Postoperative subcutaneous emphysema: prevention and treatment

Lodhia, Joshil; Tenconi, Sara

doi:10.21037/shc.2020.03.08

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…It should be evaluated by bronchoscopic examination, to rule out major tracheo bronchial tree injuries before assessing with thoracoscopy. 7 Air leak is rare complication after minimal invasive oesophagectomies. Some of the rare scenarios explained the potential complications of massive pneumothorax due to use of corrugated rubber drain in neck.…”

Section: Discussionmentioning

confidence: 99%

Lessons learnt from uncommon events during robotic assisted minimally invasive oesophagectomy

Pawar,

Bagul,

Nilapwar

et al. 2024

Int Surg J

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Esophagectomy is the mainstay treatment for cancer of the esophagus. Over the last two decades robotic assisted minimally invasive oesephagectomy (RAMIE) have become increasingly popular in esophageal surgery. We present a rare complication of an air leak following RAMIE. Our patient underwent a robotic assisted total esophageal mobilization, lymph node dissection transthoracically for a lower oesophageal tumour. He developed persistent air leak and needed oxygen support. Following which thoracoscopic bullectomy was done, lung was successfully re-inflated. To the authors’ knowledge, this rare complication has only handful cases reported in the medical literature; other surgeons should be made aware of this problem.

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Section: Discussionmentioning

confidence: 99%

Lessons learnt from uncommon events during robotic assisted minimally invasive oesophagectomy

Pawar,

Bagul,

Nilapwar

et al. 2024

Int Surg J

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“…Regarding the latter, however, a significantly higher proportion of patients undergoing VATS experienced subcutaneous emphysema compared to those who underwent RATS (3.2% versus 0.3%; p = 0.03). Subcutaneous emphysema is a postoperative complication that can lead to increased patient distress, empyema, and prolonged hospitalization [ 38 ]. A strong risk factor for postoperative air leak and subcutaneous emphysema is the presence of adhesions between the visceral pleura and surrounding structures [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic versus Video-Assisted Thoracic Surgery for Lung Cancer: Short-Term Outcomes of a Propensity Matched Analysis

Lampridis

Maraschi

Reun

et al. 2023

Cancers

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Robot-assisted thoracic surgery (RATS) has gained popularity for the treatment of lung cancer, but its quality outcome measures are still being evaluated. The purpose of this study was to compare the perioperative outcomes of lung cancer resection using RATS versus video-assisted thoracic surgery (VATS). To achieve this aim, we conducted a retrospective analysis of consecutive patients who underwent lung cancer surgery between July 2015 and December 2020. A propensity-matched analysis was performed based on patients’ performance status, forced expiratory volume in 1 s% of predicted, diffusing capacity of the lungs for carbon monoxide% of predicted, and surgical procedure (lobectomy or segmentectomy). Following propensity matching, a total of 613 patients were included in the analysis, of which 328 underwent RATS, and 285 underwent VATS, with satisfactory performance indicators. The results of the analysis indicated that RATS had a significantly longer operating time than VATS (132.4 ± 37.3 versus 122.4 ± 27.7 min; mean difference of 10 min 95% CI [confidence interval], 4.2 to 15.9 min; p = 0.001). On the other hand, VATS had a significantly higher estimated blood loss compared to RATS (169.7 ± 237.2 versus 82.2 ± 195.4 mL; mean difference of 87.5 mL; 95% CI, 48.1 to 126.8 mL; p < 0.001). However, there were no significant differences between the groups in terms of the duration of chest tubes, length of hospital stay, low- and high-grade complications, as well as readmissions and mortality within 30 days after surgery. Moreover, the number of dissected lymph-node stations was significantly higher with VATS than RATS (5.9 ± 1.5 versus 4.8 ± 2.2; mean difference of 1.2; 95% CI, 0.8 to 1.5; p = 0.001). Nonetheless, the percentage of patients who were upstaged after histopathological analysis of the resected lymph nodes was similar between the two groups. In conclusion, RATS and VATS yielded comparable results for most of the short-term outcomes assessed. Further research is needed to validate the implementation of RATS and identify its potential benefits over VATS.

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“…The presence of air in the subcutaneous area is defined as surgical emphysema [ 1 ]. Tracheal injury may result in extensive subcutaneous surgical emphysema, and potentially critical conditions like tension pneumothorax, mediastinal emphysema, stridor, and respiratory distress in patients.…”

Section: Introductionmentioning

confidence: 99%

Extensive Surgical Emphysema Following Stab Injury to the Neck

Kolleri¹,

Al-warqi²,

Mohamed³

et al. 2021

Cureus

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Extensive surgical emphysema can lead to a life-threatening condition causing hemodynamic instability and significant physician challenges in its management. Here we describe an uncommon case of extensive subcutaneous emphysema caused by stabbing neck, which led to complications such as pneumothorax, pneumopericardium, pneumomediastinum as well as pneumoperitoneum. The role of radiological imaging is crucial in managing this relatively uncommon presentation. This article highlights clinical presentation, radiological findings, and various management options.

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Postoperative subcutaneous emphysema: prevention and treatment

Cited by 4 publications

References 23 publications

Lessons learnt from uncommon events during robotic assisted minimally invasive oesophagectomy

Lessons learnt from uncommon events during robotic assisted minimally invasive oesophagectomy

Robotic versus Video-Assisted Thoracic Surgery for Lung Cancer: Short-Term Outcomes of a Propensity Matched Analysis

Extensive Surgical Emphysema Following Stab Injury to the Neck

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