scholarly journals Detecting Oropharyngeal and Esophageal Emptying by Submental Ultrasonography and High-Resolution Impedance Manometry: Intubated vs. Non-Intubated Video-Assisted Thoracoscopic Surgery

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1079
Author(s):  
Chih-Jun Lai ◽  
Jin-Shing Chen ◽  
Shih-I Ho ◽  
Zhi-Yin Lu ◽  
Yi-Ju Huang ◽  
...  
Keyword(s):  
High Resolution ◽  
Primary Outcome ◽  
Thoracoscopic Surgery ◽  
Oral Intake ◽  
Secondary Outcome ◽  
Video Assisted ◽  
Objective Evidence ◽  
Esophageal Emptying ◽  
Time Required ◽  
Video Assisted Thoracoscopic Surgery

Postoperative swallowing, affected by general anesthesia and intubation, plays an important part in airway and oral intake safety regarding effective oropharyngeal and esophageal emptying. However, objective evidence is limited. This study aimed to determine the time required from emergence to effective oropharyngeal and esophageal emptying in patients undergoing non-intubated (N) or tracheal-intubated (I) video-assisted thoracoscopic surgery (VATS). Hyoid bone displacement (HBD) by submental ultrasonography and high-resolution impedance manometry (HRIM) measurements were used to assess oropharyngeal and esophageal emptying. HRIM was performed every 10 min after emergence, up to 10 times. The primary outcome was to determine whether intubation affects the time required from effective oropharyngeal to esophageal emptying. The secondary outcome was to verify if HBD is comparable to preoperative data indicating effective oropharyngeal emptying. Thirty-two patients suitable for non-intubated VATS were recruited. Our results showed that comparable HBDs were achieved in all patients after emergence. Effective esophageal emptying was achieved at the first HRIM measurement in 11 N group patients and 2 I group patients (p = 0.002) and was achieved in all N (100%) and 13 I group patients (81%) within 100 min (p = 0.23). HBD and HRIM are warranted for detecting postoperative oropharyngeal and esophageal emptying.

A randomized trial of erector spinae plane block for analgesia after video-assisted thoracoscopic surgery

2019 ◽  
Author(s):  
Yang Jin ◽  
Xuemei Jiang ◽  
Meng Sun ◽  
Xin Lv ◽  
Zongmei Wen
Keyword(s):  
Postoperative Pain ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Secondary Outcome ◽  
Video Assisted ◽  
Erector Spinae Plane Block ◽  
The Impact ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background: Erector spinae plane block (ESPB) is a novel local nerve block technique. However, evidence regarding the impact of ESPB on postoperative pain management after video-assisted thoracoscopic surgery (VATS) is lacking. This randomized controlled trial aimed to evaluate the effect of erector spinae plane block on postoperative analgesia and intra-operative opioid consumption for video-assisted thoracoscopic surgery patients. Methods: We randomly allocated 91 participants to block with 30ml ropivacaine 0.375% (n=45), or no block without placebo or sham procedure (n=46). We analyzed results from 41 participants in each group ultimately. The primary outcome was postoperative NRS pain score. The secondary outcome was intra-operative sufentanil consumption. Postoperative QoR-40 scores and postoperative complications were also recorded. Results: Erector spinae plane block reduced the median (IQR) pain scores during postoperative 0-1h, 1-6h, 6-12h and 12-24h: 3 (3-5) vs. 6 (5-7), p<0.0001; 5 (3-5) vs. 6 (5-7), p<0.0001; 4 (3-5) vs. 6 (5-7), p<0.0001 and 4 (3-5) vs. 5 (5-7), p<0.0001, respectively. Block also reduced the mean (SD) intra-operative total sufentanil consumption and per hour, per kilogram sufentanil consumption, as well as increased the median (IQR) global QoR-40 scores on POD1. Conclusions: Erector spinae plane block can be used to reduce postoperative pain and intra-operative opioid consumption for VATS patients.

Myasthenia gravis miatt végzett három különböző típusú csecsemőmirigy-eltávolítás sebészeti és korai neurológiai eredményei

