Intraoperative Lung Ultrasound (ILU) for the Assessment of Pulmonary Nodules.

Background: The primary aim of this study was to confirm the validity of intraoperative lung ultrasound (ILU) as a safe and effective method of localization for difficult to visualize pulmonary nodules during Video-Assisted Thoracoscopic Surgery (VATS) and open thoracotomy. The secondary aim was to enhance knowledge on the morphological patterns of presentation of pulmonary nodules on direct ultrasound examination.

Materials And Methods: 131 patients with lung nodule and indication for surgery were enrolled.

The use of ultrasound in detecting and defining ground-glass opacities: results of an ex vivo evaluation.

Objectives: To evaluate the role of ultrasound in detecting and defining ground-glass opacities (GGOs) in surgical specimens of patients undergoing thoracoscopic diagnostic resection.

Methods: We performed an observational single-centre study of all consecutive patients undergoing thoracoscopic diagnostic resection of GGOs. In each patient, the specimen was scanned with ultrasound; then, a needle was inserted into the lesion to facilitate its detection by the pathologist.

Percutaneous dilatational tracheostomy using the ETView Tracheoscopic Ventilation Tube: a teaching course in a pig model.

Objective: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model.

Methods: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model.

Comparison of plethysmographic and helium dilution lung volumes in patients with a giant emphysematous bulla as selection criteria for endobronchial valve implant.

Objectives: To assess whether the difference in lung volume measured with plethysmography and with the helium dilution technique could differentiate an open from a closed bulla in patients with a giant emphysematous bulla and could be used as a selection criterion for the positioning of an endobronchial valve.

Methods: We reviewed the data of 27 consecutive patients with a giant emphysematous bulla undergoing treatment with an endobronchial valve. In addition to standard functional and radiological examinations, total lung capacity and residual volume were measured with the plethysmographic and helium dilution technique.

Bronchopleural fistula closed with cellulose patch and fibrin glue.

We describe a bronchoscopic technique for closing small postoperative bronchopleural fistulas, using an oxidized regenerated cellulose patch and fibrin glue. The patch is mounted on the end of endoscopic forceps and introduced into the fistula to cover it. Intracavitary and submucosal injections of fibrin glue fill the bronchial stump and achieve apposition of the fistula edges.

Efficacy of wound analgesia for controlling post-thoracotomy pain: a randomized double-blind study†.

Objectives: Continuous wound infusion of local anaesthetics has been successfully applied for postoperative pain control in several procedures but, surprisingly, it is underused in thoracic surgery. We aimed to investigate the effects of wound analgesia associated with systemic patient-controlled analgesia in patients undergoing lung cancer resection with muscle-sparing thoracotomy.

Methods: Sixty consecutive patients undergoing lung cancer resection via standard muscle-sparing thoracotomy were randomized into two groups (wound analgesia and placebo groups).

Quantitative assessment of emphysematous parenchyma using multidetector-row computed tomography in patients scheduled for endobronchial treatment with one-way valves†.

Objectives: To investigate the role of volume quantitative assessment using multidetector-row computed tomography to select patients scheduled for endobronchial one-way valves treatment.

Methods: Twenty-five consecutive patients (15 with heterogeneous emphysema and 10 with giant emphysematous bulla) undergoing endobronchial valves treatment were enrolled. All patients were studied pre- and postoperatively with standard pulmonary functional tests and quantitative volume assessment of target lobe and entire lung.