Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THORACOSCOPY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1993

[Resection of posterior mediastinal cyst under thoracoscopy].

A 52-year-old woman with left posterior mediastinal cyst underwent surgical removal using thoracoscopy. Under general anesthesia by use of one lung ventilation, thoracoscopy was introduced through a trocar at the mid-axillary line of the 7th intercostal space. Grasping forceps were introduced through a incision in the anterior-axillary line of 4th and 5th intercostal space. The lung was held with grasping forceps. The lung was fixed to the region of anterior-mediastinum with the weight of forceps. Then posterior-mediastinum was able to be observed well by the operator. The thin cyst-wall was biopsied and excised as much as possible. Residual cyst-wall was burned by electric knife. A pathological diagnosis probed that the tumor was bronchogenic cyst without malignancy. Post operative pain markedly reduced. The patient rapidly recovered and was discharged on the 6th postoperative day. Thoracoscopic resection of mediastinum cyst may be a useful approach.

Female↗
PubMed1993

[Surgical thoracoscopy; initial results in 13 patients].

In various diagnostic and therapeutic thoracic operations the use of thoracoscopy can replace the more radical thoracotomy. On account of the development of endoscopic video systems and specialised instrumentation, this technique is increasingly being used. Our first experiences with this new development in thoracic surgery are promising. In the period July 1991-June 1992 we performed 14 thoracoscopic operations in the Merwede Hospital in Dordrecht, for the surgical treatment of spontaneous pneumothorax (8x), for open lung biopsy (5x) and for resection of a peripheral benign tumour of the lung (Ix). No major complications occurred and patient recovery was surprisingly fast. Because of the decreased operation trauma, for several procedures already established via thoracotomy, the surgical thoracoscopy can be regarded as a great improvement in thoracic surgery.

Adult↗
PubMed1995

[Combined thoracoscopy in thoracoabdominal wounds using ultrasound, the CO2 laser and the plasma jet].

Under analysis is an experience with treatment of 178 patients with thoracoabdominal wounds. The authors have developed a rational curative methods and original thoracoscopic techniques, which allowed to considerably reduce the amount of thoracotomies. Thoracoscopy was performed in 157 (88%) of 178 patients. Indications for thoracotomy were established in 7 patients, in 19 patients only drainage of the pleural cavity was made. Curative thoracoscopy was used in 131 patients, in 60 of them ultrasonic glue hermetization of the lung wound was made, 36 patients had laser photocoagulation of the lung wound, 21 patients had plasma coagulation of pleuro-pulmonary defects, in 14 patients--coagulated hemothorax was removed. Clinical effectiveness of thoracoscopic techniques was more than 90%. Thoracotomy was performed in 28 (15%) patients, in 11 patients it was supplemented with diaphragmotomy. Laparotomy was performed in 167 patients. Lethality was 6.8%.

Abdominal Injuries↗
PubMed1995

[Video-assisted thoracoscopy in the treatment of recurrent pneumothorax].

Between April 1992 and May 1994, 45 patients with recurrent spontaneous pneumothorax underwent videoassisted thoracoscopy (group I). The mean chest tube duration, the length of hospital stay, the use of parenteral narcotics, the complications and the follow-up were analyzed and compared to the same data of a group of 21 patients previously treated by open approach between January 1991 and March 1993 (group II). Average age, sex and surgical indications distribution were comparable (group I: 36 males, 9 females, mean age 31.7 years; group II: 17 males, 4 females, mean age 31.5 years). Mean chest tube duration was lower in group I (group I 4.3 days vs group II 7.2 days), as was mean hospital stay (group I 4.6 days vs group II 10.3 days) and the necessity of parenteral narcotics for pain relief (group I 11% vs group II 66% of patients). No episodes of relapsing pneumothorax occurred in either group of patients after a mean follow-up of 12.4 months (range from 1-24 months) for group I and 30 months (range from 24-36 months) for group II. The incidence of minor complications was less in group I (4.4%) than group II (23.8%). Our early results in the treatment of recurrent spontaneous pneumothorax by videoassisted thoracoscopy have been encouraging and the merits of this approach make it preferable to thoracotomy.

