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 1,549 records · Page 86Linked to original sources
PubMedDate not supplied

Cardiopulmonary effects of intrathoracic insufflation in dogs.

This study was designed to quantify the effects of incremental positive insufflation of the intrathoracic space on cardiac output (CO), heart rate (HR), arterial pressure (AP), central venous pressure (CVP), and percent saturation of hemoglobin with oxygen (SPO2) in anesthetized dogs. Seven healthy, adult dogs from terminal teaching laboratories were maintained under anesthesia with isoflurane delivered with a mechanical ventilator. The experimental variables were recorded before introduction of an intrathoracic catheter, at intrathoracic pressures (IP) of 0 mm Hg, 3 mm Hg insufflation, and additional increments of 1 mm Hg insufflation thereafter until the SPO2 remained <85% despite increases in minute volume. Finally the variables were measured again at 0 mm Hg IP. The cardiac output and systolic and diastolic AP significantly (P < 0.05) decreased at 3 mm Hg IP. Significant decreases in SPO2 were seen at 10 mm Hg IP. Significant increase in CVP was noted at 6 mm Hg IP. Heart rate decreased significantly at 5 to 6 mm Hg IP but was not decreased above 6 mm Hg IP. Given the degree of CO decrease at low intrathoracic pressures, insufflation-aided thoracoscopy should be used with caution and at the lowest possible insufflation pressure. Standard anesthetic monitoring variables such as HR and AP measurements may not accurately reflect the animal's cardiovascular status.

Anesthesia↗
PubMed1991

Thoracoscopic talc poudrage pleurodesis for chronic recurrent pleural effusions.

OBJECTIVE: To assess the effectiveness of thoracoscopic talc poudrage for the treatment of chronic pleural effusions. DESIGN: Prospective evaluation. SETTING: Kaiser-Permanente Hospital. PATIENTS: Forty-seven consecutive patients with recalcitrant pleural effusions, referred for thoracoscopy. INTERVENTION: Patients received general or local anesthesia; 42 had a 7-mm rigid thoracoscopic examination followed by insufflation of 5 mL of talc. Patients then had chest-tube drainage. MEASUREMENTS: We recorded clinical characteristics, final diagnosis, procedure-related pain and morbidity, days of hospitalization, patient-reported degree of symptom relief, and chest roentgenographic results at 1, 3, and 12 months. All patients were followed for 16 months or until death. MAIN RESULTS: Of 39 evaluable patients, all reported prolonged relief of effusion-related dyspnea. Radiographic results confirmed the elimination of pleural effusions in 34 patients (87%), including all 11 with benign conditions and 23 of 28 (82%) with malignancies. Treatment failed in three patients because of entrapped lung and in two patients with mesotheliomas whose effusions recurred more than a year after treatment. No procedure-related mortality or morbidity was found. Ambulatory patients required hospitalization for a mean of 3.9 days (range, 2 to 11 days). Mild pain was reported by some patients. The mean duration of chest-tube drainage was 2.7 days (range, 1 to 9 days). Patients with malignant disease lived an average of 12.4 months (range, 1 to 61 months) after the procedure. CONCLUSIONS: Thoracoscopic talc poudrage is an effective pleural sclerosing technique and is relatively painless.

Adult↗
PubMed1999

[Experience in the work of the unit of surgical diagnosis of respiratory organ diseases].

From 1986 to 1997, the Unit made 2637 diagnostic operations: 1687 thoracoscopies, 49 telethoracoscopies, 232 mediastinoscopies, 171, diagnostic thoracotomies, 108 open pleural biopsies, 390 peripheral nodal biopsies. The diseases detected were arranged as follows: tuberculosis (33.8%), nonspecific (32.5%), malignant (16.3%), sarcoidosis (9.9%), alveolitis (2.5%). Verification was 95.3%.

Biopsy↗
PubMed1999

[Ruptures and injuries to the diaphragm].

