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At least 577 records · Page 32Linked to original sources
PubMed1994

Thoracic discectomy using video assisted thoracoscopy.

STUDY DESIGN: The applicability of using video assisted thoracoscopic surgery (VATS) to resect thoracic discs was investigated. A laboratory study was conducted using two human cadavers and three live pigs as surgical specimens. A total of nine thoracic levels were decompressed. OBJECTIVE: To study the feasibility of performing thoracic resections using VATS. SUMMARY OF BACKGROUND DATA: VATS has been used by thoracic surgeons since 1991 to resect pulmonary lesions. As far as we know, VAT has not yet been used to resect thoracic discs. METHODS: Surgical resections of nine disc levels were carried out in two human cadavers and three anesthetized pigs. VATS was used to provide the surgeon with visualization of the surgical site. Large thoracotomy incisions were not necessary. RESULTS: Five of seven cadaver disc spaces and two of three porcine disc spaces were adequately evacuated of disc material. One episode of dural violation occurred. One animal died during the procedure from an anesthetic complication. CONCLUSION: VATS provides a useful means of performing thoracic discectomies using a small thoracotomy incision. The decrease in invasiveness provided by this new technology may reduce operative morbidity, hospitalization time, and costs. More work is needed, especially in the design of instrumentation, before this becomes a viable alternative to current surgical procedures.

Animals↗
PubMed2002

Thoracoscopy in management of postpneumonic pleural infections.

With expanding overall experience of video-assisted thoracic surgery in the last decade, its use in postpneumonic pleural infection is increasing, as shown by a larger number of publications advocating its efficacy. The main areas of study in the use of video-assisted thoracic surgery in this condition are (1) as an alternative to traditional open thoracotomy and (2) as an additional treatment option in the management of earlier-stage disease. The benefits of the minimally invasive approach are particularly attractive in the treatment of pediatric pleural infection. Controversy surrounds its comparative benefits over intrapleural fibrinolysis in early exudative or fibrinopurulent pleural empyema and its usefulness in the treatment of chronic pleural empyema.

Child↗
PubMed2006

Unusual complication during pediatric thoracoscopy.

A small infant with congenital cystic adenomatoid was scheduled for thoracoscopic resection of the lung cyst. During carbon dioxide insufflation, there was a sharp rise of endtidal carbon dioxide which was followed by marked hypoxemia and bradycardia due to occlusion of the tracheal tube with blood. The plan changed to open thoracotomy and total pneumonectomy. Despite several reports, which addressed successful thoracoscopic cystic lung resection, its safety remain to be determined.

Anesthesia↗
PubMed2003

[A case report of tuberculous pleuritis diagnosed by thoracoscopy using fiberoptic bronchoscope].

A 27-year-old male visited the outpatient clinic of our hospital with the chief complaints of fever, right chest pain and shortness of breath. He was admitted to our hospital for detailed examination of the right hydrothorax. The pleural effusion obtained by thoracocentesis was exudative and negative for Mycobacterium tuberculosis. Since the titer of adenosine deaminase in the pleural effusion was abnormally high, antitubercular therapy was started under suspicion of tuberculous pleuritis. Thereafter, the patient's subjective symptoms and blood parameters improved. Necrotic tissues were obtained by pleural biopsy using the Cope needle. In order to make a definitive diagnosis, pleural biopsy was performed thoracoscopically. White tubercular lesions with a smooth surface were sparsely distributed on the pleura. Histopathologically, these lesions were characterized by central areas of caseous necrosis surrounded by epithelial cells and Langhans' giant cells. Therefore, they were considered to be granulomatous lesions. The patient was given a diagnosis of idiopathic tuberculous pleuritis, and was treated with four antitubercular drugs in combination. His clinical signs subsided, and he was discharged. This case indicates that the examination of the inside of the pleural cavity with a flexible bronchoscope, instead of thoracoscope, under local anesthesia is useful to diagnose patients having tuberculous pleuritis.

Adult↗
PubMed1993

Thoracoscopy assisted pulmonary lobectomy.

BACKGROUND: This report describes a preliminary experience with six patients undergoing video imaged thoracoscopic pulmonary lobectomy. METHODS: Three left upper lobectomies, and one each of right upper, right lower and left lower lobectomy were undertaken. The resections were performed as orthodox dissectional lobectomy procedures but were carried out under videothoracoscopic imaging with instruments introduced through two stab incisions. The entire resected lobe was delivered through a 7 cm submammary intercostal incision. RESULTS: There were no operative deaths or complications attributable to the technique. In three other patients conversion to an open thoracotomy was required because of bleeding (two cases) or obscure anatomy (one case). Post-operative pain in those undergoing thoracoscopic resection was less than that encountered with standard thoracotomy and early clinic review showed the patients to be pain free with excellent shoulder movement. CONCLUSIONS: Major pulmonary resection according to standard cancer practices is feasible with videothoracoscopic techniques. This approach is likely to offer considerable functional benefit to patients. Specimen delivery through the submammary incision imposes a 5 cm primary lesion size limitation. Detailed mediastinal assessment is necessary to exclude N2 status before undertaking thoracoscopic surgery.

Aged↗