Adult↗
PubMed1996

[Location of pulmonary nodules and evaluation of lymph node size by ultrasonography under thoracoscopy].

We evaluated the usefulness of ultrasonography under thoracoscopy for locating pulmonary nodules and measuring the size of mediastinal and hilar lymph nodes. Using unilateral lung ventilation with a double lumen tracheal tube, ultrasonography was effective in evaluating the condition of completely collapsed lungs. The locations of twelve nodules, including five lung cancers, six inflammatory lesions, and one intra-pulmonary lymph node, with sizes ranging from 4 to 30 mm, were examined by ultrasonography. While all lung cancers and the intra-pulmonary lymph node were located by ultrasonography, only two of six inflammatory lesions were found. In examining mediastinal and hilar lymph nodes, all lymph nodes larger than 10 mm could be seen by ultrasonography. However, the ultrasonography could not distinguish between metastatic and non-metastatic lymph nodes. In conclusion, ultrasonography under thoracoscopy was able to locate pulmonary nodules larger than 10 mm, especially lung cancers, and was able to measure the size of mediastinal and hilar lymph nodes larger than 10 mm.

Aged↗
PubMed1996

[Anesthesia for thoracoscopy].

The thoracoscopy is used both for diagnosis and treatment of pleural and lung diseases. We describe our experience in managing anesthesia for such procedures, the number of which is increasing thanks to technical advances. We review 82 thoracoscopic procedures, 48 of which were video assisted. Sixty-two were performed under balanced general anesthesia (GA) with isoflurane, fentanyl and atracurium. Local anesthesia (LA) with fractionated doses of propofol and fentanyl was used in 20 cases. The mean age of patients receiving LA (63 +/- 17 years) was significantly greater (p < 0.05) than those receiving GA (49 +/- 13 years). ASA IV patients were given LA and sedation. Selective bronchial intubation was performed in 46 cases. Complications during surgery were severe hypoxemia (SpO2 < 85%) requiring suspension of selective lung ventilation in 8 cases, moderate hypoxemia (spO2 < 90% and > 85%) in 1 case, coughing in 3 cases and agitation in 1 case. Video-thoracoscopy is a safe technique that is less invasive than conventional thoracotomy. The number of applications is increasing, although its future place in thoracic surgery must still be determined.

Adult↗
PubMed1977

Thoracoscopy.

Poor results in the treatment of lung cancer have led to the development of several techniques designed to obtain tissue for diagnosis and to determine the feasibility of resection. Although mediastinoscopy has obtained great popularity, we have been dissatisfied with it because of the low yield of positive results and the attendant increases in length of operations and hospitalizations. We have modified the old technique of thoracoscopy, using a sterilized sigmoidoscope inserted through an intercostal space with the patient positioned and prepared for thoracotomy. Although most frequently used in patients with lung cancer, this procedure also has been helpful in patients with coin lesions, mediastinal tumors, and penetrating wounds of the chest. Although we agree that mediastinoscopy is useful in selected patients, we believe that thoracoscopy offers a greater number of patients a reliable means of obtaining the proper diagnosis more efficiently.

Humans↗
PubMed1997

Diagnostic and therapeutic thoracoscopy in esophageal cancer.

The decision before operation whether an esophagus affected by cancer can be resected is difficult. In order to determine if the tumor can be removed or not, patients must undergo surgery. This high risk intervention is often carried out only to prescribe palliative treatment. We used a thoracoscopic technique for the diagnosis and resection of esophageal cancer with the aim of improving the high morbidity rate associated with esophageal open surgery. A right thoracoscopy was performed in seven patients and only four underwent resection. The entire esophagus was mobilized thoracoscopically and the intervention was completed through the abdomen and the neck. In three patients in whom resection was not considered possible, the thoracoscopic procedure was done with excellent tolerance, and treated by palliative methods. Thoracoscopy is a very valuable procedure for the diagnosis of resectability as well as for the mobilization of the esophagus prior to resection.

