Single incision video-assisted thoracic surgery pneumonectomy for centrally located lung cancer.

Increasing experience in single-incision video-assisted thoracoscopic (SIVATS) lung resections for lung cancer has made some sophisticated lung resections such as bronchial or vascular sleeve resections, chest wall resections and pneumonectomy possible. There are some case series published in medical literature about the feasibility and safety of multiportal video-assisted thoracic surgery pneumonectomy. However, in this prepubertal period of its evolution the literature data are still immature, and limited only to rare case reports or video presentations for SIVATS pneumonectomy for lung cancer.

Uniportal video-assisted thoracic surgery lobectomy in a patient with carcinoid tumor located at the orifice of the right lower lobe.

We present here a 47-year old male patient who had a typical carcinoid tumor located at the orifice of right lower lobe bronchus underwent uniportal thoracoscopic lower lobectomy following bronchoscopic removal of the endobronchial tumor. Tumor was seen by bronchoscopy to protrude out from the lower lobe into the intermediary bronchus obstructing the lower lobe completely and the middle lob partially. However, the origin of the endobronchial tumor was in the distal part of the lower lobe bronchus.

Advantages and disadvantages of single incision VATS in major anatomical resection for lung cancer.

Safety and feasibility of lung resections by single incision thoracoscopy have been confirmed in large number of studies. As proponents claim its lesser invasive nature caused by lacking of additional intercostal port(s), opponents question the outcome measures of the approach especially in oncological manner. Since there is no major discussion regarding the superiority of video-assisted thoracoscopic surgery (VATS) on lung resections over the open technique in the surgical management of lung cancer today, advantage and disadvantage of single incision VATS lung resections was reviewed with the comparison of standard, multi-port VATS approach in this article.

Single-Incision Video-Assisted Thoracic Surgery for an Extralobar Sequestration in a Child.

Uniportal or single-incision video-assisted thoracic surgery (VATS) has been performed successfully in adult patients with different intrathoracic pathologies for years. However, no report in uniportal/single-incision VATS in pediatric patients in the English literature has been published up to date. This may be explained by the limited number of patients and the difficulties in working in very narrow thoracic cavity of babies and children.

Management of recurrence after initial surgery for malignant pleural mesothelioma: a mini-review.

Recurrence after surgery in the multimodality therapy for malignant pleural mesothelioma is a common problem. As the majority of patients experience not only local but also distant metastases, a systemic treatment strategy in addition to local control measures remains necessary. Nevertheless, none of the chemotherapy regimens have achieved clinical success.

Thoracic surgery for haemoptysis in the context of tuberculosis: what is the best management approach?

Haemoptysis is not an unusual finding in patients with old or active pulmonary tuberculosis. Because of bronchial artery or a branch of pulmonary artery erosion due to cavitary infiltration, bronchiectasis, fungus ball, broncholithiasis or destroyed lung, the bleeding can sometimes be a life-threatening situation. Assessment of the patient and finding the exact site of bleeding can be difficult especially in a patient with disseminated lung disease.

The use of single incision thoracoscopic pleurectomy in the management of malignant pleural effusion.

Background: A number of procedures have been used in the management of malignant pleural effusion including repeated thoracentesis, tube thoracostomy, drainage with catheter, chemical pleurodesis, pleurectomy and pleuro-peritoneal shunt. However, the optimal method of management remains unclear. On the other hand, single incision thoracoscopic surgery has been defined as a less invasive method than the standard threeportal videothoracoscopy.

The use of single incision thoracoscopic surgery in diagnostic and therapeutic thoracic surgical procedures.

Background: As a minimal invasive procedure, a standard threeportal videothoracoscopy may have complications such as chronic and residual pain. However, a single incision thoracoscopic surgery is a less invasive procedure with minimal complications. We present our series of patients who had single incision thoracoscopic surgical procedures.

Surgical management for hydatid disease.

Hydatid disease is caused by the parasite Echinococcus granulosus. The liver and the lungs are common sites. When a cystic lesion is seen on CT scan, diagnosis is made based on the patient having lived in an endemic area.

Superiority of video-assisted to standard mediastinoscopy in non-small-cell lung cancer staging.

Background: We compared the efficiency of videomediastinoscopy (VM) and standard mediastinoscopy (SM) in detecting mediastinal lymph node (MLN) metastasis in non-small-cell lung cancer (NSCLC) patients.

Methods: By SM method a surgeon sampled bilateral paratracheal and subcarinal lymph node stations and then by VM method, another surgeon resampled all lymph node stations once more through the same incision in the same operative setting. Results of the pathologic examinations of two methods were compared.

