RESUMEN
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.
Asunto(s)
Pulmón/cirugía , Mediastino/lesiones , Pleura/lesiones , Cirugía Torácica Asistida por Video/efectos adversos , Pared Torácica/lesiones , Toracotomía/efectos adversos , Adherencias Tisulares/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Mediastino/cirugía , Persona de Mediana Edad , Pleura/cirugía , Neumotórax , Complicaciones Posoperatorias , Factores de Riesgo , Prevención Secundaria , Cirugía Torácica Asistida por Video/métodos , Toracotomía/métodos , Adulto JovenRESUMEN
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.
Asunto(s)
Neoplasias Encefálicas/secundario , Carcinoma de Pulmón de Células no Pequeñas/secundario , Complicaciones Intraoperatorias/diagnóstico , Neoplasias Pulmonares/cirugía , Células Neoplásicas Circulantes/patología , Neumonectomía/efectos adversos , Anciano , Biopsia con Aguja , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/terapia , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Progresión de la Enfermedad , Resultado Fatal , Humanos , Complicaciones Intraoperatorias/terapia , Neoplasias Pulmonares/patología , Masculino , Estadificación de Neoplasias , Neumonectomía/métodos , Medición de RiesgoRESUMEN
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.