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video-assisted thoracic surgery for Residual Aneurysm after Total Arch Replacement

Open Journal of thoracic surgery 2021年第1期11卷 25-30页

作者： Kayo Sugiyama Hirotaka Watanuki Yasuhiro Futamura Masaho Okada Hiroki Numanami Masayuki Yamaji Satoshi Makino Katsuhiko Matsuyama Department of Cardiac surgery Aichi Medical University Nagakute Japan Department of thoracic surgery Aichi Medical University Nagakute Japan

Background: Residual aneurysms after graft replacement are rare, but they can be detrimental if they are saccular and large. The etiology of residual aneurysms remains unknown, and their management is controversial. One treatment option is late open surgical conversion;however, postoperative respiratory complications resulting from the dissection of pleural adhesions, which is frequently necessary with this approach, are often unavoidable. Case presentation: Herein, we report a case of open surgical repair of a residual distal aortic arch aneurysm that occurred after total arch replacement and thoracic endovascular aortic repair. Contrast-enhanced magnetic resonance imaging was not possible in this case due to the patient’s severe renal dysfunction;however, contrast-enhanced computed tomography using minimal contrast did not detect remarkable leakage through the graft or stent graft into the aneurysm. Late open surgical conversion using video-assisted thoracic surgery was performed by thoracic surgeons, and the adhesion between the aortic wall and the lung was safely and effectively dissected. Because there was no significant pulsation or evidence of feeding arteries in the aortic wall, the aortic wall was opened carefully. No bleeding or backflow from any branch arteries into the aneurysm was noted, so the aortic wall was ligated with continuous sutures. The patient recovered without experiencing any major complications. Conclusions: This case report demonstrates that video-assisted thoracic surgery is safe and effective for late open conversion in cases of residual aneurysm;furthermore, this case suggests that video-assisted thoracic surgery may be particularly beneficial for the dissection of adhesions between the aortic wall and lung in these cases.

关键词： Late Open Surgical Conversion Total Arch Replacement video-assisted thoracic surgery

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Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery

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World Journal of Clinical Cases 2024年第12期12卷 2040-2049页

作者： Mei-Hua Sun Liu-Sheng Wu Ying-Yang Qiu Jun Yan Xiao-Qiang Li Department of thoracic surgery Peking University Shenzhen HospitalShenzhen 518036Guangdong ProvinceChina School of Medicine Tsinghua UniversityBeijing 100084China Yong Loo Lin School of Medicine National University of SingaporeSingapore 119077Singapore

BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with *** We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of thoracic surgery of Peking University Shenzhen Hospital between May 2015 and April *** propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar *** After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine *** significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar *** ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.

关键词： Enhanced recovery after surgery Non-small cell lung cancer Perioperative care Propensity score video-assisted thoracic surgery

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Gastroparesis after video-assisted thoracic surgery:A case report

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World Journal of Clinical Cases 2023年第8期11卷 1862-1868页

作者： Hang An Yu-Cun Liu Department of General surgery Peking University First HospitalBeijing 100034China

BACKGROUND video-assisted thoracic surgery(VATS)lobectomy is a common treatment for patients with early-stage lung *** patients can experience slight gastrointestinal discomfort after lobectomy for a *** is a gastrointestinal disorder that can be severe;it is associated with an increased risk of aspiration pneumonia and impaired postoperative ***,we report a rare case of gastroparesis after VATS *** SUMMARY A 61-year-old man underwent VATS right lower lobectomy uneventfully but had an obstruction of the upper digestive tract 2 d after *** gastroparesis was diagnosed after emergency computed tomography and oral iohexol X-ray *** gastrointestinal decompression and administration of prokinetic drugs,the patient’s gastrointestinal symptoms *** perioperative medication was applied according to the recommended dose and there was no evidence of electrolyte imbalance,intraoperative periesophageal vagal nerve injury was the most likely underlying cause of *** Although gastroparesis is a rare perioperative complication following VATS,clinicians should be on the alert when patients complain about gastrointestinal *** surgeons resect paraesophageal lymph nodes with electrocautery,excessive ambient heat and compression of paraesophageal hematoma might induce vagal nerve dysfunction.