Injury to the diaphragm is a marker of severe trauma yet remains one of the most misdiagnosed traumatic lesions. The mechanism may be penetrating (stab or gunshot wounds) or blunt (high velocity injuries). Rupture of the diaphragm may be overlooked due to common associated injuries. Diagnosis is based on strong clinical suspicion and repeated chest x-rays. Current diagnostic tools include CT scan and minimally invasive surgical techniques (laparoscopy or thoracoscopy) in stable patients. These relatively new methods could provide more accurate diagnosis. The main feature of diaphragmatic injury is the incidence of late presentation with the possibility of life-threatening complications such as strangulations may even occur late.

Algorithms↗
PubMedDate not supplied

Peptic ulcer disease and thoracoscopic left truncal vagotomy.

BACKGROUND: This study illustrates our experience in treating duodenal ulcer by means of thoracoscopy and laparoscopy over a period of six years. MATERIALS AND METHODS: From October 1991 to October 1998, we submitted 38 patients (31 males and 7 females), average age 51 years (range 22-78 years), with duodenal ulcer to vagotomy with minimally invasive access: 23 Hill-Barkers, 2 Taylors, 9 thoracoscopic truncal vagotomies and 4 laparoscopic truncal vagotomies. The patients submitted to thoracoscopic truncal vagotomy had previous gastric surgery (5 ulcers of the neostoma in patients who had undergone gastric resection, 3 hemorrhagic gastritis of the gastric neostoma and 1 incomplete abdominal vagotomy). RESULTS: The average time required for the thorascopic approach was 30 minutes (range 20-40 minutes) with return to normal feeding in 1 day, without any difficulty, and discharge on day 3 (range 2-5 days). The patients were followed for 3-54 months. Twenty-two patients (91.3%) out of 23 submitted to anterior superselective and posterior truncal vagotomy, and the patients submitted to thoracoscopic vagotomy, were pain free without medical therapy. One patient (4.3%) was lost to the follow-up. There was only one relapse (4.3%) after seven months where the patient underwent left thorascopic truncal vagotomy. We had no mortality and no intraoperative or postoperative complications. CONCLUSIONS: In our opinion, minimally invasive treatment of peptic ulcer disease may represent the "gold standard." It is simple, quick, effective and delivers the same excellent results of open surgery but with minimum trauma.

Adult↗
PubMed1999

[Open-window surgery of pleural empyema].

Thoracoscopic is performed for treatment of pleuric empiema with 65% of recovery. In the old patients the Authors achieved high grade of recovery with open window (OW) procedure. In the last two years, 7 patients with pleuric empiema underwent this treatment. In two patients the origin was tuberculosis, in 4 empiema was post-pneumonitic; in one case the cause was broncho-pleuric fistula after pneumonectomy. All the operations were performed under general anesthesia. The Authors began with thoracoscopy, drainage of cavity and then they performed the resection of one or more ribs and a pleuro-cutaneous flap: 5 patients recovered without complications. OW seems to be very useful in the case in which more radical approach is impossible. Continuous irrigations of the cavity, with rapid pulmonary expansion, permits recovery without the use of myocutaneous flaps.

Aged↗
PubMed1999

Surgical staging and surgical treatment in esophageal cancer.

Esophageal cancer is the fastest growing malignancy in the United States. Surgery remains the standard primary treatment but overall survival for all patients undergoing primary surgery is dismal. This is thought to be secondary to the advanced stage in many patients at the time of diagnosis. The presence or absence of metastatic lymph nodes is indeed the single most important prognosticator. Current preoperative staging includes computerized tomography, magnetic resonance imaging, and transesophageal ultrasound. The limitations of each of these techniques are well known. Preoperative thoracoscopy and laparoscopy staging is emerging as a safe, effective, and accurate way of staging patients with esophageal cancer. Moreover, it may become important in allocating treatment, as it may be used to individualize radiation therapy fields, or to allocate bimodality or trimodality therapy to patients in trials, depending on the results of pretreatment lymph node sampling. Future trials in esophageal cancer should consider the results of pretreatment pathologic staging in allocating patients to appropriate modalities of therapy.

Esophageal Neoplasms↗
PubMed1999

Thoracoscopic surgery for intralobar pulmonary sequestration.

