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1.
J Cardiothorac Surg ; 15(1): 310, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046088

RESUMO

BACKGROUND: Spontaneous pneumothorax has been reported as a possibile complication of novel coronavirus associated pneumonia (COVID-19). We report two cases of COVID-19 patients who developed spontaeous and recurrent pneumothorax as a presenting symptom, treated with surgical procedure. An insight on pathological finding is given. CASE PRESENTATION: Two patients presented to our hospital with spontaneous pneumothorax associated with Sars-Cov2 infection onset. After initial conservative treatment with chest drain, both patients had a recurrence of pneumothorax during COVI-19 disease, contralateral (patient 1) or ipsilateral (patient 2) and therefore underwent lung surgery with thoracoscopy and bullectomy. Intraoperative findings of COVID-19 pneumonia were parenchymal atelectasis and vascular congestion. Lung tissue was very frail and prone to bleeding. Histological examination showed interstitial infiltration of lymphocytes and plasma cells, as seen in non specific interstitial pneumonia, together with myo-intimal thicknening of vessels with blood extravasation and microthrombi. CONCLUSIONS: Although rarely, COVID-19 may present with spontaneous pneumothorax. Lung surgery for pneumothorax in COVID-19 patients can be safely and effectively performed when necessary.


Assuntos
Betacoronavirus , Tubos Torácicos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Pneumotórax/etiologia , Toracoscopia/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumotórax/diagnóstico , Pneumotórax/cirurgia , Radiografia Torácica , Recidiva , Tomografia Computadorizada por Raios X
2.
Khirurgiia (Mosk) ; (10): 112-115, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33047594

RESUMO

According to the modern literature, mediastinal parathyroid glands are diagnosed in 2-20% of cases. In the available Russian-language literature, there are few reports on successful resection of mediastinal parathyroid glands in impossible surgery through cervical approach. Despite the development of minimally invasive surgical approaches and their advantages, traumatic sternotomy was used in these cases. We report a successful thoracoscopic resection of mediastinal parathyroid gland in a patient with persistent hyperparathyroidism. Preoperative topical diagnosis was essential for successful surgery. Favorable postoperative outcome was confirmed by regression of symptoms and vascular calcification, as well as improved densitometric parameters in one year after surgery.


Assuntos
Hiperparatireoidismo/cirurgia , Glândulas Paratireoides/cirurgia , Toracoscopia , Humanos , Hiperparatireoidismo/diagnóstico , Mediastino/cirurgia , Cuidados Pré-Operatórios
3.
PLoS One ; 15(10): e0237363, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33017425

RESUMO

OBJECTIVE: To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. METHODS: The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. For continuous variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used. RevMan5. 3 and Stata/MP 14.0 were used for performing the meta-analysis. RESULTS: A total of 9 trials including 440 patients (PVB block:222 patients; INB: 218 patients) met the inclusion criteria. In the primary outcome, there was no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at 1h (Std. MD = -0. 20; 95% CI = -1. 11to 0. 71; P = 0. 66), 2h (Std. MD = -0. 71; 95% CI = -2. 32to 0. 91; P = 0. 39), 24h (Std. MD = -0. 36; 95% CI = -0. 73 to -0. 00; P = 0. 05) and 48h (Std. MD = -0. 04; 95% CI = -0. 20 to 0. 11; P = 0. 57). However, there was significant difference in VAS of non Chinese subgroup at 1h (Std. MD = 0. 33; 95% CI = 0. 25to 0. 41; P<0. 00001) and VAS of Chinese subgroup at 24h (Std. MD = -0.32; 95% CI = -0.49 to-0.14; P = 0.0003). In the secondary outcome, the analysis also showed no significant difference between the groups according to the rates of postoperative nausea and vomit (OR = 0. 63; 95% CI = 0. 38 to 1. 03; P = 0. 06) and the rates of postoperative additional analgesia (OR = 0. 57; 95% CI = 0. 21 to 1. 55; P = 0. 27). There was significant difference in postoperative consumption of morphine (Std. MD = -14. 57; 95% CI = -26. 63 to -0.25; P = 0. 02). CONCLUSION: Compared with INB, PVB can provide better analgesia efficacy and cause lower consumption of morphine after thoracic surgery and breast surgery.


