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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 880-882 
    ISSN: 1432-2218
    Keywords: Elderly ; Thoracoscopic surgery ; VATS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We review our experience in video-assisted thoracoscopic surgery (VATS) on patients over 75 years of age from a single institution. Methods: From September 1992 to November 1995, 22 patients (13 males and 9 females with mean age of 78.1 years) underwent the following procedures: pleural biopsies with or without drainage and decortication (5), drainage of empyema (2), wedge lung biopsy (3), bullectomy and talc insufflation (1), major lung resections (5), mediastinal biopsy (1), pericardiectomy (3), and thymectomy (2). Pulmonary function tests of the entire group showed the mean forced expiratory volume in 1 s (FEV1) to be 1.46 1 (range 0.63–2.11) and forced vital capacity (FVC) to be 2.04 (range 0.98–3.55) 1. Results: There was no mortality. Morbidity included prolonged chest drainage over 7 days in two patients (9.1%), one of whom was discharged with a drainage bag. Particularly of note was the lack of postoperative pulmonary complications. Conclusions: We conclude that VATS in the elderly population is safe. Age alone should not be a contraindication for major lung or mediastinal surgery.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1292-1294 
    ISSN: 1432-2218
    Keywords: Video-assisted thoracoscopic surgery ; Type I cystic adenomatoid malformation infant ; Congenital cystic adenomatoid malformation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 3-month-old Chinese girl with type I cystic adenomatoid malformation involving both lobes of her left lung was successfully operated upon using the video-assisted thoracoscopic surgical (VATS) approach. The conventional endoscopic stapling device was used for resection without complications.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1029-1030 
    ISSN: 1432-2218
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. It is generally thought that simultaneous bilateral chest surgery carries a high morbidity. We reviewed the results of simultaneous (under one anesthesia) vs staged bilateral video-assisted thoracoscopic surgery (VATS) from a single institution over a 35-month period. From September 1992 to July 1995, we performed simultaneous bilateral VATS on 37 patients (31 males, six females, age ranging from 15 to 55 years) with spontaneous pneumothorax (20) for bleb resections and pleurodesis; thoracodorsal sympathectomy (12) for palmar hyperhidrosis and vasospastic disease; and metastatic sarcomas (five) for wedge lung resections. During the same period, nine patients with metachronous bilateral spontaneous pneumothorax had staged procedures, as did two with digital ischemic ulcers for sympathectomy and three with metastatic pulmonary osteosarcomas for resection. Mean postoperative hospital stays in days for the simultaneous groups were 3.3 for spontaneous pneumothorax, 2.1 for sympathectomy, and 1.5 for wedge resection, compared to 2.9, 2.5, and 2.2 for the staged groups, respectively (p 〉 0.05 by Mann-Whitney U tests). Likewise, pain assessment by visual analogue scale as well as analgesic requirement showed no significant difference between the simultaneous and the staged groups. We conclude that simultaneous VATS is not associated with increased morbidity or prolonged hospital stay compared to the staged counterparts and provides an attractive alternative to the median sternotomy, bilateral posterolateral thoracotomy, or transternal (clam-shell) thoracotomy for selected cases of simultaneous bilateral lung surgery.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1198-1200 
    ISSN: 1432-2218
    Keywords: Key words: Video-assisted thoracoscopic surgery — Cost containment — Patient selection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Video-assisted thoracoscopic surgery (VATS) is now an established approach in the management of many thoracic conditions. However, the high cost of this new technology has deterred many Asian hospitals from widely applying this technique. Methods: This article describes our strategies to reduce cost in our practice of VATS over the last few years. Results: VATS involves (1) careful patient selection, (2) use of conventional thoracic instruments as much as possible, (3) modification of conventional instruments, (4) limited use of expensive consumables, and (5) development and application of endoscopic suturing technique. Conclusions: VATS is still in evolution. Cost containment, while desirable in the West, is a high priority in Asia if this new surgical approach is to be applicable even in developing countries. More research is greatly needed in this area.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 438 -440 
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic surgery — two-dimensional camera system — three-dimensional camera system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The lack of depth perception and spatial orientation in video vision are the drawbacks of laparoscopic surgery. The advent of a three-dimensional camera system enables surgeons to regain binocular vision and may be advantageous in complex laparoscopic procedures. Methods: We prospectively studied two groups of surgeons (with and without experiences in laparoscopic surgery) who performed a designated standardized laparoscopic task using a two-dimensional camera system (Olympus OTV-S4) vs a three-dimensional camera system (Baxter-V. Mueller VS7700) and compared their time performances. Results: The results suggested that only experience in laparoscopic surgery had significant effect on individual's performance. We could not demonstrate any superiority of the 3D system over the 2D system. However, two-thirds of the surgeons commented that the depth perception did improve. Conclusions: With further refinement of the technology, the 3D system may improve its potential in laparoscopic surgery.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 439-440 
