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At least 289 records · Page 16Linked to original sources
PubMed2003

[Thoracoscopic surgery for metastatic lung tumors: computed tomography-guided localization with use of a needle with a suture].

When a metastatic lung tumor is found to be deep to the visceral surface of the pleura, or when it is found to be a small lesion, it may important to help identify the lesion by preoperative methods in order to localize it at the time of thoracoscopic operation. We performed computed tomography-guided localization of metastatic lung tumors with use of a needle with a suture in 11 cases prior to thoracoscopic resection. Placement of the needle, immediately before moving to the operation room were successfully performed in all patients. It took from 16 to 25 minutes (20.3 minutes on average). Complications included minimal pneumothorax in 8 patients, mild airway bleeding in 2, and penetration through the middle lobe to the lower lobe of the right lung in 1. However, treatment was not necessary in any of the patients. Thoracoscopic resections were successfully achieved in all patients. Our technique may be a simpler technique and advantageous for identification of small lesions and lesions deep to the visceral surface of the pleura during the thoracoscopic operation for metastatic lung tumors.

Aged↗
PubMed1998

Thoracoscopic parasternal lymph node dissection for the staging of breast cancer.

With the advent of advanced thoracoscopic techniques, new applications have been expanding their roles in thoracic surgery. The aim of this paper is to introduce our new thoracoscopic approach in performing parasternal lymph node dissection of advanced breast cancer for its staging. This technique does not need the removal of any costal cartilage which is usually done in the conventional classical technique after radical mastectomy. Thoracoscopic procedure, in which wide and complete parasternal lymph node dissection is done, is minimally invasive and easy to perform. Therefore, the thoracoscopic technique may be a suitable alternative to the conventional approach in the future.

Journal Article↗
PubMed2003

[The application of needle video-assisted thoracoscopic biopsy in pathologic diagnosis and staging for advanced lung cancer].

OBJECTIVE: To study the clinical application of needle video-assisted thoracoscopic biopsy in the pathologic diagnosis and staging for advanced lung cancer. METHODS: Ninety-four patients were diagnosed as having advanced lung cancer staged IIIa-IV by chest X-ray, computed tomography and magnetic resonance imaging, for which a pathologic diagnosis was not made by sputum and pleural effusion cytology or bronchoscopic examination. Needle video-assisted thoracoscopic biopsy was performed for primary lesions, mediastinal lymph nodes, metastatic lesions in the lungs and the chest wall. RESULTS: Pathologic samples were obtained in 89 of the 94 patients by needle video-assisted thoracoscopic surgery. The successful rate was 95%. After operation, the pathologic diagnosis was confirmed to be lung cancer in all the 89 patients. Adenocarcinoma was found in 47 patients, squamous carcinoma in 23, adenosquamous carcinoma in 12, and small cell lung cancer in 7. Compared to the clinical diagnosis before operation, the pathologic diagnosis post-operation was changed in 15 patients. Pneumothorax and mild haemoptysis occurred in 4 patients and 2 of the cases respectively. All the patients were followed for 8 - 18 months with computed tomography and physical examination. No implantation metastasis was found. CONCLUSION: Needle video-assisted thoracoscopic biopsy is an effective diagnostic measure for patients with advanced lung cancer for which pathologic diagnosis, typing and staging are not determined by routine examinations.

Adult↗
PubMed2004

[Video-assisted thoracoscopic surgery in diagnosis and treatment of pleuritis].

OBJECTIVE: To evaluate possibilites of video-assisted thoracoscopic surgery in diagnosis and treatment of pleuritis. 1997-2002 in Department of Thoracic Surgery and Oncology of Vilnius University Institute of Oncology 206 patients underwent videothoracoscopic procedures (146 (70.8%) of them for pleuritis). All procedures were performed in general anesthesia using double lumen tube. Mean patient age was 61+/-10 years. One hundred three women (71%) and 43 men (29%) were operated. Seventy four (51%) chemopleurodesis was performed with pleural biopsies: for 2 patients (1.36%) bleocine was used, and for 74 patients (50.6%) sterile talk. RESULTS: Significance of pleural videobiopsies reaches 93%. Eleven patients (7%) failed in diagnosis: in 5 cases (3.4 %) due to adhesions, in 6 cases (3.4%) we made false positive diagnosis. COMPLICATIONS: postoperative pneumonia - 12 patients (8.8%), pneumothorax - 2 patients (1.5%), pleural empiema - 1 patient (0.75%), bleeding - 1 patient (0.75%). CONCLUSIONS: Specificity of video-assisted thoracoscopic surgery in pleural diseases reaches 93.0%. Video-assisted thoracoscopic surgery is necessary even in cases of failed "blind" biopsies and possible in elderly patients. Video-assisted thoracoscopic surgery provides not only easy morphologic verification of pleural diseases but also performance of chemopleurodesis.

