Video-Assisted Thoracic Surgery最新文献_第10页

A narrative review on lymphadenectomy: from open to minimally invasive surgery 淋巴结切除术的叙述回顾:从开放到微创手术

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/vats-21-33

V. Aprile, Ilaria Ceccarelli, S. Korasidis, M. G. Mastromarino, D. Bacchin, E. Sicolo, M. Ambrogi, M. Lucchi

引用次数: 3

Searching for evidence of VATS lung metastasectomy 寻找VATS肺转移切除术的证据

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/VATS-2020-LM-10

M. Migliore, Michel Gonzalez

{"title":"Searching for evidence of VATS lung metastasectomy","authors":"M. Migliore, Michel Gonzalez","doi":"10.21037/VATS-2020-LM-10","DOIUrl":"https://doi.org/10.21037/VATS-2020-LM-10","url":null,"abstract":"We are pleased to introduce this issue devoted to video-assisted thoracic surgery (VATS) for lung metastases. Although not confirmed with prospective randomized trials, pulmonary resection(s) is the operation of choice for lung metastases with a relatively low postoperative complication rate. Nonetheless, the surgical approach to perform lung metastasectomy remains a point of debate as VATS or open transthoracic approach can both be performed. Though surgeons are looking for reliable data in favor of VATS for lung metastasectomy, there is scarce prospective data and most available practices raise questions (1) instead of giving answers. Nevertheless, after 10 years of ESTS project dedicated to lung metastases (2), this special issue dedicated to VATS metastasectomy, which also includes exceptional videos, will help to publicize important experiences, and will also stimulate young surgeons, oncologists and scientists to find new ideas for the future. There will also be an article which reports on the TNM classification for lung metastases which we initially proposed in 2016 (3). It could be an easy way to finally “personalize” the treatment of the difficult patients with lung metastases (4). One thing is certain, in the absence of scientific evidence that demonstrates that one approach (open or VATS) is better than the other, the less invasive approach should be chosen. Therefore, there is no doubt that VATS (uniportal, multiportal or subxiphoid) represents nowadays the most used “standard practice” to remove lung metastases. Nevertheless, surgeons should never forget that the fundamental goal of the procedure of lung metastasectomy is not the minimal invasiveness of the skin incision but the prolonged survival. We are in debt of gratefulness to the outstanding contributors for offering their knowledge and practice with lung metastasectomy. Finally, we would like to acknowledge Video-Assisted Thoracic Surgery (VATS) journal for allowing us organize this important special issue and for the exceptional work done by all the staff.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49396022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influence of mentorship on the duration and safety of robotic learning curve for anatomical lung resections 指导对解剖肺切除机器人学习曲线持续时间和安全性的影响

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/vats-21-38

M. Gómez-Hernández, M. Jiménez

引用次数: 0

Application of robotic surgery for paraesophageal hiatal hernia repair: a narrative review 机器人手术在食管裂孔疝修补中的应用综述

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/vats-21-44

T. Grenda, R. Reddy

{"title":"Application of robotic surgery for paraesophageal hiatal hernia repair: a narrative review","authors":"T. Grenda, R. Reddy","doi":"10.21037/vats-21-44","DOIUrl":"https://doi.org/10.21037/vats-21-44","url":null,"abstract":"Background and Objective: Paraesophageal hiatal hernia (PEH) repair has undergone evolution from open approaches (e.g., laparotomy, thoracotomy) to minimally-invasive techniques with laparoscopy. While the laparoscopic approach has offered decreased morbidity, issues related to PEH recurrence persist. As a result, there has been a continued need for innovation of PEH repair techniques to address recurrence. Increased uptake in robotic surgery has allowed for application of this technology to PEH repair. While increasing in adoption, the efficacy of robotic approach to PEH continues to undergo evaluation. Methods: We performed a review of randomized and non-randomized studies surrounding robotic-assisted PEH repair using PubMed/MEDLINE. We evaluated the literature across aspects pertaining to perioperative outcomes, long-term outcomes, and costs compared to traditional surgical approaches. There were no publication date restrictions. Key Content and Findings: Current literature suggests that robotic PEH repair is feasible and offers perioperative outcomes similar to standard laparoscopic approaches. Limited reports of long-term outcomes, specifically related to PEH recurrence and patient-reported outcomes, suggest the efficacy of robotic PEH repair. Initial cost comparisons with standard laparoscopic approaches demonstrate similar intraoperative costs, but are limited and continue to be evaluated. In addition, there is data suggesting robotic PEH repair may be applicable to large PEH (>30% intrathoracic stomach). Conclusions: Review of current literature suggests that robotic PEH repair is feasible and has similar perioperative outcomes when compared to standard laparoscopic techniques. The learning curve for transition from laparoscopic to robotic PEH repair needs to be considered, even among experienced laparoscopic surgeons. Future prospective multi-institutional studies will be needed in order to fully evaluate the value (quality/costs) of robotic PEH repair to ensure efficacious and cost-effective adoption.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45505605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

NiVATS sympathectomy for hyperhidrosis: should I stay or should I go? A Narrative Review NiVATS交感神经切除术治疗多汗症：我应该留下还是应该离开？叙事评论

