Journal of the Egyptian Society of Cardio-Thoracic Surgery最新文献

{"title":"Thoracoscopic versus subxiphoid pericardial window in patients with end-stage renal disease","authors":"Ehab F. Salim ,&nbsp;Moataz E. Rezk","doi":"10.1016/j.jescts.2018.07.002","DOIUrl":"10.1016/j.jescts.2018.07.002","url":null,"abstract":"<div><h3>Background</h3><p>Pericardial effusion is a common problem in patients with end-stage renal disease (ESRD). There are many surgical approaches to perform a pericardial window in those patients. This study compared the safety and efficacy of VATS and subxiphoid approaches in performing a pericardial window for pericardial effusion in patients with ESRD.</p></div><div><h3>Methods</h3><p>From February 2015 to March 2017, a prospective study included a total number of 30 patients of ESRD who were prepared for pericardial window. Patients were randomly divided into two groups: group A (15 patients who underwent VATS pericardial window), and group B (15 patients who underwent subxiphoid pericardial window). Patients were followed-up for 12 months postoperatively.</p></div><div><h3>Results</h3><p>Both procedures were safe and effective in the management of pericardial effusion. Preoperative data showed no significant difference between both groups. In VATS group, there were significant increased operative times (p-value = 0.031) but with a significantly shorter length of hospital stay (p-value = 0.037) when compared to the subxiphoid group. In both groups, no mortality was recorded. Recurrent pericardial effusion was detected in 5 patients (33.3%) in the subxiphoid group while it was detected in 1 patient (6.7%) in VATS group (p-value = 0.169). VATS approach was the independent predictor of freedom from recurrence (hazard ratio: 0.054; p-value = 0.020).</p></div><div><h3>Conclusions</h3><p>VATS is a safe and effective procedure in the management of pericardial effusion in patients with ESRD. VATS approach decreased total length of hospital stay and decreased the incidence of recurrence of pericardial effusion.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 3","pages":"Pages 212-218"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90984135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic diaphragmatic hernia challenging diagnosis and early management","authors":"Mohamed Abdelshafy ,&nbsp;Yusuf S.E. Khalifa","doi":"10.1016/j.jescts.2018.07.001","DOIUrl":"10.1016/j.jescts.2018.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Early diagnosis and management of traumatic diaphragmatic hernia (TDH) can be challenging for the emergency department or the trauma surgeon, as these injuries are often clinically masked by other associated severe injuries.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed data of 50 patients diagnosed with an acute traumatic hernia from September 2014 to September 2017.</p></div><div><h3>Results</h3><p>50 patients were included in this study. Blunt trauma was the main cause in 40 patients (80%) patients. TDH occurred more on the left side; in 72% of patients. The diagnosis was preoperative in 20 patients (40%). In our study, 74% of cases were repaired through abdominal approach and 26% patients through thoracic approach. Complications of TDH occurred in 30 patients (60%) and were mainly pneumonia in 16 patients (32%), only 8 patients (16%) died (6 patients of them had delayed referral and 3 patients of them had severe head injury).</p></div><div><h3>Conclusions</h3><p>TDH may be masked by associated injuries in multiple trauma patients and may lead to life-threatening intestinal and gastric strangulation. So, early diagnosis and treatment of TDH are important. Emergency physicians and trauma surgeon should maintain a high index of suspicion of TDH while dealing with patients assessed for abdominal or respiratory symptoms regardless the history of trauma was recent or delayed.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 3","pages":"Pages 219-227"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91473420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of VATS in thymectomy for non-thymomatous myasthenia gravis","authors":"Ehab F. Salim","doi":"10.1016/j.jescts.2018.05.001","DOIUrl":"10.1016/j.jescts.2018.05.001","url":null,"abstract":"<div><h3>Background</h3><p>There are different surgical techniques used for thymectomy. Each technique has its own advantages and disadvantages. However, using a less invasive approach would provide a better outcome.