[The benefits of digital chest drainage in pleural decortication in thoracic empyema. Prospective, randomized, control trial].

Background: Prolonged air leak after pleural decortication is one of the most frequent complications.

Objective: The aim of this study is to compare the effects of prolonged air leak between the digital chest drainage (DCD) system and the classic drainage system in patients with empyema class IIB or III (American Thoracic Society classification) in pleural decortication patients.

Material And Methods: A total of 37 patients were enrolled in a prospective randomized control trial over one year, consisting of 2blinded groups, comparing prolonged air leak as a main outcome, the number of days until removal of chest drain, length of hospital stay and complications as secondary outcomes.

Right main bronchial fracture resolution by digital thoracic drainage system.

Tracheobronchial stenosis is common in the thoracic surgery service, and iatrogenic injury of the airway after manipulation is not infrequent. When a digital thoracic drainage system came onto the market, many advantages were evident. A 24-year-old woman with critical right main bronchial stenosis underwent airway dilation that was complicated by a tear with a massive air leak, resulting in a total right pneumothorax.

Thoracoscopic Excision of Migrated Kirschner Wire to Right Pulmonary Hilum.

Kirschner wires are often used for the stabilization of complex fractures. Wire migration is a rare but still recognized complication of its use. A 56-year-old man suffered a clavicle fracture at age 26 that was stabilized with one Kirschner wire, and for 30 years he was asymptomatic.

A randomized prospective study of analgesic quality after thoracotomy: paravertebral block with bolus versus continuous infusion with an elastomeric pump.

Objectives: Paravertebral block (PVB) with infusion of local anaesthetic (LA) through a paravertebral catheter is an effective alternative to epidural analgesia in the management of post-thoracotomy pain. PVB can be done in two ways: either through administration of a bolus dose of the LA or continuous infusion via an infusion pump; currently, there is no consensus on which route is best. Our objective was to compare the efficacy of the PVB for post-thoracotomy pain control using bolus doses versus a continuous infusion pump.

A prospective study comparing three-port video-assisted thoracoscopy with the single-incision laparoscopic surgery (SILS) port and instruments for the video thoracoscopic approach: a pilot study.

Background: Single-incision laparoscopic surgery (SILS) has proved its advantages in several procedures, mainly a shorter hospital stay, improved aesthetic results, and less postoperative pain. The authors have used this approach for several thoracic surgical procedures.

Methods: This prospective study compared 20 cases between standard three-port video-assisted thoracic surgery (VATS) and the single-incision approach using a standard abdominal SILS system.

[Locating pulmonary nodules with a computed axial tomography-guided harpoon prior to videothoracoscopic resection. Experience with 52 cases].

Objective: Videothoracoscopic (VTC) resection of peripheral pulmonary nodules (PN) occasionally requires performing a mini-thoracotomy to locate them using palpation. The aim of this study is to evaluate the usefulness of inserting a CT-guided harpoon as a method for locating PN prior to surgery.

Material And Methods: A study was conducted on a total of 52 patients who were scheduled for locating 55 PN prior to surgery by inserting a CT-guided harpoon, from November 2004 to January 2011.

Simultaneous bilateral posterior thoracotomy with the patient in the prone position for resection of bilateral posterior lung metastases.

Lung metastases limited to posterior segments can be removed through a posterior thoracotomy with the patient in the prone position. When these metastases are bilateral, a simultaneous approach can be performed. We present three cases of bilateral lung metastases of colorectal carcinoma removed through a simultaneous bilateral posterior thoracotomy with the patient in the prone position.

The efficacy of paravertebral block using a catheter technique for postoperative analgesia in thoracoscopic surgery: a randomized trial.

Objective: The analgesic scheme combining paravertebral block (PVB) and intravenous non-steroidal anti-inflammatory drug (NSAID) has proven to be effective for postoperative pain control after thoracotomy. The hypothesis tested in this study was that this policy was also suitable to improve pain control after video-assisted thoracic surgery (VATS).

Methods: This was a prospective randomized study on 40 patients submitted to three-ports' VATS for pneumothorax or solitary pulmonary nodule.

Bilateral thoracoscopic sympathetic block by clipping.

Main cause of dissatisfaction after videothoracoscopic (VATS) sympathectomy in the treatment of hyperhidrosis (HH) and facial blushing (FB) is compensatory sweating (CS). Sympathetic nerve (SN) clipping obtains the same results as sympathectomy in terms of efficacy and safety and levels of CS are similar or lesser than with the standard procedure, with the advantage that if necessary - massive intolerable CS-, this technique theoretically allows to revert the sympathetic block by removing the clips. The surgical procedure is performed through two incisions of 10 mm at the mid axillary and anterior axillary lines (third and fifth intercostal spaces).

[The benefits of digital air leak assessment after pulmonary resection: prospective and comparative study].

Introduction: Persistent air leaks represent the most common pulmonary complication after elective lung resection. Since there are insufficient data in the literature regarding variability in the withdrawal of postoperative pleural drainages, we have designed a prospective, consecutive and comparative study to evaluate if the use of digital devices (Thopaz and DigiVent) to measure postoperative air leak compared to a Pleur-Evac varies on deciding when to withdraw chest tubes after lung resection.

Methods: A prospective, consecutive and comparative trial was conducted in 75 patients who underwent elective pulmonary resection for non small cell lung cancer.

Effectiveness of sympathetic block by clipping in the treatment of hyperhidrosis and facial blushing.

Main cause of dissatisfaction after videothoracoscopic (VATS) sympathectomy in the treatment of hyperhidrosis (HH) and facial blushing (FB) is compensatory sweating (CS). Sympathetic nerve (SN) clipping permits to revert the block effect by removing the clips in case of an intolerable CS. We present our experience with this technique.

A prospective study of analgesic quality after a thoracotomy: paravertebral block with ropivacaine before and after rib spreading.

Objective: Paravertebral block (PVB) is an effective alternative to epidural analgesia in the management of post-thoracotomy pain. Rib spreading (RS) is an important noxious stimulus considered a major cause of post-thoracotomy pain. Our hypothesis was that a bolus of ropivacaine 0.

Outpatient thoracic surgery.

In summary, from the different alternatives to conventional hospitalization developed in the last decades, outpatient surgery has been the one with the greatest growth. However, only few studies have been reported on thoracic surgery and there is still great potential for an increase in outpatient thoracic surgery. The aim of this article has been to evaluate the clinical aspects, results, and economical impact of an outpatient thoracic surgery program (OTSP).

[Results of videothorascopic sympathectomy in the treatment of facial redness and hyperhidrosis in 41 patients].

Objective: To evaluate the results and complications of thoracic sympathectomy in the treatment of patients with uncontrollable blushing and facial hyperhidrosis.

Patients And Method: Between May 2000 and August 2006 we performed 82 VATS sympathectomies on 41 patients with the diagnosis of uncontrollable blushing and/or facial hyperhidrosis. Two of them had been previously operated on without good results.

[Pericardial window by videothoracoscope in the treatment of pericardial effusion and tamponade].

Introduction: Malignancies are the most common causes of pericardial effusion (PE) or tamponade (PT). Lung and breast carcinoma are the most frequent. The treatment of PE consists in the performance of drainage and/or pericardial window (PW) usually subxiphoid.

Comparative analysis of analgesic quality in the postoperative of thoracotomy: paravertebral block with bupivacaine 0.5% vs ropivacaine 0.2%.

Objectives: Paravertebral block is an effective alternative to epidural analgesia in the management of post-thoracotomy pain, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. Our objective was to evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine).

Methods: Prospective randomized study of 70 patients submitted to thoracotomy.