Aged↗
PubMed2004

[Assessment of thoracic sympathectomy by transpleural posterolateral and thoracoscopic approach in surgical treatment of Raynaud's syndrome].

Operative treatment of patients with Raynaud's Syndrome is rarely used, and is recommended by most authors only in the case of disthrophic changes or so advanced symptoms, which disturb normal social and daily life. Recently, thoracoscopic sympathectomy is applied more frequently. The aim of this study was to assess the usefulness of thoracoscopic sympathectomy by the presentation of early and long-term outcome of 43 thoracic and eight lumbar sympathectomies performed in 41 patients with Raynaud's Syndrome. Transpleural posterio-lateral thoracotomy was performed 29 times in 27 patients, whereas thoracoscopic sympatectomy 14 times in 8 patients. Surgical techniques, early and long-term results were discussed. Based on early and long-term outcome, there were no significant differences between applied surgical techniques. Moreover, thoracoscopic sympathectomy was safe in the aspect of a short duration as well as good therapeutic and cosmetic effect of the procedure. It should be applied instead of others, so far used methods, with the exception of patients with massive pleural adhesions, which need thoracotomy.

Adult↗
PubMed2004

[Thoracoscopic splanchnicectomy for control of epigastric pain of neoplastic origin].

UNLABELLED: One of the methods for control of epigastric splanchnic pain is thoracoscopic transsection of splanchnic nerves. The purpose of the study is to evaluate the effect of thoracoscopic splanchnicectomy on pain intensity in patients with unresectable epigastric malignancies. MATERIAL AND METHODS: From 2001 to March 2004 we performed thoracoscopic splanchnicectomy in 26 patients (17 males and 9 females) aged from 42 to 76 years. Indications for the procedure were as follows: unresectable pancreatic cancer (17 cases), gastric cancer (7 cases), gallbladder cancer (2 cases). In all patients the intensity of pain was evaluated before the operation, two days and one month postoperatively by Prince Henry Hospital Pain Scale (PHHPS). RESULTS: 26 patients were evaluated during their hospitalisation and 24 of them one month postoperatively. The intensity of pain measured by PHHS before the procedure was 2.77 points in average and 1.26 point and 1.5 point in average two days and one month postoperatively respectively. All patients demanded lower doses of analgesics after an operation. CONCLUSION: Thoracoscopic splanchnicectomy is a safe and efficient method for control of pain caused by unresectable epigastric malignancies.

Adult↗
PubMed2005

[New forceps for thoracoscopic needle biopsy].

INTRODUCTION: When the diagnosis cannot be established preoperatively but malignant lung tumor is suspected, we frequently perform thoracoscopic wedge resection in order to perform rapid histodiagnosis on the specimen. If the diagnosis is malignancy, we extend the surgery to lobectomy for complete resection in many cases. However, cartridges of linear endoscopic staplers used for wedge resection are useless in such cases. This economic loss is expensive. Thoracoscopic needle biopsy is economic, but the technique is difficult and there is a risk of damage to important blood vessels when the needle penetrates deeper than is needed. Therefore, we developed forceps for thoracoscopic needle biopsy. METHOD: We changed the tip shape of endoscopic grasping forceps, fixed a guide for inserting a biopsy needle and prevented the biopsy needle from going through the grasping extension for safety. We made 3 types of forceps, small, middle, and large sized forceps that could adapt the various sizes of tumors. RESULT: We used the small forceps for 23 cases: the middle forceps for 13 cases; the large forceps for 7 cases; for a total of 43 cases, and succeeded in diagnosing 35 cases. The reason for failure in 6 cases using the small forceps was the exceeding softness of the lesion in 1 case, failure of rapid histodiagnosis in 1 case, and mal-adaptation between the forceps and tumor size in the remaining cases. The reason for failure in 2 cases using middle forceps was failure of rapid histodiagnosis in both cases. There was no complication due to biopsy. All bleeding after the puncture was quickly stopped. There was no dissemination or recurrence in the thoracic lumen. CONCLUSION: During surgery for palpable visible lung tumors with an uncertain histological diagnosis, thoracoscopic needle biopsy is very easy and economic. It is also useful for avoiding unnecessary lung lobectomy, and is a minimally invasive method, contributing to medical economy.

