Bilateral Simultaneous Pleurodesis by Median Sternotomy for Spontaneous Pneumo thorax
|
|
- Ronald Bailey
- 6 years ago
- Views:
Transcription
1 Bilateral Simultaneous Pleurodesis by Median Sternotomy for Spontaneous Pneumo thorax I. Kalnins, M.B., T. A. Torda, F.F.A.R.C.S,, and J. S. Wright, F.R.A.C.S. ABSTRACT Bilateral pleurodesis by median sternotomy was performed in 26 patients with recurrent spontaneous pneumothorax. Sixteen of these patients had a history of bilateral pneumothorax. At operation, evidence of bilateral cystic abnormalities of the lungs was detected in all patients except 1. The technique and possible place of median sternotomy and bilateral pleurodesis are discussed. S pontaneous pneumothorax is a condition which has a strong tendency to recur [l, 41. In the past two years a number of patients admitted to this unit with recurrent spontaneous pneumothorax have been treated by median sternotomy and bilateral pleurodesis. The case histories of 26 patients treated in this way were reviewed to determine whether there is sufficient indication to continue with this procedure as a rational means of treatment. The place of such treatment was originally suggested by the occurrence of contralateral pneumothorax in 6 of 41 patients who had previously undergone unilateral surgical pleurodesis. The relative frequency of bilateral pneumothorax (about 20% in our previously reported group) [4], the almost universal finding of bilateral cysts at the time of these operations, and our experience with 4 patients (2 of whom died) who had simultaneous bilateral pneumothorax have caused us to continue with bilateral simultaneous pleurodesis in selected patients. Case Material and Findings The age distribution of this group of 26 patients was between 19 and 44 years with a mean of 28 years. There were 20 men and 6 women. Sixteen patients had experienced symptoms of pneumothorax on both sides of the chest. From the Divisions of Cardio-thoracic Surgery and Anaesthesia, the Prince Henry and Prince of Wales Hospitals, Sydney, Australia. Accepted for publication Sept. 26, Address reprint requests to Dr. Wright, Chairman, Cardio-thoracic Surgery, Prince Henry Hospital, Little Bay, N.S.W. 2036, Australia. 202 THE ANNALS OF THORACIC SURGERY
2 Bilateral Simultaneous Pleurodesis CORRELATION OF SYMPTOMS WITH OPERATIVE FINDINGS IN 26 PATIENTS UNDERGOING BILATERAL SIMULTANEOUS PLEURODESIS BY MEDIAN STERNOTOMY FOR SPONTANEOUS PNEUMOTHORAX Symptoms and Findings No. of Patients Symptoms Bilateral 16 Unilateral 10 Operative findings Bilateral lesions 25 Unilateral lesions 1 At operation, 25 patients had demonstrable lung abnormalities on both sides. There was only 1 patient whose lesions were confined to the symptomatic side (Table). In the majority, the lung lesions were in the form of small cysts or blebs near the apexes of the lungs. Rupture of one of these was presumed to be the site of air leak. In 2 patients there were localized bilateral pleural adhesions walling off cystic areas, and a further 3 patients showed nonadherent cysts on one side and apical pleural adhesions which were related to cystic lesions on the other. In 2 patients, in addition to the apexes of the lungs being involved with small cysts, there were also cysts extending along the peripheries of the lower lobes. One additional patient had cysts scattered along the whole of both upper lobe peripheries. Technique of Operation Bilateral pleurodesis was performed through a median sternotomy. Both pleural cavities were explored. Localized areas of lung cysts were obliterated by ligation with heavy braided silk, and pleurodesis was accomplished by abrasion of the parietal pleura followed by talc insufflation. Access to the pleural cavities is limited during median sternotomy, though in the young patient without extensive pleural adhesions, adequate exposure of the affected areas is available. Care is taken to protect the phrenic nerve on either side, and the upper few centimeters of the mediastinal reflection of the pleura are not divided so as to facilitate the positioning of an apical drainage tube on either side during chest closure. We have considered it important to perform cyst ligation conservatively so that the ligation involves the base of the cystic areas rather than normal lung adjacent to the cysts. Parietal pleurectomy was previously employed during unilateral pleurodesis but was abandoned due to problems of hemorrhage and doubt concerning its necessity. During the procedure of bilateral pleurodesis by median sternotomy, reliance has also been placed on pleural abrasion and talc poudrage alone. VOL. 15, NO. 2, FEBRUARY,
3 KALNINS ET AL. Anesthetic Considerations In anesthetizing patients for pleurodesis, recurrence of the air leak, especially as a tension pneumothorax, is an ever-present danger. A previously placed intercostal catheter guards against tension on the drained side only, though such a catheter is not always present when the patient is operated upon. Furthermore, the occurrence of spontaneous pneumothorax is generally the result of bilateral disease, as has been pointed out. It is therefore generally considered safer to avoid positive-pressure ventilation until the pleural cavities are about to be entered [3]. Neuroleptic anesthetic techniques combined with topical anesthesia offer a safe and convenient alternative to deep inhalation anesthesia for induction and intubation with spontaneous ventilation, which can be assisted. It is not our practice to use compound endotracheal tubes for this procedure, but they are in no way contraindicated when the surgeon prefers them. In view of the bilateral nature of this disease, however, a technique using intermittent positivepressure ventilation applied only to the asymptomatic side cannot be considered to be free from hazard during the early part of the operation. In the postoperative period our patients receive no intermittent positivepressure therapy. Therefore, adequate analgesia is very important to help the patient perform the breathing exercises and coughing