A Acquired tracheo-oesophageal fistula, 198 199 Adenoid cystic carcinomas (ACC), 174 Anastomotic leaks, 194 Anterior mediastinal tumor, 143 tumor mass diagnosis, 32 33 Aortic valve implantation. See Transcatheter aortic valve implantation (TAVI) B Bronchogenic carcinoma, of left lung, 31 32 Bronchogenic cysts, 150 C Cervical incision thoracic endoscopic surgery (CITES), 53 54 complication, 58 contraindications, 57 development, 58 59 indications, 57 NOTES, 54 perioperative conditions, 54 results, 57 58 technique, 54 57 Cervical mediastinoscopy, 37, 40 Cervical mediastino-thoracoscopy (CMT), 45 46 access to left pleural cavity, 50 51 complications, 48 49 contraindications, 46 development, 51 history, 46 indications, 46 pleural malignancy, 49 50 pleurotomy, 47 pulmonary malignancy, 49 results, 47 48 technique, 46 47 Cervical oesophagus anastomosis after oesophagectomy, 194 195 anatomy of, 193 exposure, 193 194 perforation, 197 postoperative retropharyngeal abscess, 198 tracheo-oesophageal fistula, 198 199 trauma, 196 197 Zenker s diverticulum, 195 196 Cervical video-assisted thoracoscopic surgery (C-VATS), 61 complications, 65 contraindications, 62 endobronchial ultrasound, 61 62 endoscopic ultrasound, 62 history, 61 62 indications, 62 results, 64 65 in right pleural cavity, 63 suction-cautery device, 63 technique, 62 64 tracheobronchial injury, 65 Circumferential subglottic stenosis, 181 182 CITES. See Cervical incision thoracic endoscopic surgery (CITES) CMT. See Cervical mediastino-thoracoscopy (CMT) Computed tomography (CT), 77 87 electron beam, 85 multidetector, 85 C-VATS. See Cervical video-assisted thoracoscopic surgery (C-VATS) D da Vinci robot flexible arm transcervical approach, thorax, 207, 209 mediastinum approach, 205, 206 operative fields for, 206 Descending necrotizing mediastinitis anaerobic bacteria, 152 description of, 152 diagnostic criteria, 152 patient management, 153 types, 153 E ECM. See Extended cervical mediastinoscopy (ECM) Ectopic mediastinal parathyroid adenoma backdoor approach, 152 bivalved spreadable videomediastinoscope, 151 ectopic parathyroid glands, locations, 151 parathyroid hormone, monitoring, 152 M. Zieliński, R. Rami-Porta (eds.), The Transcervical Approach in Thoracic Surgery, DOI 10.1007/978-3-642-54565-8, Springer-Verlag Berlin Heidelberg 2014 217
218 Ectopic mediastinal parathyroid adenoma ( cont.) sternal retractor, 151 transcervical approach, 151 transcervical endoscopic-assisted mediastinal parathyroidectomy, 152 Ectopic parathyroid glands, locations, 151 Electron beam CT (EBCT), 85 Endobronchial ultrasound (EBUS), 61 62, 68, 85 Endoscopic clipping devices, 12 Endoscopic ultrasound (EUS), 62, 68 Extended cervical mediastinoscopy (ECM), 22, 29 anterior mediastinal masses diagnosis, 32 33 bronchogenic carcinoma of left lung, 31 32 complications, 33 34 contraindications, 30 general considerations, 30 31 history, 29 30 indications, 30 results, 33 staging values, 33 Extended thymectomy anterior mediastinum tumors, 120 cervical stage, 121 complications, 125 contraindications, 120 history, 119 120 indications, 120 mediastinal stage anterior, 121 122 completion, 123 left, 122 right, 122 123 vascular, 122 results, 123 125 technique, 120 121 thoracoscope, 119 transcervical route, 120 G Gynaecological malignancies, 7 H Hand-sewn anastomosis, 194 I Intraoperative ultrasound, 68 J Jackson-Pilling esophageal bougies, 187 