</p></div><div><h3>Methods</h3><p>From June 2015 to February 2017, a prospective study included a total number of 50 patients of non-thymomatous myasthenia gravis (MG) who were randomly divided into two groups: group A (25 patients who underwent VATS thymectomy), and group B (25 patients who underwent thymectomy via ministernotomy). Efficacy and outcome of both procedures were compared. Patients were followed-up for at least one year postoperatively.</p></div><div><h3>Results</h3><p>Both procedures were safe and effective in the management of MG. There was no significant difference between both groups regarding preoperative data. In VATS group, there were significant decreased operative times (p value = 0.00), significant decreased blood loss (p value = 0.039), significant decreased postoperative respiratory and cardiac complications (p value = 0.025 and 0.018 respectively) and significant shorter length of ICU and hospital stays (p value = 0.039 and 0.007 respectively) when compared to ministernotomy group. There was no statistically significant difference between both groups regarding complete stable remissions and clinical improvement. No mortality was recorded in both groups.</p></div><div><h3>Conclusions</h3><p>Thoracoscopic thymectomy should be the technique of choice in the management of MG. It has better intraoperative and short-term results than that of thymectomy via ministernotomy. However, longer periods of follow-up is needed to evaluate long-term results properly.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 3","pages":"Pages 205-211"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84574259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year outcomes of concomitant mitral reduction annuloplasty repair with coronary artery bypass grafting for moderate ischemic mitral regurgitation","authors":"Medhat Refaie ,&nbsp;Mohammed Alshehri ,&nbsp;Mohamed Sharaa ,&nbsp;Laila A. Elhenawy","doi":"10.1016/j.jescts.2018.03.003","DOIUrl":"10.1016/j.jescts.2018.03.003","url":null,"abstract":"<div><h3>Background</h3><p>Mitral valve repair for chronic ischemic mitral regurgitation (IMR) in the published literature has contradictory outcomes. Here, we report our center outcomes of reduction annuloplasty technique in addition to myocardial revascularization to treat ischemic IMR over a four-year period.</p></div><div><h3>Methods</h3><p>Between January 2011 and December 2014, a total of 40 patients were identified to have a reduced left ventricular ejection fraction who underwent first-time mitral valve reduction annuloplasty concomitantly with coronary artery bypass grafting to treat moderate IMR. Variations in left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), functional class, and mitral regurgitation (MR) was followed up after surgery and retrospectively analyzed.</p></div><div><h3>Results</h3><p>In our cohort, mitral reduction annuloplasty was successful in helping 33 (82%) patients to have no residual MR and to downgrade their MR from moderate (grade 3+) to trace (grade 1+) in 7 (18%) patients before leaving the operating room. A change from baseline value was observed secondary to correction of MR. At 3-months follow-up time; the mean MR grade that was 0.2 ± 0.1 by the intraoperative assessment post-bypass has increased significantly to be 1.8 ± 0.4 (p &lt; 0.05). Similarly, at one year after surgery it increased to 1.9 ± 0.3, p &lt; 0.05, compared to baseline value.</p><p>Remarkably, our patients showed a significant increase in the mean LVEF (48 ± 1.1%, p &lt; 0.05), at 3-month visit and 1-year visit post-surgery (47 ± 4.2%), %, p &lt; 0.05) compared to the baseline values (39 ± 2.3%, p &lt; 0.05 for both visits). While our patients showed gradually but non-significantly reduction in the mean LVESVI (57.6 ± 9.0 ml/m², p &gt; 0.05) at early follow-up time, mean LVESVI improved significantly to be 47.6 ± 11.0 ml/m², p &lt; 0.05 at the one year. This statistically significant increase in the LVEF% at 3-month visit, in addition to the reduction in the LVESVI after one year were capable to induce substantial clinical change in NYHA functional class, which was observed early (at 3-month visit) where 35 (88%) patients became in NYHA class I and II and later (at 1-year visit post-surgery) where 32 (80%) patients stayed in NYHA class I and II.</p><p>No deaths were reported during the one-year follow-up resulting in 95% survival rate. During the one-year follow-up time, 7 (18%) were readmitted to the hospital due to non-cardiac indications.