Assuntos
Mama/cirurgia , Bloqueio Nervoso/métodos , Procedimentos Cirúrgicos Torácicos/métodos , Analgesia/métodos , Feminino , Humanos , Nervos Intercostais , Masculino , Mastectomia , Manejo da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Segurança , Coluna Vertebral/inervação , Toracoscopia , Toracotomia , Resultado do Tratamento
4.
Kyobu Geka ; 73(8): 574-577, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32879282

RESUMO

The case was a 56-year-old man. A nodular shadow of the left upper lobe was found in the chest computed tomography, and a diagnosis of adenocarcinoma was obtained by bronchoscopy. Preoperative 3-dimensional computed tomography (3D-CT) angiography indicated an extremely rare pulmonary artery bifurcation abnormality in which A4b+5 and A8+9 bifurcate from the left main pulmonary artery. Thoracoscopic left upper lobectomy and lymph node dissection were performed. Pathological diagnosis was adenocarcinoma with pStage I B. The mediastinal basal pulmonary artery is extremely rare, and to our knowledge, the bifurcation pattern of this case has not been reported elsewhere. The 3D-CT angiography was useful to detect the anatomical vascular abnormalities of the pulmonary artery before surgery, for the safe performance of the thoracoscopic surgery.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Pulmonares/cirurgia , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Toracoscopia
5.
Kyobu Geka ; 73(8): 578-581, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32879283

RESUMO

Müllerian cyst is rarely reported in the literature. Here, we reported a rare case of Müllerian cyst of the posterior mediastinum. The patient was a 46-year-old woman who was found to have an abnormal shadow on chest X-ray film at medical examination and was followed up as suspected of bronchogenic cyst. One year later, the lesion increased and she was referred to our hospital for surgery. Chest computed tomography demonstrated a 36 mm diameter cystic tumor in front of the right 4~5 thoracic vertebra level. We performed thoracoscopic surgery for diagnosis and treatment. Histopathological examination revealed that the cyst wall was covered with a layer of columnar epithelium. In addition, the estrogen receptor was found to be positive in the epithelia by immnunohistology and the pathological diagnosis was a Müllerian cyst. Müllerian cyst have been reported in the literature to be associated with gynecological disorders or obesity. The present case was found to have ovarian enlargement, which has been carefully followed up.


Assuntos
Cisto Broncogênico , Cisto Mediastínico/diagnóstico por imagem , Feminino , Humanos , Mediastino/cirurgia , Pessoa de Meia-Idade , Radiografia , Toracoscopia , Tomografia Computadorizada por Raios X
6.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(7): 1008-1012, 2020 Jul 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895160

RESUMO

OBJECTIVE: To investigate the effect of inverse ratio ventilation (IRV) combined with positive end-expiratory pressure (PEEP) in infants undergoing thoracoscopic surgery with single lung ventilation (OLV) for lung cystadenomas. METHODS: A total of 66 infants undergoing thoracoscopic surgery with OLV for lung cystadenomas in our hospital from February, 2018 to February, 2019 were randomized into conventional ventilation groups (group N, n=33) and inverse ventilation group (group R, n=33). Hemodynamics and respiratory parameters of the infants were recorded and arterial blood gas analysis was performed at 15 min after two lung ventilation (TLV) (T1), OLV30 min (T2), OLV60 min (T3), and 15 min after recovery of TLV (T4). Bronchoalveolar lavage fluid was collected before and after surgery to detect the expression level of advanced glycation end product receptor (RAGE). RESULTS: Sixty-three infants were finally included in this study. At T2 and T3, Cdyn, PaO2 and OI in group R were significantly higher (P < 0.05) and Ppeak, PaCO2 and PA-aO2 were significantly lower than those in group N (P < 0.05). There was no significant difference in HR or MAP between the two groups at T2 and T3 (P > 0.05). The level of RAGE significantly increased after the surgery in both groups (P < 0.05), and was significantly lower in R group than in N group (P < 0.05). CONCLUSIONS: In infants undergoing thoracoscopic surgery with OLV for pulmonary cystadenoma, appropriate IRV combined with PEEP does not affect hemodynamic stability and can increases pulmonary compliance, reduce the peak pressure, and improve oxygenation to provide pulmonary protection.