necessary to avoid sputum retention. Small doses of narcotic analgesics given at frequent intervals are preferable to larger doses more widely spaced. Because the incision involves six or more dermatomes, these patients should not receive postoperative epidural analgesia. Nonetheless, median sternotomy appears to be a less painful incision than lateral thoracotomy, and most patients so treated have had an accelerated convalescence compared with those having lateral thoracotomy. During lung reexpansion at the end of the surgical procedure, care must be taken to avoid producing pleural air leaks by rupture of other cysts or by dislodgment of cyst ligatures. A technique of progressive, gentle, intermittent positive-pressure ventilation should be used, with the accent on sustained, low-pressure inflations rather than on shorter, high-pressure ventilation. Results of Operation Convalescence appears to be more rapid and less painful with median sternotomy than after lateral thoracotomy, and full lung expansion has occurred in all patients. There have been no deaths and no significant complications. No patient has had a recurrence on either side. Occupational demands have been met more satisfactorily by the assurance of freedom from further pneumothorax on both sides. 204 THE ANNALS OF THCRACIC SURGERY
4 Comment Bilateral Simultaneous Pleurodesis Recurrent spontaneous pneumothorax is frequently bilateral. The average age for pneumothorax in this series was 28 years, similar to that in other series 11, 21. There were 10 patients who had no history suggestive of contralateral pneumothorax, yet at operation 9 of them were found to have lesions in the asymptomatic lung. Taken in conjunction with the rarity of apical bullae in a young autopsy population" and in young patients having thoracotomy for other reasons, this suggests that both lungs are at risk for pneumothorax in the patient group reviewed. Also, 6 of 41 patients have returned in the past two years with a pneumothorax on the opposite side after unilateral thoracotomy pleurodesis. Although it is difficult to draw any firm conclusion, it would seem that an increasing emphasis should be placed on simultaneous bilateral pleurodesis as an effective and definitive means for treating recurrent spontaneous pneumothorax, either unilateral or bilateral. Our indications for thoracotomy pleurodesis have been stated previously [4]. Our major ambition has been to eliminate the need for repeated periods of hospitalization and convalescence in patients with a propensity to recurrence or bilateral disorder. Failure of cessation of air leakage after a week, occupational or recreational hazards, and associated hemothorax constitute important additional indications. Early in our experience with management of voluminous bilateral emphysematous lung cysts, we undertook simultaneous bilateral cyst obliteration and pleurodesis in 2 elderly patients in whom extensive pleural adhesions were present. Adequate access was not available to those areas of adhesions related to the posterior and basal portions of the lungs. Accordingly, we have limited simultaneous bilateral pleurodesis to young patients having no history or evidence to suggest extensive pleural abnormalities or diffuse emphysematous lung conditions. Generally, bilateral pleurodesis has been avoided in young women for cosmetic reasons, although in the presence of a clear history of recurrent bilateral pneumothoraxes the bilateral procedure has been employed. Conclusions Spontaneous pneumothorax has a strong tendency to recur and to be bilateral in the younger group of patients affected. In the group reviewed here bilateral cystic lesions were the rule, notwithstanding a history of unilateral symptoms alone. Because of the occurrence of contralateral pneumothorax in young patients who previously had had unilateral pleurodesis, the relative frequency of symptomatic bilateral disorder, and the occasional finding of bi- *According to a study carried out by Dr. A. Tait Smith, Associate Professor of Pathology, University of New South Wales, Sydney, Australia. VOL. 15, NO. 2, FEBRUARY,
5 KALNINS ET AL. lateral simultaneous pneumothorax, our current policy is to offer simultaneous bilateral pleurodesis by median sternotomy to young patients, particularly men, who have a history of repeated pneumothorax on one or both sides. Our operative findings have suggested that bilateral cystic lesions are extremely common. Cyst obliteration by ligation followed by pleural abrasion and talc insufflation has been associated with no recurrence over a period of more than two years and no mortality. Postoperative convalescence has been rapid and uneventful. References 1. Gobbel, J. N., Rhea, W. G., Nelson, I. A., and Daniel, R. A. Spontaneous pneumothorax. J. Thorac. Cardiovasc. Surg. 46:331, Lindskog, G. E., and Halasz, N. A. Spontaneous pneumothorax. Arch. Surg. 75:693, Mushin, W. W. Thoracic Anaesthesia. Oxford, England: Blackwell, Watts, R. E., Bennett, D. J., Horton, D. A., and Wright, J. S. Spontaneous pneumothorax: A rational approach to treatment. Med. J. Aust. 1:538, Editor's Note: We realize that this paper may raise the hackles of many conservative thoracic surgeons. We would welcome any comments pro or con. 206 THE ANNALS OF THORACIC SURGERY
Pneumothorax and Chest Tube Problems
Pneumothorax and Chest Tube Problems Pneumothorax Definition Air accumulation in the pleural space with secondary lung collapse Sources Visceral pleura Ruptured esophagus Chest wall defect Gas-forming
More informationS and secondary spontaneous pneumothorax. Primary
Secondary Spontaneous Pneumothorax Fumihiro Tanaka, MD, Masatoshi Itoh, MD, Hiroshi Esaki, MD, Jun Isobe, MD, Youichiro Ueno, MD, and Ritsuko Inoue, MD Department of Thoracic and Cardiovascular Surgery,
More informationThe diagnosis and management of pneumothorax
Respiratory 131 The diagnosis and management of pneumothorax Pneumothorax is a relatively common presentation in patients under the age of 40 years (approximately, 85% of patients are younger than 40 years).
