Right transthoracic approach for robotic left main stem bronchus sleeve resection.
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ABSTRACT:
SUBMITTER: Iriarte F
PROVIDER: S-EPMC8690527 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC8288632 | biostudies-literature
Project description:A 42-year-old man was diagnosed with cancer of the right lower lung lobe with a posteparterial type of tracheal bronchus, in which the posterior segmental bronchus of the right upper lobe arose from the distal bronchus intermedius. A mass involved the distal bronchus intermedius, requiring a right lower bilobectomy with an additional posterior segmental resection of the right upper lung lobe. Thus, we performed a right lower bilobectomy and sleeve anastomosis of the posterior segmental bronchus of the right upper lobe to the proximal bronchus intermedius, sparing the pulmonary parenchyma of the same lobe.
| S-EPMC5548210 | biostudies-other
Project description:BackgroundTracheobronchial schwannomas are extremely rare, which account for lower than 0.2% in all pulmonary tumors. In large part because of the rarity and insufficient reported clinical details, tracheobronchial schwannoma lacks guidelines or expert consensus for diagnosis and treatment, and the delay in diagnosis can range from months to years. The main treatment option is surgery. Endoscopic intervention can also be selected. An increasing number of thoracic surgery cases were performed on the robotic platforms in recent years. With their assistance, surgeons can accomplish the high technique required surgical procedures with ease.Case descriptionIn this case, a 48-year-old female had a history of shortness of breath for more than 1 year. The chest computed tomography (CT) and bronchoscopy examination revealed a new growth of nodule in the left main bronchus. The nodule was considered a schwannoma by transbronchial biopsy, which was removed by robot-assisted bronchial resection with primary anastomosis. The application of Da Vinci Si robotic surgical system benefited the process of this surgery. Pathology and immunohistochemistry results confirmed the diagnosis of schwannomas. The patient tolerated the treatment without any complications. No sign of recurrence was discovered at present, 6 months after the intervention.ConclusionsWe reported the first sleeve resection for bronchial schwannoma using Da Vinci robotic surgical system. The clinical details of tracheobronchial schwannoma should be revealed more specifically to achieve more systematic diagnosis and treatment.
| S-EPMC11002510 | biostudies-literature
Project description:A child with accidental inhalation of a metallic foreign body into left main bronchus is reported. The foreign body was removed by rigid bronchoscopy. The problems in management are discussed and current literature reviewed.
| S-EPMC5529707 | biostudies-other
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| S-EPMC9735356 | biostudies-literature
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| S-EPMC8691652 | biostudies-literature
Project description:Dysphagia lusoria occurs due to compression of the esophagus as an aberrant right subclavian artery (ARSA) crosses the mediastinum. Surgical management includes open, hybrid, and endovascular techniques, with no consensus gold standard. There are few reports of robotic-assisted ARSA resection. We describe the innovative technique and outcomes for two patients who successfully underwent robotic-assisted transthoracic resection of an ARSA after right carotid-subclavian bypass for dysphagia lusoria. Both patients experienced improvement or resolution of their dysphagia and no major complications. In select patients with a noncalcified origin of the ARSA without aneurysmal degeneration, the robotic-assisted approach represents a viable option.
| S-EPMC11222948 | biostudies-literature
Project description:Endobronchial tumours requiring sleeve resection have been usually considered a contraindication for video-assisted thoracoscopic surgery (VATS). However, with new technical advances and the experience gained in VATS, sleeve lobectomy has been performed by thoracoscopy in experienced VATS centres. Right-sided sleeve anastomoses are easier to perform by VATS than left-sided ones because of the presence of the pulmonary artery and aortic arch on the left side. Most surgeons use a 3 to 4 incision VATS technique for sleeve anastomosis but the surgery can be performed by using only one incision. This is the first report of a left-sided sleeve lobectomy by uniportal approach.
| S-EPMC3895057 | biostudies-literature
Project description:AIM:Transthoracic contrast echocardiography (TTCE) is recommended for screening of pulmonary arteriovenous malformations (PAVMs) in hereditary haemorrhagic telangiectasia. Shunt quantification is used to find treatable PAVMs. So far, there has been no study investigating the reproducibility of this diagnostic test. Therefore, this study aimed to describe inter-observer and inter-injection variability of TTCE. METHODS:We conducted a prospective single centre study. We included all consecutive persons screened for presence of PAVMs in association with hereditary haemorrhagic telangiectasia in 2015. The videos of two contrast injections per patient were divided and reviewed by two cardiologists blinded for patient data. Pulmonary right-to-left shunts were graded using a three-grade scale. Inter-observer and inter-injection agreement was calculated with ? statistics for the presence and grade of pulmonary right-to-left shunts. RESULTS:We included 107 persons (accounting for 214 injections) (49.5% male, mean age 45.0?±?16.6 years). A pulmonary right-to-left shunt was present in 136 (63.6%) and 131 (61.2%) injections for observer 1 and 2, respectively. Inter-injection agreement for the presence of pulmonary right-to-left shunts was 0.96 (95% confidence interval (CI) 0.9-1.0) and 0.98 (95% CI 0.94-1.00) for observer 1 and 2, respectively. Inter-injection agreement for pulmonary right-to-left shunt grade was 0.96 (95% CI 0.93-0.99) and 0.95 (95% CI 0.92-0.98) respectively. There was disagreement in right-to-left shunt grade between the contrast injections in 11 patients (10.3%). Inter-observer variability for presence and grade of the pulmonary right-to-left shunt was 0.95 (95% CI 0.91-0.99) and 0.97 (95% CI 0.95-0.99) respectively. CONCLUSION:TTCE has an excellent inter-injection and inter-observer agreement for both the presence and grade of pulmonary right-to-left shunts.
| S-EPMC5876176 | biostudies-literature
Project description:BackgroundThe variation of right main stem bronchus leads to the orifice of the right upper lobe bronchus may be obstructed or increase the incidence of malposition intraoperatively when the right sided double-lumen tube is used. Therefore, the aim of this study was to compare the accuracy of three methods measured the length of the right main stem bronchus via chest computed tomography as a guide to the use of right sided double-lumen tube.MethodsIn this study, 168 adult patients undergoing left sided thoracic surgery were included. All these patients were allocated to carina-proximal (C-P) group, carina-distal (C-D) group and carina-carina (C-C) group. The position of endobronchial cuff observed via Fiberoptic bronchoscopy after successful initial placement and after turning the patients to the lateral decubitus position, as well as the incidence of malposition of right sided double-lumen tube intraoperative were recorded to assess the accuracy of three methods in predicting the position of right sided double-lumen tube.ResultsThe distance between the carina to the proximal margin of the right upper lobe orifice, carina to the distal margin of the right upper lobe orifice and carina to the first right interlobar carina of the right upper lobe orifice were 17.2 ± 2.3 mm, 25.4 ± 3.7 mm and 28.5 ± 3.1 mm (P < 0.05). In the C-D group, the number of endobronchial cuffs seen to be herniating out of the carina, the number of bronchoscopies during initial placement and on the lateral position, the number of total malposition intraoperative and the number of reposition manoeuvres intraoperative were significantly less than the C-P group or the C-C group (P < 0.05).ConclusionsThe length of the right main stem bronchus measured by the carina to distal margin of right upper lobe orifice method was more accurate than the other two methods in guiding the use of right sided double-lumen tube.Trials registrationClinical Trials. gov. no. NCT04127903. Registered at https://register.Clinicaltrialsgov on 16/10/2019.
| S-EPMC9387006 | biostudies-literature