Motoaki Yasukawa1, Ryosuke Taiji2, Nagaaki Marugami2, Takeshi Kawaguchi3, Noriyoshi Sawabata3, Takashi Tojo4, Junko Takahama2, Naoki Hamazaki5, Toshiko Hirai6, Shigeki Taniguchi3. 1. Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan myasukawa@naramed-u.ac.jp. 2. Department of Radiology, Nara Medical University School of Medicine, Nara, Japan. 3. Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Nara, Japan. 4. Department of Thoracic Surgery, Saiseikai Chuwa Hospital, Nara, Japan. 5. Shioya Clinic of Internal Medicine, Nara, Japan. 6. Department of Endoscopy and Ultrasound, Nara Medical University School of Medicine, Nara, Japan.
Abstract
BACKGROUND/AIM: Video-assisted thoracic surgery (VATS) for ipsilateral reoperations is challenging because of the potential for pleural adhesions. Insertion of the initial port can lead to lung injury because of the blinded intrathoracic area. We assessed the usefulness of ultrasonography before VATS to reduce the incidence of lung injury at the time of the initial port insertion during secondary ipsilateral VATS. PATIENTS AND METHODS: Thirty-three patients who underwent repeat VATS for ipsilateral pulmonary lesions were included. All patients underwent preoperative ultrasonography to assess the possible presence of pleural adhesions using the lung sliding sign. RESULTS: Seven adhesions were found at the VATS ports. Two of these adhesions were not evaluated as pleural adhesions using ultrasonography; however, they were loose. All initial ports were inserted without lung injury. There were no major complications. CONCLUSION: Preoperative detection of pleural adhesions using ultrasonography can determine the best initial port for secondary ipsilateral VATS. Copyright
BACKGROUND/AIM: Video-assisted thoracic surgery (VATS) for ipsilateral reoperations is challenging because of the potential for pleural adhesions. Insertion of the initial port can lead to lung injury because of the blinded intrathoracic area. We assessed the usefulness of ultrasonography before VATS to reduce the incidence of lung injury at the time of the initial port insertion during secondary ipsilateral VATS. PATIENTS AND METHODS: Thirty-three patients who underwent repeat VATS for ipsilateral pulmonary lesions were included. All patients underwent preoperative ultrasonography to assess the possible presence of pleural adhesions using the lung sliding sign. RESULTS: Seven adhesions were found at the VATS ports. Two of these adhesions were not evaluated as pleural adhesions using ultrasonography; however, they were loose. All initial ports were inserted without lung injury. There were no major complications. CONCLUSION: Preoperative detection of pleural adhesions using ultrasonography can determine the best initial port for secondary ipsilateral VATS. Copyright
Authors: Gaetana Messina; Mary Bove; Antonio Noro; Giorgia Opromolla; Giovanni Natale; Francesco Leone; Vincenzo Di Filippo; Beatrice Leonardi; Mario Martone; Mario Pirozzi; Marianna Caterino; Sergio Facchini; Alessia Zotta; Giovanni Vicidomini; Mario Santini; Alfonso Fiorelli; Della Corte Carminia; Fortunato Ciardiello; Morena Fasano Journal: J Cardiothorac Surg Date: 2022-05-04 Impact factor: 1.522