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Transaxillary minithoracotomy in intrathoracic surgery for 316 infants and children

Chinese Medical Journal 2003年第7期116卷 1008-1010页

作者：舒强张泽伟朱雄凯李建华林茹俞建根陈自力 Department of Thoracic and Cardiovascular Surgery Medical College Zhejiang University Hangzhou 310003 China Department

Objective To introduce the technique of intrathoracic surgery performed through vertical transaxillary minithoracotomy Methods From March 1989 to March 2001, 316 patients underwent intrathoracic surgery through a vertical transaxillary minithoracotomy 285 patients suffered from patent ductus arteriosus (PDA), 10 congenital esophageal atresia, 8 congenital pulmonary cysts, 6 congenital emphysema, 1 pulmonary sequestration, 5 mediastinal tumor, and 1 eventration of the diaphragm Results All of the patients were successfully treated under satisfactory exposure No operative mortality and severe postoperative complications occurred Conclusions Intrathoracic surgery performed through a vertical transaxillary minithoracotomy appears to be less invasive, and is a simple, safe, cosmetically acceptable and efficient approach

关键词： minithoracotomy infants children surgical procedure

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Mini Thoracotomy Approach to Upper Thoracic Spine

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Neuroscience & Medicine 2018年第1期9卷 9-15页

作者： Hedaya Hendam Hatem El-Samouly Hamdy M. Behairy Medhat Noaman Gamal Abd Elshafy Neurosurgery Department Faculty of Medicine Al Azhar University Cairo Egypt Department of Neurosurgery Al-Azhar University Cairo Egypt Anesthesia Department Faculty of Medicine Al Azhar University Cairo Egypt Cardiothoracic Department Faculty of Medicine Al Azhar University Cairo Egypt

Upper thoracic spine lesions are characterized by delayed diagnosis due to nonspecific symptoms and its anterior aspect (T1 - T4) is difficult to be approached surgically. This retrospective clinical study was done to assess the efficacy of mini thoracotomy approach in management of these lesions. We studied 14 cases with upper thoracic spine different pathological lesions at levels (T1 - T4). These lesions were indicated for anterior approach surgery. Radiological assessment included plain X-ray, MRI and CT scan thoracic spine. The anaesthesia was specifically selective intubation and unilateral ventilation. All patients were operated upon through mini inter-costal thoracotomy approach (left sided in 13 patients and right sided in 1patient). Out of 14 patients there were 7 males and 7 females. The age range was 20 - 55 years (mean 38.7 years). Preoperative symptoms included vague nonspecific upper thoracic pain in 11 patients, lower limbs weakness in 6 patients, sphincteric disturbance in 5 patients, upper thoracic kyphotic deformity in 4 patients, severe brachialgia in 3 patients and neck pain in 2 cases. The operative time was ranged from 90 - 210 minutes (mean 152 m). Blood loss ranged from 250 to 750 cc (mean 464 cc). Chest tube drainage was inserted in all patients. There were no intra-operative or post-operative surgically related complications and no patients needed ICU admission. The lesions were neoplasms in 8 patients, traumatic fracture dislocation in 3 cases, tuberculous spondylodiscitis in 2 cases and degenerative disc prolapse in 1 case. All patients improved post-operative as regard their pre-operative complaints except one patient. During the follow up period, no mortality was recorded. In conclusion, mini thoracotomy approach seems to be ideal only for patients with mono- or bi-segmental pathology involving the upper thoracic spine.

关键词： minithoracotomy upper dorsal spine

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