Current regimens of induction treatment do not seem to increase the risk of morbidity, early mortality and late mortality after pneumonectomy in properly selected patients. This study warrants confirmation from future multicentre prospective randomised trials powered on early outcomes.
Subxiphoid puncture is considered the standard approach for epicardial ablation of ventricular arrhythmia, but in some cases this access is impracticable due to the patient's anatomy. We describe the case of a patient with electrical storm and abnormal subdiaphragmatic anatomy that precluded the usual subxiphoid approach. In this patient the pericardial space was gained through a direct thorax puncture at the fifth intercostals space close to the mammary line. The tools and technique utilized in this case were similar to what is usually used for traditional subxiphoid puncture. The thorax percutaneous puncture was successfully carried out without complication.
To date the conventional open surgery has been the standard surgical management of nonsmall cell lung cancer with chest wall invasion, which is seen in less than 10% of patients with lung cancer in mostly reported series. Minimally invasive techniques have emerged as alternative approaches for the treatment of locally advanced and more complex cases, with a demonstrated oncologic outcomes equivalent to open thoracotomy and lower overall complication and mortality rates. Despite, there are few published studies, the en-bloc chest wall resection with vertebrectomy can be perform by a video-thoracoscopic hybrid techniques in selected patients with lung cancer invading the spine. In this article, we describe our surgical approach and technical aspects of VATS hybrid approach for T4 vertebra combined resection. In addition, the different minimally invasive approaches described in the existing literature are briefly examined.
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