Biopsy, Needle↗
PubMed2005

[Video-assisted thoracoscopic extended thymectomy for myasthenia gravis: analysis of 107 cases].

OBJECTIVE: To evaluate the results of video-assisted thoracoscopic extended thymectomy for myasthenia gravis. METHODS: We retrospectively reviewed data from 107 patients received thoracoscopic extended thymectomy from June 1995 to June 2004. All patients had confirmed diagnosis of myasthenia gravis by clinical manifestation and electromyogram. Thoracoscopic extended thymectomy as well as dissection of all fatty tissue anterior to the pericardium was performed. RESULTS: During a follow-up of 1-98 months, symptom was significantly improved in 83% of patients, including 34 patients experienced complete remission. There was no postoperative mortality. CONCLUSION: Favorable results of video-assisted thoracoscopic extended thymectomy can be achieved in patients with myasthenia gravis. The technique is safe and minimally invasive.

Adolescent↗
PubMed2005

An early case of pulmonary lymphangioleiomyomatosis diagnosed by video-assisted thoracoscopic surgery.

Pulmonary lymphangioleiomyomatosis (LAM) is a rare and progressive disease of young women that usually causes death from respiratory failure. Here we report an early case that was diagnosed by thoracoscopy. A 28-year-old woman presented to a local clinic with chest pain and her chest X-ray film showed left pneumothorax. After placement of a chest tube, the lung re-expanded fully. Following the recurrence of left pneumothorax, she was referred to our hospital and underwent video-assisted thoracoscopic surgery (VATS). However, left pneumothorax recurred again one month later. She underwent a second thoracoscopic operation, during which a bulla was recognized in the lingular segment of the left lung and was resected. On histological examination of the surgical specimen findings consistent with LAM were obtained. Taking the preoperative imaging findings and the thoracoscopic findings into consideration, a diagnosis of early lymphangioleiomyomatosis was made. Thoracoscopic management of pneumothorax in young women can facilitate the early diagnosis of this condition.

Adult↗
PubMed2006

[Current status and evaluation of thoracoscopic esophagectomy for thoracic esophageal cancer].

The current status and evaluation of esophagectomy by thoracoscopic approach for thoracic esophageal cancer are described. The esophagectomy by thoracoscopic approach for thoracic esophageal cancer have been reported in some Instituts since 1996 in Japan. In 10 years, series consisting a large number of esophageal cancer patients have been treated with esophagectomy by thoracoscopic approach and evaluated about operative safety, curabirity and postoperative morbidity. Now, the establishment of training system is the most important subject to achieve the standardization of thoracoscopic esophagectomy for thoracic esophageal caner.

Esophageal Neoplasms↗
PubMed2006

[Research on complications of thoracoscopic assisted thoracic spine surgery].

OBJECTIVE: To analyze occurrence, prevention and treatment of the complications of thoracoscopic assisted spine surgery. METHODS: Retrospective review of 182 patients who underwent standard thoracoscopic technique or video-assisted thoracic surgical procedure from October 1998 to August 2004. The treatment of thoracic diseases included debridement, decompression with (or) reconstruction. The total number of complications were recorded, and its mechanism, prevention and treatment were analyzed. RESULTS: Complications occurred in 16 patients, 12 cases of perioperative complications included 3 patients suffered from pneumonia, 3 pulmonary atelectasis, 2 patients' lung injured by trocar, 1 patient obtained transient monoplegia, 2 suffered from transient intercostal nerve pain and 1 had superficial incision infection. Long-term complications occurred in 4 cases: spinal tuberculosis relapsed 2 cases (one who had diabetes obtained relapse in 8 months of post-operation and another relapsed with complex spinal tuberculosis in 4 weeks postoperation), 2 patients suffered from kyphosis deformity and pain. CONCLUSIONS: The type and incidence of complications with thoracoscopic spine surgery mainly depend on indication, operation procedures and anesthesia, only by limit surgical indication, ameliorate technique, obey surgical principle and consummate perioperative treatment can we obtain mini-invasive effect by thoracoscopic assisted spine surgery.