Endoscopes↗
PubMedDate not supplied

Combined thoracoscopy and mediastinoscopy for mediastinal lymph node staging of lung cancer.

It is very difficult to obtain accurate staging of mediastinal lymph node metastases (N-staging) in patients with lung cancer. We recommend combined thoracoscopy and mediastinoscopy for the assessment of N-staging. The indications and techniques of these combined procedures are described in this paper. Combined thoracoscopy and mediastinoscopy may provide more accurate N-staging of lung cancer than either procedure alone or a non-invasive staging procedure.

Humans↗
PubMed1997

[Emergency surgery making use of video-assisted thoracoscopy--2 case reports].

We recently experienced two emergency operating cases using video-assisted thoracoscopy. First case was a 17-year-old male with foreign body and pneumothorax in the right thorax. He was emergencilly treated by means of video-assisted thoracoscopic surgery. The operation was carried out using double-lumen endotracheal anesthesia. Short trocars were inserted through the right intercostal spaces to introduce a flexible video thoracoscope and surgical instruments. Foreign body was looked for easily and removed out. Second case was a 22-year-old male with hemo-pneumothorax at the right side. He was treated using video-assisted thoracoscopy emergencilly. Bleeding point was searched and hemostasis was done by the electrical mess and the clip. Bulla was removed out with surgical instruments. These were good adaptation of emergency operation using video-assisted thoracoscope. The advantages of this thoracoscopic surgery are: less operative invasion and postoperative pain, early recovery and short hospital stay, and cosmetic preservation.

Adolescent↗
PubMed1997

[Surgical treatment of spontaneous pneumothorax: comparison of thoracotomy and thoracoscopy].

The video-thoracoscopic treatment of spontaneous pneumothorax currently has the same role of laparoscopic cholecystectomy in abdominal surgery. The Authors consider thoracoscopic approach and traditional thoracotomy examining advantages versus disadvantages, comparing 50 patients with spontaneous pneumothorax treated by thoracoscopy, from February 1992 up to February 1995, and 50 patients, previously treated by open surgery. Video-thoracoscopy has the same percentage of recurrences of thoracotomic approach but assures a quicker functional recovery and, above all, a remarkable reduction of pain.

Adult↗
PubMed1997

[Anterior spinal fusion by thoracoscopy. A non-traumatic technique].

