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2.
Ann Card Anaesth ; 25(3): 286-292, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35799555

RESUMO

Aims: Chest wall blocks are effective alternatives for postoperative pain control in mitral valve surgery in right mini-thoracotomy (mini-MVS). We compared the efficacy of Serratus Anterior plane block (SAPB) and Erector Spinae plane block (ESPB) on postoperative pain relief after mini-MVS. Settings and Design: It is a prospective, observational study. Material and Methods: A total of 85 consecutive patients undergoing continuous SAPB and continuous ESPB for mini-MVS from March 2019 to October 2020 were included. The primary outcome was the assessment of postoperative pain evaluated as absolute value of NRS at 12, 24 and 48 h. Secondary outcomes were assessment of salvage analgesia (both opioids and NSAIDs), incidence of mild adverse effects (i.e. nausea, vomiting, and incorrect catheter placement) and timing of postoperative course (ICU and hospital length of stay, duration of mechanical ventilation, ventilator-free days). Results: The median NRS was 0.00 (0.00-3.00) at 12 h and 0.00 (0.00-2.00) at 24 and 48 h. No significant differences were observed between groups. Postoperative morphine consumption in the first 24 h was similar in both groups (P = 0.76), whereas between 24 and 48 h was significantly less in the ESPB group compared with SAPB group, P = 0.013. NSAIDs median consumption and Metoclopramide consumption were significantly lower in the ESPB group compared to SAPB group (P = 0.002 and P = 0.048, respectively). Conclusions: ESPB, even more than SAPB, appears to be a feasible and effective strategy for the management of postoperative pain, allowing good quality analgesia with low consumption of opioids, NSAIDs and antiemetic drugs.


Assuntos
Bloqueio Nervoso , Toracotomia , Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Humanos , Valva Mitral/cirurgia , Bloqueio Nervoso/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Toracotomia/efeitos adversos
3.
Kyobu Geka ; 75(7): 511-517, 2022 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-35799486

RESUMO

Since 2014, we have used the da Vinci surgical system to perform internal thoracic artery harvest in minimally invasive direct coronary artery bypass (MIDCAB), and since 2016, we have also performed robot-assisted cardiac surgery( RACS) for mitral and tricuspid valve surgery, left atrial thrombosis, and myxoma, all of which we have had performed as minimally invasive cardiac surgery( MICS) previously. Even after the introduction, different ideas (Chordalizer, COR-KNOT, special long CP cannula, de-air technique, etc.) were developed. As a result of the learning curve, more stable surgery could be performed. However, keeping in mind that RACS is only a means and not a purpose, the RACS indication should always be carefully considered. When problems, such as intracardiac manipulation or uncontrollable bleeding, occur, safe surgery must be decided to switch to normal thoracotomy as soon as possible. A further enhancement would be expected for even better results and expansion of the RACS indications.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Artéria Torácica Interna , Procedimentos Cirúrgicos Robóticos , Robótica , Procedimentos Cirúrgicos Cardíacos/métodos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Toracotomia , Resultado do Tratamento
4.
Kyobu Geka ; 75(7): 537-542, 2022 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-35799489

RESUMO

Minimally invasive cardiac surgery( MICS) has emerged in 1990s. Nowadays, MICS via mini thoracotomy became popular for valvular heart disease. Robot-assisted cardiac surgery was introduced with extension to MICS. Robot-assisted cardiac surgery for valvular heart disease has been covered by health insurance since 2018. So far, the number of authorized facilities for robot-assisted cardiac surgery is only 25. Currently available da Vinci surgical system is a burden to not only the surgical team but also the facility. There are a lot of problems to overcome for applying robot-assisted cardiac surgery as a standardized procedure. An educational institution like a university hospital needs to expand systematic human resource development and technological innovation for continuing and developing the robot-assisted cardiac surgery. The most important thing for the surgeon is to keep in mind for true minimally invasive surgery for the patients not for minimally incisional surgery for the cosmetic reason.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Doenças das Valvas Cardíacas , Procedimentos Cirúrgicos Robóticos , Robótica , Doenças das Valvas Cardíacas/cirurgia , Humanos , Toracotomia
5.
Heart Surg Forum ; 25(3): E353-E357, 2022 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-35787754