More informationSURGERY FOR GIANT BULLOUS EMPHYSEMA
SURGERY FOR GIANT BULLOUS EMPHYSEMA Dr. Carmine Simone Head, Division of Critical Care & Thoracic Surgeon Department of Surgery December 15, 2006 OVERVIEW Introduction Classification Patient selection
More informationPleurectomy for spontaneous pneumothorax
Thorax (1970), 25, 165. Pleurectomy for spontaneous pneumothorax in cystic fibrosis PETER F. MITCHELL-HEGGS and JOHN C. BATTEN Brompton Hospital, London, S.W3 Five cases of cystic fibrosis complicated
More informationConservative management of spontaneous
Thorax (1966), 21, 145. Conservative management of spontaneous pneumothorax PETER STRADLING AND GRAHAM POOLE From the Hammersmith Chest Clinic and Postgraduate Medical School of London In recent years
More informationProcedure: Chest Tube Placement (Tube Thoracostomy)
Procedure: Chest Tube Placement (Tube Thoracostomy) Basic Information: The insertion and placement of a chest tube into the pleural cavity for the purpose of removing air, blood, purulent drainage, or
More informationAlper Toker, MD. VATS decortication. Istanbul University, Istanbul Medical School Department of Thoracic Surgery
VATS decortication Alper Toker, MD Istanbul University, Istanbul Medical School Department of Thoracic Surgery Pleural space infection is a common pathology causing morbidity and mortality. It is a collection
More informationComputer Tomography of the Thorax Selection of
Diagnostic and Therapeutic Endoscopy, 1995, Vol. 2, pp. 89-92 Reprints available directly from the publisher Photocopying permitted by license only (C) 1995 Harwood Academic Publishers GmbH Printed in
More informationRoutine chest drainage after patent ductus arteriosis ligation is not necessary
Original Article Brunei Int Med J. 2010; 6 (3): 126-130 Routine chest drainage after patent ductus arteriosis ligation is not necessary Amy THIEN, Samuel Kai San YAPP, Chee Fui CHONG Department of Surgery,
More informationEarly Outcomes of Single-Port Video-Assisted Thoracic Surgery for Primary Spontaneous Pneumothorax
Korean J Thorac Cardiovasc Surg 2014;47:384-388 ISSN: 2233-601X (Print) ISSN: 2093-6516 (Online) Clinical Research http://dx.doi.org/10.5090/kjtcs.2014.47.4.384 Early Outcomes of Single-Port Video-Assisted
More informationPneumothorax has long been listed as one of the
Pneumothorax in Cystic Fibrosis* Patrick A. Flume, MD, FCCP Spontaneous pneumothorax is a common complication in patients with cystic fibrosis (CF). It is thought to occur more frequently in patients with
More informationProceedings of the World Small Animal Veterinary Association Sydney, Australia 2007
Proceedings of the World Small Animal Sydney, Australia 2007 Hosted by: Next WSAVA Congress THE LAST GASP II: LUNGS AND THORAX David Holt, BVSc, Diplomate ACVS University of Pennsylvania School of Veterinary
More informationPneumothorax. Defined as air in the pleural space which can occur through a number of mechanisms
Pneumothorax Defined as air in the pleural space which can occur through a number of mechanisms Traumatic pneumothorax Penetrating chest trauma Common secondary to bullet or knife penetration Chest tube
More informationThoracic anaesthesia. Simon May
Thoracic anaesthesia Simon May Contents Indications for lung isolation Ways of isolating lungs Placing a DLT Hypoxia on OLV Suitability for surgery Analgesia Key procedures Indications for lung isolation
More informationA Repeat Case of Idiopathic Spontaneous Hemothorax
Case Report A Repeat Case of Idiopathic Spontaneous Hemothorax Felix R. Gaw, MD Jack H. Bloch, MD, PhD, FACS Nolan J. Anderson, MD, FACS Spontaneous hemothorax, a collection of blood in the pleural cavity
More informationIntrapleural Instillation of Qllinacrjne for Treatment of Recurrent Spontaneous Pneumothorax
Intrapleural Instillation of Qllinacrjne for Treatment of Recurrent Spontaneous Pneumothorax Alberto J. Larrieu, M.D., G. Frank. Tyers, M.D., Edward H. Williams, M.D., Martin J. O'Neill, M.D., and John
More informationComparison of video-assisted thoracoscopic talcage for recurrent primary versus persistent secondary spontaneous pneumothorax