</p><p>Early operative mortality (within 30 days after surgery) was 5%. One-year survival was 95%. The mean duration of follow-up was 1.1 ± 2.4 years (range, 1.0–3.5 years).</p></div><div><h3>Conclusions</h3><p>Mitral reduction annuloplasty concomitant to surgical myocardial revascularization may be sufficient to correct moderate IMR. It is associated with substantial improvement in early and intermediate-term survival rates, left ventric","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 3","pages":"Pages 171-177"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90159532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and mid-term results of aortic valve replacement in patients with severe aortic regurgitation","authors":"Ibrahim Kassab ,&nbsp;Moataz E. Rezk ,&nbsp;Hany E.E. Osman","doi":"10.1016/j.jescts.2018.06.003","DOIUrl":"10.1016/j.jescts.2018.06.003","url":null,"abstract":"<div><h3>Background</h3><p>Aortic regurgitation (AR) represents pressure and volume overload resulting in left ventricular (LV) dysfunction. Poor LV function was shown to be reversible after aortic valve replacement (AVR) which is the only effective treatment. The surgical risk increases in the presence of LV dysfunction. The aim of this study was to determine effect of AVR on LV functions in severe AR.</p></div><div><h3>Methods</h3><p>Sixty patients were included with severe chronic AR with NYHA classes III and IV, diagnosed clinically and by imaging studies as transthoracic echocardiography (TTE) and cardiac catheterization. Patients were followed up postoperatively at regular intervals by TTE examination.</p></div><div><h3>Results</h3><p>TTE values at discharge and 6 months after AVR were compared with pre-operative findings. We found no significant statistical difference between LV functions pre-operatively and at discharge. However, there was statistical improvement in these functions at 6 months post-operatively compared to their values at discharge. ECHO findings of NYHA class III and IV at 6 months post-operatively showed evidence of improvement in LV functions of class III patients while those in class IV didn't show change or even some deterioration in the ECHO findings.</p></div><div><h3>Conclusions</h3><p>LV functions showed mild or no improvement in early follow-up while after 6 months it showed that patients in NYHA class III got benefits more than those in class IV.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 3","pages":"Pages 178-184"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80773533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vacuum assisted closure therapy for poststernotomy mediastinitis: Definitive or bridge to reconstruction","authors":"Yasser Elnahas,&nbsp;Ayman Ammar","doi":"10.1016/j.jescts.2018.04.001","DOIUrl":"10.1016/j.jescts.2018.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Vacuum assisted closure (VAC) system is used to promote granulation tissue formation and hence, wound healing in chronic difficult wounds when all traditional treatment strategies fail. The idea behind the device was introduced in 1997 which is simply putting the wound under continuous and controlled negative suction pressure inducing arteriolar vasodilation and wound stability.</p></div><div><h3>Methods</h3><p>17 patients (with a mean age of 65.8 ± 5.3 years (range 58–79 years) who were diagnosed with poststernotomy mediastinitis after cardiac surgery received VAC system during the course of their treatment. 11patients [64.7%] underwent coronary artery bypass grafting [CABG], 3 [17.6%] mitral valve replacement [MVR], 2 [11.7%], aortic valve replacement and 1 [5.8%]) Bental operation. Total operative time ranged between 145 and 300 min with a mean of 216.7 ± 45.5 min. 7 [41.1%] patients required exploration for mediastinal bleeding.</p></div><div><h3>Results</h3><p>Healing by secondary intention was achieved in 7 [41.2%] patients without the need of any further surgery. In 6 [35.3%] patients, primary closure of the wound in layers could be achieved after discontinuation of the VAC therapy. In the remaining 4 [23.5%] patients, the VAC therapy was considered as a bridge to further reconstruction with pectoral muscle flap. Of the group who received pectoral muscle flap, one [5.88%] patient died.</p></div><div><h3>Conclusions</h3><p>VAC therapy can be considered as good alternative to more aggressive surgery that might not be suitable for some patients during certain times of their treatment course.