The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Jing Wang - One of the best experts on this subject based on the ideXlab platform.
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video assisted thoracoscopic surgery sleeve lobectomy with Bronchoplasty an improved operative technique
European Journal of Cardio-Thoracic Surgery, 2013Co-Authors: Jing WangAbstract:OBJECTIVES: We summarize our experiences of video-assisted thoracoscopic surgery (VATS) sleeve lobectomy with Bronchoplasty for non-small-cell lung cancer and discuss the indications and technical details of the operation. METHODS: From September 2011 to December 2012, 15 patients underwent VATS sleeve lobectomy with Bronchoplasty at our institution (right upper lobe 10, right middle and lower lobes 1, left lower lobe 2 and left upper lobe 2), with mediastinal lymphadenectomy. Three incisions were utilized. The utility incision was made at the fourth intercostal space, anterior axillary line. Simple continuous and simple interrupted suturing of the membranous and cartilaginous portions of the bronchus were performed for the anastomosis. RESULTS: All procedures were uneventful, with a median operative time of 165 min, a median bronchial anastomosis time of 44 min and a median blood loss of 150 ml. There were no conversions to thoracotomy. There were 14 squamous carcinomas and 1 adenocarcinoma. All patients recovered well, and 1 experienced a minor complication. The median duration of chest tube drainage was 5.4 days, and the median length of hospital stay was 7 days. All patients were followed postoperatively for a range of 1-16 months without tumour recurrence. CONCLUSIONS: VATS sleeve lobectomy with Bronchoplasty is safe and effective. The utility incision placed at the fourth intercostal space, anterior axillary line, is convenient for the anastomosis, and the suturing technique is expeditious and secure. Preserving the azygos vein does not compromise exposure for the anastomosis. This technique is very suitable for centrally located lung cancers <3 cm in diameter, particularly when the cancers are located within the brachial lumen.
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video assisted thoracoscopic surgery sleeve lobectomy with Bronchoplasty
World Journal of Surgery, 2013Co-Authors: Jing WangAbstract:We review our experiences with video-assisted thoracoscopic surgery (VATS) sleeve lobectomy with Bronchoplasty for NSCLC. The safety, effectiveness, indications, and operation precautions of this approach were examined. From September 2011 to September 2012, 11 patients underwent VATS sleeve lobectomy with Bronchoplasty in our hospital (right upper lobe = 8, left lower lobe = 2, left upper lobe = 1). The operation consisted of VATS anatomic sleeve lobectomy with Bronchoplasty combined with systematic lymph node dissection. Three incisions were made. Bronchial anastomosis was combined with simple continuous suture anastomosis of the membranous part of the bronchus and simple interrupted suture anastomosis of the cartilaginous part of the bronchus. All procedures went uneventfully. Median operative time was 178 min; median bronchial anastomosis time was 42 min; median blood loss was 180 ml. There was no case of conversion to thoracotomy. Pathological examination showed 10 squamous cell carcinomas and 1 adenocarcinoma. All patients recovered well, except one who suffered minor complications. Median postoperative chest tube drainage duration was 6.8 days, and median hospital stay was 8.9 days. All patients were followed up for 2–13 months without recurrence. Video-assisted thoracoscopic surgery sleeve lobectomy with Bronchoplasty is a safe and effective surgical approach in the treatment of non-small cell lung cancer. The operating incision placed at the 4th intercostal space on the anterior axillary line is convenient for anastomosis our experience shows that anastomosis combining simple continuous suture of the membranous part of bronchus and simple interrupted suture anastomosis of the cartilaginous part of the bronchus is fast and secure. Moreover, preserving the azygos vein does not affect the anastomosis.
Kozo Nakanishi - One of the best experts on this subject based on the ideXlab platform.