Eur Respir J 1997; 10: 412 416 DOI: 10.1183/09031936.97.10020412 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1997 European Respiratory Journal ISSN 0903-1936 Comparison of video-assisted
More informationSurgery has been proven to be beneficial for selected patients
Thoracoscopic Lung Volume Reduction Surgery Robert J. McKenna, Jr, MD Surgery has been proven to be beneficial for selected patients with severe emphysema. Compared with medical management, lung volume
More informationRobotic-assisted right inferior lobectomy
Robotic Thoracic Surgery Column Page 1 of 6 Robotic-assisted right inferior lobectomy Shiguang Xu, Tong Wang, Wei Xu, Xingchi Liu, Bo Li, Shumin Wang Department of Thoracic Surgery, Northern Hospital,
More informationOriginal Research. Mummadi, Srinivas; Pack, Sasheen; Hahn, Peter
The Official Journal of the International Society of Pleural Diseases Original Research The Use of Bronchoscopic Oxygen Insufflation to Isolate Persistent Air Leaks in Secondary Pneumothorax Due to COPD
More informationOriginal Article. Abstract
Original Article How VATS has changed the Management of Spontaneous Pneumothorax in the 21st century Saulat Hasnain Fatimi, 1 Hashim Muhammad Hanif, 2 Shahida Aziz, 3 Sana Mansoor, 4 Marium Muzaffar 5
More informationChest Tube Thoracostomy
Chest Tube Thoracostomy INTRODUCTION A chest tube thoracostomy is commonly done in the ED to evacuate an abnormal accumulation of fluid (blood, empyema) or air from the pleural space under an elective,
More information(SKILLS/HANDS-ON) Chest Tubes. Rebecca Carman, MSN, ACNP-BC. Amanda Shumway, PA-C. Thomas W. White, MD, FACS, CNSC
(SKILLS/HANDS-ON) Chest Tubes Rebecca Carman, MSN, ACNP-BC Nurse Practitioner, Trauma Services, Intermountain Medical Center, Intermountain Healthcare Amanda Shumway, PA-C APC Trauma and Critical Care
More informationKathmandu University Medical Journal (2007), Vol. 5, No. 4, Issue 20,
Kathmandu University Medical Journal (2007), Vol. 5, No. 4, Issue 20, 521-525 Empyema thoracis Original Article Singh DR 1, Joshi MR 2, Thapa P 2, Nath S 3 1 Assistant Professor, 2 Lecturer, 3 Professor,
More informationAspiration versus tube drainage in primary spontaneous pneumothorax: a randomised study
Eur Respir J 2006; 27: 477 482 DOI: 10.1183/09031936.06.00091505 CopyrightßERS Journals Ltd 2006 CLINICAL FORUM Aspiration versus tube drainage in primary spontaneous pneumothorax: a randomised study A.K.
More informationBTS GUIDELINES FOR THE MANAGEMENT OF SPONTANEOUS PNEUMOTHRAX 2003
BTS GUIDELINES FOR THE MANAGEMENT OF SPONTANEOUS PNEUMOTHRAX 2003 GRADING OF PRIMARY LITERATURE(The Bibliographies) Ia Meta-analysis analysis of randomised trials Ib Randomised controlled trial IIa Well
More informationVideo-assisted thoracoscopic thymectomy using 5-mm ports and carbon dioxide insufflation
Art of Operative Techniques Video-assisted thoracoscopic thymectomy using 5-mm ports and carbon dioxide insufflation René Horsleben Petersen Department of Cardiothoracic Surgery, Copenhagen University
More informationCRUSH AND PNEUMOPERITONEUM THERAPY
Thorax (1950), 5, 194. A MODIFIED CONCEPTION OF PHRENIC NERVE CRUSH AND PNEUMOPERITONEUM THERAPY BY WALLACE FOX From Preston Hall Hospital, Aylesford, Kent The object of this paper is to present a modified
More informationLung Surgery. Patient Education. What to expect before, during, and after your surgery. Tests Before Surgery. Your Health Care Team
Patient Education What to expect before, during, and after your surgery This handout explains what will happen before, during, and after your surgery. It also includes information about taking care of
More informationThoracoplasty for the Management of Postpneumonectomy Empyema
ISPUB.COM The Internet Journal of Thoracic and Cardiovascular Surgery Volume 9 Number 2 Thoracoplasty for the Management of Postpneumonectomy Empyema S Mullangi, G Diaz-Fuentes, S Khaneja Citation S Mullangi,
More informationVideo-assisted thoracoscopic surgery (VATS) represents
Long-Term Results After Video-Assisted Thoracoscopic Surgery for First-Time and Recurrent Spontaneous Pneumothorax Rudolf A. Hatz, MD, Michaela F. Kaps, MD, Georgios Meimarakis, MD, Florian Loehe, MD,
More informationCHEST INJURIES. Jacek Piątkowski M.D., Ph. D.