RESUMO

BACKGROUND: There is an increasing demand for minimally invasive myxoma resection. This study aimed to investigate the safety and feasibility of minimally invasive myxoma resection. METHODS: In this retrospective study, we collected information from 95 patients who underwent myxoma resection between January 2016 and December 2020. Based on the operative approach, the patients were divided into the minimally invasive myxoma resection (Mini-MR) group (N = 30) and the sternotomy myxoma resection (SMR) group (N = 65). Intraoperative and postoperative data were compared between the two groups. RESULTS: The postoperative ventilator-assisted time, CSICU time, and postoperative hospital stay were shorter in the Mini-MR group than in the SMR (13.05 ± 4.98 vs. 17.07 ± 9.52 h; 1.73 ± 0.29 vs. 2.27 ± 1.53 d; 6.20 ± 1.50 vs. 9.48 ± 3.37 d, respectively), and the difference was statistically significant (P < 0.05). Mini-MR had lower postoperative drainage and blood transfusion rate in the first 24 h compared with SMR (38.93 ± 69.62 vs. 178.25 ± 153.06 ml; 26.6% vs. 63.1%), and the differences were statistically significant (P < 0.05). CONCLUSION: Mini-MR has the advantages of less CSICU stay time, less ventilator time, less postoperative drainage in the first 24h, less blood transfusion, fewer postoperative hospital stays, and faster recovery. Mini-MR is a safe and feasible surgical procedure for myxoma resection.


Assuntos
Mixoma , Humanos , Mixoma/diagnóstico , Mixoma/cirurgia , Estudos Retrospectivos , Esternotomia/métodos , Toracotomia/métodos , Resultado do Tratamento
6.
Kyobu Geka ; 75(8): 634-637, 2022 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-35892304

RESUMO

Transcatheter aortic valve replacement has increasingly been used as a standard treatment option for patients with aortic valve stenosis, especially in the frail and the elderly. However, it is not recognized as a valid treatment for patients with aortic valve regurgitation. In this study, we report our experience in conducting a right anterior minithoracotomy for a minimally invasive aortic valve replacement in the elderly. An 87-year-old woman with severe aortic valve regurgitation was admitted to our department. Minimally invasive aortic valve replacement was performed, through a right anterior minithoracotomy in the second intercostal space. A localized transverse aortotomy was performed at a position higher than that in an ordinary aortotomy. Our procedure for aortic valve replacement was similar to the conventional method. The postoperative course was uneventful, and the patient was discharged after 10 days. Therefore, we conclude that right anterior minithoracotomy for a minimally invasive aortic valve replacement is a feasible, effective, and safe technique.


Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Feminino , Idoso Fragilizado , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Toracotomia/métodos , Resultado do Tratamento
7.
J Am Heart Assoc ; 11(14): e026517, 2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35861815

RESUMO

Background Until recently, a large right ventricle outflow tract interfered with the feasibility of standard transcatheter pulmonary valve replacement (PVR). We are describing our experience using a hybrid approach for PVR using a left anterior thoracotomy approach to allow for plication of the main pulmonary artery followed by a transcatheter PVR using a Sapien S3 valve. Methods and Results This is a single-center, retrospective review of patients who were evaluated to be appropriate for a hybrid PVR approach. The patients' demographics, procedure details, and follow-up data were collected. Between May 2018 and April 2021, a total of 11 patients presented for hybrid transcatheter PVR. The median age and weight were 24 years (interquartile range, 19-43 years) and 81.8 kg (interquartile range, 69-91 kg), respectively. Nine out of 11 patients received a transcatheter PVR after main pulmonary artery plication. There were no procedurally related deaths. One major complication was encountered in which the valve was malpositioned requiring successful surgical PVR. Minor complications included acute kidney injury (n=1) and a broken rib (n=1). The median length of stay was 4 days (interquartile range, 2-4 days), with median follow-up of 7 months (interquartile range, 3-18 months). A well-functioning pulmonary valve was observed in all patients at the last follow-up. Conclusions A hybrid approach using left anterior thoracotomy with pulmonary artery plication followed by transcatheter Sapien S3 PVR provides a less-invasive option for patients with an enlarged right ventricular outflow tract. Preliminary results demonstrated this to be a safe option with good short-term outcomes.


