scholarly journals Initial result of uniportal non-intubated thoracoscopic surgery to manage the thoracic diseases at Vietduc University Hospital

2019 ◽  
Vol 9 (4) ◽  
Author(s):  
Lu Pham Huu ◽  
Keyword(s):  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Initial Result ◽  
University Hospital ◽  
Drainage Time ◽  
Thoracic Diseases ◽  
Average Operative Time ◽  
Initial Results

Abstract Introduction: The study aimed to evaluate the initial results of uniportal non-intubated thoracoscopic surgery for treatment of thoracic diseases at the VietDuc University Hospital. Material and Methods:A descriptive study of 17 patients with intrathoracic diseases were treated with uniportal non-intubated thoracoscopic surgery from 02/2019 to 07/2019. The data of pre-peri and post – operative were recorded. Results: There were 04 men and 13 women, mean age was 49,2 ± 20,5 (06 – 71). The average BMI: 21,48 ± 2,14 kg/ m2(15,39 – 23,93). Surgical techniques: GGO (Wedge resection): 03 (17,6%); Bullous lung disease (Wedge resection): 01 (5,9%); Mediastinal tumor (resection): 08 (47,1%); NSLC (lobectomy + dissection node): 05 (29,4%). The average operative time: 108,6 ± 28,17 minutes (60 – 160). The average drainage time was 3,7 ± 1,18 days (2 – 8). The average hospitalization time was 4,9 ± 1,76 days (3 – 12). No mortality and major complications after operation was recorded. Conclusion: Treatment of thoracic diseases with uniportal non-intubated thoracoscopic surgery is a safe, feasible, and well-tolerated .

Nonintubated Uniportal Video-Assisted Thoracoscopic Surgery for Intrathoracic Diseases: Initial Results in Vietnam

2020 ◽  
pp. 155698452096974
Author(s):  
Lu Huu Pham ◽  
Diep Ke Trinh ◽  
Ha Thi-Ngoc Doan ◽  
Uoc Huu Nguyen ◽  
Quynh Danh Do
Keyword(s):  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Ground Glass Opacity ◽  
Mediastinal Tumors ◽  
Lung Cancers ◽  
Video Assisted ◽  
Drainage Time ◽  
Operative Indications ◽  
Initial Results ◽  
Video Assisted Thoracoscopic Surgery

Objective Nonintubated uniportal video-assisted thoracoscopic surgery (VATS) is a recent controversial procedure in many countries. Hence, the authors would like to present the experience in performing this approach and evaluate its initial results in the treatment, particularly, of intrathoracic diseases in Vietnam. Methods A prospective, descriptive study was conducted on 17 patients with intrathoracic diseases treated with nonintubated uniportal VATS from February to July 2019. Preoperative, intraoperative, and postoperative parameters were gathered and analyzed by SPSS Statistics, Version 18.0. Results Patients had an average age of 49.2 ± 20.5 (range 6 to 71) years. Regarding operative indications and methods, there were 3 ground glass opacity (17.6%) and 1 bullous lung disease receiving wedge resection (5.9%); 8 mediastinal tumors (47.1%) having resection, and 5 non-small-cell lung cancers receiving lobectomy combined with node dissection (29.4%). The average operative time and pleural drainage time were 108.6 ± 28.17 min (range 60 to 160) and 3.7 ± 1.18 days (range 2 to 8), respectively. The average hospitalization time was 4.9 ± 1.76 (range 3 to 12) days. No mortalities or major complications were recorded postoperatively. Conclusions Nonintubated uniportal VATS is a safe and considerable surgical choice for appropriate intrathoracic conditions.

scholarly journals Robot - assisted thoracic surgery using conventional thoracoscopic surgery access

2019 ◽  
Vol 9 (3) ◽  
Author(s):  
Hữu Vinh Vũ ◽  
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Tumor Resection ◽  
Transition Process ◽  
Lateral Position ◽  
Subxiphoid Approach ◽  
Trocar Placement ◽  
Tube Removal

