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 1,747 records · Page 97Linked to original sources
PubMed1998

[Pulmonary sequestration: 2 cases (intralobar and extralobar) in surgically treated adults].

We present two cases of pulmonary sequestration, one intralobar and the other extrapulmonary, in young adults. The diagnoses were obtained after surgical resection in both cases. The cases are of interest in that the first (intralobar sequestration) started with massive hemoptysis requiring emergency treatment, and the second (extrapulmonary sequestration) involved an unusual location in the upper mediastinum, requiring surgery by video assisted thoracoscopy.

Adult↗
PubMed1998

[Thoracoscopic repair of diaphragmatic eventration sustained at knife injury: a case report].

A 46-year-old male taxi driver was stabbed onto the left chest while on duty. On arrival soon after, he was hemodynamically stable. Computed tomography showed omental prolapse into the left thorax through the diaphragm. On the 11th day, he underwent thoracoscopy revealing omental prolapse via a 3-cm rent in the left diaphragm, which was reduced manually. The diaphragmatic orifice was lifted and debrided with suturing using a stapling cutter. The post-operative course was uneventful. Finger palpation through the orifice enabled safe suturing of the left diaphragm facing the omentum, the colon, and the stomach, all of which may suffer iatrogenic injury.

Endoscopy↗
PubMed1998

[Blunt thoracic trauma with hemorrhage into a mediastinal lymphangioma--case report].

We describe a young snowboarder suffering from dyspnea, chest pain and dysphagia following a blunt chest injury. These symptoms were caused by an accident-related hemorrhage within a preexisting lymphangioma of the right posterior mediastinum. At the same time a lymphangioma of the left anterior mediastinum was found. The lymphangioma of the posterior mediastinum was resected through a right posterolateral thoracotomy after thoracoscopy had demonstrated that a complete resection could not be performed on this way. The lymphangioma of the left side was resected 4 month later by a left-sided hemiclamshell approach due to its size and localisation. Complications arising from mediastinal lymphangioma are described as compression, infection, spontaneous bleeding, rupture and chylothorax. This is the first description of a posttraumatic, symptomatic hemorrhage within a mediastinal lymphangioma.

Adolescent↗
PubMed1997

[New imaging methods in diagnosis of lung cancer].

The paper reviews new imaging methods allowing more precise diagnosing and staging of lung cancer. From among the methods currently used in clinical practice computed tomography and nuclear magnetic resonance were reviewed. Advantages and limitations of these techniques were presented. As for isotopic tests we reviewed single photon emission computed tomography and positron-emission tomography as well as novel endoscopic methods--lung imaging fluorescence bronchoscopy and video assisted thoracoscopy.

Bronchoscopy↗
PubMed1998

Massive pleural effusion in systemic lupus erythematosus: thoracoscopic and immunohistological findings.

Small to moderate, bilateral pleural effusions are common during the course of systemic lupus erythematosus (SLE). These are related to several complications, particularly, congestive heart failure, nephrotic syndrome, pulmonary embolism or SLE itself. Thoracoscopy performed for a massive unilateral pleural effusion in a patient with SLE and inferior vena cava thrombosis revealed several small nodules on the visceral pleura. Immunofluorescence studies of biopsy samples showed immunoglobulin deposits confirming the lupus-related origin of the pleuritis.

Adult↗
PubMed1998

Lung volume reduction surgery for emphysema. A review.

Lung volume reduction surgery is emerging as a promising treatment option for selected patients with severe, debilitating end-stage emphysema refractory to medical management. Lung volume reduction surgery involves the removal of space occupying severely diseased, slowly ventilating and hyperexpanded lung, thus allowing the better conserved adjoining lung parenchyma to expand into the vacated space and function effectively. The operation can be accomplished by unilateral or bilateral thoracoscopy, thoracotomy or median sternotomy. The most emphysematous areas are excised using stapling or laser techniques or both. This review summarises the results of lung volume reduction surgery performed by various operative techniques. Results indicate that in the majority of patients improvement occurs in subjective dyspnoea and objective pulmonary function while oxygen and steroid dependence are reduced or eliminated at the cost of acceptable mortality and morbidity. Even though bilateral procedures produced much greater improvement, it is emphasized that it is the lung resection and not the operative approach that is critical to the success of the operation. Regardless of the technique used, the surgical treatment of emphysema is palliative in nature.

