scholarly journals Video Assisted Thoracoscopic Surgery Ipisilateral Tran-Mediastianal Approach (Using Alzandi Technique) to Contralateral Lung in Patients with Bilateral Lung Lesions

2013 ◽  
Vol 03 (03) ◽  
pp. 80-83
Author(s):  
Hassan Alghamdi
Author(s):  
Haomin Cai ◽  
Dong Xie ◽  
Samer Al Sawalhi ◽  
Lei Jiang ◽  
Yuming Zhu ◽  
...  

Abstract OBJECTIVES Subxiphoid uniportal video-assisted thoracoscopic surgery (SUVATS) is a technically difficult and challenging operation that can help decrease pain around the incision after traditional intercostal uniportal video-assisted thoracoscopic surgery (IUVATS), and can also treat bilateral lesions through the same incision. We aimed to compare perioperative outcomes and pain scores after SUVATS and IUVATS in patients receiving synchronous treatment of bilateral lung lesions. METHODS Patients who received SUVATS and IUVATS bilateral lung resections from September 2014 to February 2018 were analysed. Ultimately a total of 381 cases were analysed after using one-to-one propensity score matching to match baseline characteristics between the 2 groups. RESULTS The 381 patients included 56 with SUVATS and 325 with IUVATS. After matching, 54 SUVATS and 54 IUVATS cases were analysed. The 2 groups had similar preoperative factors and did not differ with respect to duration of chest tube placement, length of stay in hospital and incidence of postoperative complications. SUVATS was associated with a significantly longer operative time (212.3 vs 154.6 min, P < 0.001) and more blood loss (190.9 vs 72.7 ml, P < 0.001), lower pain score on the first day after operation (2.6 vs 3.0, P = 0.03) and before discharge (0.8 vs 1.4, P < 0.001). Furthermore, less patients in group SUVATS requested for additional analgesic therapy (P = 0.03). CONCLUSIONS Compared with IUVATS, despite the longer operative time and greater blood loss, SUVATS for bilateral lung lesions is a safe surgical procedure associated with significantly less postoperative pain and a similar incidence of postoperative complications in selected patients.


2020 ◽  
Vol 93 (1109) ◽  
pp. 20190938 ◽  
Author(s):  
Allen Li ◽  
S Chan ◽  
KH Thung

Objective: To describe our clinical experience of using combination of fluorescent iodized emulsion, indocyanine green & lipiodol, and hook-wire in pre-operative CT localization of patients with subsolid lung lesions prior to video-assisted thoracoscopic surgery (VATS). Methods: A retrospective review between June 2018 and July 2019 of consecutive Chinese patients whom underwent VATS for subsolid lung lesions with pre-operative CT localization done with combination of fluorescent iodized emulsion and hook-wire technique in a tertiary hospital (Tuen Mun Hospital, Hong Kong SAR). The duration and complications related to the localization procedure were recorded The clinical records, operative findings and pathology reports were retrieved from the hospital electronic clinical management system. Results: Combination fluorescent iodized emulsion with hook-wire enabled accurate localization and resection of all subsolid lung lesions in VATS. No major complications were reported. Conclusion: Combination of fluorescent iodized emulsion and hook-wire placement under CT guidance is a simple, safe and cost- effective procedure that enabled accurate localization and resection of subsolid nodule in VATS. Advances in knowledge: VATS has been the mainstay for indeterminate pulmonary nodules for diagnostic and/or curative purpose. The main problem that surgeons may encounter during operation is the difficulty in locating the target lesion particularly for subsolid lesions. Many pre-operative localization methods have been developed in this regard. With the novel technique that we described, we were able to overcome disadvantages of most described methods.


2020 ◽  
Author(s):  
Chu-Chun Liang ◽  
Chi-Hao Liao ◽  
Ya-Fu Cheng ◽  
Wei-Heng Hung ◽  
Heng-Chung Chen ◽  
...  

Abstract Background We demonstrated the safety and feasibility of image-guided video-assisted thoracoscopic surgery (iVATS) of bilateral lung lesions in a hybrid operating room. Methods This study was a retrospective analysis of a case series. A total of 7 patients with 15 small lung nodules underwent bilateral iVATS between July 2018 and May 2019. All procedures were completed within a single anesthesia procedure and performed in a hybrid operating room that had a cone-beam computed tomography (CT) apparatus equipped with a laser navigation system. The lesion characteristics, operation methods, and peri-operative clinical outcomes were summarized. Results A total of 7 patients with 15 resected lung nodules were analyzed. The most common pathological result of our bilateral iVATS was metastasis. The median length of hospital stay was 5 days (range from 3 to 10 days). The median right chest tube duration was 2 days (range from 1 to 8 days), and the median left chest tube duration was 3 days (range from 2 to 5 days). Only one patient had a complication during his hospitalization period. There was no surgery-related mortality observed. Conclusions The bilateral iVATS procedure seems to be a feasible, safe and cost-effective approach for successful resection of bilateral lung lesions.


2016 ◽  
Vol 31 (8) ◽  
pp. 3353-3362 ◽  
Author(s):  
Yojiro Yutaka ◽  
Toshihiko Sato ◽  
Jitian Zhang ◽  
Koichi Matsushita ◽  
Hiroyuki Aiba ◽  
...  

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Chu-Chun Liang ◽  
Chi-Hao Liao ◽  
Ya-Fu Cheng ◽  
Wei-Heng Hung ◽  
Heng-Chung Chen ◽  
...  

2021 ◽  
pp. 20210017
Author(s):  
Evangelos Skondras ◽  
Mohamed Basiony ◽  
Vladimir Anikin

Video-assisted thoracoscopic surgery (VATS) has been increasingly used to resect lung nodules avoiding thoracotomy thus reducing morbidity and hospitalization time. One of the main challenges is to localise the target, because very often they are not palpable and small. Various nodule localization techniques have been used to assist VATS resection including metallic marker implantation adjacent to the lesion of interest. These markers have been known to migrate, more often in the pleural space. We report an unusual case of metallic marker migration in the contralateral lung.


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