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video assisted thoracic surgery lobectomy with Bronchoplasty for lung cancer initial experience and techniques
The Annals of Thoracic Surgery, 2007Co-Authors: Kozo NakanishiAbstract:Background Many surgeons think video-assisted thoracic surgery is too complex to be applied to Bronchoplasty; therefore, our institution tried to develop some safe and reliable techniques for video-assisted thoracic surgery Bronchoplasty. Methods One hundred thirty-four patients with lung cancer underwent curative video-assisted thoracic surgery lobectomy including mediastinal dissection at Iizuka hospital between October 2001 and September 2006. Five of these patients underwent radical lung lobectomy with Bronchoplasty using video-assisted thoracic surgery. A minithoracotomy was performed at the lateral chest wall to place sutures around the bronchi. A continuous suture was placed at the median wall of the bronchi in cases of circumferential reconstruction, and shortened rubber tubes and silk suture lines were used for assisting with reconstruction. Results One patient with right lung carcinoma was treated with sleeve resection of the right main bronchus, whereas the others were treated with wedge resection. In one case, chylothorax was seen as a postoperative complication. There were no serious complications related to Bronchoplasty. All cases are alive without any recurrence during follow-up. Conclusions The importance of position of minithoracotomy and another access port, management of sutures, and the secure tightened method was assessed. There were no serious postoperative complications. Video-assisted thoracic surgery Bronchoplasty is a complex procedure, but it can safely be performed using some additional techniques.
Thirugnanam Agasthian - One of the best experts on this subject based on the ideXlab platform.
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video assisted thoracoscopic Bronchoplasty
Journal of Visceral Surgery, 2017Co-Authors: Thirugnanam AgasthianAbstract:Video-assisted thoracoscopic surgery (VATS) Bronchoplasty is an advanced VATS technique requiring experience in endoscopic sewing, tying and suturing techniques reserved for cancers arising from central airways. There are three main types of Bronchoplasty depending on the extent of cancer involvement of the bronchus. In this paper the author describes his experience with different types of Bronchoplasty with case and video illustrations.
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initial experience with video assisted thoracoscopic Bronchoplasty
European Journal of Cardio-Thoracic Surgery, 2013Co-Authors: Thirugnanam AgasthianAbstract:Objectives Bronchial-origin involvement by endobronchial tumours or direct invasion by tumour or metastatic lymph nodes is a relative contraindication for video-assisted thoracoscopic (VATS) lobectomy. However, selected cases can be resected by VATS Bronchoplasty. Methods Between 2006 and 2009, 21 of 231 (9.1%) VATS lobectomy cases underwent VATS Bronchoplasty. Cases with endobronchial involvement and limited non-bulky invasion of bronchus by tumour or metastatic nodes without major vascular invasion were selected for Bronchoplasty by preoperative bronchosocpy and CT scan thorax. Patients underwent a simple/wedge Bronchoplasty (bronchus divided at origin and closed flush or transversely), sleeve Bronchoplasty or others (Bronchoplasty combined with other extended resections). All bronchoplasties were done totally endoscopically by directly watching a TV monitor. Bronchial margins were all subjected to intraoperative pathological analysis. Anastomosis was done with interrupted sutures. Integrity of anastomosis was checked by intraoperative bronchoscopy. The follow-up was done by 6-monthly CT scans and bronchoscopy. Results Eleven patients were females. Mean age was 64.9 years (range, 47-83 years). Indications were endobronchial tumours in 3, direct invasion in 6 and metastatic nodes in 12. In 4 cases, invasion was detected at the time of surgery. Mean hospital stay was 5.2 days (range, 3-8 days). Mean duration of surgery was 287 min (range, 135-540 min). Nine had simple/wedge Bronchoplasty, 8, sleeve Bronchoplasty and 4, extended bronchoplasties. Histology was non-small-cell carcinoma (NSCLC) in 19, carcinoid in 1 and colonic metastasis in 1. In the NSCLC, 5 patients were in stage IB, 5 in stage IIA, 2 in stage IIB and 7 were in IIIA. All bronchial margins were negative for malignancy. The mean follow-up was 26.2 months (range, 6-32 months). There was no operative mortality, but 1 patient developed bronchopleural fistula. To date, there have been no local tumour recurrences. Conclusions Selected endobronchial and non bulky tumours with limited invasion at bronchial origin can be resected by VATS Bronchoplasty.
Noriaki Tsubota - One of the best experts on this subject based on the ideXlab platform.
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Bronchoplasty for bronchial carcinoid tumor without removing lung parenchyma
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2006Co-Authors: Kazuya Uchino, Takeshi Mimura, Morihito Okada, Toshihiko Sakamoto, Tsuyoshi Yuki, Noriaki TsubotaAbstract:A 15-year-old boy was admitted with a pneumothorax of the left lung. Computed tomographic scans demonstrated a tumor 20 mm in diameter situated on the left main to upper lobar bronchus that eventually was proved to be a typical carcinoid tumor by transbronchial biopsy. We performed bronchial resection with atypical Bronchoplasty, which preserves lung parenchyma in cases of s-T1N0M0 disease. The patient has had no evidence of recurrence 7 years after surgery.