Assuntos
Cistadenoma , Ventilação Monopulmonar , Cistadenoma/terapia , Humanos , Lactente , Pulmão , Respiração com Pressão Positiva , Toracoscopia
7.
Adv Clin Exp Med ; 29(8): 967-970, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32869959

RESUMO

BACKGROUND: Thoracoscopic surgery of congenital diaphragmatic hernia (CDH) is connected with a higher incidence of recurrence than open repair is. This is usually caused by the dehiscence of sutures in the lateral part of the defect. This area is characterized by increased tension on proximate tissues and difficult thoracoscopic suturing. For more effective repair, the authors adopted a variant of percutaneous internal ring suturing (PIRS) technique. OBJECTIVES: To present and evaluate the efficacy of the PIRS technique for the repair of CDH. MATERIAL AND METHODS: The study is based on retrospective analysis of the medical data of patients with CDH treated in the Department of Pediatric Surgery of the Jagiellonian University Medical College (Kraków, Poland) from January 2013 to July 2019. The PIRS technique was applied when thoracoscopic repair under acceptable tension appeared impossible. RESULTS: Fifty-one patients were identified. Of these, 11 children died before surgery and 1 after, leaving 39 (76%) who were operated on and survived. Thoracoscopy was used in 27 cases (69%), with 3 conversions. The recurrence rate in patients who underwent thoracoscopic closure of the defect with intermittent sutures was 27% (3 out of 11 children), while in the group that underwent thoracoscopic repair with the additional use of percutaneous suturing, the recurrence rate was 6.25% (1 out of 16 patients). The follow-up periods ranged from 4 months to 6 years. CONCLUSIONS: The applied PIRS technique permits safe and effective closure of intermediate-size diaphragmatic defects under acceptable tension. The method is feasible and can be listed among countermeasures against recurrence.


Assuntos
Hérnias Diafragmáticas Congênitas , Criança , Hérnias Diafragmáticas Congênitas/cirurgia , Humanos , Polônia , Estudos Retrospectivos , Técnicas de Sutura , Toracoscopia/efeitos adversos , Resultado do Tratamento
8.
Zhonghua Yi Xue Za Zhi ; 100(33): 2596-2600, 2020 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-32892605

RESUMO

Objective: To investigate the effects of thoracoscopy-guided thoracic paravertebral block for analgesia after single-port video-assisted pulmonary lobectomy. Methods: From December 2019 to April 2020, 60 patients receiving single-port video-assisted pulmonary lobectomy at Ningbo Medical Center Lihuili Hospital were selected. The patients were randomly and equally divided into control group and paravertebral block group using a random number table. Patients of paravertebral block group were injected into the thoracic 4-5 intercostal, paravertebral 1 cm using 0.375% ropivacaine (20 ml) with thoracoscopy-guided at the end of surgery, while patients of control group were given patient controlled intravenous analgesia (PCIA). Postoperative visual analogue scale (VAS) and Ramsay sedation scale were recorded at 6, 12, 24, 36, 48 h after the surgery. The incidence of postoperative adverse reactions, additional dose and times of pethidine, the time to resume eating, the rate of postoperative active cough, the first time to get out of bed after surgery and postoperative hospital stay of two groups' patients were recorded. t test and chisquare test were used for statistical analysis. Results: The VAS score of paravertebral block group were lower than those of control group at all time points (all P<0.05). The Ramsay sedation scale of paravertebral block group were higher than those of control group at all time points (all P<0.05). The additional dose and times of pethidine of paravertebral block group were (8.2±2.3) mg and (0.2±0.1) time, which were lower than (87.8±15.3) mg and (1.8±0.3) time of control group, the differences were statistically significant (t=28.91, 34.37, all P<0.05). Incidence of nausea, vomiting and pruritus of paravertebral block group were 10.0%, 6.7% and 0, which were lower than 40.0%, 30.0% and 13.3% of control group, the differences were statistically significant (χ(2)=7.20, 5.45, 4.29, all P<0.05). The rate of postoperative active cough of paravertebral block group was 33.3%, which was higher than 10.0% of control group, the difference was statistically significant (χ(2)=4.81, P<0.05). The time to resume eating, the first time to get out of bed after surgery and postoperative hospital stay were (6.5±0.4) h, (20.9±3.1) h and (4.6±1.0) d, which were lower than (8.5±0.7) h, (28.6±4.8) h and (6.1±1.3) d of control group, the differences were statistically significant (t=13.47, 7.39, 4.19, all P<0.05). Conclusion: Thoracic paravertebral block under thoracoscopy-guided can effectively reduce the postoperative pain of single-port thoracoscopic lobectomy, with fewer adverse reactions, and is beneficial to postoperative recovery.