关键词： Gastroparesis Delayed gastrointestinal emptying video-assisted thoracic surgery Lobectomy thoracic surgery Case report

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Three-dimensional image simulation of primary diaphragmatic hemangioma: A case report

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World Journal of Clinical Cases 2019年第24期7卷 4307-4313页

作者： Pei-Yi Chu Kuan-Hsun Lin Hao-Lun Kao Yi-Jen Peng Tsai-Wang Huang Division of thoracic surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Radiology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND Fewer than 200 cases of diaphragmatic tumors have been reported in the past century. Diaphragmatic hemangiomas are extremely rare. Only nine cases have been reported in English literature to date. We report a case of cavernous hemangioma arising from the diaphragm. Pre-operative three-dimensional(3D)simulation and minimal invasive thoracoscopic excision were performed successfully, and we describe the radiologic findings and the surgical procedure in the following *** SUMMARY A 40-year-old man was referred for further examination of a mass over the right basal lung without specific symptoms. Contrast-enhanced computed tomography revealed a poorly-enhanced lesion in the right basal lung, abutting to the diaphragm, measuring 3.1 cm × 1.5 cm in size. The mediastinum showed a clear appearance without evidence of abnormal mass or lymphadenopathy. A preoperative 3D image was reconstructed, which revealed a diaphragmatic lesion. video-assisted thoracic surgery was performed, and a red papillary tumor was found, originating from the right diaphragm. The tumor was resected, and the pathological diagnosis was cavernous *** In this rare case of diaphragmatic hemangioma, 3D image simulation was helpful for the preoperative evaluation and surgical decision making.

关键词： Diaphragmatic tumor Hemangioma Case report Three-dimensional image simulation video-assisted thoracic surgery Thoracoscopy

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Transcutaneous Electrical Acupoint Stimulation Improves Postoperative Cognitive Function in Senior Patients Undergoing video-assisted Thoracoscopic surgery:A Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2022年第8期28卷 730-735页

作者： WEI Hua HUANG Jun-sheng ZHAO Fang XIE Zhi-qiang XIA Zhi-yang GAN Jian-hui Department of Anesthesiology Tangshan People’s HospitalTangshanHebei Province063000China Department of Anesthesiology Tangshan Central HospitalTangshanHebei Province063000China

Objective:To evaluate the effectiveness and safety of transcutaneous electrical acupoint stimulation(TEAS)for improving postoperative cognitive function in senior patients undergoing video-assisted thoracoscopic surgical(VATS).Methods:From January to December 2020,97 participants were randomly assigned to the TEAS group(49 cases)and the control group(48 cases)by a random number *** patients in the TEAS group received TEAS,at the bilateral Neiguan(PC 6)and Zusanli(ST 36)*** control group received sham *** stimulation was started from 30 min before surgery until the end of the *** primary outcome was the incidence of pstoperative cognitive dysfunction(POCD),diagnosed based on the changes in the Mini-Mental Status Examination(MMSE)and Montreal Cognitive Assessment(MoCA)*** secondary outcomes were plasma levels of S100β protein and neuron-specific enolase(NSE).Results:The incidence of POCD on day 1 and 3 after surgery in the TEAS group was significantly lower than that in the control group[day 1 after surgery:28.3%(13/46)vs.52.3%(23/44),P=0.028;day 3 after surgery:21.7%(10/46)vs.40.9%(18/44),P=0.043].Compared with baseline,the MMSE and MoCA scores decreased to various extents in both *** MMSE scores on day 1,3,and 5 after surgery and MoCA scores on day 1,3,5,and 7 after surgery in the TEAS group were higher than those in the control group(all Psurgery(all Psurgery(all P<0.05).No obvious adverse events were found during the ***:Application of TEAS in senior patients after VATS could reduce incidence of POCD and improve postoperative cognitive function.

关键词： transcutaneous electrical acupoint stimulation video-assisted thoracic surgery senior postoperative cognitive dysfunction

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Different dissecting orders of the pulmonary bronchus and vessels during right upper lobectomy are associated with surgical feasibility and postoperative recovery for lung cancer patients

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Chinese Journal of Cancer 2017年第10期36卷 468-477页

作者： Hao-Ran Zhai Xue-Ning Yang Qiang Nie Ri-Qiang Liao Song Dong Wei Li Ben-Yuan Jiang Jin-Ji Yang Qing Zhou Hai-Yan Tu Xu-Chao Zhang Yi-Long Wu Wen-Zhao Zhong Graduate School Southern Medical University Guangdong Lung Cancer Institute Guangdong General Hospital&Guangdong Academy of Medical Sciences