L Left upper pulmonary lobectomy aortopulmonary window retractor, 161 left superior pulmonary vein, division, 162 left upper lobe bronchus, stapling, 162 lingular artery, division, 162 Linder-Dahan video-mediastinoscope, 90 92 Lobe tumour middle, 75 right upper, 75 77 Lower posterior mediastinum, tumors, 145, 146 Lung cancer, mediastinal restaging, 39 41 Lung tumours and ECM, 31 32 left upper, 75 M Main bronchus, transcervical approach bronchial artery laceration, 169 contraindications of, 167 history, 166 incomplete bronchial suture line, 169 indications for, 166 167 oesophageal laceration, 169 postoperative complications, 169 results, 168 169 technique bronchoscopy, 168 cervicotomy, 167 endoscopic stapler insertion and closure, 167, 168 golden finger dissector, 167 left main bronchus, cranial traction, 167 overholt-type forceps, 167 tracheal/bronchial wall laceration, 169 vascular laceration, 169 Malignant pleural mesothelioma (MPM), 45 Median sternotomy, for subclavian arteries, 212 Mediastinal cysts symptoms, 149 150 transcervical approach, 150 Mediastinal lymphadenopathy, 38 Mediastinal restaging in lung cancer, 39 41 with PET-CT, EUS and EBUS after induction therapy, 41 techniques for, 40 Mediastinal tumors, transcervical resection advantages, 142 143 complications of, 147 contraindications, 142 indications, 141 142 of lower posterior mediastinum, 145, 146 results of, 146 of superior anterior mediastinum, 143 of superior middle mediastinum, 143 144 of superior posterior mediastinum, 145 thyroid cancer, metastases of, 145 146 Mediastinoscopic biopsy, 6 7 Mediastinoscopic ultrasonography (MUS), 67 68, 96 complications, 83 computed tomography, 77 87 contraindications, 69
convex probes, 68, 71 73, 75 examination sequence, 73 77 history, 68 imaging in lung cancer patients, 75 77 indications, 68 69 left upper lung tumour, 75, 78 79 mediastinal structures, 69 70 middle lobe tumour, 75, 80 operation room setup, 72 principles, 72 proximal position, 71 results, 77 83 right upper lobe tumour, 75 77, 81 82 sonomorphological criteria, 72 standard planes, 73 77 ultrasonic equipment and preliminary steps, 70 72 ultrasonic probe, 72 Mediastinoscopy, 9, 53 aspirate obtained during, 20 complications, 23 24 contraindications, 11 extended cervical, 22 finger dissection and palpation, 16 general considerations, 11 13 history, 10 hyperextension of neck, 14, 15 incisional tumour implant after, 23 indications ACCP guidelines, 10 diagnostic and staging, 10 11 ESTS guidelines, 11 therapeutic, 11 instrument requirement for, 12, 13 lymph node, 21 map, 17 18 station and grouping, 19 20 mediastinal haematoma after, 23 oesophageal perforation, 24 patient with laryngectomy/tracheostomy, 17 positron emission tomography, 10 removal of gauze, 21 results, 23 retrosternal, 22 surgical procedure, 13 21 technical variants, 21 23 vein access in foot, 14 15 Mediastinum, transcervical approach bronchial injuries, 153 bronchogenic cysts, 150 cervicothoracic goiters, 153 descending necrotizing mediastinitis, 152 153 ectopic mediastinal parathyroid adenoma, 151 152 foreign bodies, surgical removal of, 153 mediastinal cysts, 149 150 tracheal diverticulum, 154 unilocular mesothelial cyst, 150 Multidetector CT (MDCT), 85 MUS. See Mediastinoscopic ultrasonography (MUS) Myasthenia gravis (MG), 127 N Natural orifice transluminal endoscopic surgery (NOTES), 54, 214 Neurinomas, 142, 145 Non-small-cell