Purpose: This study compares the outcome between thoracoscopic and thoracotomy resection of congenital lung lesions.
Methods: From November 2005 to August 2007, 14 consecutive cases of video-assisted thoracoscopic (VATS) lung resections have been performed in our institution. A retrospective review comparing these cases to the previous open thoracotomies for lung resection was performed. Intraoperative and early postoperative results were compared.
Results: The mean age for VATS resection was 10 months compared with 7 months for thoracotomy. There were no major intraoperative complications. One case was converted from thoracoscopy to thoracotomy, and there was one anesthetic failed attempt of VATS resection, which was then performed open. Seven VATS resections and 6 thoracotomies were for congenital cystic adenomatous malformations. Intraoperative chest drains were used for all VATS resections but only 10 of the 14 thoracotomies, one of which developed a tension pneumothorax within hours of discharge. Perioperative outcomes including time to removal of chest drain, length of postoperative intravenous opioid requirement, and hospital stay were similar for both groups. Three had postoperative complications. Operative time was significantly lower in the thoracotomy group (124 minutes compared with 170 minutes, P < .05). The subgroup of congenital lobar emphysema had a particularly prolonged VATS resection time of 220 vs 155 minutes (P < .05). The thoracotomy group was more likely to receive adjuvant regional anesthesia (12 of 14 compared with 5 of 14).
Conclusions: Thoracoscopic resection of lung lesions results in longer operative time but is a safe and feasible alternative to open thoracotomy. Congenital lobar emphysema is a subgroup more challenging thoracoscopically, and it is recommended that these should be preselected for open surgery.
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http://dx.doi.org/10.1016/j.jpedsurg.2008.10.081 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: Carinal resection and reconstruction are complex surgical procedures often necessitated by tumors or other pathologies involving the tracheobronchial junction. Traditional approaches to these surgeries are highly invasive. The advent of uniportal video-assisted thoracoscopic surgery (VATS) along with the integration of extracorporeal membrane oxygenation (ECMO) offer potential advantages in reducing surgical trauma and improving outcomes.
View Article and Find Full Text PDFInt J Clin Pharm
January 2025
Department of Anesthesiology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei Economic and Technological Development District, Hefei, Anhui, China.
Background: The analgesic efficacy of esketamine combined with butorphanol in thoracoscopic surgery remains unclear.
Aim: This study explored the effects of perioperative esketamine combined with butorphanol versus butorphanol alone on acute and chronic postoperative pain in patients who underwent video-assisted lobectomy.
Method: A total of 181 patients were enrolled, with 90 in the esketamine-butorphanol group (Group BK) receiving intraoperative esketamine infusion and postoperative patient-controlled intravenous analgesia (PCIA) (esketamine 1.
Int J Surg Case Rep
December 2024
Department of Pathology, Al-Istishari Hospital, Ramallah, Palestine.
Introduction And Importance: Pulmonary mucoepidermoid carcinoma (PMEC) is a rare lung tumor, accounting 0.1-0.2 % of lung malignancies, commonly affecting adults under 50.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Gastroenterology Department, Al Ahli Hospital, Hebron 90200, Palestine.
Introduction: Esophageal leiomyoma is the most common benign submucosal mesenchymal tumor of the esophagus, typically asymptomatic but can cause symptoms such as dysphagia, chest pain, or regurgitation when large. Diagnosis is often incidental, confirmed by imaging techniques like computed tomography (CT) and endoscopic ultrasound (EUS), with surgical enucleation being the standard treatment.
Presentation Of Case: A 28-year-old male presented with a one-year history of persistent epigastric discomfort and gastroesophageal reflux disease (GERD) symptoms unresponsive to proton pump inhibitors.
Front Surg
December 2024
Division of Thoracic Surgery, Department of Surgery, Kaiser Permanente Northern California, Oakland, CA, United States.
Though advancements have been made in the pharmacologic treatment of myasthenia gravis (MG), surgical resection is not only an option as a last line of defense for those patients who do not respond to medical therapy but also remains vital for those with thymic epithelial tumors (TET). While prior studies have shown the potential superiority of minimally invasive approaches via robotic- and video-assisted thoracoscopic surgery (RATS/VATS) for thymectomy compared to open surgery, in the setting of malignancies, this outcome delineation is controversial. As RATS/VATS may be associated with less post-operative complications in the treatment of TET, some surgeons argue that the open approach is necessary for complete resection (R0 resection) and to prevent potential seeding of the malignancy.
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