Journal articles on the topic 'Thoracic Surgery methods'
To see the other types of publications on this topic, follow the link: Thoracic Surgery methods.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Thoracic Surgery methods.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Sharma, Aakriti, Ranjan Sapkota, Bibhusal Thapa, and Prakash Sayami. "Operative management of pediatric empyema: a single center review." Journal of Society of Surgeons of Nepal 21, no. 1 (June 30, 2018): 10–13. http://dx.doi.org/10.3126/jssn.v21i1.24367.
Full textAbstract:
Introduction: Empyema thoracis is an uncommon complication of childhood pneumonias but a common problem faced by a thoracic surgeon. Its management is still controversial, with a range of treatment options available and evolving gradually towards adoption of video-assisted thoracoscopic surgery (VATS) as the most commonly practiced one.
Aim: The aim of this study was to review our experience in pediatric empyema thoracis.
Methods: It was a retrospective review of the prospectively recorded data, spanning a period of 18 months in the Department of Cardio-Thoracic and Vascular Surgery in Manmohan Cardio-Thoracic Vascular and Transplant Center.
Results: A total of 40 consecutive patients, 29 males and 11 females, aged 15 years or less were operated upon for a diagnosis of empyema thoracis made based on clinical, radiological and laboratory evidence. All of them were referred patients, mostly from pediatricians. VATS was undertaken in 36 of them, the remaining four treated by open approach. Deloculation sufficed in majority (26/40; 65%) of the patients which mostly (23/26; 90%) had either acute or subacute presentation. Decortication was required in 35% (14/40) of the patients. However, all of the patients but one had a successful outcome in terms of lung expansion, sterilization of the pleural cavity and absence of recurrence. There was no operative mortality.
Conclusion: Surgical management of pediatric thoracic empyema is feasible and safe with favorable outcome. VATS is gradually becoming the more favored modality of operative management.
2
Raad, Wissam N., Adil Ayub, Chyun-Yin Huang, Landon Guntman, Sadiq S. Rehmani, and Faiz Y. Bhora. "Robotic Thoracic Surgery Training for Residency Programs." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 13, no. 6 (November 2018): 417–22. http://dx.doi.org/10.1097/imi.0000000000000573.
Full textAbstract:
Objective Robotic-assisted surgery is increasingly being used in thoracic surgery. Currently, the Integrated Thoracic Surgery Residency Program lacks a standardized curriculum or requirement for training residents in robotic-assisted thoracic surgery. In most circumstances, because of the lack of formal residency training in robotic surgery, hospitals are requiring additional training, mentorship, and formal proctoring of cases before granting credentials to perform robotic-assisted surgery. Therefore, there is necessity for residents in Integrated Thoracic Surgery Residency Program to have early exposure and formal training on the robotic platform. We propose a curriculum that can be incorporated into such programs that would satisfy both training needs and hospital credential requirements. Methods We surveyed all 26 Integrated Thoracic Surgery Residency Program Directors in the United States. We also performed a PubMed literature search using the key word “robotic surgery training curriculum.” We reviewed various robotic surgery training curricula and evaluation tools used by urology, obstetrics gynecology, and general surgery training programs. We then designed a proposed curriculum geared toward thoracic Integrated Thoracic Surgery Residency Program adopted from our credentialing experience, literature review, and survey consensus. Results Of the 26 programs surveyed, we received 17 responses. Most Integrated Thoracic Surgery Residency Program directors believe that it is important to introduce robotic surgery training during residency. Our proposed curriculum is integrated during postgraduate years 2 to 6. In the preclinical stage postgraduate years 2 to 3, residents are required to complete introductory online modules, virtual reality simulator training, and in-house workshops. During clinical stage (postgraduate years 4–6), the resident will serve as a supervised bedside assistant and progress to a console surgeon. Each case will have defined steps that the resident must demonstrate competency. Evaluation will be based on standardized guidelines. Conclusions Expansion and utilization of robotic assistance in thoracic surgery have increased. Our proposed curriculum aims to enable Integrated Thoracic Surgery Residency Program residents to achieve competency in robotic-assisted thoracic surgery and to facilitate the acquirement of hospital privileges when they enter practice.