    ISSN: 1432-2218
    Keywords: Lobectomy ; Bronchogenic cyst ; Thoracoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 19-year-old male who presented with cough and fever was found to have an 8-cm cyst in his left lung. Video-assisted thoracoscopic left lower lobectomy was performed. The cyst had to be decompressed by needle aspiration prior to retrieval through a 5-cm minithoracotomy. The patient was discharged on postoperative day 4 in good condition. The technical aspects form the basis of this report.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 439-440 
    ISSN: 1432-2218
    Keywords: Key words: Lobectomy — Bronchogenic cyst — Thoracoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A 19-year-old male who presented with cough and fever was found to have an 8-cm cyst in his left lung. Video-assisted thoracoscopic left lower lobectomy was performed. The cyst had to be decompressed by needle aspiration prior to retrieval through a 5-cm minithoracotomy. The patient was discharged on postoperative day 4 in good condition. The technical aspects form the basis of this report.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 444-447 
    ISSN: 1432-2218
    Keywords: Key words: Major airway obstruction — Intraluminal stenting — Interventional bronchoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Major airway obstruction due to benign or malignant etiology is not uncommon and is always distressing. Intraluminal stenting has been shown to be a safe and effective approach for symptomatic relief in selected patients based on the European and North American experience. Methods: We reviewed our experience in Hong Kong on airway stenting over a 19-month period. Results: From February 1994 to August 1995, 33 silicone stents (Dumon stent, Cometh, Marseille, France) were placed in 23 patients (20 males, three females with mean age 61.4 years, range from 26 to 81). Eighteen stents were placed in the trachea, nine in the left main stem, five in the right main stem, and one Y-stent over the carina. Twelve patients had esophageal carcinoma involving the airway, seven had bronchial carcinoma, one had metastatic carcinoma, and three had benign strictures (of which two were due to tuberculosis). There was no procedural related mortality. Stent migration occurred in four patients (17%) and required stent change. Symptoms were improved in all patients as documented by the visual analogue scale. Conclusion: Our experience represents the ``stentable'' diseases seen in Hong Kong, where carcinoma of the esophagus (and tuberculosis) remains prevalent. We conclude that intraluminal stenting remains a safe and effective approach in selected patients with critical airway stenosis. Complications, however, do exist and should be realized by the operator, the patients, and their families.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1133-1135 
    ISSN: 1432-2218
    Keywords: Video-assisted thoracoscopic surgery ; Malignant pleural effusion ; Port-site recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Video-assisted thoracoscopic surgery (VATS) is an established modality in the management of pleural diseases. We report a case of port-site recurrence following management of malignant pleural effusion in an elderly patient with extensive pleural metastasis from adenocarcinoma of the lung. Although her shortness of breath was relieved following VAT decortication and talc insufflation, at 3 months she was found to have a 2.5-cm subcutaneous nodule at the camera port site which on biopsy was confirmed to be metastatic in nature. Even though the nodule was asymptomatic and the patient prognosis was not affected, it is important that both the surgeon and future patients should be aware of this potential complication.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1013-1016 
    ISSN: 1432-2218
    Keywords: Video-assisted thoracoscopic suturing ; Spontaneous pneumothorax ; Apical bullae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively studied thoracoscopic suturing of apical bullae in the management of primary spontaneous pneumothorax. From June 1993 to July 1994, we performed 29 such procedures in 27 patients. (All males ranging in age from 15 to 40.) Bullae less than 2 cm in diameter were imbricated (18), while larger bullae were resected and repaired with 3/0 polypropylene suture (11). Postoperative morbidity was minimal. Averaged postoperative parenteral narcotic (Pethidine) requirement was 88 mg, chest drainage was 1.7 (range 1–4) days, and hospital stay was 2.5 (range 1–7) days. There was no recurrence after a mean follow-up of 10 months. In comparison, 32 patients prior to this study period underwent staple resection of apical bulla. Demographic data in the two groups were similar. Averaged Pethidine requirement in the “staple” group was 98 mg, chest drainage was 1.8 (range 1–5) days, and hospital stay was 2.6 (range 1–7) days. There was no statistical difference in the two groups with respect to pain medication, chest drainage, or hospital stay. The technique of thoracoscopic suturing can be easily acquired. In view of the high cost of staple-cutters, endoscopic suturing should be considered as a viable alternative to staple resection of apical bullae in the treatment of primary spontaneous pneumothorax.
    Type of Medium: Electronic Resource
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