Adolescent↗
PubMed1995

Thoracoscopic assisted lobectomy.

The advances in endoscopic capabilities expanded the potential role of laparoscopic and thoracoscopic surgery. The introduction of safe linear stapling devices made thoracoscopic assisted segmental lung resections possible. Because of the postoperative advantages of a thoracoscopic operation, a technique for thoracoscopic lobectomies was developed. Three case reports are presented using the same technique. The first two cases report a right lower lobectomy and the third case a bilobectomy, right middle and lower lobe.

Aged↗
PubMed1994

[Organization and significance of quality control in recent surgical methods exemplified by 85 consecutive thoracoscopic interventions].

The rapid evolution or rather revolution of minimally invasive surgical techniques is stimulating new technical and clinical innovations. Quality control is of great importance in new areas of technical development where standards do not yet exist. By recording detailed documentation of patient data, indications, operative procedures and initial follow-up we can compare this new technology with the gold standard therapy. This documentation system for thoracoscopic interventions was developed together with the Swiss Group of Laparoscopic and Thoracoscopic Surgeons. This pilot project of 85 consecutive thoracoscopic interventions will demonstrate the acceptability, clinical application and ease with which data can be analyzed. Operative techniques are described in detail: 20 diagnostic interventions with biopsy, 19 apical parietal pleurectomies (+/- resections of bullous lung tissue), 10 therapeutic lung tissue resections, 19 palliative pleurodesis, 5 treatments of pleural empyema, 1 mediastinal tumor resection, 1 esophagectomy, 4 thoracic sympathectomies plus 6 other procedures. Data entry is efficient with mean total time of 10 min for each record. All of the data are entered into a computer database. The possibilities for interpreting and combining this data are presented. The operative techniques can easily be related with history, indications, anesthesia, complications and results. First evaluation of thoracoscopic efficiency is possible. In addition, a detailed analysis of intra- and postoperative complications and of the hospital course can be performed.

Documentation↗
PubMed1993

[Thoracoscopic treatment of bronchogenic cyst].

A central bronchogenic cyst was excised thoracoscopically from a 44-year-old woman in whom a tumor had been pointed out in the left upper posterior mediastinum at a screening examination. Since the tumor was diagnosed to be benign, only conservative follow-up was undertaken, but the patient consulted our department desiring active therapy. On the basis of the chest CT and MRI findings a bronchogenic cyst was diagnosed. Under general anesthesia and mechanical ventilation of one lung, the thoracoscope was inserted into the thoracic cavity revealing in the left upper posterior mediastinum a cyst which was excised thoracoscopically. While coagulation was performed gingerly with an electric scalpel, the tumor was detached sharply and bluntly with a pair of scissors. The postoperative course was uneventful with little wound pain or scar formation. Hitherto bronchogenic cysts have been treated by resection after thoracotomy. Although this is an easy procedure, a relatively large operative scar is left and considerable wound pain may develop. In contrast, thoracoscopic treatment is characterized by minimal surgical invasiveness, little postoperative wound pain, and small scars. These advantages suggest that this technique may be indicated for benign mediastinal tumors, particularly cysts.

Adult↗
PubMed1995

[Use of CT-guided metal wires in pre-thoracoscopic localization of peripheral pulmonary nodules].