Background: Right upper lobectomy(RUL) for lung cancer with di erent dissecting orders involves the most vari?able anatomical structures, but no studies have analyzed its e ects on postoperative recovery. This study compared the conventional surgical approach, VAB(dissecting pulmonary vessels first, followed by the bronchus), and the alter?native surgical approach, a BVA(dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer ***: According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into a BVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare periop?erative ***: Three hundred one patients were selected(109 in the a BVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the a BVA cohort than in the VAB cohort(164 vs. 221 min, P 0.05). The median disease?free survival was comparable for all patients in the two cohorts(not arrived vs. 41.97 months) and for patients with disease recurrences(13.25 vs. 9.44 months)(both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences(6.4% vs. 7.8%), distant metastases(10.1% vs. 8.3%), and both(1.8% vs. 1.6%)(all P > 0.05).Conclusions: Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the a BVA approach during

关键词： Lung cancer Dissecting order video-assisted thoracic surgery Pulmonary veins Bronchus

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Malignant pleural mesothelioma mimics thoracic empyema: A case report

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World Journal of Clinical Cases 2023年第35期11卷 8372-8378页

作者： Ya-Hsin Yao Yen-Shou Kuo Department of General Medicine Tri-Service General HospitalNational Defense Medical CenterTaipei 114202Taiwan Division of thoracic surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114202Taiwan

BACKGROUND thoracic empyema and malignant pleural mesothelioma(MPM)are distinct medical conditions with similar symptoms,including cough,chest pain,and breathing *** present a rare MPM case mimicking thoracic *** must consider MPM risks for patients exposed to building material who exhibit lobulated pleural effusions,indicating thoracic *** SUMMARY A 68-year-old retired male construction worker suffered from shortness of breath and chest tightness over 10 d,particularly during physical activity.A poor appetite and 4 kg weight loss over the past 3 wk were also *** images and laboratory data concluded a tentative impression of empyema thoracis(right).video-assisted thoracic surgery with decortication and delobulation(right)was *** pathological report yielded an MPM *** pleural bilateral effusions and respiratory failure developed postoperatively,and the patient died three weeks after the *** thoracic empyema and MPM are distinct medical conditions that can present similar symptoms,and video-assisted thoracic surgery facilitates an accurate ***-mimicking presentations and postoperative refractory pleural effusion may indicate a poor MPM outcome.

关键词： thoracic empyema Malignant pleural mesothelioma video-assisted thoracic surgery Case report

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Benign esophageal stricture after thermal injury treated with esophagectomy and ileocolon interposition

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World Journal of Gastroenterology 2014年第27期20卷 9205-9209页

作者： Toshihiro Kitajima Kota Momose Seigi Lee Shusuke Haruta Hisashi Shinohara Masaki Ueno Takeshi Fujii Harushi Udagawa Department of Digestive surgery Toranomon Hospital 2-2-2 Toranomon Minato-ku Tokyo 105-8470 Japan Department of Pathology Toranomon Hospital 2-2-2 Toranomon Minato-ku Tokyo 105-8470 Japan

Thermal injuries of the esophagus are rare causes of benign esophageal stricture, and all published cases were successfully treated with conservative management. A 28-year-old Japanese man with a thermal esophageal injury caused by drinking a cup of hot coffee six months earlier was referred to our hospital. The hot coffee was consumed in a single gulp at a party. Although the patient had been treated conservatively at another hospital, his symptoms of dysphagia gradually worsened after discharge. An upper gastrointestinal endoscopy and computed tomography revealed a pinhole like area of stricture located 19 cm distally from the incisors to the esophagogastric junction, as well as circumferential stenosis with notable wall thickness at the same site. The patient underwent a thoracoscopic esophageal resection with reconstruction using ileocolon interposition. The pathological findings revealed wall thickening along the entire length of the esophagus, with massive fibrosis extending to the muscularis propria and adventitia at almost all levels. Treatment with balloon dilation for long areas of stricture is generally difficult, and stent placement in patients with benign esophageal stricture, particularly young patients, is not yet widely accepted due to the incidence of late adverse events. Considering the curability and qualityof-life associated with a long expected prognosis, we determined that surgery was the best treatment option for this young patient. In this case, we decided to perform an esophagectomy and reconstruction with ileocolon interposition in order to preserve the reservoir function of the stomach and to avoid any problems related to the reflux of gastric contents. In conclusion, resection of the esophagus is a treatment option in patients with benign esophageal injury, especially in cases involving young patients with refractory esophageal stricture. In addition, ileocolon interposition may help to improve the quality-of-life of patients.