Assuntos
Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Insuficiência da Valva Pulmonar , Valva Pulmonar , Tetralogia de Fallot , Cateterismo Cardíaco/efeitos adversos , Próteses Valvulares Cardíacas/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/métodos , Ventrículos do Coração , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/cirurgia , Estudos Retrospectivos , Tetralogia de Fallot/cirurgia , Toracotomia/efeitos adversos , Resultado do Tratamento
8.
Agri ; 34(2): 148-150, 2022 Apr.
Artigo em Turco | MEDLINE | ID: mdl-35848811

RESUMO

We aimed to share our experience with erector spina plan block for postoperative analgesia after hydatid cyst operation in a six-year-old girl. Erector spina plan block is a new interfasial block defined by Forero in 2016. It has been reported that it can be used effectively in many different indications. Ultrasound guided erector spina plan block is a method that can be applied for postoperative analgesia after thoracotomy.


Assuntos
Bloqueio Nervoso , Toracotomia , Criança , Feminino , Humanos , Dor Pós-Operatória/prevenção & controle , Músculos Paraespinais , Ultrassonografia de Intervenção
9.
Medicina (Kaunas) ; 58(7)2022 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-35888562

RESUMO

Congenital tracheoesophageal fistula (TEF) without esophageal atresia is usually diagnosed and treated in the neonatal period. It is uncommon to occur in adulthood. Conventional treatment of adult-onset TEF involves repair by either cervicotomy or thoracotomy. We reported the case of a 31-year-old male patient with clinical and radiographic evidence of congenital H-type TEF. Although this fistula was located at the level of the second thoracic vertebra, the repair of the anomaly was performed successfully using a thoracoscopic approach with the novel use of a polyglycolic acid sheet reinforcement.


Assuntos
Atresia Esofágica , Fístula Traqueoesofágica , Adulto , Atresia Esofágica/cirurgia , Humanos , Recém-Nascido , Masculino , Ácido Poliglicólico/uso terapêutico , Estudos Retrospectivos , Toracotomia , Fístula Traqueoesofágica/congênito , Fístula Traqueoesofágica/diagnóstico , Fístula Traqueoesofágica/cirurgia
10.
Thorac Cancer ; 13(15): 2085-2099, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35790080

RESUMO

The potential complications related to unplanned conversion to thoracotomy remains a major concern in thoracoscopic lobectomy and may limit the wide adoption of this strategy. We reviewed the literature from 1990 until February 2022, analyzing all papers comparing successful thoracoscopic lobectomy versus converted thoracoscopic lobectomy and/or upfront thoracotomy lobectomy to establish whether unplanned conversion negatively affected outcomes. Thirteen studies provided the most applicable evidence to evaluate this issue. Conversion to thoracotomy was reported to occur in up to 23% of cases (range, 5%-16%). Vascular injury, calcified lymph nodes, and dense adhesions were the most common reasons for conversion. Converted thoracoscopic lobectomy compared to successful thoracoscopic lobectomy was associated with longer operative time and hospital stay in all studies, with higher postoperative complication rates in seven studies, and with higher perioperative mortality rates in four studies. No significant differences were found between converted thoracoscopic lobectomy and upfront thoracotomy lobectomy. Five studies evaluated long-term survival, and in all papers conversion did not prejudice survival. Surgeons should not fear unplanned conversion during thoracoscopic lobectomy, but to avoid unexpected conversion that may negatively impact surgical outcome, a careful selection of patients is recommended-especially for frail patients.