Spontaneous pneumomediastinum: report of two cases.

Spontaneous pneumomediastinum (SPM) is an uncommon, benign, self-limited disorder that usually occurs in young adult males without any apparent precipitating factor or disease. SPM responds extremely well to conservative treatment, without recurrence in the great majority of cases. In this report, two patients who were admitted for SPM are discussed together with the associated literature.

[A rare cause of hemopneumothorax: an aberrant systemic artery].

Spontaneous hemopneumothorax is a rare situation that can be life-threatening in young patients presenting hemodynamic instability due to hypovolemic shock. One of the extraordinary causes of hemopneumothorax is rupture of an apically located aberrant artery after pneumothorax, which is noticed as a third etiological factor in the literature. This case is presented in order to highlight this uncommon etiological factor together with the literature.

Streptokinase for malignant pleural effusions: a randomized controlled study.

Effective palliative treatment in malignant pleural effusion can only be carried out when the lung is fully expanded after drainage of effusion. We investigated the efficacy of intrapleural fibrinolytics for lysing fibrin deposits and improving lung reexpansion in patients with malignant pleural effusion. We randomly allocated 47 patients with malignant pleural effusion into 2 groups: a fibrinolytic group of 24 were given 3 cycles of 250,000 U intrapleural streptokinase; the control group of 23 received pleural drainage only.

An unusual presentation of Castleman's disease.

Castleman's disease is one of the heterogeneous group of lymphoproliferative disorders of unknown aetiology. It commonly presents as a mediastinal mass. It can be unicentric involving only a single site, or multicentric involving multiple sites.

The autologous pleural buttressing of staple lines in surgery for bullous lung disease.

Objective: Prolonged air leak remains as one of the most common complications after surgery for bullous lung disease. Reinforcement of the staple line with either prosthetic material or bovine pericardial strips has been advocated to avoid this problem. We used the patients' own parietal pleural layer to cover the staple lines to prevent air leak and subsequently assessed the comparative results.

A patient with massive hemoptysis treated by videothoracoscopic clipping of the causative aberrant artery.

Massive hemoptysis is a life-threatening situation and can have a variety of underlying causes. Bronchial arteries are mostly the source of bleeding but in rare cases an aberrant systemic artery may be present, causing hemoptysis. Here, we present a patient in whom an aberrant systemic artery was defined to be the cause of hemoptysis.

The treatment results of patients with multidrug resistant tuberculosis and factors affecting treatment outcome.

The treatment of multi-drug resistant tuberculosis (MDR-TB) is complicated and results are not always satisfactory. We aimed to investigate treatment results of our patients, relapse rates, factors affecting treatment outcome. We evaluated prospectively, 142 patients, who had been hospitalised with diagnosis of MDR-TB in our clinic between January 1995-December 2000 at Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital in Istanbul, Turkey.

Lingual inferior segmentectomy for a 7-cm pulmonary arteriovenous malformation.

Pulmonary arteriovenous malformation (PAVM) is a relatively rare abnormal pulmonary vascular connection that is mostly congenital. We report on a patient who was treated by lingual inferior segmentectomy for a 7-cm PAVM. This particular case emphasized the feasibility of resection of the PAVM by pulmonary segmentectomy regardless of the size of the lesion.

Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience.

Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this retrospective study, we present our 10-year experience in the management and clinical outcome of 4205 cases with chest trauma associated with blunt and penetrating injuries in a level I trauma hospital in Turkey. In 66% of the cases, blunt injury mostly related to traffic accidents was the cause of chest trauma.

Lung decortication for chronic empyaema: effects on pulmonary function and thoracic asymmetry in the late period.

Objective: Chronic empyaema deteriorates lung function and causes thoracic asymmetry due to intercostal narrowing in the diseased hemithorax. This study aims to investigate the rates of improvement in the pulmonary function tests (PFTs) and the thoracic deformity in late postoperative period of lung decortication, performed for chronic empyaema.

Methods: A total of 50 patients who underwent standard open decortication for empyaema were included.

Extrapleural pneumonectomy for pyothorax-associated lymphoma.

Pyothorax-associated lymphoma (PAL) is a non-Hodgkin's lymphoma that occurs in the pleural cavity of patients with a long-standing history of pyothorax. Here, we report a left pleuropneumonectomy performed for PAL in a 76-year-old male patient with a 60-year history of pyothorax due to tuberculosis.