Endoscopy↗
PubMed1998

Preliminary results of thoracoscopic Belsey Mark IV antireflux procedure.

Laparoscopic Nissen fundoplication has replaced open approaches for refractory gastroesophageal reflux disease (GERD) in many major medical centers. Here we report our preliminary results of the Belsey Mark IV antireflux procedure performed by video-assisted thoracoscopy (VATS-Belsey). Fifteen patients underwent VATS-Belsey. The indications for surgery included GERD refractory to medical therapy (n=10), achalasia (n=2), diffuse esophageal spasms (n=1), epiphrenic esophageal diverticulum (n=1), and paraesophageal hernia (n=1). The median operative time was 235 min. There were three conversions to open minithoracotomy (8-10 cm) necessitated by severe adhesions (n=2) and repair of a gastric perforation (n=1). The median hospital stay was 4 days. Postoperative complications included persistent air leaks, requiring discharge with a Heimlich valve in one patient. There were no perioperative deaths. At a median follow-up of 19 months, ten patients (66%) were asymptomatic and were not taking any antacids. One patient who had taken proton pump inhibitors preoperatively required postoperative H2 blockers for mild heartburn. In three patients, recurrent GERD symptoms (mean follow-up 6 months) led to laparoscopic takedown of the Belsey and Nissen fundoplication. One patient with achalasia, who had recurrent dysphagia after 1 year of relief following VATS myotomy and Belsey, underwent esophagectomy. The Belsey Mark IV antireflux procedure is technically feasible by VATS with minimal morbidity. However, our preliminary results suggest that open thoracotomy for Belsey Mark IV should remain the standard operation for GERD with poor esophageal motility when a thoracic approach is desired. We have modified our approach to laparoscopic partial fundoplications (Toupet or Dor) for severe GERD and poor esophageal motility when an abdominal approach is possible.

Adult↗
PubMed1998

[Surgical diagnosis and therapy in patients with mediastinal space-occupying lesions. A retrospective analysis of 223 intervention with special reference to long-term course].

UNLABELLED: The diagnostic and therapeutic approach in patients with mediastinal masses (MM) treated at our institute between 1983 and 1993 was retrospectively reviewed. METHODS AND MATERIAL: 193 patients with MM (105 males and 88 females, average age 53, ranging from 16-81) underwent 223 interventions. Staging mediastinoscopies in lung cancer patients were ruled out. Long-term follow-up data were available in 123 of 162 cases with neoplastic MM (average follow-up time 5.5 years). Of all 223 surgical interventions 143 were diagnostic (53 parasternal mediastinotomies, 78 mediastinoscopies and 8 thoracoscopies) and 80 therapeutic (46 sternotomies and 34 posterolateral and a second half). The analysed period was splitted up in a first half (1983-1987) and second half (1988-1993) to study an eventual trend in the management of MM. RESULTS: The most frequent diagnoses were: thymoma (21%), malignant lymphoma (18%) and mediastinal sarcoidosis (14%). 43% of the MM were localized in the anterior, 46% in the middle and 7% in the posterior mediastinum. Thoracic pain, cough and dyspnoea represented the most common symptoms, leading to an invasive diagnostic procedure. 25% of the patients had no symptoms. The mortality and morbidity rate of all interventions was 3.4% and 18.7% respectively and concerned almost nerval injuries and postoperative respiratory failure. The percentage of direct tumor excisions increased from 21% during the first half of the period to 40% during the second half of the period, whereas diagnostic surgical interventions decreased from 57% to 44%. The percentage of total excisions after previous surgical biopsies decreased from 22% to 16%. In spite of the introduction of high resolution CT scan and MRI techniques during this time period no significant change in the use of presurgical diagnostic procedures was obvious. Fine needle biopsies and bronchoscopies were performed less frequent in the second half in comparison to the first half (11%, 7%, 29%, 13% respectively). From 123 patients with neoplastic disease data were available for long-term results. 35 had benign and 83 malignant histologies, in five cases dignity was unclear. 54% of these patients were disease-free at follow-up time, 10% had local recurrency or distant metastasis and 37% died during the observed time period. CONCLUSIONS: Surgical biopsy seems to remain the most important investigation for a successful interdisciplinary approach to MM. Overall morbidity and mortality rate of mediastinal surgery might appear remarkable but has to be related to the favorous long-term results after different individual treatment modalities in patients with mediastinal masses.