A 47-year-old male with intralobar pulmonary sequestration successfully treated by thoracoscopic surgery was reported. Preoperative selective angiography revealed two aberrant arteries originating from the left infraphrenic artery. Under thoracoscopy, adhesive tissues around the sequestered lung were dissected, aberrant arteries were divided and the sequestered lung was resected. We considered that preoperative detailed analysis of the aberrant artery was very important to safely perform thoracoscopic procedures for pulmonary sequestration.

Angiography, Digital Subtraction↗
PubMed2000

[Multiple nodular pulmonary amyloidosis with multiple bullae].

We report a case of multiple nodular amyloidosis accompanied by multiple emphysematous bullae. The patient was a 72-year-old nonsmoking woman who presented with chronic cough and had a history of pneumothorax. Chest computed tomography disclosed multiple nodules up to 1 cm in diameter, and multiple small emphysematous bullae predominantly distributed in the middle and lower lung fields. Left lung biopsy was performed under thoracoscopy. The nodules were histopathologically diagnosed as amyloidoma. The mechanism of the accompanying bullae formation was also considered.

Aged↗
PubMed2000

Endoscopic thoracoplasty and anterior spinal release in scoliotic deformity.

Severe rigid and complex deformities of the spine often require a first stage procedure to adequately mobilize the spine to provide adequate flexibility during the actual application of instrumentation for surgical correction. This first stage involves soft tissue releases and removal of intervertebral disks from the anterior spine. Exposure to the anterior spine has traditionally been accomplished through thoracotomy or a thoracolumbar incision. The open thoracotomy, however, has several disadvantages, such as post-thoracotomy pain, a large scar, and breathing difficulties. Since the first thoracoscopy at the beginning of this century, the procedure, at first limited by the available technology, has gradually gained more uses and favor among physicians. The last 10 years have seen significant improvement in optical technology and instrumentation. These advances have allowed the spine surgeon to begin performing anterior spinal releases using endoscopic techniques. These endoscopic techniques can carry the same efficacy as the open thoracotomy but less morbidity. Thoracoplasty, the resection of rib segments, is an excellent way to not only correct the convex rib deformities seen in scoliosis but it is also an excellent source of bone which can be used as a graft for fusion. Although traditionally, thoracoplasty has also been done through an open procedure, it can be performed endoscopically. This prospective study presents nine patients who underwent combined endoscopic anterior spinal release and thoracoplasty followed by same day posterior instrumentation and fusion for correction of their spinal deformities. All nine procedures were completed successfully endoscopically. It is our conclusion that in the hands of an experienced surgeon, the endoscopic technique is an excellent procedure providing the same efficacy as the open thoracotomy. There is however a learning curve associated with the procedure. In addition, a team approach in which the surgeon and an experienced anesthesiologist with experience with double lumen intubation and selective single lung ventilation and thoracoscopic surgery is crucial. Although there were no surgical complications related to the thoracoscopic technique one patient did require prolonged intubation postoperatively, which leads us to believe that single lung ventilation in and of itself is very demanding and each patient must be considered carefully prior to its undertaking.

Adolescent↗
PubMed2000

Descending aorta-to-femoral artery bypass: preliminary experience with a thoracoscopic technique.

Descending aorta-to-femoral artery bypass is a durable procedure with excellent long-term patency rates. The operation is usually performed using a lateral thoracotomy combined with retroperitoneal tunneling of the graft. Assuming that a smaller incision would reduce the operative trauma, minimally invasive video endoscopic techniques were used to perform a thoracoscopic bypass operation. In all patients, exposure of the descending aorta was obtained using thoracoscopy. This was accomplished with a maximum of four ports. For placing the conventional side-biting aortic clamp, a 3- to 4-cm incision was necessary. Using this incision as an access port, the proximal anastomosis was sutured endoscopically. Retroperitoneal tunneling was performed using laparoscopically guided balloon dissection. Eleven consecutive patients underwent surgery. In two patients, conversion to a standard thoracotomy was necessary because of extensive intrathoracic adhesions. There were no major complications, except for one hematoma. After a mean follow-up of 9.5 months, all bypass grafts were still patent. Patients could be discharged after a mean postprocedural hospital stay of 7.4 days (range, 5-12). Thoracoscopic descending aorta-to-femoral artery bypass is an operation with excellent patency rates; however, it is a novel technique that still requires further technical improvements. Clinical studies are needed to prove the safety and efficacy of this minimally invasive technique.