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Bronchoplasty at the level of the segmental bronchus.
Seminars in thoracic and cardiovascular surgery, 2006Co-Authors: Noriaki TsubotaAbstract:The efficacy of anastomosis including the segmental bronchus performed in Hyogo Medical Center was reviewed. There were 18 patients with anastomosis of segmental bronchi (group 1), 14 patients with anastomosis between the upper, lingular, or basal segmental bronchus and main bronchus, avoiding pneumonectomy (group 2), and a miscellaneous group (group 3). Patients in group 1 had early-stage lung cancer or low-grade malignant tumors, whereas those in group 2 had advanced hilar tumors. Though technical requirements for these operations are higher than for typical Bronchoplasty, they provide better quality of life postoperatively and reasonably good outcomes without increasing morbidity. The specialist in general thoracic surgery must make every effort to avoid excessively large resection of lung tissue such as lobectomy or pneumonectomy.
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hybrid surgical approach of video assisted minithoracotomy for lung cancer significance of direct visualization on quality of surgery
Chest, 2005Co-Authors: Morihito Okada, Takeshi Mimura, Toshihiko Sakamoto, Tsuyoshi Yuki, Kei Miyoshi, Noriaki TsubotaAbstract:Study objectives Controversy regarding the most suitable surgical approach for treating malignancies of the lung is a matter of continuous discussions. “Complete” video-assisted thoracic surgery (VATS) that is performed using only the vision of a monitor is generally limited to lung resections of minimal difficulty. With the great interest in minimally invasive techniques for treating various pathologies, we have widely applied an integrated surgical approach that combines muscle-sparing minithoracotomy (incision, 4 to 10 cm) and video assistance using mainly direct visualization of the lung resection, which we have called hybrid VATS . The aim of this study is to evaluate the usefulness of hybrid VATS. Design Retrospective single-center study. Interventions From January 1998 to October 2004, 405 of 678 lobectomies (60%) and 165 of 226 segmentectomies (73%) were performed for primary lung cancer using hybrid VATS. Results Bronchoplasty was performed in 93 of the 678 patients (14%) who underwent lobectomy and in 11 of the 226 patients (5%) who underwent segmentectomy. Hybrid VATS was utilized in 33% of sleeve lobectomy procedures and in 27% of sleeve segmentectomy procedures. The mean (± SD) surgical time using hybrid VATS was 164 ± 48 min for lobectomy and 158 ± 35 min for segmentectomy, and the mean blood loss was 166 ± 120 and 109 ± 80 mL, respectively. There was one operative mortality (0.2%) secondary to cardiogenic shock. Postoperative complications developed in 11% of patients with p-stage IA disease after undergoing hybrid VATS, in contrast to 19% of patients after undergoing open thoracotomy. The prognosis of patients treated by hybrid VATS was equivalent to that obtained with open thoracotomy. Conclusions Minithoracotomy combined with video support that is performed predominantly via direct visualization is a secure, integrated, minimally invasive approach to performing major resection for lung cancer, including atypical procedures such as Bronchoplasty. This hybrid VATS can be an acceptable and satisfactory option whenever the performance of complete VATS is considered to be challenging.
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atypical Bronchoplasty to lung cancer and benign bronchial disease
Tohoku Journal of Experimental Medicine, 1994Co-Authors: Noriaki Tsubota, Masahiro Yoshimura, Akihiro Murotani, Yoshifumi Miyamoto, Yasumi MatobaAbstract:TSUBOTA, N., YOSHIMURA, M., MUROTANI, A., MIYAMOTO, Y, and MATOBA, Y. Atypical Bronchoplasty to Lung Cancer and Benign Bronchial Disease. Tohoku J. Exp. Med., 1994, 172 (3), 209-220-Twenty-one cases of atypical bronchplasty were selected from a series of 125 tracheobronchoplastic procedures by the same surgeon between 1979 and 1993 and were reviewed to assess the indications and technical problems. The procedures were classified as follows: Type A (3 cases) was anastomosis between the right main and lower bronchi with upper and middle lobe resection. Type B (4 cases) was anastomosis between the left main and upper segmental bronchi with resection of the lower lobe and lingula or between the left main bronchus and the basal bronchus with resection of the upper lobe and superior segment of the lower lobe. Type C (5 cases) was resection of the right lateral wall of the trachea with various types of lung resection. Type D (4 cases) was sleeve segmentectomy. Type E (2 cases) was bronchial reconstruction without lung resection. Type F (3 cases) was miscellaneous procedures. All these procedures except one achieved favorable results. It is emphasized that lung-preserving surgery must always be considered under strict observation using frozen section study, even if an unusual procedure is required. If lung tissue has to be resected, as little as possible should be removed.