lung cancer (NSCLC) restaging, guidelines, 42 TEMLA, 102, 113 transcervical pulmonary lobectomy for ( see Transcervical pulmonary lobectomy) with VATS lobectomy, 96 O Oesophagectomy, 213 214 P Pharyngo-oesophageal diverticulum. See Zenker s diverticulum Pleural cavity, left, 50 51 Pleural malignancy, 49 50 Positron emission tomography (PET), 10, 85 Primary hyperparathyroidism, 151 Primary tracheal neoplasms, tracheal resection adenoid cystic carcinomas, 174 contraindications, 174 175 results, 177 R0 resection, 174 squamous cell carcinomas, 174 surgical management, 174 surgical technique, 175 177 symptoms, 174 Pulmonary lobectomies, 213 Pulmonary malignancy, 49 R Refractory myasthenia gravis, rethymectomy for advantage, 140 complications, 140 contraindications, 138 description, 138 indications, 138 results, 139 140 transcervical rethymectomy technique, 139 VATS technique, of resternotomy, 139 Remediastinoscopy, 37 complications, 42 43 contraindications, 38 history, 37 38 indications, 38 mediastinal lymphadenopathy, 38 mediastinal restaging in lung cancer, 39 41 non-small cell lung cancer restaging, guidelines, 42 results, 41 technique, 38 39 TEMLA, 41 VAMLA, 41 VATS, 42 219
220 Rethymectomy, 128 contraindications, 138 for refractory myasthenia gravis ( see Refractory myasthenia gravis, rethymectomy for) transcervical, 139 Right upper pulmonary lobectomy, 160 161 Robotic laparoscopic transdiaphragmatic access, 206 208 Robotic subxyphoid approach, 206 208 Rochard frame, 141 143, 146 S Scalene fat pad biopsy, 3 complications, 7 contraindications, 4 5 general considerations, 5 history, 3 4 indications, 4 mediastinoscopic technique, 6 7 open technique, 5 6 results, 7 Secondary tracheal neoplasms, 177 178 Squamous cell carcinomas (SCC), 174 Standard cervical mediastinoscopy (SCM), 29 Sternal retractors, 151, 165, 167, 168 Subcarinal tumor, 146 Subglottic stenosis, 178 182 Suction-cautery device, 63 Superior anterior mediastinum, tumors of, 143 Superior middle mediastinum, tumors of, 143 144 Superior posterior mediastinum, tumors of, 145 Supermediastinoscopy, 101 T TAVI. See Transcatheter aortic valve implantation (TAVI) TEMLA. See Transcervical extended mediastinal lymphadenectomy (TEMLA) Thymectomy for myasthenia gravis treatment, 137 use of robots, 134 Thyroid cancer, mediastinal metastases, 145 146 Total transcervical oesophagectomy, 213 214 Tracheal diverticulum, 154 Tracheal resection, 173 complications, 189 190 laryngotracheal stenosis, reconstruction and resection, 180, 181, 183 184 post-intubation stenosis, 178 180, 185 postoperative management, 188 189 primary tracheal neoplasms adenoid cystic carcinomas, 174 contraindications, 174 175 results, 177 R0 resection, 174 squamous cell carcinomas, 174 surgical management, 174 surgical technique, 175 177 symptoms, 174 secondary tracheal neoplasms, 177 178 subglottic stenosis, 178 182 tracheal obstruction management aggresive suction, 188 emergent tracheal dilation, 187 heliox treatment, 187 intermittent ventilation, 188 post procedural bleeding, 188 rigid Jackson bronchoscopes, 187 tracheoesophageal fistula, 184 185 tracheoinnominate fistula, 185 186 tracheostomy, 186 187 Tracheobronchial injury, 65 Tracheoesophageal fistula, 184 185 Tracheoinnominate fistula, 185 186 Tracheo-oesophageal fistula, 198 199 Tracheostomy, 186 187 Transcatheter aortic valve implantation (TAVI) advantages, 211 introduction