ABSTRACT
Minimal invasive surgery has become the gold standard for surgical repair of pectus excavatum. The procedure can be performed as fast-track surgery and cosmetic results are excellent. In addition, cardiac performance improves after correction. With increased awareness on the Internet, the number of patients who seek help continues to rise, primarily for cosmetic reasons. Pectus carinatum is much less frequent than pectus excavatum. Over the past decade surgery has largely been replaced by compression techniques that use a brace, and cosmetic results are good. Rare combinations of pectus excavatum and carinatum may be treated by newer surgical methods.
Subject(s)
Funnel Chest/surgery , Pectus Carinatum/surgery , Thoracoscopy/methods , Humans , Patient Selection , Perioperative Care/methods , Thoracoscopy/rehabilitation , Treatment OutcomeABSTRACT
INTRODUCTION: The objectives of outpatient surgery are to reduce the risks related to the hospitalization, to improve the postoperative recovery and to optimize contact with family physicians. The objective of this work is to present the first unit of outpatient pulmonary surgery and to report the results of the resections of pulmonary nodules in outpatient surgery in the setting of early discharge. METHODS: The indications for the resection of nodules were discussed in a multidisciplinary thoracic oncology meeting. The patients underwent resection of one or more lung nodules by thoracoscopy after verification that they met the anaesthetic and surgical criteria for ambulatory surgery. We analyzed the characteristics of the population, the duration of surgery, the type of resection, the time of the chest drain removal and the postoperative follow-up. RESULTS: Between November 2013 and December 2014, 51 patients underwent sub-lobar pulmonary resections. Among them 7 patients (4 men and 3 women), with an average age of 57.6 years (39-64) and histories of malignant tumor, underwent 7 atypical resections and two segmentectomies in outpatient surgery (3 patients had two resections). The average operating time was 53.75min (30-90). The chest drain was removed before the third hour in 8 cases and on the third day in one case. The average tumor diameter was 10.375mm (6-23). The histology revealed a metastasis of colorectal carcinoma in 4 cases, a metastasis of a renal carcinoma in 1 case, an in situ adenocarcinoma in 1 case and a benign tumor in 3 cases. Neither recurrence nor complication was observed during an average follow-up of 6 months. CONCLUSION: Thanks to a protocol of early mobilisation and discharge included in a well established clinical care pathway, thoracoscopic resection of lung nodules is feasible, with safety in properly selected and prepared patients in outpatient surgery.
Subject(s)
Ambulatory Care/methods , Critical Pathways , Multiple Pulmonary Nodules/surgery , Pneumonectomy/rehabilitation , Thoracic Surgery, Video-Assisted/rehabilitation , Adult , Critical Pathways/organization & administration , Critical Pathways/standards , Female , Humans , Male , Middle Aged , Multiple Pulmonary Nodules/rehabilitation , Operative Time , Patient Discharge , Pneumonectomy/methods , Retrospective Studies , Thoracoscopy/methods , Thoracoscopy/rehabilitation , Time FactorsABSTRACT
20 patients were operated thoracoscopically on the cause of the solid tumors of the pleural cavity. Patients were aged from 1 day of life to 17 years. Minimal size of the tumor was 3.1×3.5×4.0 sm; maximal 10×10×20 sm. The control group was created of 22 children with thoracic tumors, operated via thoracotomy. The postoperative period and outcomes were statistically better among patients, treated thoracoscopically.
