen
Keyword(s):  
Thoracoscopic Surgery ◽  
Practical Significance ◽  
Post Anesthesia Care Unit ◽  
General Anesthetic ◽  
Double Lumen ◽  
Case Presentation ◽  
Respiratory Physician ◽  
Surgical Sutures ◽  
Bronchial Intubation ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background The anesthetist and other members of the perioperative team need to be extremely cautious for successful completion of any surgery. If the final step of any general anesthetic-extubation is not sufficiently well planned, it can lead to critical airway incidents during the extubation and hinder transportation of the patient to the post-anesthesia care unit. Case presentation A 48-year-old female underwent video-assisted thoracoscopic surgery (VATS) combined with left lower lobectomy. The distal end of the left branch of the tracheal tube was lodged by surgical sutures. In this case, the respiratory physician burned the sutures using an argon electrode, after discussion with the thoracic surgery experts. Conclusions Teamwork is essential when caring for a patient with a shared airway. The anesthetist and surgeon must communicate well with each other to achieve optimal surgical outcomes. Importantly, testing the patency of the ETT prior to extubation should be a regular procedure, which is practical significance to guide safe extubation.

scholarly journals Development of cavitary lung disease as a long-term complication of coronavirus disease 2019 in a young previously healthy patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Goar Egoryan ◽  
Elise Hyser ◽  
Ammar H. Mushtaq ◽  
Maria Adriana Yanez-Bello ◽  
Daniela Patricia Trelles-Garcia ◽  
...  
Keyword(s):  
Lung Disease ◽  
Acute Inflammation ◽  
Thoracoscopic Surgery ◽  
Late Complication ◽  
Left Lung ◽  
Lung Lesion ◽  
Pleuritic Chest Pain ◽  
Case Presentation ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Cavities are frequent manifestations of a wide variety of pathological processes involving the lung. There has been a growing body of evidence of coronavirus disease 2019 leading to a cavitary pulmonary disease. Case presentation A healthy 29-year-old Filipino male presented to the hospital a couple of months after convalescence from coronavirus disease 2019 with severe pleuritic chest pain, fever, chills, and shortness of breath, and was found to have a cavitary lung lesion on chest computed tomography. While conservative management alone failed to improve the patient’s condition, he ultimately underwent left lung video-assisted thoracoscopic surgery decortication. Even though the surgical pathology revealed only necrosis with dense acute inflammation and granulation tissue with no microorganisms, he gradually improved with medical therapy adjunct with surgical therapy. Conclusion Documented cases of cavitary lung disease secondary to coronavirus disease 2019 have been mostly reported in the acute or subacute phase of the infection. However, clinicians should recognize this entity as a late complication of coronavirus disease 2019, even in previously healthy individuals.

scholarly journals Thoracoscopic Resection of Bilateral Multiple Superior Mediastinal Neurofibromas

2020 ◽  
Author(s):  
Yoko Azuma ◽  
Naobumi Tochigi ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Satoshi Koezuka ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Thoracoscopic Resection ◽  
Case Presentation ◽  
Postoperative Course ◽  
Superior Mediastinum ◽  
Chest Cavity ◽  
Video Assisted ◽  
First Case ◽  
Video Assisted Thoracoscopic Surgery ◽  
Multiple Nodules

Abstract Background: The indications for surgical resection concerning multiple bilateral neurofibromas in the superior mediastinum remain controversial, because vascular injury or development of postoperative Horne syndrome are concerned.Case presentation: A 60-year-old woman presented with multiple nodules in her right neck and bilateral chest cavity tops which indicated neurofibromatosis. The thoracic masses grew slowly over 9 years, and she then underwent a 2-stage resection starting with the left to right side. Bilateral tumors were completely removed via video-assisted thoracic surgery. The patient’s postoperative course was uneventful, without postoperative Horner syndrome. Conclusions: To the best of our knowledge, this is the first case of multiple bilateral superior mediastinal neurofibromas resected from the pulmonary apices via thoracoscopy. We selected a minimally invasive pure video-assisted thoracoscopic surgery approach and enucleated some tumors to avoid nerve injury. This approach may be safe and useful for multiple neurofibromas in patients with neurofibromatosis.

