Search results for " Video-Assisted"
showing 10 items of 15 documents
Wider implications of video-assisted thoracic surgery versus open approach for lung metastasectomy
2015
ABSTRACT Lung metastasectomy is considered a safe and potentially curative procedure despite there is not a strong evidence that metastasectomy prolongs long-term survival in patients with lung metastases. Moreover, the debate is open regarding the best approach for lung metastasectomy, video-assisted thoracic surgery versus open approach. A systematic review of literature to clarify what is the best approach to prolong survival in patients with lung metastases was performed. Our study confirms that overall survival is equivalent for video-assisted thoracic surgery and thoracotomy, therefore the ‘gold standard’ surgical treatment for lung metastases remains a point of debate. The choice o…
3D CT scan for perioperative identification of anatomical variations of lungs.
2016
Aim: The aim of this study is to investigate anatomical lung variations and vascular patterns using volumetric 3D computed tomography (CT) representations. Methods & results: We considered 24 major thoracic surgery performed in our ward. In these, we discovered some interesting anatomical variations of the main pulmonary fissures. These findings were not visible on the plain x-ray or during routine examination of a preoperative CT scan. After re-examination of 3D CT scan reconstruction the anatomical variations were detected. Discussion: General thoracic surgeons must familiarize themselves with anatomical variations in lungs. 3D images may aid the general thoracic surgeon in performin…
Thoracoscopy in pleural effusion –two techniques: awake single-access video-assisted thoracic surgery versus 2-ports video-assisted thoracic surgery …
2015
Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs. Materials & methods: Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the 'single-access', and two incisions for the '2-trocars technique'. Results: Mortality rate was 0% in both groups. Postoperative stay: 3dd ± 4 versus 4dd ± 5, mean operative time: 39 min versus 37 min (p < 0.05). Chest tube duration: 2dd ± 5 versus 3dd ± 6. Complications: 11/95 versus 10/79. Conclusion: Awake technique reduce postoperative hospital stay and chest drainage duration, similar complications and recurrence rate. The authors ca…
Uniportal Video-Assisted Thoracoscopic Surgery Resection of a Giant Midesophageal Diverticulum
2017
We describe a new video-assisted technique for the management of a giant midesophageal diverticulum using a single 5-cm port. It maintained the same principles of the traditional open technique as diverticulectomy, myotomy, and fundoplication. The better visualization of the main esophageal body, diverticulum, and esophagogastric junction and the better alignment of the stapler cartridge to the longitudinal axis of the esophagus are all technical factors supporting our procedure. Heavily calcified mediastinal lymph nodes and diffuse pleural adhesions are the main contraindications. However, future experiences are needed before this technique can be recommended as acceptable treatment. (C) 2…
Comparative intention-to-treat analysis of the video-assisted thoracoscopic surgery approach to pulmonary segmentectomy for lung carcinoma
2015
Objectives To compare the video-assisted thoracoscopic surgery (VATS) with the open thoracotomy access to pulmonary segmentectomy by the clinical outcomes and long-term survival in lung carcinoma. Methods Non-randomized comparative intention-to-treat study of prospective institutional registry data and survival data of 100 consecutive patients undergoing segmentectomy. Results Within one decade (2002-12), 100 patients with proven or highly suspected lung carcinoma underwent 100 anatomical sub-lobar pulmonary resections (52 typical and 20 atypical segmentectomies, 28 split-lobe procedures). Fifty-six patients were operated by VATS and 44 by thoracotomy access. Comparison of demographic, medi…
Video-thoracoscopic surgical pleurodesis in the management of malignant pleural effusion: the importance of an early intervention.
2005
Thoracentesis plays an important role in cancer patients with symptomatic effusions, although its effect is short-lived and symptoms recur in almost all patients. Early video-thoracoscopic surgical pleurodesis may provide added benefit to a group of patients with advanced cancer presenting with symptomatic malignant pleural effusion. Seventy-six patients with advanced cancer and pleural effusion due to pulmonary-pleural metastases were recruited. In 51 cases (67.1%), at least one thoracentesis was performed before admission for surgery. Preoperative staging consisted of chest radiograph, CT scan, and blood gas analysis. The mean Karnofsky performance status was about 50. Pleurodesis with ta…
Bilateral thoracoscopic thymectomy using a novel positioning system.
2013
Several techniques of bilateral video-assisted thoracoscopic extended thymectomy have been proposed, and each has its own proponents. We summarize our experience in 20 patients who underwent bilateral video-assisted thoracoscopic extended thymectomy, using a new patient positioning that amplifies the thoracoscopic view of the cardiophrenic regions which are often difficult to visualize with standard techniques. In all cases, en-bloc thymectomy with complete dissection of the mediastinal fatty tissue was achieved without sternal retractors or additional incisions.
The use of video-assisted thoracic surgery in the management of Pancoast tumours
2010
We describe our experience using video-assisted thoracic surgery (VATS) as an adjunct to the surgical management of Pancoast tumors. Between March 2004 and November 2009, 13 patients with Pancoast tumors were included in this study. Surgery was performed by positioning the patient to allow either an anterior or a posterior thoracotomy. VATS was employed to explore the pleural cavity, to optimize the surgical access and as an assistance during surgical resection. Three patients with pleural carcinosis at thoracoscopy did not undergo further surgery. Seven lobectomies and three wedge resections were performed with an en bloc chest-wall resection and mediastinal lymphadenectomy. The surgical a…
A comparative analysis of Pancoast tumour resection performed via video-assisted thoracic surgery versus standard open approaches.
2014
OBJECTIVES: The aim of the present paper was to conduct a comparative analysis of outcomes after thoracoscopic resection versus standard thoracotomy approach in the treatment of Pancoast tumours. METHODS: All consecutive patients with Pancoast tumours undergoing surgical treatment from March 2000 to November 2012 were enrolled. Patients were divided into 2 groups according to whether a thoracoscopic or standard thoracotomy approach was adopted. In addition to morbidity and mortality, (i) intensity of pain; (ii) respiratory function focusing on the postoperative value and its variation with respect to the predicted value (Delta); (iii) analgesic consumption at different times during the post…
Impact of video-assisted thoracic surgery approach on postoperative mortality after lobectomy in octogenarians.
2019
The number of octogenarians who present with localized lung cancer eligible for surgical resection is increasing. Video-assisted thoracic surgery lobectomy has been widely accepted, but the potential benefit in octogenarians is not well established, especially for postoperative mortality. This study aimed to assess the impact of a video-assisted thoracic surgery approach on postoperative mortality after lobectomy for lung cancer in octogenarians.From January 2005 to December 2016, all patients aged more than 80 years who received lobectomy treatment for lung cancer were retrieved from the French Administrative Database. The end point was 30-day postoperative death. A propensity score was ge…