2015 ◽  
Vol 68 (6) ◽  
pp. 219-224
Author(s):  
Aurél Ottlakán ◽  
Tibor Géczi ◽  
Balázs Pécsy ◽  
Bernadett Borda ◽  
Judit Lantos ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Thoracoscopic Surgery ◽  
Extended Thymectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Absztrakt Célkitűzés: A myasthenia gravis (MG) kezelésében számos nyitott, illetve minimálisan invazív thymectomia ismert. A tanulmány ugyanazon intézeten belül a transsternalis (TS), illetve kétféle minimálisan invazív thymectomia (video-assisted thoracoscopic extended thymectomy – VATET; unilateral video-assisted thoracoscopic surgery – UL-VATS) eredményeit hasonlítja össze. Anyag és módszerek: Három különböző időintervallumban 71 betegnél történt thymectomia MG miatt (60 nő, 11 férfi): 23 transsternalis thymectomia (1995. január–2004. szeptember), 22 VATET (2004. szeptember – 2009. augusztus) és 26 UL-VATS thymectomia (2009. szeptember – 2011. december). Az eredmények értékelésénél a műtéti idő, MG-hez társuló neurológiai és a műtét utáni sebészi szövődmények, valamint az MG státuszában az egyéves utánkövetéskor észlelt neurológiai változások szerepeltek. Eredmények: Perioperatív mortalitás nem fordult elő. A műtéti idő 112, 211, 116 perc (p = 0,001), a kórházi napok száma: 8,9, 5,6 és 4 nap (p = 0,001) volt a TS-, VATET- és UL-VATS-csoportban. Az MG-hez kapcsolódó postoperativ neurológiai szövődmények 21,7%, 18,2% és 7,7% (p = 0,365) értékeket mutattak. A sebészi szövődmény 4,3%, 13,7%, 0% (p = 0,118) volt. Az MG tüneteinek javulása 91,3%, 94,7%, 87,5% (p = 0,712), míg komplett remisszió 13%, 10,5%, 11,5% (p = 0,917) volt a TS-, VATET- és UL-VATS-csoportokban. Következtetések: A műtéti idő, valamint a kórházban eltöltött napok száma UL-VATS esetében volt a legrövidebb. A kisebb sebészi beavatkozáshoz alacsonyabb sebészi, illetve MG-s neurológiai szövődmények társultak. Az MG-tünetek javulásában mindhárom módszernél kiváló eredményt értek el.

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun
Keyword(s):  
Thoracoscopic Surgery ◽  
Anterior Mediastinum ◽  
Laryngeal Mask ◽  
Double Lumen Tube ◽  
Perioperative Outcomes ◽  
Video Assisted ◽  
Incision Size ◽  
The Mean ◽  
End Tidal ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

Video-assisted thoracoscopic surgery in bronchogenic cysts of the esophagus

2006 ◽  
Vol 40 (Supplement 4) ◽  
pp. S190
Author(s):  
Ming-Jang Hsieh ◽  
Sheung-Fat Ko ◽  
Jui-Wei Lin ◽  
Chung-Cheng Huang ◽  
Chih-Chia Li ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Bronchogenic Cysts ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Deng ◽  
Xiao-min Hou ◽  
Xu-yan Zhou ◽  
Qing-he Zhou
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Prospective Randomized Controlled Trial ◽  
Numerical Rating ◽  
Intercostal Block ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

Lung nodule radio-guided localization and uniportal video-assisted thoracoscopic surgery resection

2021 ◽  
Author(s):  
Carlos Carvajal ◽  
Felipe González ◽  
Rafael Beltrán ◽  
Ricardo Buitrago ◽  
Amelia de los Reyes ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Nodule ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery ◽  
Surgery Resection

scholarly journals Development of patient specific, realistic, and reusable video assisted thoracoscopic surgery simulator using 3D printing and pediatric computed tomography images

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dayeong Hong ◽  
HaeKang Kim ◽  
Taehun Kim ◽  
Yong-Hee Kim ◽  
Namkug Kim
Keyword(s):  
Computed Tomography ◽  
Mechanical Properties ◽  
Fused Deposition Modeling ◽  
Thoracoscopic Surgery ◽  
Clinical Situation ◽  
Patient Specific ◽  
Fused Deposition ◽  
Video Assisted ◽  
Computed Tomography Images ◽  
Video Assisted Thoracoscopic Surgery

AbstractHerein, realistic and reusable phantoms for simulation of pediatric lung video-assisted thoracoscopic surgery (VATS) were proposed and evaluated. 3D-printed phantoms for VATS were designed based on chest computed tomography (CT) data of a pediatric patient with esophageal atresia and tracheoesophageal fistula. Models reflecting the patient-specific structure were fabricated based on the CT images. Appropriate reusable design, realistic mechanical properties with various material types, and 3D printers (fused deposition modeling (FDM) and PolyJet printers) were used to represent the realistic anatomical structures. As a result, the phantom printed by PolyJet reflected closer mechanical properties than those of the FDM phantom. Accuracies (mean difference ± 95 confidence interval) of phantoms by FDM and PolyJet were 0.53 ± 0.46 and 0.98 ± 0.55 mm, respectively. Phantoms were used by surgeons for VATS training, which is considered more reflective of the clinical situation than the conventional simulation phantom. In conclusion, the patient-specific, realistic, and reusable VATS phantom provides a better understanding the complex anatomical structure of a patient and could be used as an educational phantom for esophageal structure replacement in VATS.

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