Retrograde simultaneous ligation of apico-ventral vessels during VATS RUL.

Thoracoscopic right upper lobectomy is a demanding procedure especially in case of hilar adhesions. Herein, we reported a simple technique as the simultaneous ligation of hilar structures to facilitate thoracoscopic right upper lobectomy. After resections of fissures and of hilar lymph nodes, the following structures were sequentially isolated and simultaneously resected in their natural position: V2+A2 vessels; right upper bronchus; and V1+V3+A1+A3 vessels.

3D Computed Tomography Reconstruction for Pre-Operative Diagnosis of Anomalous Venous Drainage of the Right Upper Lobe.

Anatomical variation of the pulmonary vessels poses challenges to thoracoscopic lung resection and may be associated with an increased risk of intraoperative bleeding and damage to pulmonary circulation. Herein, we reported a rare and dangerous variation as the partial anomalous venous drainage of the right upper lobe into the superior vena cava in a patient undergoing thoracoscopic lobectomy for management of lung cancer of right upper lobe. The preoperative identification of such variation by 3D computed tomography scan allowed to plan a safe and accurate resection, and to prepare additional strategies for overcome unexpected intraoperative bleeding.

Multidisciplinary Management of Descending Necrotizing Mediastinitis: Is Thoracoscopic Treatment Feasible?

Descending necrotizing mediastinitis (DNM) is a life-threatening condition, generally caused by downward dissemination of oropharyngeal infections through cervical fascial planes. Mediastinal drainage is conventionally achieved by thoracotomy, but a Video-Assisted Thoracoscopic Surgery (VATS) approach is gaining interest due to the reduced invasiveness of procedure. We aimed to evaluate the effectiveness of VATS treatment in patients with DNM.

Modified blade: an interventional option in rigid bronchoscopy for non-resectable benign tracheal stenosis.

Introduction: Benign tracheobronchial stenosis is a abnormal tracheal lumen narrowing that may incur progressive dyspnea and life-threatening hypoxemia. There is no consensus on which patients should be treated with endoscopic or surgical method. This study investigates the outcomes of bronchoscopic dilatation in the treatment of benign tracheal stenosis using a device equipped with a blade to cut the stenotic lesions with dense fibrosis.