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Related Concept Videos

Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Author Spotlight: Expanding Interventional Pulmonology Research with Robotic-Assisted Bronchoscopy
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Algorithm-based troubleshooting to manage bleeding during thoracoscopic anatomic pulmonary resection.

Hitoshi Igai1, Mitsuhiro Kamiyoshihara1, Ryohei Yoshikawa1

  • 1Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, 389-1 Asakura-cho, Maebashi, Gunma 371-0811, Japan.

Journal of Thoracic Disease
|January 7, 2020
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Summary

Intraoperative vessel injury during thoracoscopic anatomic pulmonary resection is manageable with appropriate hemostasis. Despite potential vascular hazards, this procedure remains safe and feasible, with no significant impact on long-term outcomes.

Keywords:
Algorithmintraoperative bleedingpulmonary resectionthoracoscopytroubleshooting

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Vascular Injury Management

Background:

  • Intraoperative complications, specifically vessel injury, during thoracoscopic anatomic pulmonary resection are not well-documented.
  • This study addresses the impact of intraoperative vessel injury and evaluates management strategies.

Purpose of the Study:

  • To evaluate intraoperative vessel injury during thoracoscopic anatomic pulmonary resection.
  • To assess troubleshooting methods for managing such injuries.
  • To compare perioperative outcomes between patients with and without vessel injury.

Main Methods:

  • Retrospective analysis of 378 patients undergoing thoracoscopic anatomic pulmonary resection (2012-2018).
  • Identification and analysis of 40 patients with intraoperative vessel injury.
  • Comparison of perioperative outcomes and bleeding rates over time.

Main Results:

  • Pulmonary artery branches were the most commonly injured vessels (55%).
  • Thrombostatic sealant was effective for hemostasis in 65% of cases.
  • Patients with vessel injury had longer operation times and blood loss, but similar postoperative hospitalization and morbidity.

Conclusions:

  • Thoracoscopic anatomic pulmonary resection is safe and feasible with proper hemostasis.
  • Vascular hazards are inherent but manageable, irrespective of surgeon experience.
  • Effective management of intraoperative bleeding is crucial for patient outcomes.