Adolescent↗
PubMed1998

The diagnosis and management of pleural empyema.

The diagnosis and management of pleural infection continues to improve steadily. Recent advances include: newer, smaller, and more comfortable chest drainage catheters; improved pleural pus drainage with the aid of intrapleural fibrinolytics; and improved surgical procedures including thoracoscopic surgery. The optimal size of chest drainage tube remains a matter of debate, with no large data sets available to clarify the optimal tube size. In contrast, there are now small controlled trials of sound basic methodology which suggest a therapeutic role for both fibrinolytics and thoracoscopy. Studies large enough to establish clearly the efficacy and safety of these approaches are now at the planning and recruitment stage.

Anti-Bacterial Agents↗
PubMed1998

[Endoscopic and invasive approach].

Bronchoscopy plays a major role in the histological diagnosis of stage III lung cancer and the choice among bronchoscopic techniques may very according to the central or peripheral localization of the lesion. To obtain the histological diagnosis, percutaneous needle aspiration and bronchoscopic procedures are rather complementary. In staging of bronchogenic carcinoma, bronchoscopy may confirm neoplastic involvement of the main carina (T4), involvement within 2 cm of the main carina (T3) or involvement of mediastinal nodes (N2 or N3) by the use of transbronchial needle aspiration. Extension of lung cancer to intrathoracic lymph nodes is better assessed by mediastinoscopy. The use of thoracoscopy in staging has been increasing in particular in cases of concomitant pleural effusion.

Biopsy↗
PubMedDate not supplied

[Therapeutic approach in non-postoperative pleural empyema].

The Authors carried out an retrospective analysis on 81 patients, 67 men and 14 women, suffering from non post-surgical thoracic empyema, to evaluate the different therapeutic procedures and respective indications. The unsuccessful response to the preserving approach (intercostal drainage and pleural lavage twice a day with specific antibiotics or antiseptics) in 56 cases, induced the Authors to carry out a video-thoracoscopy (VAT), that allowed them to define the infection stage and subsequent treatment (the carrying on of a pleural drainage-lavage in 32 cases, the transcurrent pleural irrigation in 10 cases, the open window thoracostomy followed by myoplasty in 6 cases with bronchopleural fistula, the decortication with associated pleural exeresis in 6 cases with bronchopleural fistula, the decortication with associated pleural exeresis in 6 cases, the streptokinase in pleural cavity in 2 cases). There were registered totally 3 deaths (3.7%). The Authors in conclusion assert that the VAT, carried out after the unsuccessful preserving treatment, allows the evaluation of the infection stage and consequently suggests therapy.

Adolescent↗
PubMed1998

[Laparoscopic and thoracoscopic reintervention after mini-invasive surgery in emergencies].

One-hundred-eighty patients underwent emergency minimally invasive procedures (laparo and thoracoscopy) in the last two years. In twelve postoperative drawbacks another surgical procedure was performed. Laparoscopic or thoracoscopic exploration was undertaken in 8 cases while open surgery was done in 4. Complications and surgical overtiming rate was higher after endoscopic than open surgery. This approach allows us to correct very few and selected disease when a skilled surgical team is available especially during reoperations.

Emergencies↗
PubMed1998

[Videoscopic resection of a thrombosed aneurysm of a patent ductus arteriosus in a neonate].

Aneurysmal dilatation of a patent ductus arteriosus is a rare condition. One hundred and fifty three cases have been reported, of which 59 (39%) were operated, with an operative mortality of 16%. The authors report a case detected in a premature neonate on chest X-ray showing a mass in the mid-mediastinal region. Surgical resection was undertaken by video-thoracoscopy. Peroperative analysis of the resected specimen suggested a vascular structure and this was confirmed by histological study, which showed spontaneous aneurysm of a thrombosed patent ductus arteriosus or cystic residue of a patent ductus arteriousus. The authors underline the importance of peroperative puncture of structures of uncertain origin and the possibility of conversion of such a procedure to that of an extreme emergency.

Aneurysm↗
PubMed1998

[Our initial experience with video-assisted thoracoscopic surgery (VATS)].