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/vats-21-11

Gabriela Haessig, C. Caviezel

{"title":"NiVATS sympathectomy for hyperhidrosis: should I stay or should I go? A Narrative Review","authors":"Gabriela Haessig, C. Caviezel","doi":"10.21037/vats-21-11","DOIUrl":"https://doi.org/10.21037/vats-21-11","url":null,"abstract":"Non-intubated video-assisted thoracoscopic surgery (NiVATS) has been shown to be a practicable and beneficial procedure for many thoracic operations. This review summarizes the current literature about NiVATS focusing on patients with hyperhidrosis. Seven studies about NiVATS and its efficacy and/or feasibility have been found and are discussed. There are only two randomized trials, while all other reports are case series. Four studies compare NiVATS with VATS. As seen for many other procedures as wedge resection, pleural biopsy and even anatomical resection, NiVATS sympathectomy for hyperhidrosis is a safe and feasible procedure to perform. Especially, due to the usual young, slim and otherwise healthy patients, this method is well suited to start a NiVATS program. Although NiVATS has a short learning curve, it challenges the whole team including surgeons and anesthesiologists, working on an awake patient. Nevertheless, evidence for clinical advantages of NiVATS compared to VATS is still scarce. The majority of thoracic surgery patients still gets a chest tube for a few days, which might outlast the positive effects of NiVATS, as for example lesser anestesiological trauma. However, there is evidence to show that NiVATS might be suitable in managing thoracoscopic sympathectomy as an outpatient operation, as these patients seem to have a faster general recovery postoperatively.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44506303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

VATS mediastinal lymph node dissection: surgical technique and literature review VATS纵隔淋巴结清扫术:手术技术及文献复习

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/vats-21-27

L. Andriolo, D. A. Fegatelli, A. Spagnoli, G. Rienzo

引用次数: 1

Non-intubated VATS for lung cancer—a focus on segmentectomy: a narrative review 非插管式胸腔镜治疗肺癌——以节段切除术为重点：叙述性综述

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2021-01-01 DOI: 10.21037/VATS-21-9

C. Diotti, S. Mohamed, M. Cattaneo, F. Damarco, D. Tosi

{"title":"Non-intubated VATS for lung cancer—a focus on segmentectomy: a narrative review","authors":"C. Diotti, S. Mohamed, M. Cattaneo, F. Damarco, D. Tosi","doi":"10.21037/VATS-21-9","DOIUrl":"https://doi.org/10.21037/VATS-21-9","url":null,"abstract":": Traditionally, lobectomy is the gold standard for early-stage non-small-cell lung cancer (NSCLC) treatment but in recent years lung segmentectomy is gaining a key role in small-sized or subsolid peripheral lung lesion <2 cm. It can be performed with minimally invasive approaches leading to better pulmonary function preservation, less postoperative pain and shorter hospitalization. Although for decades general anesthesia with tracheal intubation was considered mandatory, non-intubated video-assisted thoracic surgery (NiVATS) has been proposed as an alternative to traditional surgery. Its role in more challenging thoracoscopic procedures such as VATS anatomical lung resections is currently being evaluated. NiVATS applied to lung resections for early-stage NSCLC treatment, even if technically more challenging than conventional intubated thoracic surgery, is an innovative and promising surgical strategy allowing less intubation-related adverse effects and a faster recovery; several encouraging results have recently been reported, proving that minimally invasive surgical and anesthetic approaches could be a valid alternative to more invasive procedures in selected patients also in technical challenging anatomical resections. The aim of this review is to describe various technical aspects of NiVATS procedures and to investigate the combination of thoracoscopic segmentectomy and non-intubated anesthesia in terms of feasibility, safety, intra and perioperative complications, short-term outcomes and oncological adequacy.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48487547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Segment-specific lymph node dissection and evaluation during anatomical pulmonary segmentectomy 解剖性肺节段切除术中特定节段淋巴结清扫及评价

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2020-11-23 DOI: 10.21037/VATS-2019-RCS-08

