Signa Vitae

Journal for Intensive Care and Emergency Medicine

1st South Eastern European Joint Meeting of Thoracic Anesthesiologists and Surgeons

Croatia, Split, Hotel Radisson Blu Resort Split, 6-8 April, 2016

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Complications after bilateral thoracoscopic sympathicotomy for primary focal hyperhidrosis

Introduction

Primary focal hyperhidrosis is a functional disorder of an excessive sweating that can significantly deteriorate the person’s every day quality of life. It is estimated that there is about 2.8% of world population affected with this unpleasant condition, especially among young people. Bilateral thoracoscopic sympathicotomy is nowadays well established one-day minimal invasive surgical procedure, with very good postoperative results and the opportunity for the patients to be capable for their everyday life and working, a day after the operation, with adequate analgetics if necessary. However, the complications after bilateral thoracoscopic sympathicotomy can seriously worsen their quality of life, beyond this functional disorder of an excessive perspiration.

The aim of this study is to evaluate the postoperative complications after bilateral thoracoscopic sympathicotomy and their influence on person’s quality of life.

Key words: primary focal hiperhidrosis, bilateral thoracoscopic sympathectomy, minimal invasive surgery, complications

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Uniportal VATS lobectomy in the treatment of NSCLC lung cancer

Background

Uniportal Video-Assisted Thoracic Surgery (uniportal VATS) lobectomy represents the pinnacle of evolution for minimally invasive techniques in surgical management of lung cancer. Growing evidence suggest that Uniportal VATS procedures are technically feasible and safe with immediate outcomes comparable to traditional VATS approach. Uniportal approach has demonstrated equivalent disease-free survival, at intermediate follow-up for patients with early stage NSCLC, compared to conventional VATS. It represents a less invasive approach, and offers the advantage of minimizing the extent of the surgical access trauma thus resulting in postoperative pain reduction, muffled inflammatory response, early recovery and better cosmesis. Some authors described minimal changes in pulmonary function after uniportal surgery in patients with poor cardio-respiratory function. Here we present our experiences with uniportal VATS lobectomies for NSCLC.

Key words: Uniportal, VATS, lobectomy, NSCLC

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Nonintubated video-assisted thoracoscopic surgery (VATS)

Abstract

Video –assisted thoracoscopic surgery (VATS) has become common and globally accepted surgical approach for a variety of thoracis diseases. Conventionally, it is performed under tracheal intubation with double lumen tube or bronchial blocker to achieve single lung ventilation. Nonintubated video-assisted thoracoscopic surgery (VATS) has been reported to be safe and feasible for patients with various thoracic diseases, including those who have respiratory dysfunction. VATS without tracheal intubation is safe in a series of VATS procedures, including management of pneumothorax, wedge resection of pulmonary tumors, excision of mediastinal tumors, lung volume reduction surgery, segmentectomy and lobectomy. Patiens undergoing nonintubated VATS are anesthetized using regional anesthesia in a spontaneously single lung breathing status after iatrogenic open pneumothorax. Therefore, we need to minimize the patients physical and psyichological discomfort by using sedation or intrathoracic vagal blockade on the surgical side, if analgesia and sedation are inadequate, conversion to intubated general anesthesia may be required. The early outcomes of nonintubated VATS include faster postoperative recovery and less complication rate comparing with its counterpart of intubated general anesthesia.

Key words: Nonintubated video-assisted thoracoscopic  surgery (VATS), regional anesthesia, lung cancer, analgesia and sedation

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Non-Intubated VATS procedures: Our initial experiences

Background

Non-intubated thoracic surgery is not a new idea or concept. It was developed early in the 20th century and used successfully for many years for even the most complex thoracic cases until the development of double lumen intubation in the 1950s made the use of single-lung ventilation possible. Multiple studies have reported successful thoracic surgery outcomes in Non-intubated patients, thus eliminating the majority of risks related to general anesthesia, as well as uni-lung ventilation via mechanical ventilation and intubation. Non-Intubated VATS procedures have demonstrated a high rate of success in treating those at the very margins of the thoracic surgery patient population (the extreme elderly, patients with advanced respiratory disease, or other serious medical co-morbidities) who are often deemed inoperable using current techniques. Here we present our initial experiences and results with Non-Intubated VATS procedures.

Key words: Non-Intubated, VATS

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