Assuntos
Neoplasias Pulmonares , Toracotomia , Humanos , Pneumonectomia/efeitos adversos , Pneumonectomia/métodos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/métodos , Toracotomia/efeitos adversos , Toracotomia/métodos , Translocação Genética
11.
Port J Card Thorac Vasc Surg ; 29(2): 67-69, 2022 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-35780409

RESUMO

We report the clinical case of a 38 weeks gestational age neonate, antenatally diagnosed with a left large macrocystic pulmonary malformation conditioning dextrocardia. At birth, he presented with respiratory distress requiring non-invasive ventilation with high-flow nasal cannula (HFNC). A left inferior lobectomy was performed via thoracotomy on day 21 of life. Histological features of the lesion were compatible with congenital pulmonary airway malformation (CPAM) type I with muci- nous cell clusters. No surgical complications were reported and the neonate was discharged six days after surgery. Follow-up two months after surgery was unremarkable.


Assuntos
Malformação Adenomatoide Cística Congênita do Pulmão , Anormalidades do Sistema Respiratório , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Pulmão/diagnóstico por imagem , Masculino , Anormalidades do Sistema Respiratório/diagnóstico , Toracotomia
12.
Medicine (Baltimore) ; 101(29): e29284, 2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35866794

RESUMO

RATIONALE: Pulmonary sequestration, which can be divided into 2 main types: intralobar pulmonary sequestration (IPS) and extralobar pulmonary sequestration, is an uncommon congenital condition for which surgical resection is usually indicated. Video-assisted thoracoscopic surgery, as compared with open thoracotomy, has increasingly become the preferred operative procedure in the treatment of PS, owing to less postoperative pain and faster recovery. This report describes a rare and challenging case with a giant IPS undergoing video-assisted thoracic lobectomy. PATIENT CONCERNS: A 39-year old woman suffered from recurrent pneumonia for nearly 3 years. An enhanced computed tomography scan performed in our hospital revealed a 12.0 cm × 10.0 cm-sized IPS in the left lower lobe, supplied by an 8-mm aberrant artery originating from the descending thoracic aorta. DIAGNOSIS: Histology of the resected lobe confirmed the diagnosis of giant intralobar pulmonary sequestration associated with infection. INTERVENTIONS: Thoracoscopic left lower lobectomy was performed. OUTCOMES: The patient has been discharged from the hospital on the ninth day after surgery with an uneventful recovery, she was in good health after a 1-year follow-up. LESSONS: Although full of challenges, thoracoscopic lobectomy for giant IPS is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional thoracotomy.


Assuntos
Sequestro Broncopulmonar , Adulto , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/patologia , Sequestro Broncopulmonar/cirurgia , Feminino , Humanos , Dor Pós-Operatória/cirurgia , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/métodos , Toracotomia
13.
Eur J Cardiothorac Surg ; 62(1)2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35678570

RESUMO

We present the case of a 78-year-old woman suffering from coronary artery disease and secondary severe mitral valve regurgitation due to left ventricular and annular distention. The interdisciplinary heart team recommended a simultaneous hybrid procedure consisting of minimally invasive direct coronary artery bypass grafting with subsequent transapical mitral valve replacement using the Tendyne prosthesis via the same small anterolateral thoracotomy. The operation was performed using a heart-team approach with close collaboration between heart surgeons and cardiologists in the hybrid operating theatre. The intra- and postoperative courses were uneventful. Predischarge transthoracic echocardiography on postoperative day 8 revealed the immaculate functioning of the implanted valve without para- or transvalvular insufficiency, a mean gradient of 2 mmHg, no left ventricular outflow tract obstruction and a stable ejection fraction of 50%. The combination of minimally invasive direct coronary artery bypass grafting revascularization with concomitant transapical mitral valve replacement is feasible and enables a further step towards minimally invasive therapy, even in complex situations. It shows that the modern heart-team approach exceeds mere decision making and expands towards a hybrid treatment for patients.


