Diagnostische videoassistierte Thorakoskopie

Bergmann, Thorsten; Bölükbas, Servet; Beqiri, S.; Schirren, J.

doi:10.1007/s00104-006-1244-x

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…VATS was performed to remove the fibrinous deposits and to decorticate the thickened pleura followed by jet lavage to debride the necrotic tissue and fibrin deposits. In the end, chest tubes were inserted [9,10,14].…”

Section: Therapeutic Strategiesmentioning

confidence: 99%

Management of Pleural Empyema Using VATS with Jet-Lavage System

Kusch¹

2018

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Pleural empyema is a serious medical condition that is treated according to the stage. Because of the protracted course of this disease, treatment is very problematic in many cases. In general, pleural empyema therapy should be early and stage-appropriate. In stage I a combination of antibiotic therapy and drainage of the infected pleural effusion via a chest tube is performed. In stage II, proper drainage of loculated pleural empyema is only possible with operative intervention (Videoassisted thoracoscopy). The III stage of the disease results in pleural thickening which hinders lung expansion and restricts pulmonary function significantly. Therefore, early thoracotomy within 3 to 4 weeks is advised to prevent the formation of pleural thickening. In this study, pleural empyema in stage II is treated by means of video-assisted thoracoscopy with jet lavage The purpose of video-assisted thoracoscopy is the resolution of septations and removal of fibrin patches to allow the reexpansion of the lung. The Pulsavac Plus system is highly efficient through a variety of attachments coupled with a high flushing performance. In general, 3 accesses are required: 1 x 10 mm trocar for the camera, 1 x 15 mm trocar for the Pulsavac Plus system and 1 x 5 mm trocar for additional instruments. Between 1998 and 2015, a total of 311 patients were treated successfully with the above technique. Pulsed lavage irrigation provided efficient debridement by most patients and can, therefore, be considered as a useful alternative to the already established procedures. 90% of patients (279/311) were successfully treated. In this paper, a not yet established surgical technique is presented (Video-assisted thoracoscopy with jet lavage), which offers an alternative to the conventional surgical techniques. The results are promising. The median hospital stay averaged 8 days. Randomized trials are still, of course, necessary to evaluate the effectiveness of the procedure.

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Section: Therapeutic Strategiesmentioning

confidence: 99%

Management of Pleural Empyema Using VATS with Jet-Lavage System

Kusch¹

2018

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“…6 Perfecting video-assisted thoracoscopic surgery (VATS) in the early 90's made possible performing such interventions by minimally invasive approach and avoiding the disadvantages of thoracotomy. 7 The aim of the present report was to share our experience with VATS in the diagnostics and therapy of patients with solitary pulmonary nodules.…”

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confidence: 99%

Our Experience in the Diagnostics and Therapy of Patients with Solitary Peripheral Lung Tumours

Prisadov¹,

Wallimann²,

Welcker³

2011

Folia Medica

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Patients presenting with a solitary pulmonary nodule are often a serious diagnostic-therapeutic problem. the aim of the present report is to share our experience with vAts in the diagnostics and therapy of patients with solitary pulmonary nodules. Patients and methOds: between 2005 and 2009 we performed primary videothoracoscopic tumor resection in 125 patients with peripheral lung tumours. Results: In 93 (74.4%) of the cases complete successful thoracoscopic resection of the tumor and subsequent intraoperative frozen section histology was accomplished. In the remaining 32 cases (25.6%) various reasons demanded conversion to thoracotomie with wedge resection of the nodule. 54.2% of the removed tumours were malignant and 45.8% -benign. In 18 of the patients the intraoperative frozen section histology diagnosis was primary bronchial carcinoma which required to do oncologic resection of the tumor. In 10 patients the intraoperative frozen section histology was unable to differentiate between pulmonary metastasis and primary bronchial carcinoma, and the oncologic resection was performed in another surgical session after the definitive pathomorphologic diagnosis had been available. In 28 of the cases pulmonary metastases of a primary extrapulmonary tumor were removed. cOnclusiOns: Despite improvement in the diagnostic techniques, only the video-thoracoscopic removal of the lung nodule and its subsequent histological examination enables the definitive diagnosis, solving definitively the problem with benign lesions and indicating appropriate treatment of the malignant pulmonary lesions.

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“…Beim Wechsel von VATS auf eine laterale Thorakotomie kann im OP-Saal eine Erweiterung der Operation auf eine Lobektomie mit systemischer mediastinaler Lymphknotendissektion erfolgen(Schirren et al 1994). Im Vergleich mit einer internistischen Thorakoskopie nur durch VATS können mit einer Adhäsiolyse die Verwachsungen gelöst und die Kammerungen geöffnet werden(Bergmann et al 2006). So ist VATS die Methode der Wahl bei der Behandlung von septierten chronischen Pleuraergüssen oder organisierten Pleuraempyemen in den Händen von Chirurgen.…”

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Übereinstimmung in der Beurteilung zwischen Pneumologen und dem Zytopathologen, die identisches Pleuraergussmaterial untersucht haben

Pietrzak¹

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Diagnostische videoassistierte Thorakoskopie

Cited by 5 publications

References 32 publications

Management of Pleural Empyema Using VATS with Jet-Lavage System

Management of Pleural Empyema Using VATS with Jet-Lavage System

Our Experience in the Diagnostics and Therapy of Patients with Solitary Peripheral Lung Tumours

Übereinstimmung in der Beurteilung zwischen Pneumologen und dem Zytopathologen, die identisches Pleuraergussmaterial untersucht haben

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