Postresectional pulmonary oxidative stress in lung cancer patients. The role of one-lung ventilation

Misthos, Panagiotis; Katsaragakis, Stylianos; Milingos, Nikolaos; Kakaris, Stamatios; Sepsas, Evangelos; Athanassiadi, Kalliopi; Theodorou, Dimitrios; Skottis, Ion

doi:10.1016/j.ejcts.2004.12.023

Cited by 156 publications

(113 citation statements)

References 23 publications

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“…It is well known that OLV in itself, regardless of surgical manipulations, may induce inflammatory changes at the level of small airways and lung parenchyma, through diverse mechanisms [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. The latter include elevated positive pressure (barotrauma), alveolar overdistension (volutrauma) [8,10], repetitive collapse-reopening cycles (atelettrauma) [10], low oxygen tension, and the so-called reventilation injury [13,14,22].…”

Section: General Principlesmentioning

confidence: 99%

“…The latter include elevated positive pressure (barotrauma), alveolar overdistension (volutrauma) [8,10], repetitive collapse-reopening cycles (atelettrauma) [10], low oxygen tension, and the so-called reventilation injury [13,14,22]. All these factors are responsible for oxidative stress [16,19,20,21] and excess recruitment of inflammatory cells, with subsequent activation of cytokine network and establishment of an inflamed microenvironment [8,[11][12][13]15]. These compartmental changes, which can involve both the dependent and non-dependent (operated) lung, configure a condition known as "Ventilator-Associated Lung Injury" (VALI).…”

Section: General Principlesmentioning

confidence: 99%

“…These compartmental changes, which can involve both the dependent and non-dependent (operated) lung, configure a condition known as "Ventilator-Associated Lung Injury" (VALI). The latter leads, in turn, to interstitial edema [12,14,16], loss of surfactant [11,12], ventilationto-perfusion mismatch, and decreased lung compliance [11,12]. These effects occur in a time-dependent manner, as they increase remarkably after 1-hour of OLV [20].…”

Section: General Principlesmentioning

confidence: 99%

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Nonintubated Videothoracoscopic Operations in Thoracic Oncology

Mineo¹,

Tacconi²

2014

J de Chirurgie

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Section: General Principlesmentioning

confidence: 99%

Section: General Principlesmentioning

confidence: 99%

Section: General Principlesmentioning

confidence: 99%

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Nonintubated Videothoracoscopic Operations in Thoracic Oncology

Mineo¹,

Tacconi²

2014

J de Chirurgie

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“…Even with smaller incisions, transthoracic manipulation mandates one‐lung ventilation or collapsing the right lung with artificial pneumothorax. One‐lung ventilation is reported to result in mechanical damage to both the ventilated and the collapsed lung 8, 10…”

Section: Introductionmentioning

confidence: 99%

Technical details of video‐assisted transcervical mediastinal dissection for esophageal cancer and its perioperative outcome

Mori

Aikou

Yagi

et al. 2017

Annals of Gastroent Surgery

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To reduce pulmonary complications after esophagectomy, the transthoracic procedure should be shortened or totally avoided. Transcervical approach assisted by mediastinoscope for the upper mediastinum may be advantageous for this purpose. We carried out video‐assisted transcervical mediastinal dissection (VATCMD) as part of totally non‐transthoracic radical esophagectomy. A single‐port laparoscopy device was adopted to a small cervical incision and the mediastinum was inflated with a positive pressure of 6 to 10 mmHg. Without assistant's retractor, the upper mediastinum and partially the middle mediastinum were dissected mainly by mediastinoscopic‐assisted surgery. Video of the operation is demonstrated with illustrations. We have carried out and reported 17 cases of esophagectomy including VATCMD and its perioperative outcome. Non‐transthoracic esophagectomy was completed without conversion to transthoracic procedure in all 17 cases. Procedure‐related adverse event was not observed and postoperative course was favorable with a zero occurrence (0%) of recurrent laryngeal nerve palsy, chyle leakage or pulmonary complications. Median number of harvested lymph nodes from the upper mediastinal stations was 10. VATCMD is suggested as a safe and feasible approach for the upper mediastinum in esophagectomy for malignancies. It enabled a totally non‐transthoracic radical esophagectomy in combination with a transhiatal approach.Video‐assisted transcervical mediastinal dissection is suggested as a safe and feasible approach for the upper mediastinum in esophagectomy for malignancies. It enabled a totally non‐transthoracic radical esophagectomy in combination with a transhiatal approach.

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“…The administration of 1-lung ventilation is reported to induce mechanical damage to both the ventilated and collapsed lung. 3,4 We considered that it is possible to perform radical esophagectomy without the thoracic approach, as the esophagus and regional lymph nodes are located inside the bilateral mediastinal pleura. Therefore, total transhiatal and bilateral transcervical radical lymphadenectomy may well be carried out without thoracic damage.…”

mentioning

confidence: 99%

Mediastinoscopic Subaortic and Tracheobronchial Lymph Node Dissection With a New Cervico-Hiatal Crossover Approach in Thiel-Embalmed Cadavers

Tokairin

Nagai

Fujiwara

et al. 2015

International Surgery

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The use of mediastinal surgery for minimally invasive esophagectomy (MIE) has been proposed; however, this method is not performed as radical surgery because it has been thought to be impossible to perform complete upper mediastinal dissection, including the left tracheobronchial lymph nodes (106tbL). We herein describe a new method for performing complete dissection of the upper mediastinum. We developed a method for performing complete mediastinoscopic esophagectomy as radical surgery via the bilateral transcervical and transhiatal approach in 6 Thiel-embalmed human cadavers. The lower and middle mediastinal lymph nodes are dissected via the transhiatal approach. The dorsal side of the left recurrent nerve is dissected up to the aortic arch and left recurrent nerve lymph nodes (106recL) are dissected under pneumomediastinum. Next, the right recurrent nerve lymph nodes (106recR) are dissected. The cartilage of the left main bronchus is dissected and pushed downward, thereby obtaining a good view between the aortic arch and left main bronchus via the transhiatal approach. The 106tbL lymph nodes are dissected until the aortic arch is reached. Simultaneously, the lymph nodes are dissected via a right cervical incision. This method is termed the ''cross-over technique.'' We herein demonstrated that the upper mediastinal lymph nodes, including the 106tbL nodes, can be dissected using the bilateral transcervical and transhiatal

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Postresectional pulmonary oxidative stress in lung cancer patients. The role of one-lung ventilation

Cited by 156 publications

References 23 publications

Nonintubated Videothoracoscopic Operations in Thoracic Oncology

Nonintubated Videothoracoscopic Operations in Thoracic Oncology

Technical details of video‐assisted transcervical mediastinal dissection for esophageal cancer and its perioperative outcome

Mediastinoscopic Subaortic and Tracheobronchial Lymph Node Dissection With a New Cervico-Hiatal Crossover Approach in Thiel-Embalmed Cadavers

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