Assuntos
Bloqueio Nervoso , Analgesia Controlada pelo Paciente , Humanos , Manejo da Dor , Dor Pós-Operatória , Cirurgia Torácica Vídeoassistida , Toracoscopia
9.
J Cancer Res Ther ; 16(4): 933-934, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930145

RESUMO

Hemothorax cannot always be treated by thoracic surgeon. Rapidly improved interventional pulmonology broadens the application of medical thoracoscopy. We attempt to share our experiences of medical thoracoscopy for hemothorax and discuss the value of medical thoracoscopy in pleural diseases. We reported a 76-year-old male with hemothorax who was cured by medical thoracoscopy under local anesthesia together with argon plasma coagulation. Moreover, final pathological diagnosis was acquired as pleural sarcomatoid carcinoma. The unusual manifestation under medical thoracoscopy of such a relative rare disease was also described in this paper. The medical thoracoscopy could be used successfully for hemothorax instead of treating with surgeon, especially for those who cannot tolerate procedure of operation or surgical thoracoscopy.


Assuntos
Carcinossarcoma/patologia , Hemotórax/diagnóstico , Hemotórax/terapia , Derrame Pleural/patologia , Toracoscopia/métodos , Idoso , Biópsia , Carcinossarcoma/diagnóstico , Carcinossarcoma/terapia , Hemotórax/patologia , Humanos , Masculino , Doenças Pleurais/diagnóstico , Doenças Pleurais/patologia , Doenças Pleurais/terapia
10.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(10): 839-843, 2020 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-32992437

RESUMO

Objective: To analyze the clinic features of isolated myeloid sarcoma (IMS) involving the pleural cavity. Methods: A case of pleural isolated myeloid sarcoma (PIMS) with pleural effusion as the first manifestation was described. The related cases in literatures were reviewed with"myeloid sarcoma"and"pleural effusions"as the keywords to search China HowNet, Wanfang database and PubMed database. Results: A 59-year-old man complained of right chest pain for 2 months and worsening pain with distress and shortness of breath for 2 weeks. The chest CT scan showed pleural effusion on the right side. Flow cytometric analysis of pleural fluid showed that a population of blasts with CD34 expressing was 37.6% of the total nucleated cells. The pleural biopsy through medical thoracoscopy indicated lymphoproliferative lesions by pathological examination. Immunohistochemistry was performed on pleural histological sections and cell blocks of pleural effusions, which showed CD34 and CD117 positive expression. The diagnosis of PIMS was finally made. Two literature papers with 2 complete cases were found and reviewed. The 3 cases were analyzed. There were 2 males and 1 female. The age was 59, 51, 56 years respectively. One case was a patient with 3 weeks of right upper quadrant and epigastric pain, nausea, and weight loss. Cytological examination of the pleural fluid showed numerous poorly differentiated malignant cells. Histology from an open laparotomy in duodenal biopsies, gallbladder, and mesenteric lymph nodes supported the diagnosis of IMS. The other case was a patient with 6 weeks of dyspnea and a large swelling in the upper vestibular region. Thoracentesis showed 82% myeloid blasts in the pleural fluid. A gingival biopsy showed a diffuse infiltration by cells with a blastic appearance and supported IMS. Conclusion: PIMS was a very rare cause of pleural effusions. The cytological and histopathological evidences were useful to diagnose IMS involving the pleural cavity.


