A comparison of bronchial blocker under artificial pneumothorax and double-lumen endobronchial tube for lung isolation in thoracoscopic enucleation of oesophageal leiomyoma

Background Oesophageal leiomyomas are one of the most common benign oesophageal tumours. This retrospective, observational study summarized and compared the clinical outcomes of thoracoscopic enucleation of oesophageal leiomyoma between single-lumen endotracheal intubation with a bronchial blocker and double-lumen endotracheal intubation. Methods A total of 36 patients who underwent thoracoscopic enucleation of oesophageal leiomyoma at Peking Union Medical College Hospital between 2014 and 2020 were retrospectively analysed. Fifteen patients received single-lumen endotracheal intubation combined with a right bronchial blocker (SLT-B group), and twenty-one patients received double-lumen endotracheal intubation (DLT group). Clinical data, surgical variables, and postoperative complications were analysed and compared. Results The average tumour size in all patients was 4.3 ± 2.0 cm. The average tumour size among symptomatic patients was significantly larger than that among asymptomatic patients (5.1 ± 2.0 cm vs 3.7 ± 1.7 cm, P < 0.05). Patients in the SLT-B group had a significantly larger average tumour size than patients in the DLT group (5.4 ± 2.1 cm vs 3.5 ± 1.4 cm, P < 0.05). The SLT-B group had a significantly shorter operation time and shorter total hospital stay than the DLT group. No mucosal injury, conversion to thoracotomy, or other operative complications occurred in the SLT-B group. In the follow-up, no recurrence, dysphagia, or regurgitation was found in any of the patients. Conclusions Compared with traditional double-lumen intubation, artificial pneumothorax-assisted single-lumen endotracheal intubation combined with a bronchial blocker for thoracoscopic oesophageal leiomyoma enucleation can achieve complete removal of larger tumours, with fewer complications and shorter hospital stays.

Artificial pneumothorax — long-term results. Veran (Presse Med. No. 10, 1932)

Veran (Presse Med. No. 10, 1932) examined 226 cases of pt. In 60% pt was discontinued for medical reasons.

Application of right bronchial blocker under artificial pneumothorax in thoracoscopic enucleation of oesophageal leiomyoma

Background Oesophageal leiomyomas are one of the most common benign oesophageal tumours. This study summarized and analysed the clinical experience of thoracoscopic enucleation of oesophageal leiomyoma. Methods A total of 36 patients who underwent thoracoscopic enucleation of oesophageal leiomyoma at Peking Union Medical College Hospital between 2014 and 2020 were retrospectively analysed. Fifteen patients received single-lumen endotracheal intubation combined with a right bronchial blocker (SLET-B group), and twenty-one patients received double-lumen endotracheal intubation (DLET group). Clinical data, surgical variables, and postoperative complications were analysed and compared. Results The average tumour size in all patients was 4.31 ± 1.96 cm. The average tumour size among symptomatic patients was significantly larger than that among asymptomatic patients (5.08 ± 2.02 vs 3.71 ± 1.72, P < 0.05). Patients in the SLET-B group had a significantly larger average tumour size than patients in the DLET group (5.39 ± 2.13 vs 3.54 ± 1.42, P < 0.05). The SLET-B group had a significantly shorter operation time and shorter total hospital stay than the DLET group. No mucosal injury, conversion to thoracotomy, or other operative complications occurred in the SLET-B group. In the follow-up, no recurrence, dysphagia, or regurgitation was found in any of the patients. Conclusions Compared with traditional double-lumen intubation, artificial pneumothorax-assisted single-lumen endotracheal intubation combined with a bronchial blocker for thoracoscopic oesophageal leiomyoma enucleation can achieve complete removal of larger tumours, with fewer complications and shorter hospital stays.

Simultaneous bilateral artificial pneumothorax Kaminsky (Amer. Rev. Tuber. 1931. No. 3)

Kaminsky (Amer. Rev. Tuber. 1931. No. 3) reports that in American clinics, simultaneous bilateral artificial pneumothorax is very rarely used, while European phthisiatricians use it widely.

Artificial pneumothorax prof. Yarotsky (Doctor. Delo, 1922, No. 3-6)

Based on a number of personal observations of prof. Yarotsky (Doctor. Delo, 1922, No. 3-6) considers artificial pneumothorax to be a very valuable therapeutic agent, in appropriate cases saving such patients who would inevitably die without it.

221 THORACOSCOPIC ESOPHAGECTOMY WITH OR WITHOUT SMALL THORACOTOMY FOR ADVANCED THORACIC ESOPHAGEAL CARCINOMA IN THE LEFT LATERAL DECUBITUS POSITION

Standardized thoracoscopic esophagectomy for thoracic esophageal carcinoma in the left lateral decubitus position under artificial pneumothorax is slightly more difficult to dissect the middle and lower mediastinum than in prone position, but it is possible to operate the upper mediastinum with good visual field. In salvage surgery after definitive chemoradiotherapy, it is difficult to complete the operation only by throscopic surgery, and it is thought that sometimes small thoracotomy can be performed safely and reliably. Methods If this procedure is considered feasible, start with thoracoscopic surgery. If it is decided that the procedure cannot be completed, add a small thoracotomy of about 10–15 cm to allow one hand. Thoracoscopy not only reduced invasiveness, shared detailed anatomy, but also improved operability by taping the esophagus and ensured emergency safety. Results This standardized procedure is applied to salvage surgery after definitive chemoradiotherapy from January 2016 to March 2019. Thoracoscopic surgery was performed in 14 of the 27 cases (52%). Thoracoscopic surgery was completed in 10 cases and small thoracotomy was used in 4 cases. There are no serious complications such as bleeding. Conclusion Starting surgery with a thoracoscopy and adding small thoracotomy as appropriate can share the advantages of thoracotomy and throcoscopic surgery. This technique has the advantage that it can be easily converted to thoracotomy even in an emergency, and is considered to be superior to advanced cancer. Video https://www.dropbox.com/sh/47jcqu3palpsfvg/AAC4PvReWDP_WPBkJufxWU3da?dl=0.

On traumatic pneumothorax with primary gas injection

Over the last 10-15 years, treatment of tuberculosis patients with artificial pneumothorax has become widespread and there are many works devoted to collapse therapy in the press; details of the technique, efficiency of treatment, and complications are discussed. Spontaneous pneumothorax (SP) is one of the most dangerous complications of pneumothorax. Under p. p. we understand gas accumulation in pleural cavity in case of lung perforation, as the result of pathological process in the lung, more often of subpleural cavernous cavity breakthrough, caseous focus, or due to lung parenchyma needle trauma while applying pneumothorax.

On the spleen diet in pulmonary tuberculosis

Pulmonary tuberculosis with its most complex symptom complex and various effects of tuberculosis toxaemia on almost all major organs of the human body, although it has created its own huge therapy problem, however, to date it has not yet found its definite and exact method of treatment. Among a number of various methods of treatment of pulmonary tuberculosis only collapsotherapy, and mainly artificial pneumothorax, has recently managed, indeed, to take a rather solid, solid and almost true place in the problem of tuberculosis therapy. Some limited use of pneumothorax continues to encourage a number of clinicians and researchers, both in your Union and in Western Europe, to look for more and more new and more correct ways to treat tuberculosis in general and pulmonary tuberculosis in particular.