Abdomen↗
PubMed1999

Transaxillary thoracoscopic sympathectomy experience in a hot climate: management of the dominant hand.

Primary palmar hyperhydrosis is a functionally and socially disabling problem of unknown etiology, affecting adolescents and young adults, especially in hot climates. Thoracoscopic sympathectomy is the most effective treatment for palmar hyperhydrosis. Postsympathectomy rebound hyperhydrosis may limit its success, especially in hot climates. The aim of this study is to report experience with thoracoscopic sympathectomy in a hot climate, managing the dominant hand (unilateral), followed by the other hand at a later date, based on the patient's choice. One hundred twenty patients were operated on during a 3 year period. The mean operative time was 25 minutes. The procedure was successfully completed in 169 operated limbs and was abandoned in one limb because of severe pleural adhesions. The procedure was done for the dominant hand (unilateral) in 120 patients. Fifty patients returned for contralateral thoracoscopic sympathectomy. There were 18 postoperative complications. Most of the patients (95%) were discharged after an overnight stay. The early observed cure rate was high (97%). During the mean follow-up period of 300 days, there was no recurrence of the original symptoms, except for one patient in whom the nerve of Kuntz was found and diathermized on the second thoracoscopy with symptomatic relief. Rebound hyperhydrosis occurred in 40 patients (33% of the total; 21% in the unilateral group and 42% in the bilateral group). In conclusion, it seems that transaxillary endoscopic sympathectomy of the dominant hand is an alternative method of treatment for patients with hyperhydrosis. Managing the dominant hand first and giving the patient the chance to observe the severity of the rebound hyperhydrosis may facilitate the decision for contralateral sympathectomy.

Adult↗
PubMed2000

[Thoracoscopic treatment of pulmonary hydatidosis: a case report].

Hydatidosis is a ubiquitous parasitic condition observed in a pulmonary localization in 30 to 40% of cases. The hydatid cyst develops slowly and is well tolerated by the host who presents no signs for a long period. Complications include compression, fissuration, rupture, anaphylactic shock or infection after a latency phase of variable duration. Treatment of pulmonary hydatidosis is classically surgical with enucleation of the cyst by cleavage between the adventice and the anhistic membrane via thorachotomy using the Ugon and Barret procedure. Needle aspiration is also possible via thorachotomy or thoracoscopy. Finally resection of the pulmonary parenchyma can be used to excise the hydatic cyst. We describe a thoracoscopic treatment using specific material, in a man with complications due to a voluminous pulmonary hydatid cyst.

Adult↗
PubMed2000

[Thoracoscopic surgery for pulmonary nodules in patients with previous malignant tumor].

We evaluated the clinico-pathological characteristics of thirty-four cases with previous malignant tumor who was operated under thoracoscopy for pulmonary nodules. In twenty-three cases (67.6%), including 20 cases suspected metastatic pulmonary tumor before operation, thoracoscopic surgery was performed without doing the preoperative examinations for the definite diagnosis. The mean diameter of resected tumors was 13.5 mm and the definite diagnosis was determined in all cases by the intraoperative pathological diagnosis. There were 26(76.5%) cases of malignancy, including 20 cases(58.8%) of metastatic pulmonary tumor and 6 cases (17.7%) of primary lung cancer. Accuracy rate of predictive diagnosis before operation was 67.6%. From the analysis of difference between pre- and post-operative diagnoses, inflammatory nodules or tuberculoma in the solitary nodule and intrapulmonary lymph nodes or silicotic nodules in the multiple nodules should have been considered with more carefully attention. Univariate and multivariate analysis showed that patients with metastatic tumor previously was only a predictive factor for metastatic tumor. Age, gender, CT findings, the number of nodules, disease free interval and tumor markers were unreliable factors in this study. In conclusion, there were a lot of cases with previous malignant tumor in which thoracoscopic surgery could become a first choice of modalities for the diagnosis of pulmonary nodules. Early thoracoscopic procedure will be recommended for such patients to perform the immediate treatment.

