Minimally invasive surgical strategy for refractory hepatic hydrothorax.

Objectives: Treatment of refractory hepatic hydrothorax, a complication of liver cirrhosis, is complex. We aimed to investigate the usefulness of the '4-step approach', which is a minimally invasive surgical strategy combining 4 therapeutic modalities: (i) pneumoperitoneum to localize diaphragmatic defects; (ii) thoracoscopic pleurodesis; (iii) postoperative positive-pressure ventilation; and (iv) peritoneal drainage for abdominal decompression.

Methods: We retrospectively analysed the medical records of 12 patients with hepatic hydrothorax who underwent surgical treatment using the 4-step approach from January 2013 to December 2017.

Activated clotting time test alone is inadequate to optimize therapeutic heparin dosage adjustment during post-cardiopulmonary resuscitational extracorporeal membrane oxygenation (e-CPR).

Background: We conducted an observational study to evaluate the relationship between activated clotting time (ACT) and activated partial thromboplastin time (aPTT) tests, anticipating the possibility that the ACT will become a substitute test for the aPTT in post-CPR extracorporeal membrane oxygenation (e-CPR).

Patients And Methods: Three hundred and fifteen paired ACT and aPTT samples were derived from 60 in-hospital e-CPR patients and were divided into three groups according to the observed ACT value: low level (ACT < 170 s, Group A), intended target level (ACT 170-210 s Group B) and high level (ACT > 210 s, Group C). The relationship of aPTT in each group was analyzed.

Paravertebral mediastinal Mullerian cyst resected by video assisted thoracoscopic surgery.

Ever since Hattori et al. had described the mediastinal Mullerian cyst in 2005 there has been several new cases described in the literature. We report a 51-year-old woman with an incidentally found 2 cm × 3 cm mass in her left paravertebral mediastinum.

Nonossifying fibroma of the rib resected by video-assisted thoracoscopic surgery with preservation of periosteum.

Nonossifying fibromas are not uncommon, but those described in the rib are unique. We report the case of a 15-year-old patient with symptoms of chest wall pain for 5 days who underwent a video-assisted thoracoscopic rib resection for a 2.5-cm rib mass.

Silastic molding method for pectus excavatum correction using a polyvinyl alcohol (ivalon) sponge.

Pectus excavatum is rare, but it is the most common type of sternal congenital disorder. There are many surgical methods to correct pectus excavatum such as the Ravitch method, Wada method, Silastic mold method, and the Nuss operation. We report a case of minimal invasive surgery for pectus excavatum using a polyvinyl alcohol sponge.

Postinfarct ventricular septal defect after coronary covered stent implantation.

We report a case of a postinfarction ventricular septal defect caused by an acute recurrent occlusion after the implantation of a covered stent, which was performed as a rescue procedure for the ruptured left anterior descending artery during a percutaneous coronary intervention. Although the emergent implantation of a covered stent for the ruptured coronary arteries such as the left main coronary artery or the origins of the left anterior descending artery can be performed during a percutaneous coronary intervention, and a coronary bypass surgery should be considered in order to decrease the risk of complete occlusion, thus providing a superior long term patency.

A simple method of substernal bar removal after the Nuss procedure.

The Nuss procedure for pectus excavatum is a well-known technique. Although there are numerous reports on the Nuss procedure, the reports on its removal are few. Removal has been done with many variations in the supine position, which involves bending the bar or bringing the bar beneath the operating table, which can prove to be troublesome and dangerous.

Double primary tumor, thymic mass and posterior mediastinal neurogenic tumor, in a patient with acute pancreatitis performed with single-staged robotic-assisted thoracoscopic surgery.

Finding 2 primary benign lesions at 2 extremes of the mediastinum is a rare event. A minimal invasive operation performed in a single-staged procedure can prove to be difficult, especially when the procedure is performed with a robot. We discuss the positioning and details of the procedure carried out in a 52-year-old woman with acute pancreatitis.

Primary peripheral pulmonary adenoid cystic carcinoma: report of a case diagnosed by fine needle aspiration cytology.

Adenoid cystic carcinoma (ACC) arising from anatomic sites other than the salivary gland is rare and those occurring in the lung are extremely rare. When arising from the lung, the tumor generally arises from extrapulmonary bronchi, originating from bronchial glands. Primary ACC of the lung located peripherally within lung parenchyma is an even rarer event.

Rib xanthoma resected by video-assisted thoracoscopic surgery using a bone punch.

Xanthomas of the rib are extremely rare benign neoplasms, most commonly reported in soft tissue, but rarely in bone. We report a case of a 4-cm xanthoma of the rib resected by video-assisted thoracoscopic surgery and pulled through a 2-cm port incision around the patient's areola. To the best of our knowledge, there are only 8 other such cases, and none of which were removed by thoracoscopic surgery.

Brachial plexus injury with emphasis on axillary nerve paralysis after thoracoscopic sympathicotomy for axillary hyperhidrosis.

Thoracic sympathicotomy for the treatment of axillary hyperhidrosis with the use of 2 mm thoracoscope and instruments is a simple and safe procedure. Nerve paralysis of any type after thoracic sympathicotomy is an extremely rare event. We report a 44-year-old woman who developed brachial plexus injury of her left arm after thoracoscopic sympathicotomy for axillary hyperhidrosis.

Diagnosis and prognosis of traumatic pulmonary psuedocysts: a review of 12 cases.

Background: Traumatic pulmonary pseudocysts or post-traumatic pneumatocoeles are a relatively rare-encountered condition occurring after trauma and an even rarer talked about subject. Most resolve within a few weeks, but if complicated by hematoma, may persist for months. This study intends to evaluate the resolution times of traumatic pulmonary pseudocysts and their clinical significance.

Calcifying fibrous pseudotumor causing thoracic outlet syndrome.

Calcifying fibrous pseudotumor (CFP) is a relatively rare benign mass lesion that generally involves the soft tissues. We report a case of CFP occurring in an extremely rare location. The patient is a 34-year-old woman presenting symptoms of numbness of her right upper extremity caused by a CFP in her thoracic outlet and we discuss its clinical significance with a review of the literature.

Calcifying fibrous pseudotumor of the pleura.

Calcifying fibrous pseudotumor is an uncommon benign lesion that has unique histologic features. We report a case of calcifying fibrous pseudotumor of the pleura occurring in a 31-year-old woman. A computed tomographic scan revealed a pleural mass in the right anterior costophrenic angle.