Journal of visualized surgery最新文献

{"title":"Uniportal video-assisted removal of a right paratracheal pericardial cyst: an unusual location.","authors":"Andrea Dell'Amore, Alessio Campisi, Domenica Giunta, Stefano Congiu, Giampiero Dolci, Roberto Agosti","doi":"10.21037/jovs.2018.02.08","DOIUrl":"10.21037/jovs.2018.02.08","url":null,"abstract":"<p><p>Cystic lesions of the pericardium are a rare entity. Generally, they are congenital and located in the cardiophrenic angle. The right paratracheal location is unusual and differential diagnosis in particular with bronchogenic cyst is difficult even when using magnetic resonance imaging (MRI). The surgical indication exists in case of symptomatic patients or huge mass with compression of nearby structures. Different surgical approaches have been reported in literature to treat mediastinal cysts. We report a case of uniportal thoracoscopic removal of an unusual located right paratracheal pericardial cyst.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"55"},"PeriodicalIF":0.0,"publicationDate":"2018-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897685/pdf/jovs-04-2018.02.08.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032537","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":"Gastric inflammatory fibroid polyp tumor with acute intestinal obstruction-Vanek's tumor can mimick a giant gastrointestinal stromal tumor or a gastric lymphoma.","authors":"Francesco Fleres,&nbsp;Carmelo Mazzeo,&nbsp;Antonio Ieni,&nbsp;Maurizio Rossitto,&nbsp;Eugenio Cucinotta","doi":"10.21037/jovs.2018.02.09","DOIUrl":"https://doi.org/10.21037/jovs.2018.02.09","url":null,"abstract":"<p><p>An inflammatory fibroid polyp (IFP) is a solitary rare benign neoplasm of the gastrointestinal tract, frequently located in the gastric antrum. IFPs account for about 0.1% of all gastric polyps. We report a case of a giant gastric inflammatory polyp of 2.5 cm × 7 cm that determines a gastric outlet obstruction called \"ball valve syndrome\" mimicking a gastrointestinal stromal tumor (GIST) and a gastric lymphoma, with an intestinal obstruction of high origin. Therefore, due to acute presentation we have decided to submit the patient to a subtotal gastrectomy. The patient was discharged two weeks later, asymptomatic. At 14 months of follow-up, patient is disease free at abdominal CT and OGDS. Depending on their size and location, IFPs can be associated with unspecific symptoms. Giant IFPs of the gastric antrum or the duodenum can determine an intermittent gastric outlet obstruction called \"ball valve syndrome\". Endoscopic biopsies are unhelpful and right diagnosis can be reached only with resection. In fact, only about 10% of the gastric lesions are diagnosed correctly prior to resection. Surgical treatment with complete resection with safe margins is curative. Giant IFPs are rare benign lesions whose atypical presentation can mimic GISTs, lymphomas or carcinomas. Clinical and radiological findings may not clarify the right diagnosis until histopathological evaluation aided with immunohistochemical analysis. The resection of IFPs with negative margins is curative with a good clinical outcome. In acute presentation, like in our case, surgery is the mainstay of treatment.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"54"},"PeriodicalIF":0.0,"publicationDate":"2018-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.02.09","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032536","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":"Reasons for conversion during VATS lobectomy: what happens with increased experience.","authors":"Dario Amore,&nbsp;Davide Di Natale,&nbsp;Roberto Scaramuzzi,&nbsp;Carlo Curcio","doi":"10.21037/jovs.2018.03.02","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.02","url":null,"abstract":"<p><p>Although controlled studies have demonstrated the benefits of a minimally invasive approach for pulmonary lobectomy over thoracotomy, reports have also documented that significant complications can occur during thoracoscopic lobectomy and sometimes require planned or emergent conversion to open surgery. Several authors have identified and reported causes and implications of intraoperative conversion to thoracotomy using different types of classification. The aim of this single centre retrospective review is to evaluate how the reasons for conversion change with increased experience, dividing patients who were converted to thoracotomy during video-assisted thoracic surgery (VATS) lobectomy, between 2011 and 2017, in two groups: those treated during learning curve (LC group) and those treated after learning curve (ALC group). Our research suggests that the conversion rate, with increased skills, decreases but a variety of reasons for conversion persist. Of these, calcified, benign or malignant hilar adenopathy is the most frequent and represents the leading cause of conversion to open surgery due to complicated vascular dissection or vessel injury. It's strongly recommended, with increased confidence in performing VATS lobectomies, also to develop management strategies and techniques to prevent and control possible intraoperative adverse events.