CHEST INJURIES Jacek Piątkowski M.D., Ph. D. CHEST INJURIES 3-4% of all injuries 8% of patients hospitalized due to injuries 65% of patients who died at the accident place CLASSIFICATION OF THE CHEST INJURIES
More informationSurgical treatment of bullous lung disease
Surgical treatment of bullous lung disease PD POTGIETER, SR BENATAR, RP HEWITSON, AD FERGUSON Thorax 1981 ;36:885-890 From the Respiratory Clinic, Groote Schuur Hospita', and Departments of Medicine, Anaesthetics,
More informationThoracoscopic Lobectomy: Technical Aspects in Years of Progress
Thoracoscopic Lobectomy: Technical Aspects in 2015 16 Years of Progress 8 th Masters of Minimally Invasive Thoracic Surgery Orlando September 25, 2015 Thomas A. D Amico MD Gary Hock Professor of Surgery
More informationAPPROACH TO PLEURAL EFFUSIONS. Raed Alalawi, MD, FCCP
APPROACH TO PLEURAL EFFUSIONS Raed Alalawi, MD, FCCP CASE 65-year-old woman with H/O breast cancer presented with a 1 week H/O progressively worsening exersional dyspnea. Physical exam: Diminished breath
More informationThe Portsmouth thoracoscopy experience, an evaluation of service by retrospective case note analysis
Respiratory Medicine (2007) 101, 1021 1025 The Portsmouth thoracoscopy experience, an evaluation of service by retrospective case note analysis Sophie V. Fletcher,1, Robin J. Clark Respiratory Centre,
More informationRobotic-assisted right upper lobectomy
Robotic Thoracic Surgery Column Robotic-assisted right upper lobectomy Shiguang Xu, Tong Wang, Wei Xu, Xingchi Liu, Bo Li, Shumin Wang Department of Thoracic Surgery, Northern Hospital, Shenyang 110015,
More informationPneumothorax in the newborn
Archives of Disease in Childhood, 1975, 50, 449. Pneumothorax in the newborn Changing pattern V. Y. H. YU, S. W. LIEW, and N. R. C. ROBERTON* From the Department of Paediatrics, University of Oxford, John
More informationRight lung. -fissures:
-Right lung is shorter and wider because it is compressed by the right copula of the diaphragm by the live.. 2 fissure, 3 lobes.. hilum : 2 bronchi ( ep-arterial, hyp-arterial ), one artery mediastinal
More informationNontuberculous Mycobacteria
Nontuberculous Mycobacteria When antibiotics are not enough a surgical approach John D. Mitchell, M.D. Davis Endowed Chair in Thoracic Surgery Professor and Chief Section of General Thoracic Surgery University
More informationIs blood pleurodesis effective for determining the cessation of persistent air leak?
doi:10.1510/icvts.2010.234559 Interactive CardioVascular and Thoracic Surgery 11 (2010) 468 472 Best evidence topic - Thoracic non-oncologic Is blood pleurodesis effective for determining the cessation
More informationF.M.N.H. Schramel*, T.G. Sutedja*, J.C.E. Braber*, J.C. van Mourik**, P.E. Postmus*
Eur Respir J, 1996, 9, 1821 1825 DOI: 10.1183/09031936.96.09091821 Printed in UK - all rights reserved Copyright ERS Journals Ltd 1996 European Respiratory Journal ISSN 0903-1936 Cost-effectiveness of
More informationScience & Technologies
A GIANT LIVER HYDATIDE CYST SIMULTANEOUSLY PERFORATED TO PERITONEAL AND PLEURAL CAVITIES A RARE CASE REPORT. Ivan P. Novakov Department of Special Surgery; Medical University - Plovdiv Abstract. Background.
More informationOSAMA A. ABDULMAJID, ABDELMOMEN M. EBEID, MOHAMED M. MOTAWEH, and IBRAHIM S. KLEIBO
Aspirated foreign bodies in the tracheobronchial tree: report of 250 cases Thorax (1976), 31, 635. OSAMA A. ABDULMAJID, ABDELMOMEN M. EBEID, MOHAMED M. MOTAWEH, and IBRAHIM S. KLEIBO Thoracic Surgical
More informationSurgical Management of Idiopathic Spontaneous Pneumothorax Ashley A. Magee, DVM, DACVS DoveLewis Annual Conference Speaker Notes
Surgical Management of Idiopathic Spontaneous Pneumothorax Ashley A. Magee, DVM, DACVS DoveLewis Annual Conference Speaker Notes Introduction Spontaneous pneumothorax is an acute, life threatening disease
More informationLecture 2: Clinical anatomy of thoracic cage and cavity II
Lecture 2: Clinical anatomy of thoracic cage and cavity II Dr. Rehan Asad At the end of this session, the student should be able to: Identify and discuss clinical anatomy of mediastinum such as its deflection,
More informationRobotic thoracic surgery of total thymectomy
Robotic Thoracic Surgery Column Page 1 of 5 Robotic thoracic surgery of total thymectomy Shiguang Xu, Xingchi Liu, Bo Li, Renquan Ding, Tong Wang, Shumin Wang Department of Thoracic Surgery, Northern Hospital,
More informationSpontaneous pneumothorax
Follow the link from the online version of this article to obtain certified continuing medical education credits Spontaneous pneumothorax Oliver Bintcliffe, Nick Maskell Academic Respiratory Unit, School
More informationGuidelines and Protocols
TITLE: CHEST TRAUMA PURPOSE: Provides a standardized treatment algorithm for patients with chest trauma PROCESS: I. INITIAL ASSESSMENT OF THORACIC TRAUMA A. Penetrating Thoracic Trauma 1. Hemodynamically
More informationEndobronchial valve insertion to reduce lung volume in emphysema
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Endobronchial valve insertion to reduce lung volume in emphysema Emphysema is a chronic lung disease that
More informationQuality of life evolution after surgery for primary or secondary spontaneous pneumothorax: a prospective study comparing different surgical techniques