Diagnostic and therapeutic potentials and our first two-year experience with video-assisted thoracic surgery (VATS) are reported. From May 1995 to April 1997, at the Department of Surgery, University Hospital Split, VATS approach was planned in 55 cases (recurrent pneumothorax in 23, tension pneumothorax in 1, traumatic effusion in 5, malignant metastatic lung tumor in 1, benignant lung tumor in 11, traumatic effusion in 5, suspected mediastinal lymph nodes in 4, long lasting unconfirmed pleural effusion in 9, foreign body in 1, mediastanal cyst in 1). Of these, 48 procedures (87.2%) were performed using VATS (diagnostic thoracoscopy in 12, wedge resection with or without pleural abrasion in 21, partial pleurectomy in 1, decortications in 3, mediastinal lymph nodes biopsy in 4, lung biopsy in 7). Seven patients (12.7%) underwent conventional posterolateral thoracotomy. Complications included persistent air leak in three patients, prolonged bleeding in one patient and supraventricular tachycardia in one patient. The mean duration of chest tube drainage after the procedure was 3.7 days (range 2 to 19 days), and mean hospital stay was 5.1 days (range 3 to 15 days). All patients received routine antimicrobial chemoprophylaxis with single-dose ceftriaxone 2 g intravenously immediately prior to the surgery, and average postoperative patient-controlled analgesia with buprenorphine 0.15 mg. We conclude that VATS is a very useful alternative to conventional thoracotomy in managing cases of exploration, recurrent spontaneous pneumothorax, benign pulmonary lesions, solitary pulmonary nodes, early decortications and different intrathoracic biopsies.

Endoscopy↗
PubMed1998

[Endometriosis of the lung diagnosed with videothoracoscopy].

A case of non symptomatic pulmonary endometriosis appearing as multiple nodules on chest X ray and chest CT scan is reported. 43 year old woman was admitted to surgical department because of suspicion of neoplastic dissemination of unknown origin. Non invasive diagnostic procedures were not effective. Diagnosis of pulmonary endometriosis was established with thoracoscopy with lung sampling, confirmed with histopathologic evidence.

Biopsy↗
PubMedDate not supplied

Thoracoscopic assisted pneumonectomy.

A lung carcinoma with tumor involving more than one lobe or in close proximity to the mainstem bronchus often requires pneumonectomy for surgical cure. Inflammation, bulky tumors, and dense adhesions limit the operative field of vision and may result in the abandonment of procedures with potential for complete extirpation. This case illustrates the utility of thoracoscopy in visualization of the hilum and other neurovascular structures in a patient with a proximal tumor and dense intrathoracic adhesions. Successful resection was made possible by use of combined open and thoracoscopic modalities.

Biopsy, Needle↗
PubMedDate not supplied

Minimally invasive anterior spinal exposure and release in children with scoliosis.

BACKGROUND: The early experience with thoracoscopy in children has involved the diagnosis and treatment of pleural and pulmonary diseases. Recent advances have allowed surgeons to perform more complex procedures through video-assisted thoracoscopic surgery (VATS), potentially decreasing the pain and pulmonary impairment associated with an open thoracotomy. The authors report their initial experience with thoracoscopic assisted anterior spinal exposure and release as part of the treatment for children with spinal deformities. METHODS: A retrospective chart review of five children who underwent VATS for anterior spinal surgery between June 1995 and January 1997 was performed. RESULTS: The ages of the patients ranged from 11 to 16 years with a mean of 13.4 years. All patients had an anterior spinal release with or without fusion and same-day posterior spinal fusion with instrumentation. VATS was successfully completed in all patients without major morbidity and no mortality. The average operative time for the anterior portion of the procedure was 305 minutes, and a mean of 7 disc levels were released. Mean length of chest tube drainage and hospitalization were 6.8 and 8.6 days, respectively. CONCLUSIONS: The objectives of anterior exposure for spinal surgery in children can safely and effectively be accomplished using minimally invasive surgery.

Adolescent↗
PubMed1998

Video-assisted thoracic surgery for lung volume reduction surgery.

Lung volume reduction surgery by video thoracoscopy can result in significant improvement in quality of life and pulmonary function for selected patients suffering from severe emphysema. Clinical trials comparing the use of lasers versus staples, unilateral versus bilateral procedures, and video surgery versus mediansternotomy are summarized. Patient selection and patient care issues are addressed. Information gathered from the selection, evaluation, and study of almost 500 patients treated surgically for emphysema at a single institution is summarized.

Endoscopy↗