PURPOSE OF THE STUDY: Video assisted thoracic surgery (VATS) is a new modality which allows visualization of, and access to the intrathoracic organs without thoracotomy. Recently, this technique has been used for anterior thoracic spine approach to perform surgery which previously required standard postero-lateral thoracotomy. The authors report their initial experience of anterior spinal fusion using thoracoscopy and give a detailed description of their surgical procedure. MATERIAL AND METHODS: This technique, started on June 1993, was performed only in one level 1 in 10 patients who had thoracic spine trauma with fracture or luxation. The procedure was performed in the lateral decubitus position. The patient was prepared in the standard manner for a full thoracotomy. Surgical instruments that are needed for conversion to an open procedure must be in the operative room. Ventilation was stopped to the ipsilateral lung. Lung's collapse of the surgical side was obtained with a double lumen tube. Carbon dioxide (CO2) insufflation was used to further collapse. The first thoracoscopic portal was placed through the sixth or seventh intercostal space in the posterior axillary line, which was the safest place. All subsequent portals were placed under thoracoscopic visualization, in a triangular way as recommended by Landreneau (1992). Only open trocars were used to avoid complication of CO2 insufflation. Once the target level has been defined, a needle was placed into the disc space and roentgenographic confirmation obtained. The parietal pleura was then divided using monopolar electrocautery. Segmental vessels of the operation field lied transversely across the midportion of the vertebral body. They were mobilised and systematically ligated with endoscopic clip to simplify the procedure. Then the intervertebral space was opened and bone and disc were removed, restricted to the anterior and middle third. The graft was placed into the thoracic cavity by using a high density calcium hydroxyapatite ceramic block. Peroperative radiologic control ascertained the good position of the implant. At the end of the procedure a chest tube was placed through the lower trocar site and the lung re-expanded. A post operative CT Scan controlled good position of the graft and complete lung expansion. Contra-indications for VATS are previous surgical procedures or empyema causing extensive pleural adhesions. Procedures not appropriate for VATS approach are some that require anterior instrumentation for stabilisation, burst fracture, or fracture with posterior wall involved. RESULTS: The planned procedure was accomplished in all but one patient who required conversion to an open procedure because of segmental artery bleeding. Mean operative time was 1 h 45 mm, and mean estimated blood loss was 650 cc. There was no complication from CO2 insufflation neither postoperative complication. With an average of 2 years follow up, anterior grafting is as good as an open technique, radiologic evaluation according to Uchida (1990) showed good incorporation of each block without any radiolucent line or displacement. DISCUSSION: According to literature this technique was performed safely in 10 cases, especially without any respiratory complications and chronic pain (impairement of pulmonary function, re-expansion failure, incisional complications, rib fractures, chronic pain and malfunction of the chest wall, limitation of shoulder girdle motion) which are considered to be the main disadvantage of traditional thoracotomy. Many authors previously used VATS for multi level thoracic discectomy for correction of spinal deformities (Mack 1995), spinal reconstructive surgery (Mac Afee 1995) or removal of protrude thoracic disc (Rosenthal 1994). CONCLUSION: This original technique demonstrates that thoracoscopy for anterior thoracic surgery is better for the patients, reducing surgical trauma of the chest wall and to the lung parenchyma (in term of post operative comfort, sh

Adult↗
PubMedDate not supplied

[The use of laser through thoracoscopy in the treatment of spontaneous pneumothorax. Presentation of a clinical case].

The authors present the case of a patient with right plurirecidive pneumothorax. During the 12 months before the operation the patient suffered from 3 episodes of pneumothorax, treated with the insertion of an intrapleural drainage. Preoperative exams showed the presence of multiple emphysematous blebs with diameter ranging from 0.5 cm to 3 cm. The patient was treated with Nd:YAG laser photocoagulation of the blebs and mechanical abrasion of the parietal pleura through thoracoscopy. The laser photocoagulation of the blebs was performed using the contact technique and a 25 Watt power. After operation a TX of the thorax, using the high resolution technique, showed the presence of residual blebs involving the apex and the mediastinal surface of the inferior lobe of the right lung. After a 12 month follow-up no recidive pneumothorax occurred and the general conditions of the patient were good. The authors state that the laser treatment of spontaneous pneumothorax secondary to bullous emphysema is effective and safe and it is also successful in patients with multiple blebs. As it is often difficult to find and treat all the blebs, it may be useful to perform thoracography during thoracoscopy.

Adult↗
PubMedDate not supplied

Thoracoscopy for trauma.

Thoracoscopy is currently undergoing a revival in the surgical world. As the role of thoracoscopy increases in the general thoracic surgery arena, the indications for the technique in the care of trauma patients is also expanding. Trauma surgeons are investigating both diagnostic and therapeutic indications. Penetrating thoracoabdominal trauma is a proven indication to evaluate the diaphragm for possible violation. Investigation of thoracic hemorrhage with identification of bleeding sites, evacuation of hemothorax, and control of ongoing blood loss have all been reported successfully via the thoracoscope. Recent reports have sited isolated patients were diaphragmatic repair has been accomplished with endoscopic techniques. Other indications await the improvement of techniques and instruments, and the imagination of future surgeons.

Abdominal Injuries↗
PubMed1997

[Short and long term follow-up of spontaneous pneumothorax treated using video-thoracoscopy].