Assuntos
Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral , Disfunção Ventricular Esquerda , Idoso , Ponte de Artéria Coronária , Feminino , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Toracotomia/métodos , Resultado do Tratamento , Disfunção Ventricular Esquerda/cirurgia
14.
J Pak Med Assoc ; 72(5): 947-949, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35713061

RESUMO

This short report highlights the patient outcome of lung resections for congenital and acquired lung lesions in children who presented to the Liaquat National Hospital, Karachi, from January 2013 to April 2019. Common indications were congenital pulmonary airway malformation (CPAM), congenital lobar emphysema (CLE), and bronchiectasis. Two patients died whereas, 21 were discharged home. Lung resection can be performed safely in children. Early diagnosis and surgery may improve the outcome.


Assuntos
Enfisema Pulmonar , Toracotomia , Criança , Humanos , Lactente , Pulmão/anormalidades , Pneumonectomia , Enfisema Pulmonar/congênito , Estudos Retrospectivos , Resultado do Tratamento
15.
Wiad Lek ; 75(5 pt 2): 1403-1407, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35758465

RESUMO

OBJECTIVE: The aim: The aim of this work is to describe the clinical case of the first lung transplant in Ukraine through anterolateral access and to analyze management of patient in the postoperative period, followed by assessment of his general condition and quality of life. PATIENTS AND METHODS: Materials and methods: Analysis of the clinical case of the patient who underwent the first lung transplantation in Ukraine, including a description of surgery, anesthesia, and postoperative recovery. CONCLUSION: Conclusions: Thus, based on the data of the world literature, as well as on the results of treatment on the basis of Municipal Non-Profit Enterprise " Lviv Emergency Clinical Hospital" we can conclude that lung transplantation is one of the most effective methods of treatment of patients with end-stage lung disease. This operation improves patients' quality of life, general well-being and ability to physical activity.


Assuntos
Transplante de Pulmão , Toracotomia , Humanos , Transplante de Pulmão/efeitos adversos , Transplante de Pulmão/métodos , Período Pós-Operatório , Qualidade de Vida , Toracotomia/efeitos adversos , Toracotomia/métodos , Ucrânia
16.
Artigo em Inglês | MEDLINE | ID: mdl-35748763

RESUMO

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether intraoperative conversions to thoracotomy have an impact on long-term survival for patients with non-small-cell lung cancer who underwent video-assisted thoracoscopic lobectomy initially. A total of 461 papers were found using the reported search, of which 6 retrospective cohort studies represented the best evidence to answer the clinical question. The authors, date of publication, journal, country of the authors, patient group, study type, relevant outcomes and results of these papers were tabulated. Five cohort studies clarified that conversion did not compromise long-term survival, whereas 1 cohort study reported worse long-term outcomes after conversion to thoracotomy. However, the limited samples, different characteristics between groups and selection bias due to inherent design made it difficult to make a conclusion. Based on the current evidence, we concluded that intraoperative conversion from video-assisted thoracoscopic surgery (VATS) to thoracotomy for non-small-cell lung cancer might not impact long-term survival compared to a successful VATS lobectomy. In-hospital mortality might not be prejudiced, whereas longer hospitalizations were observed. However, whether conversion would adversely affect postoperative complication rates remained unclear because of the conflicting results. Moreover, 3 studies reported no statistical differences in short- and long-term survival between emergency and non-emergency conversions. Therefore, we suggest that thoracic surgeons should not hesitate to convert VATS into thoracotomy in the case of blood vessel injury or difficult hilum.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Estudos de Coortes , Humanos , Neoplasias Pulmonares/cirurgia , Pneumonectomia/métodos , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Toracotomia/efeitos adversos , Toracotomia/métodos , Resultado do Tratamento
17.
Artigo em Inglês | MEDLINE | ID: mdl-35699486

RESUMO

A 74-year-old man with a history of retrosternal oesophageal reconstruction was referred for surgical treatment of mitral valve regurgitation and coronary artery disease. He underwent mitral valve replacement combined with coronary artery bypass grafting through a left thoracotomy. Combined mitral valve replacement and coronary artery bypass grafting through a left thoracotomy were feasible in this patient with a retrosternal neo-oesophageal conduit.