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"53"},"PeriodicalIF":0.0,"publicationDate":"2018-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032535","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":"James D. Luketich: future for esophageal cancer patients is bright with growing technology and better therapy.","authors":"Skylar Gao, Pengcheng Lee","doi":"10.21037/jovs.2018.02.04","DOIUrl":"10.21037/jovs.2018.02.04","url":null,"abstract":"","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2018-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897699/pdf/jovs-04-2018.02.04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032108","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":"Capsaicin patch for persistent postoperative pain after thoracoscopic surgery, report of two cases.","authors":"Nicola Tamburini,&nbsp;Giacomo Bollini,&nbsp;Carlo Alberto Volta,&nbsp;Giorgio Cavallesco,&nbsp;Pio Maniscalco,&nbsp;Savino Spadaro,&nbsp;Francesco Qurantotto,&nbsp;Riccardo Ragazzi","doi":"10.21037/jovs.2018.02.06","DOIUrl":"https://doi.org/10.21037/jovs.2018.02.06","url":null,"abstract":"<p><p>Effective postoperative pain control after thoracic surgery is a significant clinical issue because it reduces pulmonary complications and accelerates the pace of recovery. Persistent postoperative pain syndrome is a recognized and frequent complication after thoracoscopic surgery. The capsaicin 8% patch contains a high concentration of synthetic capsaicin approved for treatment of peripheral neuropathic pain in adults. Little clinical data exist on the use of capsaicin patch in thoracic persistent postoperative pain syndrome. This report included two patients who were evaluated after receiving capsaicin for thoracic surgery. Satisfactory pain relief was achieved in both cases without side effects.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"51"},"PeriodicalIF":0.0,"publicationDate":"2018-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.02.06","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032107","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":"Simple retrograde cerebral perfusion is as good as complex antegrade cerebral perfusion for hemiarch replacement.","authors":"Akiko Tanaka,&nbsp;Anthony L Estrera","doi":"10.21037/jovs.2018.02.10","DOIUrl":"https://doi.org/10.21037/jovs.2018.02.10","url":null,"abstract":"<p><p>Cerebral complication is a major concern after aortic arch surgery, which may lead to death. Thus, cerebral protection strategy plays the key role to obtain respectable results in aortic arch repair. Deep hypothermic circulatory arrest was introduced in 1970s to decrease the ischemic insults to the brain. However, safe duration of circulatory arrest time was limited to 30 minutes. The 1990s was the decade of evolution for cerebral protection, in which two adjuncts for deep hypothermic circulatory arrest were introduced: retrograde and antegrade cerebral perfusion (ACP) techniques. These two cerebral perfusion techniques significantly decreased incidence of postoperative neurological dysfunction and mortality after aortic arch surgery. Although there are no large prospective studies that demonstrate which perfusion technique provide better outcomes, multiple retrospective studies implicate that ACP may decrease cerebral complications compared to retrograde cerebral perfusion (RCP) when a long circulatory arrest time is required during aortic arch reconstructions. To date, many surgeons favor ACP over RCP during a complex aortic arch repair, such as total arch replacement and hybrid arch replacement. However, the question is whether the use of ACP is necessary during a short, limited circulatory arrest time, such as hemiarch replacement? There is a paucity of data that proves the advantages of a complex ACP over a simple RCP for a short circulatory arrest time. RCP with deep hypothermic circulatory arrest is the simple, efficient cerebral protection technique with minimal interference to the surgical field-and it potentially allows to flush atheromatous debris out from the arch vessels. Thus, it is the preferred adjunct to deep hypothermic circulatory arrest during hemiarch replacement in our institution.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"50"},"PeriodicalIF":0.0,"publicationDate":"2018-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.02.10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032106","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":"Con: \"Debate: does every ascending aorta repair require at least an open distal anastomosis at the innominate? Or not?\"","authors":"Kenji Minatoya","doi":"10.21037/jovs.2018.02.05","DOIUrl":"https://doi.org/10.21037/jovs.2018.02.05","url":null,"abstract":"Ascending aortic replacement is usually performed with a cross-clamp at the distal ascending aorta. This cross-clamping is one of the routine procedures in cardiac surgery, and the risk of the cross-clamping has been lowered to minimum in regular practice. Theoretically, the cross-clamp itself is a risk to apply and might lead to aortic dissection (1) or create a source of embolization in the aortic wall. However, when there is no atheroma, calcification, or other abnormal situations including aortic dissection in the aorta, the cross-clamp is applied very safely in modern cardiac surgery.","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"49"},"PeriodicalIF":0.0,"publicationDate":"2018-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.02.05","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032105","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":"Robot-assisted thoracoscopic right upper bi-lobectomy for pulmonary tuberculosis.","authors":"Piotr Yablonskii,&nbsp;Grigorii Kudriashov,&nbsp;Larisa Kiryukhina,&nbsp;Armen Avetisyan","doi":"10.21037/jovs.2018.03.03","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.03","url":null,"abstract":"<p><p>Surgery is one of the current options in cases of pulmonary tuberculosis with failed medication treatment. Lobectomy and bi-lobectomy constitute up to one third of all surgical procedures in such cases. Nevertheless, fibrotic changes near the hilar structures and lymph nodes are limitation factors for spread of video-assisted thoracoscopic surgery (VATS) anatomical pulmonary resection. Robotic surgery can reduce some disadvantages of VATS. This is well illustrated by the large pulmonary resections. Current case report showed first robot-assisted thoracoscopic (RATS) bi-lobectomy for pulmonary tuberculosis with good results 1-year follow-up.