scholarly journals Declarations: management of a pulmonary arteriovenous fistulae by uniportal video‐assisted thoracoscopic surgery: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. Li ◽  
Y. Zhou ◽  
S. Kang ◽  
F. Kong ◽  
L. Guan ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Rare Case ◽  
Thoracoscopic Surgery ◽  
Rare Condition ◽  
Preoperative Assessment ◽  
Ct Reconstruction ◽  
Case Presentation ◽  
Lower Lobectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background A pulmonary arteriovenous fistula (PAVF) is a rare condition that is associated with pulmonary arteriovenous malformation (PAVM). Few reports have described managing PAVMs using uniportal video-assisted thoracoscopic surgery (VATS). Case presentation A 13-year-old child with PAVF in the left inferior pulmonary artery was treated by uniportal VATS with left lower lobectomy. After surgery, hemoptysis did not recur and there were no postoperative complications. Six months after the operation, postoperative review of computerized tomography showed no recrudescence of PAVF. Conclusions PAVF is a rare case that should be diagnosed and treated early. 3D- computerized tomography (CT) reconstruction is useful for diagnosis and preoperative assessment. The case shows that PAVF can be managed with uniportal VATS.

scholarly journals Thoracoscopic resection of bilateral multiple superior mediastinal neurofibromas

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yoko Azuma ◽  
Naobumi Tochigi ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Akira Iyoda
Keyword(s):  
Thoracoscopic Surgery ◽  
Thoracoscopic Resection ◽  
Case Presentation ◽  
Postoperative Course ◽  
Superior Mediastinum ◽  
Chest Cavity ◽  
Video Assisted ◽  
First Case ◽  
Video Assisted Thoracoscopic Surgery ◽  
Multiple Nodules

Abstract Background The indications for surgical resection concerning multiple bilateral neurofibromas in the superior mediastinum remain controversial, because vascular injury or development of postoperative Horne syndrome are concerned. Case presentation A 60-year-old woman presented with multiple nodules in her right neck and bilateral chest cavity tops which indicated neurofibromatosis. The thoracic masses grew slowly over 9 years, and she then underwent a 2-stage resection starting with the left to right side. Bilateral tumors were completely removed via video-assisted thoracic surgery. The patient’s postoperative course was uneventful, without postoperative Horner syndrome. Conclusions To the best of our knowledge, this is the first case of multiple bilateral superior mediastinal neurofibromas resected from the pulmonary apices via thoracoscopy. We selected a minimally invasive pure video-assisted thoracoscopic surgery approach and enucleated some tumors to avoid nerve injury. This approach may be safe and useful for multiple neurofibromas in patients with neurofibromatosis.

Myasthenia gravis miatt végzett három különböző típusú csecsemőmirigy-eltávolítás sebészeti és korai neurológiai eredményei

2015 ◽  
Vol 68 (6) ◽  
pp. 219-224
Author(s):  
Aurél Ottlakán ◽  
Tibor Géczi ◽  
Balázs Pécsy ◽  
Bernadett Borda ◽  
Judit Lantos ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Thoracoscopic Surgery ◽  
Extended Thymectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Absztrakt Célkitűzés: A myasthenia gravis (MG) kezelésében számos nyitott, illetve minimálisan invazív thymectomia ismert. A tanulmány ugyanazon intézeten belül a transsternalis (TS), illetve kétféle minimálisan invazív thymectomia (video-assisted thoracoscopic extended thymectomy – VATET; unilateral video-assisted thoracoscopic surgery – UL-VATS) eredményeit hasonlítja össze. Anyag és módszerek: Három különböző időintervallumban 71 betegnél történt thymectomia MG miatt (60 nő, 11 férfi): 23 transsternalis thymectomia (1995. január–2004. szeptember), 22 VATET (2004. szeptember – 2009. augusztus) és 26 UL-VATS thymectomia (2009. szeptember – 2011. december). Az eredmények értékelésénél a műtéti idő, MG-hez társuló neurológiai és a műtét utáni sebészi szövődmények, valamint az MG státuszában az egyéves utánkövetéskor észlelt neurológiai változások szerepeltek. Eredmények: Perioperatív mortalitás nem fordult elő. A műtéti idő 112, 211, 116 perc (p = 0,001), a kórházi napok száma: 8,9, 5,6 és 4 nap (p = 0,001) volt a TS-, VATET- és UL-VATS-csoportban. Az MG-hez kapcsolódó postoperativ neurológiai szövődmények 21,7%, 18,2% és 7,7% (p = 0,365) értékeket mutattak. A sebészi szövődmény 4,3%, 13,7%, 0% (p = 0,118) volt. Az MG tüneteinek javulása 91,3%, 94,7%, 87,5% (p = 0,712), míg komplett remisszió 13%, 10,5%, 11,5% (p = 0,917) volt a TS-, VATET- és UL-VATS-csoportokban. Következtetések: A műtéti idő, valamint a kórházban eltöltött napok száma UL-VATS esetében volt a legrövidebb. A kisebb sebészi beavatkozáshoz alacsonyabb sebészi, illetve MG-s neurológiai szövődmények társultak. Az MG-tünetek javulásában mindhárom módszernél kiváló eredményt értek el.

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.

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