Tubeless video-assisted thoracoscopic surgery in mediastinal tumor resection

Cui, Weixue; Huang, Danxia; Liang, Hengrui; Peng, Guilin; Li, Mengyang; Xu, Xin; He, Jianxing

doi:10.21037/gs-20-682

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Nonetheless, a larger-sized tube was often placed in the incision, increasing the risk of poor wound healing. With the deepening concept of rapid rehabilitation and the development of thoracoscopy technology as well as Subxiphoid uniportal VATS [ 28 , 29 ], the use of two 10 F pigtail tubes instead of the traditional larger-sized tube [ 30 ], as well as exploration of tubeless thoracoscopic surgery without endotracheal intubation and no chest drainage tube after surgery, has proven to be safe and feasible in a specific selected patient population [ 31 – 35 ]. However, this approach has limitations.…”

Section: Discussionmentioning

confidence: 99%

Experience of a modified chest tube suture-fixation technique in uniportal thoracoscopic pulmonary resection

Shi

Wang

et al. 2023

BMC Surg

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Objective This study aimed to explore the feasibility and advantages of a modified chest tube suture-fixation technique in uniportal video-assisted thoracic surgery for pulmonary resection. Methods A retrospective analysis was conducted on 116 patients who underwent uniportal video-assisted thoracic surgery (U-VATS) for lung diseases in Zhengzhou People’s Hospital between October 2019 and October 2021. Patients were stratified into two groups based on the applied suture-fixation methods, i.e., 72 patients in the active group and 44 patients in the control group. The two groups were subsequently compared in the terms of gender, age, operation method, indwelling time of chest tube, postoperative pain score, chest tube removal time, wound healing grade, length of hospital stay, incision healing grade, and patient satisfaction. Results There was no significant difference between the two groups in terms of gender, age, operation method, indwelling time of chest tube, postoperative pain score, and length of hospital stay (P = 0.167, 0.185, 0.085, 0.051, 0.927, and 0.362, respectively). However, the chest tube removal time, incision healing grade, and incision scar satisfaction in the active group were significantly better compared with those of the control group (P = < 0.001, 0.033, and < 0.001, respectively). Conclusion In summary, the new suture-fixation approach can minimize the number of stitches, and time necessary for chest tube removal process, and avoid the pain experienced when removing the drainage tube. This method is more feasible, has better incision conditions, and provides a convenient tube removal, making it more suitable to patients.

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Section: Discussionmentioning

confidence: 99%

Experience of a modified chest tube suture-fixation technique in uniportal thoracoscopic pulmonary resection

Shi

Wang

et al. 2023

BMC Surg

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“…With the favorable magnification and lighting functions of the endoscope, the tumors can be removed more thoroughly and with less trauma, more rapid recovery, and a more reliable effect. [12][13][14][15][16] However, the application of three-port thoracoscopy under the xiphoid process to assist the performance of a cervical incision in the treatment of upper mediastinal lymph node metastasis of thyroid cancer has rarely been reported. In this case, preoperative enhanced CT of the neck showed that the lymph nodes in stations VI and VII of the left neck were fused into a mass, deeply positioned, and closely adhered to the left innominate vein.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Jie

Meng

2022

J Int Med Res

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Advanced thyroid cancer with upper mediastinal lymph node metastasis is not rare in the clinical setting. For patients with severe metastasis, a thoracocervical incision is usually performed for dissection of lymph nodes. However, the difficult operation of three-port thoracoscopy to support performance of a cervical incision in the treatment of upper mediastinal lymph node metastasis has rarely been reported to date. We herein describe a case involving the treatment of thyroid cancer with upper mediastinal lymph node metastasis. The lymph node metastasis was severe, closely adhered to the innominate vein, and fused into a mass. Thoracoscopy with a cervical incision was performed and proved to be a highly difficult surgical maneuver. The patient recovered quickly after the operation. Repeat computed tomography showed no swollen metastatic lymph nodes, indicating that the dissection was thorough. Thoracoscopy with a neck incision is more difficult than conventional longitudinal split sternotomy in the treatment of upper mediastinal lymph node metastasis, but its advantages are less severe trauma and faster recovery. This procedure may be performed by surgeons with proficient skill in cervical surgery and thoracoscopy techniques.

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“…After adequate hemostasis, one drainage tube (24Fr) was inserted into the mediastinum in most patients, especially in patients who underwent concomitant resection. Chest tubes were not placed after surgeries in some patients from both groups based on the enhanced recovery after surgery (ERAS) protocol [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Robot versus video-assisted thoracoscopic thymectomy for large thymic epithelial tumors: a propensity-matched analysis

Zhu,

Zhang,

Zuo

et al. 2023

BMC Surg

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Background Both video-assisted thoracoscopic surgery (VATS) thymectomy and robot-assisted thoracoscopic surgery (RATS) thymectomy have been suggested as technically sound approaches for early-stage thymic epithelial tumors. However, the choice of VATS or RATS thymectomy for large and advanced thymic epithelial tumors remains controversial. In this study, the perioperative outcomes of VATS and RATS thymectomy were compared in patients with large thymic epithelial tumors (size ≥5.0 cm). Methods A total of 113 patients with large thymic epithelial tumors who underwent minimally invasive surgery were included. Sixty-three patients underwent RATS, and 50 patients underwent VATS. Patient characteristics and perioperative variables were compared. Results Compared with the VATS group, the RATS group experienced a shorter operation time (median: 110 min vs.130 min; P < 0.001) and less blood loss (30.00 ml vs. 100.00 ml, P < 0.001). No patients in the RATS group needed conversion to open surgery, but in the VATS series, five patients required conversion to open procedures (0% vs. 14.29%, P = 0.054). The rate of concomitant resection in the RATS group was similar to that in the VATS group (11.43% vs. 5.71%; P = 0.673). There was no significant difference between the two groups in the duration of chest tube (P = 0.587), postoperative complications (P = 1.000), and the duration of postoperative hospital stay (P = 0.141). Conclusion For large thymic epithelial tumors, RATS thymectomy can be performed safely and effectively in a radical fashion. Due to the advanced optics and precise instrument control, concomitant resections can be easily achieved in larger thymic epithelial tumors using the robotic approach.

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Tubeless video-assisted thoracoscopic surgery in mediastinal tumor resection

Cited by 4 publications

References 16 publications

Experience of a modified chest tube suture-fixation technique in uniportal thoracoscopic pulmonary resection

Experience of a modified chest tube suture-fixation technique in uniportal thoracoscopic pulmonary resection

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Robot versus video-assisted thoracoscopic thymectomy for large thymic epithelial tumors: a propensity-matched analysis

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