关键词： Thermal injury Benign esophageal stricture Esophageal resection Ileocolon interposition video-assisted thoracic surgery

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Effect of ulinastatin on the inflammatory response after video-assisted thoracic lobectomy in patients with lung cancer:a randomized controlled study

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Chinese Medical Journal 2022年第7期135卷 806-812页

作者： Won Jung Hwang Min A.Joo Jin Joo Department of Anesthesiology and Pain Medicine Seoul St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoulRepublic of Korea

Background:The first-line treatment for lung cancer is surgical resection,and one-lung ventilation(OLV)is the most basic anesthetic management method in lung *** OLV,inflammatory cytokines are released in response to the lung tissue damage and promote local and contralateral lung damage through the systemic *** designed a randomized,prospective study to evaluate the effect of the urinary trypsin inhibitor(UTI)ulinastatin on the inflammatory response after video-assisted thoracic lobectomy in patients with lung ***:Adult patients aged 19 to 70 years,who were scheduled for video-assisted thoracic lobectomy surgery to treat lung cancer between May 2020 and August 2020,were enrolled in this randomized,prospective ***(300,000 units)mixed with 100 mL of normal saline in the ulinastatin group and 100 mL of normal saline in the control group was administered over 1 h after inducing ***:The baseline(T0)interferon-γ(IFN-γ)/interleukin-4(IL-4)ratio was not different between the groups(6941.3±2778.7vs.6954.3±2752.4 pg/mL,respectively;P>0.05).The IFN-γ/IL-4 ratio was significantly higher in ulinastatin group at 30 min after entering the recovery room than control group(20,148.2±5054.3vs.6674.0±2963.6,respectively;adjustedPvideo-assisted thoracic surgery in lung cancer *** registration:Clinical Research Information Service of Korea National Institute of Health(CRIS),KCT0005533.

关键词： Ulinastatin Lung cancer video-assisted thoracic surgery INF-γ IL-4

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Experience of segmentectomy from 36 Chinese patients with non-small cell lung cancer at stage I

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Chinese Medical Journal 2013年第14期126卷 2687-2693页

作者： QIAN Li-qiang ZHAO Xiao-jing LUO Qing-quan HUANG Jia Shanghai Chest Hospital Shanghai Jiao Tong University Shanghai 200030 China

Background Although video-assisted radical operation for lung cancer has been widely accepted for treatment of non- small cell lung cancer （NSCLC）, the debate over video-assisted thoracic surgery （VATS） segmentectomy still remains. This study analyzed the clinical outcomes using VATS segmentectomy for stage I NSCLC patients to explore the safety and efficacy of VATS segmentectomy for la NSCLC. Methods Retrospective review was conducted of patients who underwent VATS segmentectomy for clinical stage I NSCLC at Shanghai Chest Hospital between November 2009 and May 2012. VATS segmentectomy was performed on 36 patients. Analyses of the patient group were performed on patient demographics and clinical characteristics, intraoperative parameters, complications, and postoperative survival. Results Thirty-five of thirty-six patients underwent VATS segmentectomy with only one conversion to open thoracic surgery. There was one peri-operative mortality from the segmentectomy group and all other patients are alive with a median follow up of 327 days. The mean volume of chest tube drainage after operation for segmentectomy was 1021.4 ml. Among other parameters, the mean blood loss was 162.5 ml （50.0-1600.0 ml）, the mean operation time 124.8 minutes （75.0-271.0 minutes）, chest tube duration 4.1 days （2-8 days）, and the mean length of hospital stay 6.2 days （4-11 days）. There was one （2.8%） Iocoregional recurrence after segmentectomy. Two patients successfully underwent bilateral segmentectomies and are still disease free. Conclusion For patients with stage I NSCLC, VATS segmentectomy offers a safe and equally effective option and can be applied to complicated operations such as bilateral segmentectomy.

关键词： non-small cell lung cancer stage I video-assisted thoracic surgery segmentectomy

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