Evaluación de técnicas mínimamente invasivas en el diagnóstico de enfermedades benignas y malignas del tórax / An Assessment of Minimally Invasive Techniques for the Diagnosis of Benign and Malignant Thoracic Diseases

Introducción: Los cambios en la tecnología médica abarcan todas las especialidades y dentro de ellas, en la cirugía general. Las técnicas mínimamente invasivas han ocupado un papel cimero en el diagnóstico y tratamiento de enfermedades en la cavidad torácica. Objetivo: Describir el uso de las técnicas mínimamente invasivas en el diagnóstico de enfermedades intratorácicas. Métodos: Se realizó un estudio observacional, retrospectivo de corte transversal para evaluar el uso de técnicas mínimamente invasivas en el diagnóstico de las enfermedades intratorácicas en el Hospital Universitario "Manuel Ascunce Domenech" desde enero de 2017 hasta mayo de 2020. El universo estuvo compuesto por 104 pacientes con sospecha diagnóstica de enfermedades benignas o malignas del tórax. Resultados: La mayor parte de los pacientes con enfermedades benignas y malignas del tórax tenían una edad de 49 (±7,05) años, sin significación intersexo. La hipertensión arterial predominó como principal comorbilidad. La videotoracoscopia fue la técnica mínimamente invasiva más empleada y la sospecha de cáncer pulmonar y enfermedad pleural constituyeron las indicaciones más frecuentes que motivaron el proceder. El diagnóstico posoperatorio que predominó en la serie fue el cáncer pulmonar. Las técnicas mínimamente invasivas empleadas mostraron una alta validez. La mayoría de los pacientes egresaron vivos y sin complicaciones. Conclusiones: El uso de técnicas mínimamente invasivas en varias enfermedades intratorácicas son de vital importancia para definir diagnóstico y tratamiento(AU)

Introduction: Changes in medical technology cover all specialties and, within them, general surgery. Minimally invasive techniques have played a paramount role in the diagnosis and treatment of thoracic cavity diseases. Objective: To describe the use of minimally invasive techniques in the diagnosis of intrathoracic diseases. Methods: An observational, retrospective and cross-sectional study was carried out, from January 2017 to May 2020, in order to assess the use of minimally invasive techniques in the diagnosis of intrathoracic diseases at Manuel Ascunce Domenech University Hospital. The universe was made up of 104 patients with suspected benign or malignant diseases of the chest. Results: Most of the patients with benign and malignant chest diseases were 49 (± 7.05) years old, without intersex significance. Arterial hypertension predominated as the main comorbidity. Videothoracoscopy was the most widely used minimally invasive technique, while suspicion of lung cancer and pleural disease were the most frequent indications that motivated the procedure. The postoperative diagnosis that predominated in the series was lung cancer. The minimally invasive techniques used showed high validity. Most of the patients were discharged alive and without complications. Conclusions: The use of minimally invasive techniques in various intrathoracic diseases are of vital importance to define diagnosis and treatment(AU)

Video-mediastinoscopy: Report of 128 cases / 中国微创外科杂志

Objective To study the application of video-mediastinoscopy in the preoperative staging of lung cancer and the diagnosis and treatment of mediastinal tumors or malignant pleural effusion.Methods Video-mediastinoscopy was performed in 128 cases under general anesthesia and single lumen endotracheal intubation,including 48 cases of cervical mediastinoscopy,33 cases of parasternal mediastinoscopy,and 47 cases of intercostal mediastinoscopy.Results The diagnosis was clarified under video-mediastinoscopy in 125 cases,including 38 cases of adenocarcinoma,33 cases of metastatic squamous cell carcinoma,9 cases of tuberculosis,8 cases of lymph node inflammation,7 cases of small cell carcinoma,6 cases of squamous cell carcinoma of the thymus,5 cases of non-Hodgkin's lymphoma,4 cases of neuroblastoma,4 cases of thymoma,3 cases of pleural mesothelioma,2 cases of Hodgkin's lymphoma,2 cases of neurilemmoma,1 case of sarcoidosis,1 case of hyperplasia of thymus gland,1 case of carcinoid,and 1 case of primitive neuroectodermal tumor.In 1 case,the mediastinal lymph nodes were diagnosed as reactive hyperplasia by video-mediastinoscopy,and then were confirmed as squamous cell carcinoma by postoperative pathological examination.Two cases were confirmatively diagnosed as having lung cancer in the left inferior lobe by brochoscopy, and video-mediastinoscopy revealed the metastasis to right paratracheal lymph nodes.Complications included 1 case of pneumothorax,1 case of hemorrhage,2 cases of recurrent laryngeal nerve paralysis,and 2 cases of superficial incision infection. Conclusions Video-mediastinoscopy is not only an important examination for preoperative staging of lung cancer and diagnosis of mediastinal diseases,but also a surgical treatment for mediastinal tumors and malignant pleural effusion.

The preliminary experience of intercostal video-mediastinoscopy in clinical application / 中华胸心血管外科杂志

Objective: To determine the value of intercostal video mediastinoscopy (VMS) in clinical application. Methods: The clinical data of 126 patients treated with intercostal VMS were summarized retrospectively. Of them, 8 patients with suspected malignant pleural effusion underwent intercostal VMS pleural biopsy and talc poudrage pleurodesis, 118 patients with palmar hyperhidrosis underwent bilateral intercostal VMS sympathectomy. Results: Definitive pathologic diagnosis has been made through VMS pleural biopsy in pleural effusion group, and the efficiency of talc pleurodesis was 100%(8/8). In 118 patients with palmar hyperhidrosis, the symptom of hands sweating disappeared completely after operation. Both hands became dry with an increasing skin temperature of 1 5℃～3 0℃ immediately after operation. No recurrence was recorded during the follow up. No mortality and morbidity were reported in this group. Conclusion: Comparing with VATS, intercostal VMS is easier to operate and less invasive. It is an effective and alternative procedure in the treatment of malignant pleural effusion and palmar hyperhidrosis.

Video-mediastinoscopy in the diagnosis of mediastinal tumor and the staging of lung cancer / 中国微创外科杂志

1.0 cm) by radiographic examinations, video-mediastinoscopy showed positive results in 30 cases, and negative in 14 cases, in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes. No postoperative complications and mortality were observed. Conclusions Video-mediastinoscopy offers clear operation field, high resolution, convenient application, safety and reliability. We suggest that it be adopted as a routine method in the diagnosis of mediastinal tumor and the staging of lung cancer.