Abstract Introduction: Video-assisted thoracic surgery (VATS) has been widely used and confirmed to be effective and less invasive compared to traditional open surgery. Robotic-assisted thoracic surgery (RATS ) is actually a VATS using a robot controlled by human surgeon. RATS has been applied worldwide, however still less in Vietnam. We have been starting RATS since July 2018, using conventional thoracoscopic access (trocars). Aim of our paper is to report our initial results after 18 months implementing. Material and Methods: Retrospectively review 116 cases of RATS from July 2018 to January 2020. Trocar were placed according to type of operations: for lobectomy and pathologies of posterior and middle at lateral position with 4 ports, for thymectomy without tumor or with small tumor at lateral position at a 45 degree angle with 4 ports at one chest side or bilateral at subxiphoid approach with 4 ports. Trocars placed follow the endoscopic triangle principle similar to those for VATS Results: Among of 116 cases were : 57 cases of lobectomy, 9 cases of wedge resection, thymectomy - 19 cases, mediastinal tumor resection - 28 cases, esophagectomy - 1 case, esophageal leiomyoma resection - 1 case, and diaphragmatic plication - 1 case. Good outcomes are 110 cases, no complications, 5 cases with prolong air leak requiring chest tube for over 5 days. One death after 35 days due to pneumonia. The surgery time is similar to VATS. Average chest tube removal was 2 days. Post-operative length stay was equivalent to VATS. Conclusion: RATS is safe with good results in our series. The transition process from VATS to RATS is safe in the medical facilities with surgeons who have good background in VATS. The conventional trocar placement is suitable for RATSs application. Keywords: VATS, RATS

Recurrence Rate of Lumbar Disc Herniation After Standard Discectomy and Microdiscectomy: A 5-Year Study

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev
Keyword(s):  
Recurrence Rate ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Reoperation Rate ◽  
University Hospital ◽  
Recurrence Rates ◽  
Chi Square ◽  
Common Procedure

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.

scholarly journals Procedural times in early non-intubated VATS program - a propensity score analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabella Metelmann ◽  
Johannes Broschewitz ◽  
Uta-Carolin Pietsch ◽  
Gerald Huschak ◽  
Uwe Eichfeld ◽  
...  
Keyword(s):  
Propensity Score ◽  
Surgical Procedure ◽  
Recovery Time ◽  
Propensity Score Analysis ◽  
Wedge Resection ◽  
University Hospital ◽  
Implementation Phase ◽  
Score Analysis ◽  
Significant Difference ◽  
Procedural Time

Abstract Background Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. Methods This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Results Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Conclusions Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

Reconstruction of the Mandibular Condyle

2021 ◽  
Author(s):  
Spencer R. Anderson ◽  
Kaitlynne Y. Pak ◽  
Aurora G. Vincent ◽  
Adrian Ong ◽  
Yadranko Ducic
Keyword(s):  
Gold Standard ◽  
Traumatic Injury ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Mandibular Condyle ◽  
Facial Aesthetics ◽  
Mandibular Growth ◽  
Alloplastic Materials ◽  
Technological Advances ◽  
Integral Structure

AbstractThe mandibular condyle is an integral structure in the temporomandibular joint (TMJ) serving not only as the hinge point for mandibular opening, but also facilitating mandibular growth and contributing to facial aesthetics. Significant compromise of the TMJ can be debilitating functionally, psychologically, and aesthetically. Reconstruction of the mandibular condyle is rarely straightforward. Multiple considerations must be accounted for when preparing for condylar reconstruction such as ensuring eradication of all chronically diseased or infected bone, proving clear oncologic margins following tumor resection, or achieving stability of the surrounding architecture in the setting of a traumatic injury. Today, there is not one single gold-standard reconstructive method or material; ongoing investigation and innovation continue to improve and transform condylar reconstruction. Herein, we review methods of condylar reconstruction focusing on autologous and alloplastic materials, surgical techniques, and recent technological advances.

scholarly journals A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure

2021 ◽  
Vol 18 (1) ◽  
pp. 278
Author(s):  
Jahyung Kim ◽  
Sanghyeon Lee ◽  
Jeong Seok Lee ◽  
Sung Hun Won ◽  
Dong Il Chun ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Simple Procedure ◽  
Wedge Resection ◽  
Operation Time ◽  
University Hospital ◽  
Wound Infections ◽  
Germinal Matrix ◽  
One Year ◽  
Ingrown Toenails

(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes.