Ghulam Abbas, Beebarg Raza, Kamil Abbas, J. Lamb, A. Toker

{"title":"Segment-specific lymph node dissection and evaluation during anatomical pulmonary segmentectomy","authors":"Ghulam Abbas, Beebarg Raza, Kamil Abbas, J. Lamb, A. Toker","doi":"10.21037/VATS-2019-RCS-08","DOIUrl":"https://doi.org/10.21037/VATS-2019-RCS-08","url":null,"abstract":"Lung cancer continues to be the leading cause of cancer related deaths both in men and women. Most patients present with locally advanced disease and are not candidates for resection. A recent surge of lung cancer screening programs for high-risk patients across the western world has led to a rising number of patients with early stage lung cancer. These patients with clinical stage I lung cancer and compromised pulmonary reserves can be candidates for sub-lobar resection with curative intention and similar outcomes as compare to lobectomy. Systemic or lobe-specific mediastinal lymph node dissection is an integral part of lung cancer surgery, especially during lobectomy as nodal upstaging can occur up to 18% of clinical stage I lung cancers and is associated with a worse prognosis. Nodal upstaging can occur in N1 lymph nodes only or as a skip metastasis to the N2 lymph nodes or both. The characteristics and location of the tumor plays an important role in lymph node metastasis. Recently, it has been suggested that a lobe-specific mediastinal lymph node dissection is equivalent to multi-station aggressive nodal dissection for early stage lung cancer detected during screening. Determining mediastinal and intersegmental lymph node metastasis is important during segmentectomy as it is associated with an increase recurrence rate and poor survival. These patients are perhaps better served with lobectomy rather than segmentectomy. The techniques and method of standard mediastinal lymph node dissection are well described in literature but description of a systematical approach for N1 lymph node dissection during a segmentectomy to efficiently identify the nodal upstaging intra-operatively, is lacking. We describe a methodological evaluation of N1 lymph node during segmentectomy in an effort to avoid failure to recognize nodal upstaging.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45610233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Advantages and disadvantages of robotic and uniportal video-assisted thoracoscopic surgery 机器人和单门电视胸腔镜手术的优缺点

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2020-10-19 DOI: 10.21037/VATS-20-34

H. Nagano, T. Suda

{"title":"Advantages and disadvantages of robotic and uniportal video-assisted thoracoscopic surgery","authors":"H. Nagano, T. Suda","doi":"10.21037/VATS-20-34","DOIUrl":"https://doi.org/10.21037/VATS-20-34","url":null,"abstract":"Robotic-assisted thoracoscopic surgery (RATS), which aims to increase accuracy, and uniportal video-assisted thoracoscopic surgery (U-VATS), which aims to decrease invasiveness, have been reported as new surgical methods for pulmonary resection. The advantages of robotic-assisted surgery include a threedimensional surgical view, elimination of physiological tremors, and enabling surgical manipulation in a natural orientation because of the presence of forceps that move in the same manner as human wrist joints. Therefore, it allows some surgeries that are not feasible with the manual thoracoscopic techniques performed by human hands available currently. Its disadvantages include the lack of tactile sensation, an increased number of ports, the high cost, and unproven commensurate patient benefits. The advantages of uniportal surgery include a lower level of postoperative pain and faster patient recovery because of the single incision, whereas the fact that all surgical instruments are inserted via a single incision, thereby limiting surgical manipulation and decreasing surgical safety and accuracy, represents a disadvantage of this technique. Although many reports have indicated that both robotic-assisted surgery and uniportal surgery are more useful than conventional thoracoscopic surgery, sufficient demonstration based on a high level of evidence remains to be achieved. In the future, the safety, level of invasion, and oncological long-term results of these new surgical methods should be compared with those of conventional surgical methods and investigated regarding their utility.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48795946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

What have we learned in the process of setting up and running the PulMiCC (Pulmonary Metastasectomy in Colorectal Cancer) randomised controlled trial? 在建立和运行PulMiCC（癌症结直肠癌肺转移切除术）随机对照试验的过程中，我们学到了什么？

IF 0.2 4区医学

Video-Assisted Thoracic Surgery Pub Date : 2020-09-18 DOI: 10.21037/VATS-2020-LM-08

F. Fiorentino, M. Milošević, T. Treasure

{"title":"What have we learned in the process of setting up and running the PulMiCC (Pulmonary Metastasectomy in Colorectal Cancer) randomised controlled trial?","authors":"F. Fiorentino, M. Milošević, T. Treasure","doi":"10.21037/VATS-2020-LM-08","DOIUrl":"https://doi.org/10.21037/VATS-2020-LM-08","url":null,"abstract":": The majority of lung metastasectomy operations are for colorectal cancer (CRC). The practice is highly selective. Of patients who have had a potentially curative resection, about 2–3% subsequently have a lung metastasectomy. The motive for operation is to cure the patient by removing the only evident remaining cancer. We review the methods used to investigate the evidence on which this practice is based, going from review of published observational cohort studies, through a citation network to a randomised controlled trial (RCT). The non-inferiority RCT Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) compared survival, quality of life, and health utility in 46 patients randomised to metastasectomy and 47 control patients. The two arms were well balanced for the known prognostic characteristics: the number of metastases, carcinoembryonic antigen levels, previous liver metastasectomy, cancer stage, and the interval since primary resection. Median survival was similar in the two arms: 3.5 years after metastasectomy and 3.8 years among controls and hazard ratio for death within five years of 0.93 (95% CI: 0.56–1.56). There were 12 five-year survivors after metastasectomy and 11 among controls. The size of the trial does not exclude the possibility of occasional long-term survivors in whom metastasectomy appears to have removed the only residue of cancer, as has been observed anecdotally. As might be expected, after metastasectomy there was a decline in lung function as measured by % predicted FEV1. There were also more lung symptoms among the patient reported outcomes. The decline in self-reported health state was similar in the two arms. The generally assumed near zero five-year survival without metastasectomy was not found in PulMiCC or in the control groups of two other randomised studies, CLOCC and SABRE-COMET. Patients, and those treating for them, should be aware of this new information in reaching a decision about lung metastasectomy.","PeriodicalId":42086,"journal":{"name":"Video-Assisted Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47482597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0