doi:10.1510/icvts.2007.159939 Interactive CardioVascular and Thoracic Surgery 7 (2008) 45 49 www.icvts.org Institutional report - Thoracic general Quality of life evolution after surgery for primary or
More informationCase Report Ruptured Hydatid Cyst with an Unusual Presentation
Case Reports in Surgery Volume 2011, Article ID 730604, 4 pages doi:10.1155/2011/730604 Case Report Ruptured Hydatid Cyst with an Unusual Presentation Deepak Puri, Amit Kumar Mandal, Harinder Pal Kaur,
More informationIn 1941, Tyson and Crandall reported excision of subpleural
Videothoracoscopic Bleb Excision and Pleural Abrasion for the Treatment of Primary Spontaneous Pneumothorax: Long-Term Results Loïc Lang-Lazdunski, MD, PhD, Olivier Chapuis, MD, Pierre-Mathieu Bonnet,
More informationRespiratory System. Clinical notes. Published on Second Faculty of Medicine, Charles University ( https://www.lf2.cuni.cz)
Published on Second Faculty of Medicine, Charles University ( https://www.lf2.cuni.cz) Respiratory System The test of the respiratory system follows the general rules for written tests (see Continuous
More informationComplications During and One Month after Surgery in the Patients Who Underwent Thoracoscopic Surgery
Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2016, 5, 8:305-309 Complications During and One Month after Surgery in the Patients Who
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More informationInterventional procedures guidance Published: 20 December 2017 nice.org.uk/guidance/ipg600
Endobronchial valve insertion to reduce lung volume in emphysema Interventional procedures guidance Published: 20 December 2017 nice.org.uk/guidance/ipg600 Your responsibility This guidance represents
More informationCHAPTER 7 Procedures on Respiratory System
CHAPTER 7 Propunere noua clasificare proceduri folosind codificarea ICD-10-AM versiunea 3, 30 martie 2004 Procedures on Respiratory System BLOCK 520 Examination procedures on larynx 41764-03 Fibreoptic
More informationInfluence of Intrapleural Infusion of Marcaine on Post Thoracotomy Pain
ORIGINAL ARTICLE Tanaffos (2007) 6(1), 47-51 2007 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran Influence of Intrapleural Infusion of Marcaine on Post Thoracotomy Pain Hamid
More informationRobotic-assisted left inferior lobectomy
Robotic Thoracic Surgery Column Robotic-assisted left inferior lobectomy Shiguang Xu, Hao Meng, Tong Wang, Wei Xu, Xingchi Liu, Shumin Wang Department of Thoracic Surgery, Northern Hospital, Shenyang 110015,
More informationand were considered unfit for thoracotomy because of their poor respiratory function. Twenty-eight men and three women were treated.
Thorax, 1977, 32, 668-672 Intracavity suction and drainage in the treatment of emphysematous bullae A. M. MACARTHUR AND S. W. FOUNTAIN From King's College Hospital, London, UK Macarthur, A. M. and Fountain,
More informationminimally invasive techniques Video-Assisted Thoracoscopic Surgery Using Single-Lumen Endotracheal Tube Anesthesia*
minimally invasive techniques Video-Assisted Thoracoscopic Surgery Using Single-Lumen Endotracheal Tube Anesthesia* Robert James Cerfolio, MD, FCCP; Ayesha S. Bryant, MSPH; Todd M. Sheils, MD; Cynthia
More informationPneumothorax Management in John Foote MD CCFP(EM) Chair of CFPC Community of Practice Emergency Medicine
Pneumothorax Management in 2016 John Foote MD CCFP(EM) Chair of CFPC Community of Practice Emergency Medicine Objectives Classify pneumothorax Who needs re-expansion? What hardware to use Who needs admission
More informationSingle centre experience on short bar technique for pectus excavatum
Featured Article Single centre experience on short bar technique for pectus excavatum Hans Kristian Pilegaard 1,2 1 Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus,
More informationSurgical pleurodesis for Vanderschueren s stage III primary spontaneous pneumothorax
Eur Respir J 2008; 31: 837 841 DOI: 10.1183/09031936.00140806 CopyrightßERS Journals Ltd 2008 Surgical pleurodesis for Vanderschueren s stage III primary spontaneous pneumothorax O. Rena*, F. Massera #,
More informationComparative Study for the Efficacy of Small Bore Catheter in the Patients with Iatrogenic Pneumothorax
Korean J Thorac Cardiovasc Surg 20;44:48-422 ISSN: 2233-60X (Print) ISSN: 2093-656 (Online) Clinical Research http://dx.doi.org/0.5090/kjtcs.20.44.6.48 Comparative Study for the Efficacy of Small Bore
More information& Guidelines. For The Management Of. Pneumothorax
Guidelines For The Management Of Pneumothorax By Dr. Sinan Butrus F.I.C.M.S Clinical Standards & Guidelines Dr.Layla Al-Shahrabani F.R.C.P (UK) Director of Clinical Affairs Kurdistan Higher Council For
More informationPAPER. Video-Assisted Thoracic Surgery in the Treatment of Posttraumatic Empyema
PAPER Video-Assisted Thoracic Surgery in the Treatment of Posttraumatic Empyema Lynette A. Scherer, MD; Felix D. Battistella, MD; John T. Owings, MD; Michael M. Aguilar, MD Background: Video-assisted thoracic
More informationRCH Trauma Guideline. Management of Traumatic Pneumothorax & Haemothorax. Trauma Service, Division of Surgery
RCH Trauma Guideline Management of Traumatic Pneumothorax & Haemothorax Trauma Service, Division of Surgery Aim To describe safe and competent management of traumatic pneumothorax and haemothorax at RCH.
