scholarly journals Cloward’s approach for Pancoast neurogenic tumors: illustrative cases

2021 ◽  
Vol 1 (23) ◽  
Author(s):  
Yi-Hsuan Kuo ◽  
Po-Kuei Hsu ◽  
Jau-Ching Wu ◽  
Wen-Cheng Huang ◽  
Tsung-Hsi Tu
Keyword(s):  
Thoracoscopic Surgery ◽  
Complete Resection ◽  
Viable Option ◽  
Common Procedure ◽  
Neurogenic Tumors ◽  
Minimal Invasiveness ◽  
Less Invasive ◽  
Wide Range ◽  
Video Assisted Thoracoscopic Surgery ◽  
Pancoast Tumors

BACKGROUND Pancoast tumors are a wide range of tumors located in the apex of the lung. Traditional surgery for Pancoast neurogenic tumors frequently involves extensive approaches, whether anterior or posterior or a combination, in which osteotomies are sometimes required. In this study, the authors proposed a less invasive surgical strategy using the standard Cloward’s approach for complete resection of a schwannoma arising from the T1 nerve root. OBSERVATIONS Two patients, each harboring a large T1 tumor, one on each side, underwent Cloward’s approach with and without thoracoscopic surgery. Both patients had complete resection of the tumor. Considering the benign and encapsulated nature of neurogenic tumors, Cloward’s approach under neuromonitoring, which is a common procedure for anterior cervical discectomy for most neurosurgeons, is a safe and less invasive alternative for Pancoast neurogenic tumors. For patients whose tumor cannot be removed completely via Cloward’s approach, video-assisted thoracoscopic surgery is a viable backup plan with minimal invasiveness. LESSONS Cloward’s approach is a viable option for Pancoast neurogenic tumors.

scholarly journals Thoracic Endometriosis: a Clinical Review and Update of Current and Evolving Diagnostic and Therapeutic Techniques

2021 ◽  
Author(s):  
Ravi Kanth Velagapudi ◽  
John P. Egan
Keyword(s):  
Multidisciplinary Approach ◽  
Thoracoscopic Surgery ◽  
Clinical Manifestations ◽  
Clinical Suspicion ◽  
Diagnostic Workup ◽  
Medical Thoracoscopy ◽  
High Clinical Suspicion ◽  
Wide Range ◽  
Thoracic Endometriosis ◽  
Video Assisted Thoracoscopic Surgery

Abstract Purpose of Review The goal of this review is to provide a comprehensive understanding of the pathophysiology, clinical presentation, diagnostic workup, and clinical management of thoracic endometriosis (TE), as well as highlight our personal experience with TE workup and management. Recent Findings TE can present in a wide range of clinical manifestations. Without high clinical suspicion, diagnosis can be delayed. Since no specific laboratory testing is available, diagnosis is often based on careful history taking, imaging, and direct visualization of endometrial lesions through video-assisted thoracoscopic surgery (VATS). Medical thoracoscopy (MT) may also be a useful tool in the diagnostic workup of TE. Summary The diagnosis and management of TE require a multidisciplinary approach and a high index of clinical suspicion. While VATS remains the gold standard for diagnosis, we share our experience using MT to diagnose and manage a case of TE-related hemothorax.

scholarly journals Rare Condition of Intrathoracic Phrenic Nerve Schwannoma Successfully Treated with Uniportal Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Lu Huu Pham ◽  
Kinh Quoc Nguyen ◽  
Hung Quoc Doan ◽  
Lanh Sy Nguyen ◽  
Ha Thi-Ngoc Doan
Keyword(s):  
Computerized Tomography ◽  
Phrenic Nerve ◽  
Thoracoscopic Surgery ◽  
Rare Condition ◽  
Mediastinal Tumors ◽  
Neurogenic Tumors ◽  
Video Assisted ◽  
Middle Mediastinum ◽  
The Right ◽  
Video Assisted Thoracoscopic Surgery

Introduction. Neurogenic tumors in the mediastinum account for approximately 20-30% of all types of mediastinal tumors in adults. This pathology is usually benign and has no or very few symptoms. Schwannoma rarely involves the phrenic nerve. We report a unique case of schwannoma involvement of phrenic nerve. Case Presentation. The 43-year-old female patient has an annual check-up of computerized tomography to detect the mass in the right middle mediastinum, so the patient was admitted to the hospital. Chest computerized tomography image found a mass of the middle mediastinum with the size of 23 × 22.3  mm located between the right pulmonary artery and the pericardium with uniform margins and clear boundaries, not invading the surrounding organization. Very little contrast is absorbed after injection. She underwent a uniportal video-assisted thoracoscopic surgery, and this mass was found to be originating from the right phrenic nerve. Resection of the portion of phrenic nerve with mass was performed. Postoperatively, the patient was discharged from the hospital after 4 days of treatment in a clinical condition with no difficulty breathing and no chest pain; postoperative X-ray showed no abnormality, and the right diaphragm was unchanged. Conclusion. Although they are very rare, schwannomas of the phrenic nerve should be considered in the differential diagnosis of mediastinal tumors. Uniportal video-assisted thoracoscopic surgery is a preeminent option with properly sized tumors that deliver good results and have no postoperative complications associated with surgery.