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2018-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032104","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":"Sternum reconstruction using titanium plates matched with \"sandwich\" Gore-Tex meshes.","authors":"Marco Chiappetta,&nbsp;Francesco Facciolo","doi":"10.21037/jovs.2018.02.12","DOIUrl":"https://doi.org/10.21037/jovs.2018.02.12","url":null,"abstract":"<p><p>Chest wall reconstruction after extensive resection may be technically difficult, and which technique permits to obtain the right compromise between rigidity and plasticity of the chest wall is still argument of debate. Indeed, many techniques and materials have been proposed and tested to cover chest wall defects and to ensure correct respiratory movements, but unique results still miss. We herein report the case of a 55-years old woman with soft-tissue sarcoma involving the sternum treated with sternum and anterior ribs arch resection (from the second to the fourth). The chest wall defect was repaired using titanium plates and Gore-Tex meshes combined as a \"sandwich\". The scope was to obtain a synchronous movement of the prosthesis with the titanium ribs, reducing the scratching between the different materials and avoiding paradox chest wall movements.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2018-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.02.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032103","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":"Con-debate: short circulatory arrest times in arch reconstructive surgery: is simple retrograde cerebral perfusion or hypothermic circulatory arrest as good or better than complex antegrade cerebral perfusion for open distal involvement or hemi-arch?","authors":"Luca Di Marco,&nbsp;Giacomo Murana,&nbsp;Alessandro Leone,&nbsp;Davide Pacini","doi":"10.21037/jovs.2018.01.18","DOIUrl":"https://doi.org/10.21037/jovs.2018.01.18","url":null,"abstract":"Aortic arch open surgery continues to represent a formidable challenge for heart surgeons. In fact, the interruption of physiological brain perfusion is a major detrimental effect during the systemic circulatory arrest resulting in a series of neurological complications. In order to protect the brain from these injuries, three techniques have been proposed and widely utilized as a means of protecting the brain: deep hypothermic circulatory arrest (DHCA), retrograde cerebral perfusion (RCP) and antegrade cerebral perfusion (ACP). The basis for all the techniques is the protection afforded by hypothermia with the consequent metabolic suppression. The duration of cerebral protection is an important consideration, which has to be evaluated in the selection of the appropriate cerebral protection method. In fact, although the three techniques have provided for safer thoracic aortic surgery and increased perfusion times, the time of brain perfusion is not unlimited and in light of this, debate remains as to the better cerebral circulatory management technique for arch reconstructive surgery with short circulatory arrest times. It is universally accepted that DHCA, although is a simple and valid method of brain protection, has the main disadvantage of a limited “safe” time of circulatory arrest. In fact, the “safe” time-period of DHCA to prevent neurologic injuries has been showed to be less than 45 minutes at 18 °C, with some authors who showed an increase of the rate of neurologic deficit with DHCA-time ranged between 30 and 50 minutes (1). It is clear how, in order to increase the “safe” time of DHCA, adjunct techniques of RCP and ACP with various levels of hypothermia have been adopted. In 1992, Ueda and co-workers published the first series on continuous RCP in combination with DHCA during aortic arch surgery (2). Before DHCA introduction, the technique was realized using the bypass connecting the arterial and venous lines of the extracorporeal circuit to reverse the flow into the superior vena cava cannula (2,3). In this landmark paper, circulatory arrest times ranged from 11 to 56 minutes and nasopharyngeal temperatures ranged from 16 to 18 °C (2). Thereafter, the same technique evolved, operative times shorten, early mortality and morbidity improved and many other series finally validated the efficacy of RCP for cerebral protection (1,4-7). However, during the same decades, the excellent results coming from the ACP with a direct cannulation of the supraaortic vessels progressively clouded the retrograde technique (8-10). Although potential benefits of the RCP have been proved in terms of the embolic debris, intracranial hypothermia maintenance and cerebral metabolic support, other possible disadvantages have been identified in clinical and experimental studies. Reich et al. performed preoperative and postoperative neuropsychological evaluation in 21 patients undergoing DHCA and RCP during elective thoracic aortic repair (11). The overall cognitiv","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"46"},"PeriodicalIF":0.0,"publicationDate":"2018-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.01.18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032102","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}