Assuntos
Doença da Artéria Coronariana , Insuficiência da Valva Mitral , Idoso , Ponte de Artéria Coronária , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia , Toracotomia
18.
J Card Surg ; 37(9): 2581-2585, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35726656

RESUMO

BACKGROUND AND AIM OF THE STUDY: Periareolar minithoracotomy represents an interesting option in minimally invasive cardiac surgery and it is our preferred approach for women. Our aim is to assess the results in female patients, in terms of nipple postoperative pain, local sensitivity, and eventual alterations in mammography after surgery. METHODS: Fifty-seven female patients underwent periareolar incision, as minithoracotomy approach, from December 2018 to December 2021. Their mean age was 56 ± 12 years, their body mass index was 22.5 ± 4.8; their surgery was elective in 93%, with mean Euroscore II about 2 ± 1.3. RESULTS: Of 57 patients, 87.7% (50 patients) underwent mitral valve repair, whose six with associated procedures; 8.8% (five patients) underwent mitral valve replacement whose two with tricuspid annuloplasty associated and 3.5% (two patients) had isolated tricuspid surgery. The cardiopulmonary bypass and aortic cross-clamp time were 123.2 ± 30.2 and 101.3 ± min respectively. There were no conversions to either full sternotomy or larger thoracotomy approach. There were no in-hospital and follow-up deaths. No strokes or wound infections were observed. Mean follow-up was 16± 9 months. Within the investigated follow-up, 100% of the patients were satisfied with the esthetic result, no remarkable postoperative pain was reported, two patients had slight hyposensitivity in the nipple area. About 50% IThad mammography as prevention screening after surgery and no abnormalities were found. CONCLUSIONS: Periareolar minithoracotomy is a feasible surgical option in female patients, with excellent healing and cosmetic results and preserving the tissues of the mammary gland.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Implante de Prótese de Valva Cardíaca , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Feminino , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Dor Pós-Operatória , Estudos Retrospectivos , Toracotomia/métodos , Resultado do Tratamento , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia
20.
BMC Surg ; 22(1): 237, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725438

RESUMO

BACKGROUND: With the growing number of patients with coexisting pulmonary and mediastinal lesions detected, reports about simultaneous video-assisted thoracic surgery (VATS) for these concurrent diseases are still rare. To further explore the safety and effectiveness of simultaneous resection of pulmonary and mediastinal lesions by uniportal or biportal VATS, we retrospectively analyzed the clinical data of the largest series of cases to date. METHODS: From July 2018 to July 2021, all patients whose pulmonary lesions and mediastinal tumors were resected simultaneously in our institution were retrospectively reviewed. Their demographic and clinical data were collected and analyzed. RESULTS: A total of 54 patients were enrolled, of whom 44 underwent unilateral uniportal VATS, 3 underwent bilateral uniportal VATS and 7 underwent unilateral biportal VATS. Seven cases were converted to thoracotomy during surgery. For the remaining 47 patients with various demographic and clinical characteristics, most of the operations were completed within 3 h (n = 33, 70.2%) with blood loss of no more than 100 mL (n = 43, 91.5%). The duration of chest tube drainage was 5.66 ± 3.34 days, and the average daily volume was 196.90 ± 122.31 mL. Four cases of postoperative complications occurred during hospitalization. The length of postoperative hospital stay was 8.60 ± 3.63 days. No severe complications or deaths were observed during follow-up. CONCLUSIONS: Uniportal and biportal VATS are safe and effective for simultaneous resection of selected coexisting pulmonary and mediastinal lesions, but the indications and operational details need more evaluation.


Assuntos
Neoplasias Pulmonares , Cirurgia Torácica Vídeoassistida , Humanos , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Estudos Retrospectivos , Toracotomia
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