More informationFactors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures
Korean J Thorac Cardiovasc Surg 2013;46:130-134 ISSN: 2233-601X (Print) ISSN: 2093-6516 (Online) Clinical Research http://dx.doi.org/10.5090/kjtcs.2013.46.2.130 Factors Affecting Pneumonia Occurring to
More informationRight sided VATS thymectomy: current standards of extended thymectomy for myasthenia gravis
Review Article on Videothoracoscopic Surgery Page 1 of 5 Right sided VATS thymectomy: current standards of extended thymectomy for myasthenia gravis Erkan Kaba 1, Tugba Cosgun 1, Kemal Ayalp 2, Mazen Rasmi
More informationWhat is cpt code for chest tube placement
What is cpt code for chest tube placement Search 11-4-2016 Chest Tube Placement (Thoracostomy) and Pleurodesis Thoracostomy inserts a thin plastic tube into the pleural space between the lungs and the
More informationType of intervention Anaesthesia. Economic study type Cost-effectiveness analysis.
Is intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia? Wurnig P N, Lackner H, Teiner C, Hollaus P H, Pospisil M, Fohsl-Grande B, Osarowsky M, Pridun N S
More informationORIGINAL ARTICLE. Characteristics of the patients undergoing surgical treatment for pneumothorax: A descriptive study
554 Characteristics of the patients undergoing surgical treatment for pneumothorax: A descriptive study Muharrem Cakmak, Melih Yuksel, Mehmet Nail Kandemir ORIGINAL ARTICLE Abstract Objective: To identify
More informationPULMONARY RESECTION FOR TUBERCULOSIS
Thorax (1951), 6, 375. PULMONARY RESECTION FOR TUBERCULOSIS IN CHILDREN BY COLIN A. ROSS From Shotley Bridge Hospital and Poole Sanatorium (RECEIVED FOR PUBLICATION JULY 9, 1951) The literature concerning
More informationTHORACOSCOPY IN ACQUIRED IMMUNODEFICIENCY SYNDROME
THORACOSCOPY IN ACQUIRED IMMUNODEFICIENCY SYNDROME David R. Flum, MD Scott D. Steinberg, MD Thomas R. Bernik, MD Enrique Bonfils-Roberts, MD Marshall D. Kramer, MD Peter X. Adams, MD Marc K. Wallack, MD
More informationManagement of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010
1 Respiratory Medicine, Royal Infirmary of Edinburgh, UK 2 Department of Respiratory Medicine, Castle Hill Hospital, Cottingham, East Yorkshire, UK 3 North Bristol Lung Centre, Southmead Hospital, Bristol,
More informationPersistent Spontaneous Pneumothorax for Four Years: A Case Report
303) Persistent Spontaneous Pneumothorax for Four Years: A Case Report Mizuno Y., Iwata H., Shirahashi K., Matsui M., Takemura H. Department of General and Cardiothoracic Surgery, Graduate School of Medicine,
More informationRe-expansion pulmonary oedema
Thorax (1975), 30, 54. Re-expansion pulmonary oedema M. WAQARUDDIN and A. BERNSTEIN Department of Thoracic Medicine, Hope and Ladywell Hospitals, Salford M6 8HD Waqaruddin, M. and Bernstein, A. (1975).