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 136-140"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81830490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of unfavourable early outcome following Fontan completion","authors":"Amr Ashry ,&nbsp;Ahmed Ghoneim ,&nbsp;Francesco Donatelli ,&nbsp;Alessandro Frigiola ,&nbsp;Ahmed Elminshawy","doi":"10.1016/j.jescts.2018.05.002","DOIUrl":"10.1016/j.jescts.2018.05.002","url":null,"abstract":"<div><h3>Background</h3><p>In spite of the magnificent improvement in Fontan operation results in the last two decades, there are still some concerns regarding the unfavourable early outcomes that may follow Fontan completion.</p></div><div><h3>Methods</h3><p>From 2003 to 2016, 79 patients underwent Fontan operation at IRCCS Policlinico San Donato. Unfavourable early outcome was defined by the presence of one or more of these occurrences: prolonged hospital stay &gt;25 days, prolonged pleural effusion ≥14 days and prolonged inotropic support ≥72 h. Univariable and multivariable analyses were performed to detect the risk factors associated with early unfavourable outcome after Fontan completion.</p></div><div><h3>Results</h3><p>Prolonged hospital stay &gt;25 days was found in 24.05% of patients and its associated significant risk factors were low preoperative O₂ saturation (p 0.007), Fontan fenestration (p 0.009) and plasma transfusion (p 0.030). Prolonged pleural effusion ≥14 days was found in 24.05% and no significant risk factors were detected. Prolonged inotropic support ≥72 h was found in 35.44% and significant risk factors were prolonged cardiopulmonary bypass (CPB) time (P 0.003), fenestration (P 0.023), plasma transfusion (P 0.028) and non staged Fontan (P 0.039). In multivariable analysis of combined unfavourable outcome, significant risk factors were fenestration (P 0.030) with some trends towards low preoperative O₂ saturation (P 0.056).</p></div><div><h3>Conclusions</h3><p>Unfavourable early outcome can occur following Fontan completion with associated prolonged hospital stay. Risk factors include low preoperative O₂ saturation, prolonged CPB time, Fontan fenestration, plasma transfusion and non staged Fontan.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 127-132"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81110806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannulation of innominate artery as an alternative to axillary artery in repair for type A aortic dissection","authors":"Amr Rouchdy,&nbsp;Ahmed Abdelrahaman","doi":"10.1016/j.jescts.2018.05.004","DOIUrl":"10.1016/j.jescts.2018.05.004","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to compare innmoinate artery cannulation with axillary artery cannulation in the setting of repair of acute type A aortic dissection. The primary end point of this study was the difference in neurological complications. The difference in mortality, operative time and limb complications were the secondary end points.</p></div><div><h3>Methods</h3><p>Between January 2014 and January 2016, 30 patients operated upon in Kasr Al-Aini hospitals, Egypt were studied prospectively. All patients underwent repair of ascending aorta ± aortic arch for type A aortic dissection using open clamp technique and antegrade cerebral perfusion. Patients with dissected innominate artery were excluded from this study. Patients were divided randomly into two equal groups. Patients with axillary cannulation were allocated to group A, while patients with innominate artery cannulation were allocated to group B.</p></div><div><h3>Results</h3><p>Bentall operation was done in 6 patients in group A (40%) and 8 patients in group B (53.3%). Tirone David operation was done in 9 patients in group A (60%) and 7 patients in group B (46.6%). The Ischemic time was 147.3 ± 35.1 min in group A versus 138.3 ± 51.9 min in group B with no statistical significance. The operative time was obviously shorter (313.6 ± 23.48min) in the innominate artery group versus 348.3 ± 29.25 min in the axillary artery group with no statistical significance. One patient died in each group. One patient in group A had a transient cognitive dysfunction versus two patients in each group B. One patient in group A had a stroke. Two patients (13.3%) of the axillary group had a temporary upper limb parasthesia that resolved completely in 3 months. One patient (6.6%) in the same group had a superficial wound infection. No adverse events were reported with innominate artery grafting.