An audit of pain control pathways following video-assisted thoracoscopic surgery.

Objective: To compare different modes of pain management following video-assisted thoracoscopic surgery (VATS) to our national standard.

Methods: This is an audit based on patient's experiences. One hundred consecutive patients who underwent VATS with or without pleurodesis were managed by one of the following pain relief pathways: (A) thoracic paravertebral block + morphine patient-controlled analgesia (PCA), (B) percutaneous thoracic paravertebral catheter +/- morphine PCA, (C) thoracic epidural +/- morphine PCA, (D) morphine PCA alone, and (E) intravenous or subcutaneous morphine as required.

Thoracoscopy in the diagnosis and management of recurrent pleural effusions.

Between April 1984 and July 1988, 102 patients with persistent or recurrent pleural effusions investigated by conventional methods in whom a diagnosis had not been achieved were submitted to thoracoscopy under general anesthesia. A positive diagnosis was obtained in 80.3% of the patients.

Management of Pulmonary Metastases in Osteogenic Sarcoma.

Twenty-three patients presented with isolated pulmonary metastases from osteogenic sarcoma following primary treatment by amputation or limb salvage, combined with chemotherapy. The metastases were treated by conservative surgical excision, combined with chemotherapy; surgicl excision was repeated for recurrent pulmonary metastases provided there were none elsewhere. Six patients are alive and disease free following their initial surgery.

Combined chemotherapy and surgery for pulmonary metastases from osteogenic sarcoma. Results of 10 years experience.

Twenty-three patients presented with isolated pulmonary metastases from osteogenic sarcoma following primary treatment by amputation or limb salvage, combined with chemotherapy. The metastases were treated by conservative surgical excision combined with chemotherapy; surgical excision was repeated for recurrent pulmonary metastases, provided there were none elsewhere. Six patients are alive and disease-free following their initial surgery.

Experimental en bloc double-lung transplantation.

A technique of en bloc double-lung transplantation through a median sternotomy has been developed. Hypothermic circulatory arrest was used after surface cooling in 7 puppies (mean weight, 3.1 kg; range, 1.