The outcome of video-assisted thoracoscopic treatment of spontaneous pneumothorax was analyzed. Eighty-three procedures were performed in 79 patients (58 men, 21 women: mean age 28.3 years, range 16 to 76 years). The reasons for intervention were recurring pneumothorax in 53 patients, contralateral pneumothorax in 10 (one of whom was treated on both sides), bilateral involvement in 3, and persistent air leakage in 13. Seven patients (8.4%) also required open thoracotomy. In 72 (88%) of the remaining 76 procedures, only video thoracoscopy was used. Three patients (3.6%) underwent video-assisted thoracotomy. Mean postoperative hospital stay was 5.1 days (2 to 24 days). No related deaths occurred but surgical complications were reported for 3 (3.9%). Significant postoperative complications developed in 9 cases (11.8%). One patient with prolonged air leakage underwent a second procedure, video-assisted thoracotomy, 12 days after the first intervention. Seventy-one of the 72 patients received follow-up examinations, with a mean follow-up period of 28.1 months (range 54 days to 54 months). Three recurrences (3.9%) were recorded but there were no cases of chronic pain requiring analgesia. We conclude that video thoracoscopy is an effective approach, with the advantage of being minimally invasive. We therefore believe it should be the procedure of choice, once improved morbidity and recurrence rates are observed, as these factors are influenced by the learning curve.

Adolescent↗
PubMed1998

Examination of the thoracic cavity and lung lobectomy by means of thoracoscopy in dogs.

The feasibility of thoracoscopy for viewing the chest cavity and performing pulmonary lobectomy was assessed in 8 mongrel dogs. Previously, selective intubation had been performed in another group of dogs (n = 8) in order to monitor respiratory physiology and assess its safety. Each hemithorax was intubated using a double-barrelled endotracheal tube with one barrel placed in the left main bronchus and the other in the bifurcation of the trachea. The thoracoscope was introduced through a cannula inserted through a 2-cm incision at the ventral third of the left 5th intercostal space. The cranial, dorsal, and caudal surfaces of the pleura, lobes of the left lung, and the mediastinum were examined. A 2nd cannula was located in the dorsal 3rd of the 5th intercostal space with a prior incision and used for the introduction of forceps to separate the viscera. To biopsy, a 3rd cannula was inserted at the dorsal third of the 8th intercostal space with a prior incision, through which a 12-mm diameter stapler was introduced. Should a lobectomy be necessary, a 4th cannula is located in the middle third of the 4th intercostal space. Excision of the left caudal pulmonary lobe was performed through the incision made for the 12-mm diameter cannula (8th intercostal space); a twisting movement facilitated removal. Thoracoscopy is a procedure that can be used in dogs and is particularly suitable for examination, collection of biopsy specimens, and even lung lobectomies.

Anesthesia, General↗
PubMed1998

[Therapeutic thoracoscopy for empyema thoracis].

In empyema thoracis, it is important to reduce the duration of treatment and to expand the collapsed lung as fully as possible while managing intrathoracic infection. We used thoracoscopy to treat 10 cases of empyema that were not completely cured by antibiotics or thoracic drainage. The 8 men and 2 women were 43-73 years of age. Thoracoscopy was done under general anesthesia except for 2 pneumonia patients. After inserting two trocars into the thoracic cavity, we removed pus, the purulent coat, and fibrinous membrane. Into one unilocular cavity, two intrathoracic tubes were inserted via trocarholes. Postoperative irrigation of the thoracic cavity was conducted daily through the two tubes. We subclassified the fibropurulent stage into three phases, namely, the purulent, fibrous, and purulent-capsular. One case required redrainage, but no cases were accompanied by severe complications or postoperative death. Patients were discharged on post-operative day 33, on average. We found no recurrence or cases of recollapsed lung during the study, from 8 months to 4 years and 11 months postoperatively.

Acute Disease↗