Variability in the reported surgical techniques and methods for intercalary reconstruction following tumor resection

2021 ◽  
pp. 101610
Author(s):  
Elif Ugur ◽  
Rui Yang ◽  
Nicole Levine ◽  
Jichuan Wang ◽  
Harrison Volaski ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Surgical Techniques

scholarly journals Suspected Pulmonary Metastasis of Actinic Cutaneous Squamous Cell Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Monet E. Meter ◽  
David J. Nye ◽  
Christian R. Galvez
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Actinic Keratosis ◽  
Uv Light ◽  
Light Exposure ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Lung Lesion ◽  
The Right

Introduction. It is rare for actinic or squamous cell carcinoma (SCC) in situ to metastasize. Case Presentation. A 67-year-old male had a significant medical history including severe psoriatic arthritis treated with UVB, methotrexate, and rapamycin. He had twenty-five different skin excisions of actinic keratosis four of which were invasive SCC. Our patient developed shortness of breath necessitating a visit to the emergency department. A CT scan of his chest revealed a mass in the right lower lung. A subsequent biopsy of the mass revealed well-differentiated SCC. He underwent thoracoscopic surgery with wedge resection of the lung lesion. Discussion. Actinic keratosis (AK) is considered precancerous and associated with UV exposure. It exists as a continuum of progression with low potential for malignancy. The majority of invasive SCCs are associated with malignant progression of AK, but only 5–10% of AKs will progress to malignant potential. Conclusion. In this case, a new finding of lung SCC in the setting of multiple invasive actinic cutaneous SCC associated with a history of extensive UV light exposure and immunosuppression supports a metastatic explanation for lung cancer.

scholarly journals Adrenocortical carcinoma masquerading as pheochromocytoma: a histopathologic dilemma

2020 ◽  
Vol 2020 ◽  
Author(s):  
Impana Shetty ◽  
Sarah Fuller ◽  
Margarita Raygada ◽  
Maria J Merino ◽  
B J Thomas ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Lynch Syndrome ◽  
Adrenocortical Carcinoma ◽  
Renal Carcinoma ◽  
Thoracoscopic Surgery ◽  
Adrenal Adenoma ◽  
Wedge Resection ◽  
Genetic Profile ◽  
List Type

Summary Adrenocortical carcinoma (ACC) is an aggressive cancer that originates in the cortex of the adrenal gland and generally has a poor prognosis. ACC is rare but can be more commonly seen in those with cancer predisposition syndromes (e.g. Li-Fraumeni and Lynch Syndrome). The diagnosis of ACC is sometimes uncertain and it requires the use of precise molecular pathology; the differential diagnosis includes pheochromocytoma, adrenal adenoma, renal carcinoma, or hepatocellular carcinoma. We describe a case of a 57-year-old woman with Lynch Syndrome and metastatic ACC who was initially diagnosed as having pheochromocytoma. The tumor was first identified at 51 years of age by ultrasound followed by a CT scan. She underwent a left adrenalectomy, and the histopathology identified pheochromocytoma. Two years later, she had tumor recurrence with imaging studies showing multiple lung nodules. Following a wedge resection by video-assisted thoracoscopic surgery (VATS), histopathology was read as metastatic pheochromocytoma at one institution and metastatic ACC at another institution. She later presented to the National Institutes of Health (NIH) where the diagnosis of ACC was confirmed. Following her ACC diagnosis, she was treated with mitotane and pembrolizumab which were stopped due to side effects and progression of disease. She is currently receiving etoposide, doxorubicin, and cisplatin (EDP). This case highlights the importance of using a multi-disciplinary approach in patient care. Thorough evaluation of the tumor’s pathology and analysis of the patient’s genetic profile are necessary to obtain the correct diagnosis for the patient and can significantly influence the course of treatment. Learning points: Making the diagnosis of ACC can be difficult as the differential diagnosis includes pheochromocytoma, adrenal adenoma, renal carcinoma, or hepatocellular carcinoma. Patients with Lynch Syndrome should undergo surveillance for ACC as there is evidence of an association between Lynch Syndrome and ACC. Conducting a complete tumor immunoprofile and obtaining a second opinion is very important in cases of suspected ACC in order to confirm the proper diagnosis. A multi-disciplinary approach including genetic testing and a thorough evaluation of the tumor’s pathology is imperative to ensuring that the patient receives an accurate diagnosis and the appropriate treatment.

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