routes, 211, 212 purse-string suture, 211 Transcervical endoscopic assistance, 153 Transcervical extended mediastinal lymphadenectomy (TEMLA), 41, 101 102, 159 161, 165 166 causes of death, 114 changes in operative steps, 115 116 complications, 113 114 contraindications, 102 dissection aortopulmonary window nodes, 102, 110 111 left paratracheal nodes, 106 109 mediastinal nodes, 105 para-aortic, 110 111 periesophageal nodes, 107 110 prevascular nodes, 106, 108 retrotracheal nodes, 106, 108 right paratracheal nodes, 105 107 subcarinal, 107 110 subplatysmal flaps, 102, 103 hook insertion under sternum/sternoclavicular joint, 104, 105 indications, 102 instruments, 114 115 intraoperative complications management, 112 113 laryngeal recurrent nerves visualization, 103 104 Linder-Dahan mediastinoscope, 102, 107, 109, 112, 115 malignant pleural mesothelioma, 102 remarks, 111 112 results, 113 retractor, 115 skin incision, 102 surgical technique modifications, 114 vagus nerves visualization, 103 105 Yankauer suction tube, 114 Transcervical pulmonary lobectomy advantages, 159, 163 complications, 163
contraindications, 160 indications, 160 left upper lobectomy, 161 162 postoperative pain management, 162 163 results, 163 right upper lobectomy, 160 161 TEMLA, 159 Transcervical resection, of mediastinal tumors. See Mediastinal tumors, transcervical resection Transcervical robotic access da Vinci robot ( see da Vinci robot) mediastinum and pleural cavities, subxyphoid view, 206, 207 robotic laparoscopic transdiaphragmatic access, 206 208 robotic subxyphoid approach, 206 208 port and robot arm placement, 205, 206 Transcervical-subxiphoid-videothoracoscopic maximal thymectomy aorta-caval groove, 131, 133 aortopulmonary window view, 131, 132 complications, 133 contraindications, 128 ectopic foci, 133, 134 hemiazygos accessory vein view, 131 indications, 127 128 intrathoracic thymus view, 132 laryngeal recurrent nerve visualization, 129, 130 lower thyroid vein clipping and division, 130 view, 130 results, 132 135 surgical technique, 128 129 cervical part, 128 131 subxiphoid part, 128, 131 132 thymus dissection, 130, 132 vein management, 131 Transcervical superior mediastinal lymphadenectomy, 153 154 Transcervical thymectomy anterior mediastinum tumors, 120 cervical stage, 121 complications, 125 contraindications, 120 history, 119 120 indications, 120 mediastinal stage anterior, 121 122 completion, 123 left, 122 right, 122 123 vascular, 122 results, 123 125 technique, 120 121 transcervical route, 120 Transesophageal echography, 85 U Unilocular mesothelial cyst, of mediastinum, 150 V Video-assisted mediastinoscopic lymphadenectomy (VAMLA), 41 bimanual dissection technique, 92 complications, 96 contraindications, 92 description, 165 history, 89 90 indications, 90 93 Linder-Dahan video-mediastinoscope, 90 92 mediastinal dissection, 89, 90 mediastinal staging, 92 MUS and, 68 69, 86 results, 94 96 subcarinal dissection, 95 surgical evaluation, 92 technique, 92 94 Video-assisted mediastinoscopic surgery (VAMS), 68 Video-assisted thoracoscopic surgery (VATS), 29, 42, 139 Video-gastroscope, 55 57, 62 64 Video-mediastinoscope, 10, 12 14, 54, 165 ESTS guidelines and, 17 nodes and nodal stations, 23 Video-thoracoscopy, 53 thorax preparation, 55 Z Zenker s diverticulum description, 195 diagnosis, 195, 196 endoscopic appearance of, 195, 196 myotomy, 196 postoperative complications, 196 221