scholarly journals Uniportal thoracoscopic surgery for difficult late stage empyema: Case series

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Klein Dantis
Keyword(s):  
Methicillin Resistant Staphylococcus Aureus ◽  
Thoracoscopic Surgery ◽  
Case Series ◽  
Open Approach ◽  
Open Thoracotomy ◽  
Invasive Approach ◽  
Video Assisted ◽  
Chronic Empyema ◽  
Clinical Scenarios ◽  
Video Assisted Thoracoscopic Surgery

Early, aggressive, and minimally invasive approach is an advanced surgical approach for chronic empyema management. The traditional video-assisted technique is considered superior over open thoracotomy for empyema management; however, with further modification, the uniportal video-assisted thoracoscopic surgery (UVATS) has greater advantage for surgeons, providing better anatomical view of target tissues, allowing bimanual instrumentation similar to open approach, and nullifying the creation of dihedral angle by instruments that are not favorable in traditional VATS. The present case series describes different clinical scenarios including chronic empyema secondary to traumatic hemothorax, recurrent tubercular empyema following postoperative open decortication, and methicillin-resistant staphylococcus aureus chronic empyema in pediatric patient, which are effectively managed with UVATS approach.

Analysis of conversion to thoracotomy during thoracoscopic lung resection

2019 ◽  
Vol 27 (5) ◽  
pp. 381-387 ◽  
Author(s):  
Katsunari Matsuoka ◽  
Tetsu Yamada ◽  
Takahisa Matsuoka ◽  
Shinjiro Nagai ◽  
Mitsuhiro Ueda ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Thoracoscopic Surgery ◽  
Clinical Stage ◽  
Lung Resection ◽  
Open Thoracotomy ◽  
Advanced Clinical Stage ◽  
Video Assisted ◽  
Surgery Group ◽  
Intraoperative Conversion ◽  
Video Assisted Thoracoscopic Surgery

Background Video-assisted thoracoscopic surgery has been widely adopted. However, conversion to open thoracotomy is still necessary when intraoperative complications are encountered. Methods Between January 2009 and December 2014, 1566 patients underwent anatomical lung resection for lung cancer using video-assisted thoracoscopic surgery at our institution. Among these patients, 39 required conversion to open thoracotomy. We retrospectively examined the current status of conversion to thoracotomy during video-assisted thoracoscopic surgery in a single city hospital. Data were compared with those of 89 patients undergoing a scheduled thoracotomy. Results The main reason for conversion was the need for angioplasty for pulmonary artery invasion by silicotic lymph nodes (12 cases), and metastatic lymph nodes or tumors (9 cases). Univariate analysis demonstrated that the risk factors for conversion were male sex, smoking habit, induction therapy, large tumor size, and advanced stage. Multivariate analysis showed that advanced clinical stage was the only significant predictor of intraoperative conversion. Compared to the video-assisted thoracoscopic surgery group, mortality and morbidity in the conversion group were significantly higher, but there was no significant difference in mortality or morbidity between the conversion and scheduled thoracotomy groups. The conversion group showed a significantly higher rate of lethal acute exacerbation of interstitial pneumonitis than the video-assisted thoracoscopic surgery group. Conclusion The main reason for conversion was angioplasty, and advanced clinical stage was a significant predictor of intraoperative conversion. Conversion was safely performed but postoperative complications, although similar in frequency to scheduled thoracotomy cases, were more frequent than those in thoracoscopic surgery cases.

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.

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.

Video-Assisted Thoracoscopic Surgery in the Treatment of Chronic Empyema Thoracis

Surgery Today ◽  
2002 ◽  
Vol 32 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Yu-Jen Cheng ◽  
Hsing-Hsien Wu ◽  
Shah-Hwa Chou ◽  
Eing-Long Kao
Keyword(s):  
Thoracoscopic Surgery ◽  
Empyema Thoracis ◽  
Video Assisted ◽  
Chronic Empyema ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Image-guided video-assisted thoracoscopic surgery for small ground glass opacities: a case series

2017 ◽  
Vol 3 ◽  
pp. 142-142 ◽  
Author(s):  
Hsin-Yueh Fang ◽  
Yin-Kai Chao ◽  
Ming-Ju Hsieh ◽  
Chih-Tsung Wen ◽  
Pei-Hsuan Ho ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Case Series ◽  
Ground Glass ◽  
Image Guided ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery
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