Minimally invasive posterior thoracic fusion

2008 ◽  
Vol 25 (2) ◽  
pp. E9 ◽  
Author(s):  
Justin S. Smith ◽  
Alfred T. Ogden ◽  
Richard G. Fessler
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Spine Surgery ◽  
Thoracic Spine ◽  
Thoracoscopic Surgery ◽  
High Rate ◽  
Video Assisted ◽  
Wide Range ◽  
Spine Pathology ◽  
Video Assisted Thoracoscopic Surgery

Thoracic spine fusion may be indicated in the surgical treatment of a wide range of pathologies, including trauma, deformity, tumor, and infection. Conventional open procedures for surgical treatment of thoracic spine disease can be associated with significant approach-related morbidity, which has motivated the development of minimally invasive approaches. Thoracoscopy and, later, video-assisted thoracoscopic surgery were developed to address diseases of the thoracic cavity and subsequently adapted for thoracic spine surgery. Although video-assisted thoracoscopic surgery has been used to treat a variety of thoracic spine diseases, its relatively steep learning curve and high rate of pulmonary complications have limited its widespread use. These limitations have motivated the development of minimally invasive posterior approaches to address thoracic spine pathology without the added risk of morbidity involved in surgically entering the chest. Many of these advances are ongoing and represent the forefront of minimally invasive spine surgery. As these techniques are developed and applied, it will be important to assess their equivalence or superiority in comparison with standard open techniques using prospective trials. In this paper the authors focus on minimally invasive posterior thoracic procedures that include fusion, and provide a review of the current literature, a discussion of future pathways for development, and case examples. The topic is divided by pathology into sections including trauma, deformity, spinal column tumors, and osteomyelitis.

scholarly journals Uniport vs. multiport video-assisted thoracoscopic surgery for anatomical lung resection—which is less invasive?

2021 ◽  
Vol 13 (1) ◽  
pp. 244-251
Author(s):  
Natsumi Matsuura ◽  
Hitoshi Igai ◽  
Fumi Ohsawa ◽  
Tomohiro Yazawa ◽  
Mitsuhiro Kamiyoshihara
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Less Invasive ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Postero-apical thoracic schwannoma with cervical extension resected by complete video-assisted thoracoscopic surgery

2019 ◽  
Vol 89 (2) ◽  
Author(s):  
Harry Etienne ◽  
Apostolos C. Agrafiotis ◽  
Hicham Masmoudi ◽  
Jalal Assouad
Keyword(s):  
Nervous System ◽  
Thoracic Surgery ◽  
Brachial Plexus ◽  
Subclavian Artery ◽  
Thoracoscopic Surgery ◽  
Benign Tumors ◽  
Neurogenic Tumors ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery ◽  
Risk Of Relapse

Schwannomas or neurilemmomas are benign tumors developed from the peripheral nervous system. Complete video-assisted thoracic surgery (cVATS) has set itself over the years as the preferred approach for the removal of small mediastinal neurogenic tumors. However, in case of apical location, complete VATS seems challenging because of proximity with the subclavian artery and/or elements of the brachial plexus. In case of a cVATS procedure, some authors prefer enucleation instead of resection, with a higher risk of relapse. We present two cases of cVATS resection of thoracic apical schwannomas.

scholarly journals The Role of Video-Assisted Thoracoscopic Surgery in Pediatric Oncology: Single-Center Experience and Review of the Literature

2021 ◽  
Vol 9 ◽  
Author(s):  
Giovanna Riccipetitoni ◽  
Mirko Bertozzi ◽  
Marta Gazzaneo ◽  
Alessandro Raffaele ◽  
Fabrizio Vatta
Keyword(s):  
Germ Cell ◽  
Pediatric Oncology ◽  
Recent Literature ◽  
Thoracoscopic Surgery ◽  
Germ Cell Tumors ◽  
Neurogenic Tumors ◽  
Video Assisted ◽  
Oncological Patients ◽  
Ablative Surgery ◽  
Video Assisted Thoracoscopic Surgery

Aim: Video-assisted thoracoscopic surgery (VATS) has been widely used in the last decades. Nevertheless, the pros and cons of thoracoscopy vs. open surgery in pediatric oncology are still under debate. In literature, VATS has been applied for both diagnostic and ablative surgery to treat neurogenic tumors, thymic neoplasms, lung tumors and metastases, germ cell tumors, lymphoproliferative diseases, and other rare tumors. Recent reviews described excellent outcomes in pediatric oncology as well as in the treatment of adult lung cancer, with a significantly higher rate of mortality and complication in thoracotomy compared to VATS. We reviewed our experience on thoracoscopy in pediatric malignancy and compared it to the literature.Materials and Methods: This was a retrospective cohort-study of pediatric oncological patients who underwent VATS at our institution from 2007 to 2020, and a review of the recent literature on the topic.Results: A total of 43 procedures were performed on 38 oncological patients (18 males, 20 females). Median age was years 7.72 (0.35–18.6). Diagnosis: 10 neurogenic tumors, nine hematological diseases, five metastases, four lypoblastomas, three thymic pathologies, three germ cell tumors, two pleuropneumoblastomas, two myofibroblastic tumors, one myoepithelial carcinoma, one liposarcoma, and three suspected oncological mass. In three cases, a 3D model was elaborated to better plan the surgical approach. Diagnostic biopsies were 22 (51.1%), and ablative surgeries, 21 (48.9%). One neurogenic tumor was resected with the Da Vinci Robot. Median operative time was 120 min (30–420). A drain was left in place in 20 (46.5%) for a median of 4 days. Median length of hospitalization was 5 days (1–18). One case (2.3%) was converted (intraoperative bleeding). There were three post-operative complications (7.0%): one pneumonia, one pleural effusion, and one diaphragmatic paralysis (need for plication). Results were compared to recent literature, and morbidity and conversion rate were comparable to reviewed publications.Conclusion: VATS represents a valuable tool for diagnostic and therapeutic procedures in pediatric oncology. Nonetheless, it is a challenging technique that should be performed by expert surgeons on oncological and mini-invasive surgery. Three-dimensional reconstruction can optimize the pre-operative planning and guarantee a safer and more targeted treatment. Finally, the advent of robotics-assisted surgery represents a new challenge that may further implement the advantages of VATS.

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