[85 consecutive VATS non-rib spread simultaneously stapled lobectomies for malignancy].

A new technique for pulmonary lobectomy has been utilized for malignant lesions. Eighty-five consecutive patients with pulmonary neoplasms underwent a VATS non-rib spread Simultaneously Stapled Lobectomy. There were 34 males and 51 females with 61 adeno, 21 squamous, 2 large cell and 1 carcinoid tumor who underwent 18 left upper, 13 left lower, 20 right upper, 7 right middle and 27 right lower lobectomies.

One hundred video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading.

Background: This study was performed to evaluate and determine the validity and benefits of video-assisted thoracic surgical simultaneously stapled pulmonary lobectomy without rib spreading.

Methods: Between September 1992 and August 1995, 100 consecutive video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading were performed.

Results: Forty-five male and 55 female patients had 24 right upper, 8 right middle, 29 right lower, 24 left upper, 15 left lower lobectomies for 66 adenocarcinomas, 20 squamous cell carcinomas, 4 large cell carcinomas, 8 benign lesions, and 2 metastatic lesions.

Does VATS favor seeding of carcinoma of the lung more than a conventional operation?

Seeding of carcinoma has always been of concern to surgeons. Recent reports have focused on possible implantation of tumor in the small wounds of minimally invasive procedures, i.e.

VATS-Argon Beam Coagulator treatment of diffuse end-stage bilateral bullous disease of the lung.

Diffuse bullous disease of the lungs remains an unrelentless, debilitating, terminal disease. Intensive medical therapy can give transient relief of symptoms. Thoracotomy and resection has not always been successful and can be associated with an increased mortality and morbidity.

Endobag.

A simple method for placing specimens in a protective bag during video-assisted thoracic surgery has been developed. The equipment is readily available, and the technique is easy to perform.

Video-assisted thoracic surgical resection of malignant lung tumors.

Forty patients with malignant pulmonary disease underwent evaluation, staging, and a biopsy or resection by means of video-assisted thoracic surgery. There were 20 men and 20 women whose ages ranged from 27 to 82 years. Eight patients had a wedge resection for metastatic carcinoma, three a lobectomy for primary carcinoma, six exploration of the thorax, five biopsy of the aortopulmonary window, and eighteen a sublobar resection for primary carcinoma of the lung.

One hundred consecutive patients undergoing video-assisted thoracic operations.

Video-assisted thoracic surgery is a new modality that allows visualization of and access to the intrathoracic organs without making a thoracotomy incision. One hundred consecutive patients underwent 113 thoracic procedures using this technique. Eight wedge resections for metastatic lesions, 6 pericardial windows, 1 bronchogenic cystectomy, 4 explorations of the aortopulmonary window, 1 decortication, 5 pleural scleroses, 8 bullous ablations, 25 lung biopsies, 19 wedge resections for carcinoma, 9 explorations of the thorax, 3 lobectomies, 1 esophageal cystectomy, 14 wedge resections for benign lesions, 4 pleurectomies, 1 excision of a neurogenic tumor, 3 mediastinal explorations, and 1 imaged axillary dissection were performed.

Imaged thoracoscopic lung biopsy.

Imaged thoracoscopic surgery is a technique utilized to operate on the intrathoracic organs without making a formal thoracotomy incision. Eleven patients underwent lung biopsy with this procedure and each had markedly reduced postoperative pain. Each patient resumed preoperative activity levels within one week of discharge from the hospital.

Imaged thoracic lobectomy: should it be done?

Imaged thoracic surgery is a new modality that is rapidly gaining acceptance from thoracic surgeons. Procedures that traditionally required a thoracotomy can now be done successfully using this technique in some patients. Three patients with primary carcinoma of the lung have undergone lobectomy using imaged thoracic surgery.

Imaged thoracoscopic surgery: a new thoracic technique for resection of mediastinal cysts.

Previously, intrathoracic organs have been approached by either thoracotomy or thoracoscopy. A technique, imaged thoracoscopic surgery, using video optics and projection of images on a screen provides another option for the thoracic surgeon. Two patients with mediastinal cysts, one bronchogenic and one esophageal, underwent surgical removal using imaged thoracoscopic surgery.

Special report: video-endoscopic thoracic surgery.

Since the advent of video optics, with the projection of images on a screen, a new option has been added to the armamentarium of the thoracic surgeon: video-endoscopic thoracic surgery. A case report of a 33-year-old woman demonstrates the successful new procedure.

Tracheal stenosis.

A case report of tracheal stenosis is used to review the pathophysiology and surgical management of symptomatic tracheal stenosis following intubation and/or tracheostomy. The authors discuss tracheal resection and reconstruction, the preferred permanent method of managing benign tracheal stenosis.

The clinical oral examination in psychiatry: association between subscoring and global marks.

Fifteen academic psychiatrists rated a videotaped clinical oral examination done in the Royal College format. In addition to assigning an overall mark, the raters completed a detailed scoring form. The ratings of the case presentation and discussion accounted for most of the variance in the overall mark.

Reversible total esophageal exclusion.

A 23-year-old man with miliary tuberculosis had severe esophageal hemorrhage secondary to eroding tuberculous nodes. Balloon tamponade and packing with gauze did not alter the profuse bleeding. Empyema of the right thorax, massive mediastinal nodes, an unknown site of bleeding in the esophagus, and diffuse pulmonary involvement with tuberculosis precluded a thoracotomy.

A study of the reliability of the clinical oral examination in psychiatry.

A study of the variability between raters in scoring an oral clinical examination in psychiatry in the format of the certification by the Royal College of Physicians and Surgeons of Canada is reported. A video-taped examination from another centre was rated independently by academic psychiatrists, nonacademic psychiatrists and residents. Considerable inter-rater differences between and within these groups were found.

Urinary catabolites of ribonucleic acid as cancer markers: a preliminary report of their use in patients with lung cancer.

Rats with aflatoxin-B1-induced hepatomas and dimethylnitrosamine-induced nephroblastomas excreted greater than normal amounts of urinary modified nucleosides and bases, catabolites of ribonucleic acid (RNA). Although both neoplasms caused increased excretions of the same catabolites, their quantitative profiles differed, suggesting that it may be possible to distinguish between tumors. Rats with transplanted tumors (e.

Repeat mediastinoscopy.

Although it has been maintained that a repeat mediastinoscopy results in high morbidity and mortality, it was considered an essential staging procedure in this group of 12 patients. The results of repeat mediastinoscopy were negative in 10 patients and positive in 2. On the basis of negative findings, 6 patients underwent thoracotomy.

Mediastinoscopy in advanced superior vena cava obstruction.

Superior vena cava syndrome can be a rapidly progressive, lethal process that is caused by a malignancy in 92 to 94% of cases. Since all effective therapy is inherently harmful, it would be reassuring to have a definitive tissue diagnosis before initiating treatment. Because easily accessible tissue is not always available, mediastinoscopy must be relied on to confirm the diagnosis in some patients.

Diffuse, mixed malignant pleural mesothelioma.

Forty-six patients with diffuse, mixed malignant pleural mesothelioma were treated between January, 1970, and May, 1979. All had a history of exposure to asbestos. The diagnosis was established by thoracentesis in 3 patients, thoracoscopy in 28, thoracotomy in 5, and minithoracotomy in 9.

Direct diagnostic thoracoscopy.

Direct diagnostic thoracoscopy under general anesthesia using the mediastinoscope or bronchoscope has been done in 40 patients. No deaths or serious morbidity occurred. We recommend the use of this technique when other efforts fail to establish a diagnosis in patients with pleural disease.