More informationPrognostic Factors in Patients With Spontaneous
Diagnostic and Therapeutic Endoscopy, 1995, Vol. 2, pp. 1-5 Reprints available directly from the publisher Photocopying permitted by license only (C) 1995 Harwood Academic Publishers GmbH Printed in Singapore
More informationCarcinoma of the Lung
THE ANNALS OF THORACIC SURGERY Journal of The Society of Thoracic Surgeons and the Southern Thoracic Surgical Association VOLUME 1 I - NUMBER 3 0 MARCH 1971 Carcinoma of the Lung M. L. Dillon, M.D., and
More informationRobotic subxiphoid thymectomy
Review Article on Subxiphoid Surgery Robotic subxiphoid thymectomy Takashi Suda Correspondence to: Takashi Suda, MD.. Email: suda@fujita-hu.ac.jp. Abstract: When endoscopic surgery is indicated for myasthenia
More informationPneumothorax lecture no. 3
Pneumothorax lecture no. 3 Is accumulation of air in a pleural space or accumulation of extra pulmonary air within the chest, Is uncommon during childhood, may result from external trauma, iatrogenic,
More informationParenchyma-sparing lung resections are a potential therapeutic
Lung Segmentectomy for Patients with Peripheral T1 Lesions Bryan A. Whitson, MD, Rafael S. Andrade, MD, and Michael A. Maddaus, MD Parenchyma-sparing lung resections are a potential therapeutic option
More informationTHE CONSERVATIVE TREATMENT OF THE TENSION LESIONS OF STAPHYLOCOCCAL PNEUMONIA IN INFANCY
Thorax (1960), 15, 233. THE CONSERVATIVE TREATMENT OF THE TENSION LESIONS OF STAPHYLOCOCCAL PNEUMONIA IN INFANCY BY JAMES S. DAVIDSON From the Royal Infirmary, Bradford (RECEIVED FOR PUBLICATION APRIL
More informationThoracoscopy for Lung Cancer
Thoracoscopy for Lung Cancer Introduction The occurrence of lung cancer has increased dramatically over the last 50 years. Your doctor may have recommended an operation to remove your lung cancer. The
More informationCystic Fibrosis Complications ANDRES ZIRLINGER, MD STANFORD UNIVERSITY MEDICAL CENTER MARCH 3, 2012
Cystic Fibrosis Complications ANDRES ZIRLINGER, MD STANFORD UNIVERSITY MEDICAL CENTER MARCH 3, 2012 INTRODUCTION PNEUMOTHORAX HEMOPTYSIS RESPIRATORY FAILURE Cystic Fibrosis Autosomal Recessive Genetically
More informationSelective Nonoperative Management of Contained Intrathoracic Esophageal Disruptions
Selective Nonoperative Management of Contained Intrathoracic Esophageal Disruptions John L. Cameron, M.D., Richard F. Kieffer, M.D., Thomas R. Hendrix, M.D., Denis G. Mehigan, M.., and R. Robinson aker,
More informationIndwelling Pleural Catheters in Malignant and Non-Malignant Disease
Indwelling Catheters in Malignant and Non-Malignant Disease 20th Hellenic Conference November 2011 Najib Rahman Clinical Lecturer Oxford Centre for Respiratory Medicine University of Oxford, UK Najib.rahman@ndm.ox.ac.uk
More informationD associated with chronic obstructive pulmonary disease
VATSArgon Beam Coagulator Treatment of Diffuse End-Stage Bilateral Bullous Disease of the Lung Ralph J. Lewis, MD, Robert J. Caccavale, MD, and Glenn E. Sisler, MD Department of Surgery, University of
More informationPOST-OESOPHAGECTOMY ANALGESIC REGIMES: A 15-YEAR REVIEW OF 90 CASES AT UNIVERSITY HOSPITAL, KUALA LUMPUR
Med. J. Malaysia Vol. 40 1\,1 March 1985 POST-OESOPHAGECTOMY ANALGESIC REGIMES: A 15-YEAR REVIEW OF 90 CASES AT UNIVERSITY HOSPITAL, KUALA LUMPUR A. E. DELILKAN R. VIJAYAN SANNASI SUMMARY 24-48 hour IPPV
More informationLung Cancer Resection
Lung Cancer Resection Introduction The occurrence of lung cancer has increased dramatically over the last 50 years. Your health care provider may have recommended an operation to remove your lung cancer.
More informationTRACHEOSTOMY. Tracheostomy means creation an artificial opening in the trachea with tracheostomy tube insertion
TRACHEOSTOMY Definition Tracheostomy means creation an artificial opening in the trachea with tracheostomy tube insertion Indications for tracheostomy 1-upper airway obstruction with stridor, air hunger,
More informationInitial management of primary spontaneous pneumothorax with video-assisted thoracoscopic surgery: a 10-year experience
European Journal of Cardio-Thoracic Surgery 49 (2016) 854 859 doi:10.1093/ejcts/ezv206 Advance Access publication 20 June 2015 ORIGINAL ARTICLE Cite this article as: Herrmann D, Klapdor B, Ewig S, Hecker
More informationManagement of Spontaneous Pneumothorax in a Developing Caribbean Nation: A Clinical Practice Audit
ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 10 Number 2 Management of Spontaneous Pneumothorax in a Developing Caribbean Nation: A Clinical Practice Audit S Cawich, E Williams, R Irvine,
More informationMedian Sternotomy for Pneumonectomy in Patients With Pulmonary Complications of Tuberculosis
Median Sternotomy for Pneumonectomy in Patients With Pulmonary Complications of Tuberculosis Cliff P. Connery, MD, James Knoetgen III, MD, Constantine E. Anagnostopoulos, MD, and Madeline V. Svitak, BS,
More informationSurgical atlas of thoracoscopic lobectomy and segmentectomy
Art of Operative Technique Surgical atlas of thoracoscopic lobectomy and segmentectomy Tristan D. Yan 1,2 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; 2 Department
More informationORIGINAL ARTICLE. Complete video-assisted thoracoscopic surgery for pulmonary sequestration
ORIGINAL ARTICLE Complete video-assisted thoracoscopic surgery for pulmonary sequestration Jian-Fei Shen, Xiao-Xue Zhang, Shu-Ben Li, Zhi-Hua Guo, Zhi-Qiang Xu, Xiao-Sun Shi, Jian-Xing He Department of
More information