</p></div><div><h3>Conclusions</h3><p>Innominate artery cannulation shortened the operative time and reduced complications related to the cannulation site as compared to axillary artery cannulation. It provided a safe alternative for antegrade cerebral perfusion as regards the incidence of neurological complications.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 83-88"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86595566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VATS versus ultrasound-guided Abrams needle biopsy in undiagnosed pleural effusion: Old wisdom and new insights","authors":"Ehab F. Salim ,&nbsp;Ahmed A. Torky","doi":"10.1016/j.jescts.2018.05.003","DOIUrl":"10.1016/j.jescts.2018.05.003","url":null,"abstract":"<div><h3>Background</h3><p>Video Assisted Thoracoscopic surgical Biopsy (VATS) biopsy and transthoracic ultrasound-guided Abrams needle biopsy (TUS-GANB) are important tools in management of undiagnosed pleural effusion due to their high diagnostic yield in comparison to blind closed pleural biopsies.</p></div><div><h3>Methods</h3><p>From November 2015 to July 2017, a prospective study included a total number of 90 patients of undiagnosed pleural effusion who were randomly divided into two groups: group A (45 patients who underwent VATS biopsy), and group B (45 patients who underwent TUS-GANB). Safety and efficacy of both procedures were compared.</p></div><div><h3>Results</h3><p>Both procedures were safe with no perioperative mortality. A definitive histopathological diagnosis was obtained in 43 patients (95.6%) in group A and in 39 patients (86.7%) in group B (p = 0.266). VATS was superior to ultrasound guided biopsy in diagnosing pleural effusion due to pulmonary causes (p = 0.02). Both VATS and ultrasound guided biopsy were effective in diagnosing pleural effusion due to pleural causes (p = 0.358). Complications in group A were minor bleeding in 3 (6.7%), pain in 5 (11.1%), surgical emphysema in 1 (2.2%), prolonged air leakage in 3 (6.7%), pneumothorax in 5 (11.1%) and wound infection in 2 (4.4%). Complications in group B were minor bleeding in 1 (2.2%), pain in 2 (4.4%), surgical emphysema in 1 (2.2%), pneumothorax in 2 (4.4%) and haemoptysis in 2 (4.4%).</p></div><div><h3>Conclusions</h3><p>VATS was superior to ultrasound guided biopsy in diagnosing pleural effusion due to pulmonary causes. Both VATS and ultrasound guided biopsy were effective in diagnosing pleural effusion due to pleural causes.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 151-158"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86211326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous uniportal VATS right upper lobectomy with NUSS procedure for pectus excavatum repair; first reported uniportal combined lobectomy and Nuss operation","authors":"Hussein Elkhayat ,&nbsp;Emad Zarief ,&nbsp;Mahmoud Sallam ,&nbsp;Elhussein Mohamed ,&nbsp;Ahmed El-minshawy","doi":"10.1016/j.jescts.2018.04.002","DOIUrl":"https://doi.org/10.1016/j.jescts.2018.04.002","url":null,"abstract":"<div><p>We report a case of 8 years old male child with bronchiectasis and pectus excavatum. Although feasibility and safety of VATS become well-established in treatment of benign pathologies [<span>1</span>], many surgeons would argue that two benign lesions in a small child should be approached through an open approach especially that bronchiectasis usually has thick adhesions due to repeated infections and a small chest cavity may not allow a full range of movement of staplers.</p><p>Pectus excavatum is the most common congenital chest wall deformity, and the minimally invasive repair of the pectus excavatum (MIRPE) has become the treatment of choice in the last decade [<span>2</span>]. Bronchiectasis is an airway chronic disease. Thoracoscopic surgery for localized bronchiectasis is gaining more acceptance every day [<span>3</span>].</p><p>Simultaneous open cardiothoracic operations and pectus repair are being used but still lack satisfactory cosmetic results. Few publications report simultaneous multiport VATS and MIRPE [<span>4</span>,<span>5</span>]. Our case is the first reported example of such combined procedures via Uniportal VATS approach reported in an 8 years old child.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 159-162"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72288844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}