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Objective: To study the post-operative outcomes of two-lung ventilation in patients undergoing prone position thoracoscopicesophagectomy. Study Design: Prospective comparative study. Place and Duration of Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: A total of 60 patients operated for both groups of thoraco-esophagectomy in which 34 patients for TLV (two-lung ventilation) and 26 patients for One-lung ventilation were studied. Patients position was prone for Two-lung ventilation in Thoracoscopic-esophagectomy. Post-op blood loss, Hospital stay, duration of anesthesia and operative morbidity was calculated. Results: A total of 60 patients underwent two-lung ventilation in prone position out of which patient of thoracoscopicesophagectomy were 34, while 26 underwent One-lung ventilation in semi-decubitus position thoracoscopic-esophagectomy. All of them were successfully performed without conversion to open thoracotomy. In the study with preparation span for anesthesia induction, mean time of mobilization of thoracic esophagus, mean blood loss during the thoracic mobilization phase, the mean Intensive care unit stay and total hospital stay in two-lung ventilation was less than one-lung ventilation (p<0.05). Conclusion: The present study summarized the clinical outcomes of two-lung ventilation for thoracoscopic-esophagectomy operated patients. This study data showed that Two-lung ventilation intubation in prone position is better approach during the Thoracoscopic-esophagectomy.

Ectopic parathyroid adenomas can be a cause of recurrent and refractory hyperparathyroidism. Majority of parathyroid adenomas are located in the neck region, however in very few cases they are located within the mediastinum. In such cases excision via cervical approach is not possible and it becomes a diagnostic as well as surgical challenge. Excision via thoracoscopic approach is a preferred approach in this regard. Here we represent a case of ectopic parathyroid adenoma embedded within thymus gland which underwent surgical excision via thoracoscopic approach. Key words: Ectopic, Parathyroid adenoma, Thoracoscopy

Objective: To compare outcomes of video assisted Thoracoscopic Decortication (VATD) with conventional open decortication (COD) in patients with stage–II or stage–III empyema thoracic. Study Design: Prospective comparative study. Place and Duration of Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi, Pakistan, from Jun 2018 to May 2019. Methodology: A total 60 patients underwent in this study. Patients of both gender who reported for decortication of empyema thoracic were evaluated. All patients diagnosed to have Stage II or III empyema with age 25-50 years were studied for outcomes. All patients were evaluated for operative time, blood loss, post-operative pain, pneumonitis, duration of airleak and post-operative drainage, duration of chest drains and length of hospital stay. Results: Mean operative time in group-1 was 133.63 ± 8.55 min and in group-2 was 147.83 ± 10.36 min (p-value 0.037). Mean blood loss in group-1 was 296.66 ± 46.11 while in group-2 was 207.30 ± 53.81. Post-operative pain score on VAS for pain was 5.8 ± 1.7 for group-1 and 4.06 ± 1.4 for group-2 (p-value 0.032). Chest tubes were retained for an average of 5.58 ± 0.8 days in group-1 while 3.86 ± 0.8 days in group-2 (p-value <0.001). Conclusion: Video-Assisted Thoracoscopic Surgery Decortication is superior to open decortication in operative management of Stage II and Stage III Empyema thoracic in terms of post op pain, duration of chest intubation, air leak and hospital stay of the patient.