Video-assisted thoracoscpic muscle transposition for acute empyema.

Muscle flap transposition is one of the surgical treatment options for empyema with alveolarpleural fistula (APF) or bronchopleural fistula (BPF). This surgical procedure is invasive because it is typically performed by standard thoracotomy. We performed video-assisted thoracoscopic surgery (VATS) debridement, decortication, and obliteration of an empyema cavity using a pedicled latissimus dorsi muscle (LDM) flap harvested through minimal skin incisions for a case of acute empyema with APF. This VATS procedure is effective and less invasive and can be a new option for the thoracoscopic surgical treatment of acute empyema with APF

Bilateral Endobronchial Metastasis in Postoperative Stage I Pulmonary Adenocarcinoma

We reported a case of bilateral endobronchial metastasis in postoperative synchronous adenocarcinoma. Twenty months ago, a 63-year-old man underwent combined operation. Biopsy was performed, histological diagnosis of pulmonary adenocarcinoma. When surgery is not indicated because the patient has decreased pulmonary function and contralateral metastatic lesions, the Nd–YAG laser has been used to treat focal malignancy of the trachea and mainstem bronchi, and the laser has been effective, especially in patients with inoperable lesions

Binocular stereo-navigation for three-dimensional thoracoscopic lung resection

BACKGROUND: This study investigated the efficacy of binocular stereo-navigation during three-dimensional (3-D) thoracoscopic sublobar resection (TSLR). METHODS: From July 2001, the authors’ department began to use a virtual 3-D pulmonary model on a personal computer (PC) for preoperative simulation before thoracoscopic lung resection and for intraoperative navigation during operation. From 120 of 1-mm thin-sliced high-resolution computed tomography (HRCT)-scan images of tumor and hilum, homemade software CTTRY allowed sugeons to mark pulmonary arteries, veins, bronchi, and tumor on the HRCT images manually. The location and thickness of pulmonary vessels and bronchi were rendered as diverse size cylinders. With the resulting numerical data, a 3-D image was reconstructed by Metasequoia shareware. Subsequently, the data of reconstructed 3-D images were converted to Autodesk data, which appeared on a stereoscopic-vision display. Surgeons wearing 3-D polarized glasses performed 3-D TSLR. RESULTS: The patients consisted of 5 men and 5 women, ranging in age from 65 to 84 years. The clinical diagnoses were a primary lung cancer in 6 cases and a solitary metastatic lung tumor in 4 cases. Eight single segmentectomies, one bi-segmentectomy, and one bi-subsegmentectomy were performed. Hilar lymphadenectomy with mediastinal lymph node sampling has been performed in 6 primary lung cancers, but four patients with metastatic lung tumors were performed without lymphadenectomy. The operation time and estimated blood loss ranged from 125 to 333 min and from 5 to 187 g, respectively. There were no intraoperative complications and no conversion to open thoracotomy and lobectomy. Postoperative courses of eight patients were uneventful, and another two patients had a prolonged lung air leak. The drainage duration and hospital stay ranged from 2 to 13 days and from 8 to 19 days, respectively. The tumor histology of primary lung cancer showed 5 adenocarcinoma and 1 squamous cell carcinoma. All primary lung cancers were at stage IA. The organs having metastatic pulmonary tumors were kidney, bladder, breast, and rectum. No patients had macroscopically positive surgical margins. CONCLUSIONS: Binocular stereo-navigation was able to identify the bronchovascular structures accurately and suitable to perform TSLR with a sufficient margin for small pulmonary tumors

A novel and simple method for identifying the lung intersegmental plane with an infrared thermography

25th WSCTS Annual Meeting and Exhibiotion 2015 2015年09月21日 Edinburgh, Scotlan

A novel and simple method for identifying the lung intersegmental plane with an infrared thermography

25th WSCTS Annual Meeting and Exhibiotion 2015 2015年09月21日 Edinburgh, Scotlan