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one hundred and one cases of Bronchoplasty for primary lung cancer
Surgery Today, 1994Co-Authors: Noriaki Tsubota, Akihiro Murotani, Yoshifumi Miyamoto, Masahiro Myoshimura, Yasumi MatobaAbstract:The results of 101 consecutive bronchoplasties performed between 1979 and 1993, including 8 cases of pneumonectomy, 88 cases of lobectomy, 3 cases of segmentectomy, and 2 cases of bronchial resection, are herein reported. Squamous cell carcinoma was the most common disease (59%) followed by adenocarcinoma (30%) and other diseases (11%). Anastomosis was satisfactory in 96 cases. Among the five stenosed cases, local recurrence was found in two cases, and there were three benign strictures. Two of the three benign strictures were treated with bouginage. The pulmonary artery was concomitantly reconstructed in seven cases with satisfactory results. Preoperative chemoradiotherapy was performed in 15 advanced cases and was followed by acceptable surgical results. The 5-year survival rate, according to the post-operative staging of the 86 patients without induction therapy, was 86% in stage I (19 patients), 49% in stage II (21 patients), and 27% in stage IIIA (40 patients). The overall survival rate was 46% at 5 years. There were two indications for this procedure i.e., a positive resection margin in 59 cases and positive hilar nodes in 42 cases. Better survival was noted in patients with squamous cell carcinoma, stage I, and surgery was thus selected for a positive resection margin, and not for a positive node.
Atul C Mehta - One of the best experts on this subject based on the ideXlab platform.
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suffocation from balloon Bronchoplasty
Journal of bronchology & interventional pulmonology, 2018Co-Authors: Jorge L Moralesestrella, Michael Machuzak, Bohdan Pichurko, Hanine Inaty, Atul C MehtaAbstract:Negative pressure pulmonary edema is a well-described complication of upper airway obstruction. However, the simultaneous occurrence of blood-stained secretions and petechial tracheobronchial hemorrhage are rarely recognized and a potential complication of transient intentional occlusion of the airways. We described a case of "hemorrhagic bronchial mucosa syndrome" and asymptomatic blood-tinged pulmonary edema after balloon Bronchoplasty for a concentric tracheal stenosis using a flexible bronchoscopy. This was characterized by interval appearance of diffuse petechial tracheobronchial bleeding and a persistent blood-tinged alveolar effluent after sustained occlusion of the airway. The simultaneous occurrence of both phenomena in this patient suggests different degrees of injury in a common pathogenic spectrum. We postulate that sustained, complete occlusion of the airway produces variable degrees of mechanical disruption of the bronchial and alveolar vasculature that lead to the development of negative pressure pulmonary edema and tracheobronchial hemorrhage. In this case, the syndrome was self-limited and without major consequences but highlights an unrecognized potential complication of balloon Bronchoplasty.
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airway interventions in the tracheobronchial tree
Seminars in Respiratory and Critical Care Medicine, 2008Co-Authors: Erik Folch, Atul C MehtaAbstract:The field of interventional pulmonary medicine is a relatively new area in pulmonary medicine resulting from the technological advances, as well as the increasing need for palliative and curative treatment modalities for patients with tracheobronchial, parenchymal, and pleural disease. This article reviews the advances in endoscopic techniques aimed to the tracheobronchial tree, including foreign body removal, laser photoresection, electrosurgery, argon-plasma coagulation (APC), photodynamic therapy, cryotherapy, balloon Bronchoplasty, stent placement, brachytherapy, bronchial thermoplasty, transtracheal oxygen catheter placement, as well as treatment of airway complications after lung transplantation.
