15 research outputs found
Clinical Experience on a Digital Low-Pressure Continuous Suction Unit Having a Trend Forecasting Function for Evaluating Lung Air-Leak
A Successful Case of an Implanted Polyglycolic-Acid Sheet Inside the Bulla for Preventing the Residual Cavity After Video-Assisted Thoracoscopic Bullectomy
Clinical Experience on a Digital Low-Pressure Continuous Suction Unit Having a Trend Forecasting Function for Evaluating Lung Air-Leak
Specified Kiwifruit Extract Blocks Increase of Body Weight and Visceral Fat in High-fat-diet-fed Mice by Inhibiting Intestinal Lipase
Pharmacological Profile of DZ-697b, a Novel Anti-Platelet Agent -Selective Inhibitor of vWF- and Collagen-Induced Platelet Aggregation.
Anti-Thrombotic Action of DZ-697b, a Novel Anti-Platelet Agent, on Photochemically Induced Thrombosis with Lower Bleeding Risk in Guinea Pigs.
A Successful Case of an Implanted Polyglycolic-Acid Sheet Inside the Bulla for Preventing the Residual Cavity After Video-Assisted Thoracoscopic Bullectomy
Reduction Effect of Calcium Alginate on Blood Triglyceride Levels Causing the Inhibition of Hepatic and Total Body Accumulation of Fat in Rats
A successful surgical repair of intraoperative pneumothorax and the diffuse dissection of visceral pleura during liver transplantation surgery via trans-diaphragmatic approach
Abstract Background Pneumothorax during surgery under general anesthesia is a life-threatening situation for the patient because it can progress easily to the tension pneumothorax due to positive pressure ventilation unless appropriate treatments such as inserting a drainage tube in the thoracic cavity are initiated. The authors experienced a case of intraoperative pneumothorax and the diffuse dissection of visceral pleura during liver transplantation surgery, and achieved successful repair by a trans-diaphragmatic approach without changing patient’s body position. Case presentation A 66-year-old male with multiple liver and renal cysts caused by autosomal dominant polycystic kidney disease (ADPKD) was admitted to the authors’ hospital for treating the infection of the liver cysts. The infection was unable to be controlled by conservative treatments. Therefore, the patient was planned to undergo living-donor liver transplantation. Intraoperatively, the liver was found to swell markedly and to firmly adhere to the right diaphragm. After the extraction of the liver, because the right diaphragm swelled markedly, pneumothorax was suspected. Chest tube was inserted immediately, and the small incision was made in the right diaphragm. Thoracoscopic observation revealed that (1) the visceral pleura of the bottom of the right lung widely expanded like a giant cyst due to the dissection from the lung parenchyma and (2) a large air leakage from a pin hole appeared in the dissected pleura. After the completion of the liver transplantation, the thoracoscopic leakage-closing operation was performed through the right diaphragm incision. Because the dissection of visceral pleura was too wide to perform plication or cystectomy by a stapler or sutures, the dissected pleura was opened, and absorbable fibrin sealant patches and fibrin glue were put or injected between the lung parenchyma and the pleura. Although, after being observed postoperatively, prolonged minor air leakage disappeared by a conservative drainage treatment, and the cyst on the bottom of the right lung disappeared on chest computed tomography (CT). Conclusions Although intraoperative pneumothorax and broad dissection of visceral pleura during laparotomy is a complicated situation, the authors successfully repaired air leakage via a trans-diaphragmatic approach without changing the patient’s body position