The recent developments in thoracic surgery have broadened the application spectrum of thoracoscopy. Video-assisted thoracoscopic lung resection is now available both to diagnose and to treat peripheral pulmonary nodules. A major factor limiting the success of thoracoscopic lung resection is the difficult localization of the pulmonary nodule. When lesions are very small and deep inside the lung, their preoperative detection may be difficult. This study was aimed at investigating the effectiveness of hookwires for CT-guided localization of peripheral pulmonary lesions requiring thoracoscopic resection. In 12 patients 12 nodules, previously detected with chest radiography, were localized with hookwires under CT guidance. Ten of 12 patients underwent thoracoscopic resection for diagnostic purposes, while the extant two patients underwent therapeutic wedge resection. In all patients prethoracoscopic hookwire positioning was successful. In 11 of 12 patients the lesion was accurately localized, while in the extant patient the wire tip was inserted deeper than the nodule. In 3 patients the wire was dislodged before surgery: in all of them a small hemorrhage developed on the visceral pleura and wedge resection was likewise possible. Four patients had a small pneumothorax which was not treated before surgery. In conclusion, percutaneous hookwire localization of peripheral lung lesions is an easy and efficacious technique and promotes thoracoscopy as a less invasive alternative to thoracotomy.

Adenocarcinoma↗
PubMed1995

[Anesthetic management for thoracoscopic lung biopsy].

Nine patients with diffuse interstitial pneumonia underwent thoracoscopic lung biopsy. To evaluate the usefulness of thoracoscopic lung biopsy, compared with open one, we examined the changes of lung function and blood gas before and after surgery in these patients, and also studied their prognosis after treatment based on their pathological diagnosis. We found that the decreases in %VC and PaO2 in patients after thoracoscopic lung biopsy were smaller than those after open one. Furthermore, all the patients were diagnosed finally from their pathological findings, which contributed to their therapy and prognosis. We conclude that thoracoscopic lung biopsy is very beneficial for treatment of patients with diffuse interstitial pneumoniae, although its anesthetic management often requires one lung ventilation.

Adult↗
PubMed1996

Thoracoscopic surgery for lung cancer using the two small skin incisional method. Two windows method.

Pulmonary lobectomy and mediastinal lymph node dissection was performed in 25 patients with Stage I lung cancer under thoracoscopic guidance using the two-windows method. A posterior skin incision (3 cm) and lateral skin incision (2 cm) were made in the 4th intercostal space centering on the inferior angle of the scapula. The site closest to the operating surgeon was used for direct vision, while the distant site was used for insertion of the thoracoscope. The mean operative time was 2 hours and 15 minutes, and the mean blood loss was 82.6 ml. The mean number of dissected mediastinal lymph nodes was 32. The length of hospitalization ranged from 5 to 17 days. Recovery was uneventful, and analgesics were not required by postoperative day 6. The two-windows method overcomes the three-dimentional inaccuracy due to the one-directional observation of the operative field employed during conventional thoracoscopy. In addition, since we developed this method for mediastinal lymph node dissection, the tracheal bifurcation can be confirmed under direct vision, increasing the accuracy of the procedure. The advantages of the two-window thoracoscopic method of pulmonary lobectomy are cosmesis, preservation of respiratory function, and reduced postoperative pain. In addition, there is reduced intraoperative bleeding and shortened operative time, while achieving mediastinal dissection similar to that of standard thoracotomy. The two-windows method of thoracoscopic pulmonary lobectomy is equal or superior to standard thoracotomy in every respect. This method should become the standard surgical technique for Stage I lung cancer.

Adenocarcinoma↗
PubMed1996

Thoracoscopic treatment for spontaneous pneumothorax in patients over 50 years old: a comparison with younger patients.

The purpose of this study was to compare thoracoscopic treatment for spontaneous pneumothorax in patients over 50 years old (OG) and younger patients (YG). Thoracoscopic treatment was performed in both groups using the same patient selection criteria: persistence of an air leak after tube thoracostomy drainage, ipsilateral recurrence, and bilateral pneumothoraces. Thoracoscopic treatment was performed in nine older patients (OG) over a two-year period. Their ages ranged from 50 to 81 years (average: 66 years). The mean operative time, postoperative drainage period, and hospital stay after surgery were 120 min, 6.3 days, and 10.7 days, respectively. In the YG, these indices were 71 min, 1.5 days, and 5.3 days, respectively. Each factor was significantly prolonged in the OG (p < 0.05). However, there were no major perioperative complications or recurrences 3-24 months after surgery in either group. Thus, thoracoscopic surgery is also effective in the treatment of spontaneous pneumothorax in patients over 50 years old.

Age Factors↗