Thoracoscopic right upper lobectomy in a patient with bronchial and pulmonary vein anomalies.
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ABSTRACT:
SUBMITTER: Mun M
PROVIDER: S-EPMC8304485 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Video-assisted thoracic surgery (VATS) provides less postoperative pain, preservation of the immune response and shorter recovery period, compared with thoracotomy. However, many patients complain of postoperative pain and paresthesia because VATS requires 3 or 4 incisions including a utility incision of 3-5 cm. To overcome this problem, single incision thoracoscopic surgery has emerged; this technique has been adopted for lung cancer surgery since 2010. Complete mediastinal lymph node dissection is the major role of lung cancer surgery. We describe a case of a right upper lobectomy with complete mediastinal lymph node dissection via single incision thoracosopic surgery.
| S-EPMC4022387 | biostudies-literature
Project description:Introduction and importanceMucoepidermoid carcinoma presents as an exophytic endobronchial mass that induces obstructive symptoms often followed by distal collapse atelectasis of the lung parenchyma.Case presentationA six-year-old girl had recurrent bacterial pneumonia and atelectasis of the right upper lobe. Computed tomography revealed a 30-mm mass in the anterior segment of the right upper lobe with an obstructed trachea and peripheral atelectasis. A minor salivary gland tumor was suspected, so thoracoscopic right upper lobectomy (RUL) was performed. Intraoperative bronchoscopy showed no protrusion of the tumor into the tracheal lumen. We confirmed that there was no injury to the middle lobe branch and no residual tumor via bronchoscopy before transection of the trachel bronchus of the right upper lobe. The histological type was low-grade mucoepidermoid carcinoma. The postoperative course was uneventful, and no recurrence was evident after one year.Clinical discussionPrimary pulmonary cancers in children are extremely rare. Mucoepidermoid carcinoma is the most common disease in pediatric primary lung tumors but remains relatively rare. Mucoepidermoid carcinoma of the tracheobronchial tree sometimes requires sleeve resection. Intraoperative bronchoscopy helped determine the exact position of the tumor. The value of intraoperative bronchoscopy for sparing the lung parenchyma and preserving as much of the respiratory function as possible. Intraoperative bronchoscopy should be actively performed in cases of pediatric lobectomy, especially those involving tracheobronchial tumors.ConclusionIntraoperative bronchoscopy allowed for complete RUL without residual tumor or injury of the middle lobe bronchus.
| S-EPMC10112141 | biostudies-literature
Project description: Not available
| S-EPMC7867807 | biostudies-literature
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| S-EPMC8311674 | biostudies-literature
Project description:BackgroundThe purpose of this prospective study was to explore the influence of both preoperative three-dimensional (3D) reconstruction and intraoperative preservation of the bronchial artery (BA) on postoperative cough after thoracoscopic lobectomy.MethodsA total of 60 patients who had received a combination of thoracoscopic lobectomy and systematic lymph node dissection were included in this study. They were divided into two groups, namely the BA preservation group (Group A), and conventional surgical treatment group (Group B). In group A, we used Exoview software for 3D reconstruction of the BA before the operation and the BA was preserved during the operation. 3D reconstruction of the BA was not performed before surgery in group B. The incidence of postoperative cough, the Mandarin Chinese version of the Leicester cough questionnaire (LCQ-MC), physiological, psychological and social dimensions and total score of the two groups were compared and analyzed.ResultsThe scores and total scores of LCQ-MC in group B were lower than those in group A one and two months after surgery. There were significant differences between the two groups in physiological and psychological dimensions and total scores (p < 0.05), but there was no significant difference in social dimension between the two groups (p > 0.05). The incidence of postoperative cough in group A (16.7%) was lower than that in group B (30%), while the difference was not statistically significant (p = 0.222).ConclusionsPreoperative 3D reconstruction and intraoperative preservation of the BA can reduce the severity of postoperative cough.
| S-EPMC8327694 | biostudies-literature
Project description:Intubated general anesthesia with one-lung ventilation was traditionally considered necessary for thoracoscopic major pulmonary resections. However, non-intubated thoracoscopic lobectomy can be performed by using conventional and uniportal video-assisted thoracoscopic surgery (VATS). These non-intubated procedures try to minimize the adverse effects of tracheal intubation and general anesthesia but these procedures must only be performed by experienced anesthesiologists and skilled thoracoscopic surgeons. Here we present a video of a uniportal VATS left upper lobectomy in a non-intubated patient, maintaining the spontaneous ventilation.
| S-EPMC4387442 | biostudies-other
Project description:Video 1Incision and port placement of 4 to 5 cm at the fifth or sixth intercostal space between the anterior and the midaxillary line. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 2Dissection of the anterior mediastinal pleura and division of the superior pulmonary vein. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 3Dissection of the apical mediastinal pleura and division of the anterior and apical branches of the pulmonary artery. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 4Dissection and division of the anterior oblique fissure and division of the lingular branches of the pulmonary artery. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 5Dissection and division of the interlobar fissure and the posterior branch of the pulmonary artery. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 6Dissection and division of the left upper lobe bronchus. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 7Lymph node dissection (subaortic, hilar, subcarinal, or inferior pulmonary ligament) and division of the inferior pulmonary ligament. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 8Specimen retrieval. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.Video 9Chest tube placement. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00717-3/fulltext.
| S-EPMC8691926 | biostudies-literature
Project description:INTRODUCTION:The anatomical abnormalities in pulmonary veins can have a serious impact on pulmonary resections. PRESENTATION OF CASE:We report the case of a 70-year-old woman undergoing VATS right upper lobectomy for the treatment of non-small cell lung cancer. During subcarinal dissection, an anomalous vein draining from the superior segment of the right lower lobe into the left atrium and passing behind the bronchus intermedius was incidentally discovered. The patient had, in addition to the inferior pulmonary vein formed by the confluence of superior and common basal veins, a supernumerary vessel identified as: accessory right V6. Retrospective review of preoperative enhanced chest computed tomography confirmed the pulmonary vascular anomaly. DISCUSSION/CONCLUSION:A careful dissection during pulmonary resections can help to recognize variations of the pulmonary veins, avoiding unexpected intraoperative complications.
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Project description:Circumaortic right renal vein is an extremely rare finding and to our knowledge only 1 case has been reported in the literature so far. Its rareness, in contrast to left renal vein anomalies, is thought to be due to a relatively simple embryologic development of right renal vein compared with left renal vein. On the other hand, association of Circumaortic right renal vein with inferior vena cava agenesis and aortic coarctation is an extremely rare occurrence. Our aim is to introduce a case of Circumaortic right renal vein in a 3-month-old child with inferior vena cava agenesis and aortic coarctation. Discussion on the underlying embryology of Circumaortic right renal vein, its clinical importance and the association with other vascular anomalies, will be on our focus as well. Precise understanding of renal vein anomalies is important when planning retroperitoneal surgery or interventional vascular procedures. Awareness of such anomaly implies crucial knowledge for radiologists who should include it in the medical reports to aid future patient's management.
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Project description:Despite the advances in video-assisted thoracoscopic surgery (VATS), vascular reconstruction of the pulmonary artery (PA) is still infrequently performed by thoracic surgeons because of the technical difficulties and the increased operative risk during thoracoscopy. The few published reports have been performed by using 3-4 incisions. We present the first report of a pulmonary artery reconstruction procedure performed by a single-incision VATS technique. A 73-year old male patient was operated on by the thoracoscopic approach through a single 4-cm incision with no rib spreading. The postoperative recovery was uneventful.
| S-EPMC3805214 | biostudies-literature