Adolescent↗
PubMed2000

Thoracoscopic debridement for acute pediatric empyema: efficacy of ultrasonic surgical device.

Few studies have examined thoracoscopic treatment for pediatric empyema. We encountered three children with thoracic empyema successfully treated by thoracoscopic debridement. Patients were a 3-year-old girl, a 17 month-old boy and a 13-year-old girl who developed thoracic empyema during therapy for pneumonia. We performed dissection and debridement under thoracoscopy and resolved fibrinopurulent collections using an ultrasonic surgical device in two cases to search the dissection plane while minimizing injury to the lung parenchyma. Ultrasonic surgical device (USUTM) is very useful for performing effective debridement and irrigation with minimal pleural damage. Thoracoscopic debridement performed early in the course of therapy is recommended even for acute pediatric empyema and could prevent the unnecessary open surgical intervention or decortication.

Acute Disease↗
PubMed2000

[Thoracoscopic resection for benign solitary fibrous tumor of the parietal pleura].

We have experienced thoracoscopic surgery for benign solitary fibrous tumor of the parietal pleura. A 46-year-old woman was admitted to our hospital because of chest abnormal shadow. Under thoracoscopy the tumor that was connected to the parietal pleura with a wide pedicle was completely resected with combined parietal resection of the pleura. Pathological diagnosis was a benign solitary fibrous tumor developed from the connective tissues under the parietal pleura. Thoracoscopic surgery is well indicated for a solitary fibrous tumor and wide excision of the tumor with combined resection of the pleura is important to prevent a local recurrence.

Female↗
PubMed2000

[Diagnosis and treatment of diaphragm ruptures].

72 cases of diaphragm's ruptures in patients with serious combined trauma illustrated basic methods of diagnosis in this condition including X-ray, ultrasonic methods, computed tomography and thoracoscopy. In 26.3% of the patients the diagnosis was made during laparotomy or thoracotomy for massive bleeding because of injury of other organs. In the absence of bleeding the diagnosis was based on signs of the abdominal organs dislocation into the pleural cavity. The differential diagnosis between right-sided coagulated hemothorax and diaphragm's right cupula ruptures was the most difficult.

Abdominal Injuries↗
PubMed2000

Thoracoscopic resection as the preferred approach to posterior mediastinal neurogenic tumors.

Traditionally, resection of posterior mediastinal neurogenic tumors (PMNTs) has been through a posterolateral thoracotomy. Although thoracoscopic resection of these tumors has been advocated, treatment guidelines have not been reported previously. The authors report a thoracoscopic resection of a PMNT and conducted a retrospective review of similar cases in the literature. Successful thoracoscopic resection was compared with tumor size and type using a nonpaired t test (alpha: P < 0.05). A total of 29 patients (13 men, 16 women), aged 26 to 68 years, who underwent a thoracoscopic resection of a PMNT were identified. Preoperative imaging included chest radiography and computed tomography in all patients and magnetic resonance imaging in 15 of 29 patients (52%). All tumors were located in the posterior mediastinum without preoperative evidence of invasion or malignancy. Conversion to an open procedure was necessitated in 12 of 29 (41%) patients ("minithoracotomy" in 11, posterolateral thoracotomy in 1). Tumor size necessitating conversion to an open procedure (mean = 4.79 cm) and tumor size amenable to thoracoscopy alone (mean = 3.84 cm) were not significantly different (P < 0.09). Pathology revealed 22 schwannomas (76%), 6 ganglioneuromas (21%), and 1 malignant schwannoma (3%) and was not associated with conversion to an open procedure (P < 0.99). Thoracoscopic resection of PMNTs can be performed successfully, regardless of tumor type or size; however, malignancy, local invasion, and tumors >5 cm may require an open procedure. Thoracoscopic resection can replace thoracotomy in the treatment of PMNTs.

Humans↗