Thoracoscopic lobectomy through the pulmonary hilum approach for the treatment of congenital lung malformation

Zhang, Yimao; Xin, Wenqiong; Xu, Chang; Miao, Yuan; Yang, Gang; Cheng, Kaisheng; Luo, Dengke

doi:10.1007/s00464-021-08339-8

Cited by 9 publications

(5 citation statements)

References 33 publications

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“…To achieve the required level of analgesia during the surgery under GA, higher doses of anesthetic drugs are needed, which may increase the risk of respiratory inhibition, reduce the quality of recovery, and affect postoperative rehabilitation. 12 TPVB is based on the injection of local anesthetics in the proximity of the spinal nerve in the intervertebral disc space. Local anesthetics can inhibit the inward flow of Na + and K + in the nerve cell membrane, block the pain signal transmission, block somatic and sympathetic nerves, temporarily block the nerve excitation function of this segment, and inhibit the neurogenic stress response and pain sensation.…”

Section: Discussionmentioning

confidence: 99%

Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia

Zeng,

Zhang,

Huang

et al. 2023

Pak J Med Sci

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Objective: To investigate the analgesic effect of thoracic paravertebral block (TPVB) in patients undergoing thoracoscopic lobectomy under general anesthesia (GA). Methods: Clinical records of 82 patients who underwent thoracoscopic lobectomy under GA from October 2021 to October 2022 in the General Hospital of Southern Theater Command were retrospectively analyzed. The patients were divided into two groups according to the method of anesthesia used: general anesthesia group (Group-G, n=37), and TPVB plus GA group (Group-T, n=45). The analgesic effect, mean arterial pressure (MAP), heart rate (HR) and the rate of adverse events in both groups were compared. Results: Visual analogue scale (VAS) scores of patients in Group-T at 12h, 24h and 48h after the operation were significantly lower compared to Group-G (P<0.05). MAP and HR the time of tracheal intubation induction (T1), single lung ventilation (T2), skin incision (T3), operation completion (T4), and 20 minutes after the extubation (T5) were lower in both groups compared to T0, and were significantly higher in Group-T compared to Group-G (P<0.05). The rate of adverse events in Group-T was 6.67%, significantly lower compared to Group-G (24.32%) (P<0.05). Conclusions: TPVB combined with GA can improve the analgesic effect, improve MAP and HR during the operation, and reduce the incidence of adverse events in patients undergoing thoracoscopic lobectomy. doi: https://doi.org/10.12669/pjms.39.6.7937 How to cite this: Zeng W, Zhang J, Huang L, Tang Z. Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7937 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia

Zeng,

Zhang,

Huang

et al. 2023

Pak J Med Sci

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“…Average operation time was longer than for conventional open surgery, but hospital stay was shorter (2-8 days). During thoracoscopic lobectomy, Rothenberg et al [50] reported bleeding (2.67%), air leak (2.67%) and infection (4%); Boubnova et al [51] reported air leak (6.25%) and phrenic nerve injury (6.25%); Zhang et al [52] reported conversion to open (0.7%); Rothenberg et al [50] reported air leak (0.9%) and conversion to open (1.0%); Seong et al [53] reported bleeding (2.7%), air leak (5.4%) and conversion to open (23.0%). Congenital lobar emphysema, congenital pulmonary adenomatoid malformation, and pulmonary sequestration are among congenital disorders for which lobectomy is indicated; lobectomy for malignant tumors is infrequently done [54,55].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Thoracoscopy: Ten Years Experience in Tertiary Hospital

