Evolution of Video Assisted Thoracoscopic Surgery for Thoracic Disc Herniation: Towards Biportal Thoracoscopic Approach.

Objective: This work aims to describe the evolution of the video-assisted Thoracoscopic Surgery (VATS) approach from a multiportal access to a biportal access for thoracic herniated disc surgery. Thoracic disc herniation remains a challenging pathology for spine surgeons. VATS of the thoracic spine was described in the 90s and represented an important technical leap by including minimally invasive options for thoracic pathology.

Uniportal right upper video-assisted thoracoscopic surgery lobectomy: safe and feasible.

Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is now well established and performed all around the world. We are going to share the surgical technique for uniportal VATS right upper lobectomy based on our experience. A 62-year-old patient underwent Uniportal VATS right upper lobectomy for a primary non-small cell lung cancer (NSCLC).

Uniportal video-assisted thoracoscopic lobectomy versus other video-assisted thoracoscopic lobectomy techniques: a randomized study.

Objectives: A prospective, randomized study was carried out on patients undergoing lung cancer surgery, with the aim of determining if uniportal video-assisted lobectomy has more favourable postoperative outcomes than other video-assisted thoracoscopic lobectomy techniques (Duke approach and Copenhagen approach).

Methods: Patients were randomly assigned to two groups; uniportal video-assisted lobectomy (Group A; n = 51) and other video-assisted thoracoscopic lobectomy techniques (Group B; n = 55). The primary outcome measures were: postoperative pain (analogue visual scale) and supplementary doses of analgesics (morphine, milligrams); the secondary outcome measures were: the delay in removing the paravertebral catheter and the chest drain, the duration of the postoperative hospital stay, postoperative complications and the operative or 30-day mortality.

[Prognostic factors in chest traumas: a prospective study of 500 patients].

Objective: Identify the factors of greatest impact in patients with chest trauma.

Patients And Methods: prospective study of 500 patients (425 men and 75 women) with chest trauma treated between January 2006 and December 2008. The parameters assessed include the degree of trauma, the abbreviated injury scale (AIS), the injury severity score (ISS), pre-hospital intubation, duration of mechanical ventilation, stay in the intensive care unit (ICU), number of rib fractures, presence of pulmonary contusion, haemothorax and cardio-pulmonary effects.

Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patients.

Objective: Spontaneous pneumomediastinum is uncommon and is traditionally considered a benign, self-limited disorder that usually occurs in young adults without any apparent precipitating factor or disease. The purpose of this study is to present 47 new cases because of their different clinical behaviours.

Methods: A descriptive, retrospective case series was conducted to identify adult patients with spontaneous pneumomediastinum who were diagnosed and treated in a single institution between 2000 and 2008.

Survival after traumatic complete laryngotracheal transection.

Laryngotracheal trauma may result in lifelong complications or even death if diagnosis or treatment is delayed. Emergency department physicians, trauma surgeons, anesthesiologists, and especially thoracic surgeons should maintain a high level of awareness of and suspicion for laryngotracheal trauma whenever a patient present with multiple trauma in general or with cervical-thoracic trauma in particular. A blunt or penetrating laryngotracheal injury can result in acute airway obstruction and death at the scene of an accident or crime.

Localized (solitary) fibrous tumors of the pleura: an analysis of 15 patients.

Background: Localized fibrous tumors of the pleura (LFTPs) are rare neoplasms, which are considered to originate from submesothelial connective tissue. The aim of this article is to present 15 new cases because of their different clinical behaviors and to discuss the treatment of choice of such neoplasms.

Methods: The records of 15 consecutive patients with LFTP operated at our Institution between 1995 and 2006 were retrospectively reviewed.

Quantification of eccrine sweat glands with acetylcholine sweat-spot test and anatomical redistribution of sweating after T2-T3 thoracoscopic sympathicolysis.

Background: In this study, patients treated by thoracoscopic sympathicolysis for palmar hyperhidrosis were evaluated to determine the number and response of sweat glands to intradermal acetylcholine stimulus.

Methods: A total of 30 patients were included in the study. Group A consisted of 10 patients with palmar hyperhidrosis who underwent thoracoscopic sympathicolysis in October 2005, and group B consisted of 20 patients who underwent surgery during the years 1999, 2000, and 2001.

Spontaneous pneumomediastinum: 41 cases.

Objective: Spontaneous pneumomediastinum is characterized by the presence of interstitial air in the mediastinum without any apparent precipitating factor. The purpose of this study is to review and discuss our experience with this condition.

Methods: A descriptive, retrospective study of 41 cases--34 men (83%) and 7 women (17%)--treated at our hospital for spontaneous pneumomediastinum from January 1990 through June 2006.

An assessment of anxiety in patients with primary hyperhidrosis before and after endoscopic thoracic sympathicolysis.

Objective: Endoscopic bilateral thoracic sympathicolysis (EBTS) is an effective and minimally invasive procedure used for patients with primary hyperhidrosis. The purpose of this study was to examine anxiety levels using standardized psychometric tools in hyperhidrosis patients before and after EBTS.

Methods: A total of 106 patients diagnosed with hyperhidrosis who underwent EBTS were asked to fill out a questionnaire before and 12 months after the procedure that elicited the following information: (a) symptoms associated with hyperhidrosis; (b) the patient's level of anxiety; and (c) the extent to which this anxiety was incapacitating in their daily life.

[Iatrogenic tracheal rupture after endotracheal intubation].

Tracheobronchial rupture after tracheal intubation is rare in clinical practice. Possible contributory factors are multiple vigorous attempts at intubation, overinflation of the cuff, anatomic alterations, and predisposing individual factors. These lesions can be detected by bronchoscopy, which is the most effective method to confirm the diagnosis and determine the exact location and extent of the tear.