An 84-year-old woman underwent a diagnostic laparoscopy preceding a planned total gastrectomy. A bilateral pneumothorax was diagnosed postoperatively, following an uneventful procedure. The patient's clinical parameters led to the diagnosis of capnothorax, a rare complication of laparoscopic surgery. It is important to be able to differentiate between a capnothorax and a pneumothorax because the treatment is different: a capnothorax can generally be treated conservatively. The perioperative signs and symptoms, physiology and treatment of a capnothorax are discussed in this article.
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World J Pediatr Surg
August 2024
Division of Pediatric Surgery, Departments of Surgery and Pediatrics & Child Health, Max Rady College of Medicine, Rady Faculty of Heath Sciences, University of Manitoba, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Worldwide, 150 children are born each day with congenital diaphragmatic hernia (CDH), a diaphragmatic defect with concomitant abnormal lung development. Patients with CDH with large defects are particularly challenging to treat, have the highest mortality, and are at significant risk of long-term complications. Advances in prenatal and neonatal treatments have improved survival in high-risk patients with CDH, but surgical treatment of large defects lacks standardization.
View Article and Find Full Text PDFInteract J Med Res
June 2024
Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
Spontaneous pneumothorax is one of the most common conditions encountered in thoracic surgery. This condition can be treated conservatively or surgically based on indications and guidelines. Traditional surgical management includes pleurodesis (mechanical or chemical) in addition to bullectomy if the bullae can be identified.
View Article and Find Full Text PDFJ Laparoendosc Adv Surg Tech A
March 2024
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Ventilating a pediatric patient during thoracoscopy is challenging. Few studies have highlighted the impact of capnothorax in children by measuring regional cerebral oxygen saturation (rcSO) with near infrared spectroscopy. In this systematic review, we aimed to summarize the data from relevant studies and assess whether thoracoscopy in children is associated with intraoperative pathological cerebral desaturation.
View Article and Find Full Text PDFThorac Surg Clin
February 2023
Division of Thoracic and Esophageal Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, 211 South 9th Street, Suite 300, Philadelphia, PA 19107, USA. Electronic address:
Robotic minimally invasive esophagectomy can be safely performed by adhering to key technical principles. Careful development of the gastric conduit with attention to blood supply and conduit orientation is critical. During thoracic dissection, capnothorax can distort the proximity of key mediastinal structures.
View Article and Find Full Text PDFHeart Vessels
March 2023
Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Rd., Sindian District, New Taipei City, 23142, Taiwan.
The pulmonary artery catheter (PAC)-despite its invasiveness-remains the gold standard for cardiac output (CO) monitoring. The FloTrac system, a less invasive hemodynamic monitor has been developed, which estimates CO using arterial pressure waveform analysis without external calibration. Recently, an upgraded version of FloTrac system with improved algorithm to follow changes in vascular resistance was introduced into the market.
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