Uniportal video-assisted thoracoscopy approach to the management of non-pulmonary diseases of the chest

Yeung, Ching; Dawson, Jennifer; Gilbert, Sébastien

doi:10.21037/jtd.2019.03.21

Cited by 5 publications

(7 citation statements)

References 44 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is noteworthy that some centers have the expertise to deliver VATS via a single port and under sedation without the requirement for intubation or singlelung ventilation. 85,86 Up to partial decortication can be performed during an "awake" VATS, but the availability of this technique remains limited and its efficacy versus the standard approach is yet to be tested. 85 The use of surgical intervention as a first-line treatment has been justified in a number of countries on the basis of the reduction in length of inpatient stay and improved clinical outcome.…”

Section: Surgical Interventionmentioning

confidence: 99%

“…85,86 Up to partial decortication can be performed during an "awake" VATS, but the availability of this technique remains limited and its efficacy versus the standard approach is yet to be tested. 85 The use of surgical intervention as a first-line treatment has been justified in a number of countries on the basis of the reduction in length of inpatient stay and improved clinical outcome. 87,88 However, there remains a lack of robust data justifying this practice, with those RCTs addressing this question being underpowered, with evidence of selection bias, lacking standardized criteria for surgery, and involving relatively young populations.…”

Section: Surgical Interventionmentioning

confidence: 99%

“…It is noteworthy that some centers have the expertise to deliver VATS via a single port and under sedation without the requirement for intubation or single-lung ventilation. 85 , 86 Up to partial decortication can be performed during an “awake” VATS, but the availability of this technique remains limited and its efficacy versus the standard approach is yet to be tested. 85 …”

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Recent Insights into the Management of Pleural Infection

Hassan

Patel

Sadaka

et al. 2021

IJGM

View full text Add to dashboard Cite

Pleural infection in adults has considerable morbidity and continues to be a lifethreatening condition. The term "pleural infection" encompasses complicated parapneumonic effusions and primary pleural infections, and includes but is not limited to empyema, which refers to collection of pus in the pleural cavity. The incidence of pleural infection in adults has been continuously increasing over the past two decades, particularly in older adults, and most of such patients have comorbidities. Management of pleural infection requires prolonged duration of hospitalization (average 14 days). There are recognized differences in microbial etiology of pleural infection depending on whether the infection was acquired in the community or in a health-care setting. Anaerobic bacteria are acknowledged as a major cause of pleural infection, and thus anaerobic coverage in antibiotic regimens for pleural infection is mandatory. The key components of managing pleural infection are appropriate antimicrobial therapy and chest-tube drainage. In patients who fail medical therapy by manifesting persistent sepsis despite standard measures, surgical intervention to clear the infected space or intrapleural fibrinolytic therapy (in poor surgical candidates) are recommended. Recent studies have explored the role of early intrapleural fibrinolytics or first-line surgery, but due to considerable costs of such interventions and the lack of convincing evidence of improved outcomes with early use, early intervention cannot be recommended, and further evidence is awaited from ongoing studies. Other areas of research include the role of routine molecular testing of infected pleural fluid in improving the rate of identification of causative organisms. Other research topics include the benefit of such interventions as medical thoracoscopy, high-volume pleural irrigation with saline/antiseptic solution, and repeated thoracentesis (as opposed to chest-tube drainage) in reducing morbidity and improving outcomes of pleural infection. This review summarizes current knowledge and practice in managing pleural infection and future research directions.

show abstract

Section: Surgical Interventionmentioning

confidence: 99%

Section: Surgical Interventionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Recent Insights into the Management of Pleural Infection

Hassan

Patel

Sadaka

et al. 2021

IJGM

View full text Add to dashboard Cite

show abstract

“…The U-VATS technique was first initiated in the early 2000s for a thoracic sympathectomy, and since then the technique is carried out for more and more complex procedures launched by the group of Gaetano Rocco of the national cancer institute in italy, to achieve a major step in 2010 with the world's first U-VATS lobectomy reported in 2011 by Gonzalez Rivas' group in Coruna, Spain. Since then, thoracic surgery for pulmonary and non-pulmonary lesions have been reported with great success [ 9 , 10 ]. U-VATS has demonstrated its feasibility and safety compared to conventional techniques by several advantages: less blood loss during surgery, less postoperative morbidity and mortality, better cosmetic results, shorter recovery and hospital stay [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Ectopic mediastinal thyroid removed by U-VATS approach. A case report

Haj

Hafidi

Khoaja

et al. 2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

“…Under the current standard of care, retained hemothorax is primarily treated with early video-assisted thoracoscopic surgery (VATS) (6). An advantage of prompt intervention is that it reduces the risk of activating local fibrinolysis and thus risk of recurrent hemothorax (7). However, VATS requires specialized surgical skills, is expensive, takes up operating room time, necessitates general anesthesia with a double-lumen endotracheal tube, and is contraindicated in some patients (e.g., those with spinal injuries or marginal lung function).…”

Section: Original Articlementioning

confidence: 99%

Efficacy of a novel chest tube system in a swine model of hemothorax

et al. 2021

View full text Add to dashboard Cite

Background: Tube thoracostomy is the definitive treatment for most significant chest trauma, including injuries resulting in pneumothorax, hemothorax, and hemopneumothorax. However, traditional chest tubes fail to sufficiently remove blood up to 20% of the time (i.e., retained hemothorax), which can lead to empyema and fibrothorax, as well as significant morbidity and mortality. Here we describe the use of a novel chest tube system in a swine model of hemothorax. Methods: This was an intra-animal-paired, randomized-controlled study of hemothorax evacuation using the PleuraPath™ Thoracostomy System (PPTS) compared to a traditional chest tube in large Yorkshire-Landrace swine (75-85 kg). One liter of autologous whole blood was infused into each pleural cavity simultaneously with subsequent drainage from each device individually monitored for a total of 120 minutes, before the end of the experiment and necroscopy. Results: Six animals completed the full protocol. On average, the PPTS removed 17% more blood (P=0.049) and left 19.1% less residual hemothorax (P=0.023) as compared to the standard of care during the first two hours of use. No complications or iatrogenic injury were identified in any animal for either device. Conclusions:The novel PPTS device was superior to the traditional chest tube drainage system in this acute, large-animal model of retained hemothorax. While this study supports clinical translation, further research will be required to assess efficacy and optimize device use in humans.

show abstract

Uniportal video-assisted thoracoscopy approach to the management of non-pulmonary diseases of the chest

Cited by 5 publications

References 44 publications

Recent Insights into the Management of Pleural Infection

Recent Insights into the Management of Pleural Infection

Ectopic mediastinal thyroid removed by U-VATS approach. A case report

Efficacy of a novel chest tube system in a swine model of hemothorax

Contact Info

Product

Resources

About