Assuntos
Dor no Peito/etiologia , Dispneia/etiologia , Derrame Pleural/patologia , Sarcoma Mieloide/diagnóstico , Dor no Peito/diagnóstico por imagem , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pleura , Sarcoma Mieloide/patologia , Toracoscopia
11.
Rev Med Liege ; 75(7-8): 524-528, 2020 Jul.
Artigo em Francês | MEDLINE | ID: mdl-32779904

RESUMO

We report the story of an 11-year-old girl admitted to the emergency room for diplopia and divergent squint. Promptly apparead a fluctuating ptosis, a nasal voice and swallowing disorders, evoking the diagnosis of autoimmune myasthenia. The latter has been confirmed with electromyogram. Treatment with corticoids, plasmapheresis and pyridostigmine allowed symptoms control. Thymectomy by left thoracoscopy, non-robot assisted, was performed 6 months after the appearance of the first clinical signs for the purpose of remission.


Assuntos
Miastenia Gravis , Corticosteroides , Criança , Diplopia , Feminino , Humanos , Toracoscopia , Timectomia
14.
Ann Thorac Cardiovasc Surg ; 26(5): 286-289, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-32814726

RESUMO

A 63-year-old man with protein C deficiency underwent thoracoscopic esophagectomy and digestive reconstruction using a gastric tube for thoracic esophageal cancer. On postoperative day 3, the gastric tube was removed because of anastomotic leakage and gastric tube necrosis. Digestive reconstruction using a free jejunal graft was attempted 140 days after the first surgery. However, thrombus formation in the artery and vein of the jejunal graft resulted in a failed reconstruction. Ten days after this surgery, digestive reconstruction using the colon was performed with intraoperative heparin administered for anticoagulation control. The surgery was successful, with no thrombus formation afterward. When performing digestive reconstruction in patients with conditions predisposing to thrombus formation, perioperative management should be completed with careful attention toward preventing thrombus formation. In particular, appropriate anticoagulation control, such as the administration of intraoperative heparin, is recommended in patients with protein C deficiency because necrosis of the reconstructed organ is likely.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia , Deficiência de Proteína C/complicações , Procedimentos Cirúrgicos Reconstrutivos , Toracoscopia , Trombose/etiologia , Idoso , Anticoagulantes/uso terapêutico , Neoplasias Esofágicas/patologia , Humanos , Masculino , Deficiência de Proteína C/diagnóstico , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Fatores de Risco , Trombose/diagnóstico por imagem , Trombose/cirurgia , Falha de Tratamento
15.
Curr Oncol ; 27(3): e313-e317, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32669938

RESUMO

Background: The emergence of covid-19 has the potential to change the way in which the health care system can accommodate various patient populations and might affect patients with non-covid-19 problems. The Quebec Lung Cancer Network, which oversees thoracic oncology services in the province of Quebec under the direction of the Ministère de la Santé et des Services sociaux, convened to develop recommendations to deal with the potential disruption of services in thoracic oncology in the province of Quebec. The summary provided here has been adapted from the original document posted on the Programme québécois du cancer Web site at: https://www.msss.gouv.qc.ca/professionnels/documents/coronavirus-2019-ncov/PJ1_Recommandations_oncologie-thoracique-200415.pdf. Methods: Plans to optimize the health care system and potentially to prioritize services were discussed with respect to various levels of activity. For each level-of-activity scenario, suggestions were made for the services and treatments to prioritize and for those that might have to be postponed, as well as for potential alternatives to care. Results: The principal recommendation is that the cancer centre executive committee and the multidisciplinary tumour board always try to find a solution to maintain standard-of-care therapy for all patients with thoracic tumours, using novel approaches to treatment and the adoption of a network approach to care, as needed. Conclusions: The effect of the covid-19 pandemic on the health care system remains unpredictable and requires that cancer teams unite and offer the most efficient and innovative therapies to all patients under the various conditions that might be forced upon them.


