ABSTRACT
To determine whether video-assisted thoracoscopic surgery (VATS) is associated with a lower incidence of intrathoracic adhesion after pulmonary resection, we assessed the incidence of adhesion for patients who underwent a second pulmonary resection. The site and extent of adhesion were evaluated by reviewing videotapes recorded during surgery. A significantly (P<0.05) lower rate of mediastinal or interlobar adhesion was observed in patients with pneumothorax (10%) in comparison with lobectomy (57%) or partial resection for tumors (63%), although there were no statistically significant differences in adhesion to the chest wall. There were no significant differences between VATS and thoracotomy for mediastinal or interlobar adhesion. However, a significantly (P<0.05) lower rate of adhesion to the chest wall was observed for VATS (54%) in comparison with thoracotomy (100%). Although VATS resulted in less adhesion to the chest wall than thoracotomy, there was no difference in mediastinal or interlobar adhesion.
Subject(s)
Lung/surgery , Mediastinum/injuries , Pleura/injuries , Thoracic Surgery, Video-Assisted/adverse effects , Thoracic Wall/injuries , Thoracotomy/adverse effects , Tissue Adhesions/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Incidence , Male , Mediastinum/surgery , Middle Aged , Pleura/surgery , Pneumothorax , Postoperative Complications , Risk Factors , Secondary Prevention , Thoracic Surgery, Video-Assisted/methods , Thoracotomy/methods , Young AdultABSTRACT
It is assumed that dissemination of tumor cells during pulmonary resection may be followed by metastases. A 70-year-old man with pleomorphic carcinoma of the lung had brain metastases develop secondary to brain infarction caused by tumor emboli during lobectomy. This is a rare case that clearly showed brain metastases as a consequence of tumor emboli during pulmonary resection.
Subject(s)
Brain Neoplasms/secondary , Carcinoma, Non-Small-Cell Lung/secondary , Intraoperative Complications/diagnosis , Lung Neoplasms/surgery , Neoplastic Cells, Circulating/pathology , Pneumonectomy/adverse effects , Aged , Biopsy, Needle , Brain Neoplasms/pathology , Brain Neoplasms/therapy , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/surgery , Disease Progression , Fatal Outcome , Humans , Intraoperative Complications/therapy , Lung Neoplasms/pathology , Male , Neoplasm Staging , Pneumonectomy/methods , Risk AssessmentABSTRACT
We developed a new technique to ligate an enlarged cystic duct under laparoscopy. First, the cystic duct was ligated with a large size Endoclip and cut halfway through with scissors. The rest of it was ligated by the clips and divided. This procedure does not require any special device or skill.
