Uniportal right upper video-assisted thoracoscopic surgery lobectomy: safe and feasible

Perna, Valerio; Torrecilla, Juan Antonio; Carvajal, Angel F.; Mora, Luís Carlos; Gigirey, Orlando; Cano, Paulo; Perello, Silvia; Diaz, Rosa

doi:10.21037/jovs.2016.09.04

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Thoracoscopic techniques evolved rapidly due to promising clinical results concerning postoperative pain and perioperative morbidity (11). Advanced instruments and growing surgical experience allowed surgeons to reduce the required incisions (from 3-Port to uniportal) and to resect larger and more centrally located malignancies minimal invasively (12,13). It is a logical and expected advance in thoracic surgery that video-assisted thoracoscopic surgery (VATS) would be ultimately used also for complex bronchial resections.…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery (VATS) sleeve resections for non-small cell lung cancer patients: an observational prospective study and technique analysis

Koryllos¹,

Stoelben²

2018

J. Vis. Surg.

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Bronchus sleeve resection for operative treatment of non-small cell lung cancer (NSCLC) is a gold standard in modern thoracic surgery in cases of centrally located tumors or hilär lymph node metastases. Advanced instruments and growing surgical experience allowed surgeons to reduce the required incisions (from 3-port to uniportal) and to resect larger and more centrally located malignancies minimal invasively. It is a logical and expected advance in thoracic surgery that video-assisted thoracoscopic surgery (VATS) would be ultimately used also for complex bronchial resections. We therefore present in this study our early clinical results and technique of uniportal sleeve resections for patients with centrally located NSCLC or carcinoids. In the period 2015-2017, n:40 patients with NSCLC were found eligible for uniportal VATS sleeve resection in our institution. In two cases a thoracotomy conversion because of severe hilar scar tissue was necessary. In 38 cases a uniportal VATS sleeve resection could be completed. We believe that uniportal sleeve resections are the logical evolution of VATS allowing patients with locally advanced malignancies to have quicker recovery and reduced perioperative pain.

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Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery (VATS) sleeve resections for non-small cell lung cancer patients: an observational prospective study and technique analysis

Koryllos¹,

Stoelben²

2018

J. Vis. Surg.

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Local anesthetic dosing and toxicity of adult truncal catheters: a narrative review of published practice

Bungart

Joudeh

Fettiplace

2023

Reg Anesth Pain Med

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Background/importanceAnesthesiologists frequently use truncal catheters for postoperative pain control but with limited characterization of dosing and toxicity.ObjectiveWe reviewed the published literature to characterize local anesthetic dosing and toxicity of paravertebral and transversus abdominis plane catheters in adults.Evidence reviewWe searched the literature for bupivacaine or ropivacaine infusions in the paravertebral or transversus abdominis space in humans dosed for 24 hours. We evaluated bolus dosing, infusion dosing and cumulative 24-hour dosing in adults. We also identified cases of local anesthetic systemic toxicity and toxic blood levels.FindingsFollowing screening, we extracted data from 121 and 108 papers for ropivacaine and bupivacaine respectively with a total of 6802 patients. For ropivacaine and bupivacaine, respectively, bolus dose was 1.4 mg/kg (95% CI 0.4 to 3.0, n=2978) and 1.0 mg/kg (95% CI 0.18 to 2.1, n=2724); infusion dose was 0.26 mg/kg/hour (95% CI 0.06 to 0.63, n=3579) and 0.2 mg/kg/hour (95% CI 0.06 to 0.5, n=3199); 24-hour dose was 7.75 mg/kg (95% CI 2.1 to 15.7, n=3579) and 6.0 mg/kg (95% CI 2.1 to 13.6, n=3223). Twenty-four hour doses exceeded the package insert recommended upper limit in 28% (range: 17%–40% based on maximum and minimum patient weights) of ropivacaine infusions and 51% (range: 45%–71%) of bupivacaine infusions. Toxicity occurred in 30 patients and was associated with high 24-hour dose, bilateral catheters, cardiac surgery, cytochrome P-450 inhibitors and hypoalbuminemia.ConclusionPractitioners frequently administer ropivacaine and bupivacaine above the package insert limits, at doses associated with toxicity. Patient safety would benefit from more specific recommendations to limit excessive dose and risk of toxicity.

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Uniportal right upper video-assisted thoracoscopic surgery lobectomy: safe and feasible

Cited by 2 publications

References 14 publications

Uniportal video-assisted thoracoscopic surgery (VATS) sleeve resections for non-small cell lung cancer patients: an observational prospective study and technique analysis

Uniportal video-assisted thoracoscopic surgery (VATS) sleeve resections for non-small cell lung cancer patients: an observational prospective study and technique analysis

Local anesthetic dosing and toxicity of adult truncal catheters: a narrative review of published practice

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