Assuntos
Antineoplásicos/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/terapia , Infecções por Coronavirus/epidemiologia , Neoplasias Pulmonares/terapia , Pneumonia Viral/epidemiologia , Radioterapia , Carcinoma de Pequenas Células do Pulmão/terapia , Procedimentos Cirúrgicos Torácicos , Triagem , Administração Oral , Antineoplásicos/uso terapêutico , Betacoronavirus , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Gerenciamento Clínico , Humanos , Neoplasias Pulmonares/diagnóstico , Mediastinoscopia , Oncologia , Técnicas de Diagnóstico Molecular , Estadiamento de Neoplasias , Pandemias , Quebeque/epidemiologia , Radiocirurgia , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Toracoscopia
17.
Medicine (Baltimore) ; 99(28): e21046, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664116

RESUMO

RATIONALE: Although there have been several studies describing clinical and radiographic features about the novel coronavirus (COVID-19) infection, there is a lack of pathologic data conducted on biopsies or autopsies. PATIENT CONCERNS: A 56-year-old and a 70-year-old men with fever, cough, and respiratory fatigue were admitted to the intensive care unit and intubated for respiratory distress. DIAGNOSIS: The nasopharyngeal swab was positive for COVID-19 and the chest Computed Tomography (CT) scan showed the presence of peripheral and bilateral ground-glass opacities. INTERVENTIONS: Both patients developed pneumothoraces after intubation and was managed with chest tube. Due to persistent air leak, thoracoscopies with blebs resection and pleurectomies were performed on 23rd and 16th days from symptoms onset. OUTCOMES: The procedures were successful with no evidence of postoperative air-leak, with respiratory improvement. Pathological specimens were analyzed with evidence of diffuse alveolar septum disruption, interstitium thickness, and infiltration of inflammatory cells with diffuse endothelial dysfunction and hemorrhagic thrombosis. LESSONS: Despite well-known pulmonary damages induced by the COVID-19, the late-phase histological changes include diffused peripheral vessels endothelial hyperplasia, in toto muscular wall thickening, and intravascular hemorrhagic thrombosis.


Assuntos
Infecções por Coronavirus/patologia , Endotélio Vascular/patologia , Pulmão , Pandemias , Pleura , Pneumonia Viral/patologia , Trombose/patologia , Trombose/parasitologia , Idoso , Betacoronavirus/isolamento & purificação , Biópsia/métodos , Tubos Torácicos/efeitos adversos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Humanos , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pulmão/cirurgia , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Pleura/cirurgia , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Pneumotórax/etiologia , Pneumotórax/terapia , Respiração Artificial/métodos , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Toracoscopia/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
20.
Acta Cir Bras ; 35(5): e202000501, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32638842

RESUMO

PURPOSE: To assess the feasibility of thoracoscopic transdiaphragmatic approach for biopsy of all lung lobes and to determine the optimal intercostal space (ICS) for biopsy of each lung lobe. METHODS: Ten rabbits were positioned in dorsal recumbency. Total thoracoscopy lung biopsy was made combined transdiaphragmatic approach and right ICS approaches. A camera port was made in the transdiaphragmatic approach and the instrument port was made of ICS 7 and ICS 9. A pre tied loop ligature was placed to performed a caudal lung lobe biopsy and to simulate biopsies of the others lung lobes. RESULTS: Biopsy of the cranial aspect of the right caudal lung lobe was performed at ICS 9. Simulated biopsy of the accessory lung lobe was performed at ICS 9. Simulated lung biopsy of the right cranial and middle lung lobes was performed at ICS 7. The caudal and dorsal aspect of the right caudal lung lobe was not visualized by telescope at transdiaphragmatic approach, and biopsy was not performed. CONCLUSIONS: Thoracoscopic transdiaphragmatic approach for lung lobes biopsies was a feasible technique, except for the caudal aspect of the right caudal lung lobe. An ideal intercostal port for biopsy of each right lung lobe was determined.


Assuntos
Pulmão , Toracoscopia , Animais , Biópsia/métodos , Estudos de Viabilidade , Intubação Intratraqueal , Pulmão/patologia , Pneumopatias/diagnóstico , Coelhos
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