Alharbi,

Almatrfi,

Bawazir

2023

IJPS

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Purpose: A minimally invasive Thoracoscopic Surgery (TS) offers several options in diagnosis and surgical treatment in pediatric surgery. This study evaluates experience and outcome of thoracoscopic surgery in pediatrics during 10 years period in tertiary hospital. Patients and methods: This retrospective study conducted at King Faisal Hospital and Research Center, Jeddah, Saudi Arabia from 2012 to 2022. Data of 43 patients who underwent TS were enrolled. Data include patient’s demographic characteristics, co-morbidity, diagnosis, type of thoracoscopic procedures, time of intervention, length of hospital stay, post-operative complications. Results: Mean age of patients was 4.99 years. Females were more than males (55.8 vs. 44.2%). Sixteen (37.2%) patients had comorbidities. Thoracoscopic proce- dures were feasible in 43 children and adolescents with chest diseases including lung empyema (20.9%), congenital lobar emphysema (14.0%), interstitial lung disease (14.0%), congenital pulmonary airway malformation (11.6%), mediastinal mass (9.3%), lung metastasis (11.6%), lymphoma (4.7%), chronic inflamma- tions (7.0%), hemothorax (2.3%), bronchogenic cyst (2.3%), pleural effusion (2.3%) and pulmonary sequestration and right diaphragmatic hernia (2.3%). Proce- dures were made mostly for lung biopsy (25.0%), lobectomy (22.7%), decortication (20.9%), mediastinum mass resection (6.8%), lung metastasectomy (6.8%), lymph node biopsy (4.5%), diagnostic (4.6%), cyst excision (4.6%), diaphragmatic hernia repair (2.3%) and thymectomy (2.3%). Duration of hospital stay ranged from 2-180 days. All of the cases had chest drain (100.0%) and some of them required post-operative intubations (30.2%). Conversion rate to open was (4.7%). Complications were pneumothorax (7.0%), bleeding (2.3%) and air leak (2.3%). Conclusions: Thoracoscopic approach is a challenging method for diagnosis and treatment in pediatrics. However, complications were reported as pneumo- thorax, bleeding and air leak. In order to improve results, conversion rates, and the capacity to handle thoracoscopic complications, proper training is crucial.

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“…All surgeons had more than eight years of experience in thoracoscopic resection, and the thoracoscopic approach was conventionally treated with all CLMs patients. We chose the pulmonary hilum approach, and the detailed operation methods were reported in our previous study [ 15 ]. The lesions involved were characterized as single lobe, double lobes, and triple lobes, confirmed by preoperative CT scan and thoracoscopic visualization.…”

Section: Methodsmentioning

confidence: 99%

Previous pulmonary infection impacts thoracoscopic procedure outcomes in patients with congenital lung malformations: a retrospective cohort study

et al. 2023

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Background and objectives Patients with congenital lung malformations (CLMs) are at high risk for developing pulmonary infection. Nonetheless, prophylactic surgical excision of asymptomatic CLMs is controversial and often delayed to symptoms occurring out of concern for potential operative risks. This study aims to evaluate the impact of previous pulmonary infection on the outcome of thoracoscopic procedures in CLMs patients. Methods This was a retrospective cohort study of CLMs patients who received an elective operation at a tertiary care center from 2015 to 2019. Patients were divided into pulmonary infection (PI) or non-infection of pulmonary (NPI) groups according to the history of pulmonary infection. Propensity score matching was used to minimize the bias between groups. The primary outcome was conversion to thoracotomy. Postoperative outcomes were compared between patients with and without PI. Results We identified 464 patients, of whom 101 had a history of PI. Propensity score matching yielded a well-balanced cohort of 174 patients. PI was associated with higher conversion to thoracotomy (adjusted odds ratio = 8.7, 95% confidence interval, CI, 1.1–71.2, p = 0.039), blood loss (p = 0.044), and longer operative time (p < 0.001), chest tube placement time (p < 0.001), length of stay (p < 0.001), and postsurgical length of stay (p < 0.001). Conclusions Elective operation in CLMs patients with a history of PI was associated with an increased risk of conversion to thoracotomy, operative time, blood loss, chest tube placement time, length of stay, and postsurgical length of stay. Elective thoracoscopic procedures in asymptomatic CLMs patients are safe and effective, and earlier surgical intervention may be warranted.

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Thoracoscopic lobectomy through the pulmonary hilum approach for the treatment of congenital lung malformation

Cited by 9 publications

References 33 publications

Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia

Analgesic effect of thoracic paravertebral block on patients undergoing thoracoscopic lobectomy under general anesthesia

Pediatric Thoracoscopy: Ten Years Experience in Tertiary Hospital

Previous pulmonary infection impacts thoracoscopic procedure outcomes in patients with congenital lung malformations: a retrospective cohort study

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