3
Sagiroglu, Gonul, Burhan Meydan, Elif Copuroglu, Ayse Baysal, Yener Yoruk, Yekta Altemur Karamustafaoglu, and Serhat Huseyin. "A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery." World Journal of Surgical Oncology 12, no. 1 (2014): 96. http://dx.doi.org/10.1186/1477-7819-12-96.
Full text
4
Pacini, Davide, Luca Di Marco, and Roberto Di Bartolomeo. "Methods of cerebral protection in surgery of the thoracic aorta." Expert Review of Cardiovascular Therapy 4, no. 1 (January 2006): 71–82. http://dx.doi.org/10.1586/14779072.4.1.71.
Full text
5
Mamedov E., E. Sh. "EFFICIENCY OF APPLICATION OF TUBULAR THORACOSTOMY METHODS IN THORACIC SURGERY." Bulletin of Problems Biology and Medicine 1.2, no. 143 (2018): 287. http://dx.doi.org/10.29254/2077-4214-2018-1-2-143-287-290.
Full text
6
Brown, Rachel, Petra Grehan, Marie Brennan, Denise Carter, Aoife Brady, Eoin Moore, SeÁn Paul Teeling, Marie Ward, and Donna Eaton. "Using Lean Six Sigma to improve rates of day of surgery admission in a national thoracic surgery department." International Journal for Quality in Health Care 31, Supplement_1 (December 2019): 14–21. http://dx.doi.org/10.1093/intqhc/mzz083.
Full textAbstract:
Abstract Objective The aim of this study is to improve rates of day of surgery admission (DOSA) for all suitable elective thoracic surgery patients. Design Lean Six Sigma (LSS) methods were used to enable improvements to both the operational process and the organizational working of the department over a period of 19 months. Setting A national thoracic surgery department in a large teaching hospital in Ireland. Participants Thoracic surgery staff, patients and quality improvement staff at the hospital. Intervention(s) LSS methods were employed to identify and remove the non-value-add in the patient’s journey and achieve higher levels of DOSA. A pre-surgery checklist and Thoracic Planning Meeting were introduced to support a multidisciplinary approach to enhanced recovery after surgery (ERAS), reduce rework, improve list efficiency and optimize bed management. Main Outcome Measure(s) To achieve DOSA for all suitable elective thoracic surgery patients in line with the National Key Performance Indicator of 75%. A secondary outcome would be to further decrease overall length of stay by 1 day. Results Over a 19 month period, DOSA has increased from 10 to 75%. Duplication of preoperative tests reduced from 83 to <2%. Staff and patient surveys show increased satisfaction and improved understanding of ERAS. Conclusions Using LSS methods to improve both operational process efficiency and organizational clinical processes led to the successful achievement of increasing rates of DOSA in line with national targets.
7
Erturk, Engin, Ferdane Aydogdu Kaya, Dilek Kutanis, Ahmet Besir, Ali Akdogan, Sükran Geze, and Ersagun Tugcugil. "The Effectiveness of Preemptive Thoracic Epidural Analgesia in Thoracic Surgery." BioMed Research International 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/673682.
Full textAbstract:
Background. The aim of this study is to investigate the effectiveness of preemptive thoracic epidural analgesia (TEA) comparing conventional postoperative epidural analgesia on thoracotomy.Material and Methods. Forty-four patients were randomized in to two groups (preemptive: Group P, control: Group C). Epidural catheter was inserted in all patients preoperatively. In Group P, epidural analgesic solution was administered as a bolus before the surgical incision and was continued until the end of the surgery. Postoperative patient controlled epidural analgesia infusion pumps were prepared for all patients. Respiratory rates (RR) were recorded. Patient’s analgesia was evaluated with visual analog scale at rest (VASr) and coughing (VASc). Number of patient’s demands from the pump, pump’s delivery, and additional analgesic requirement were also recorded.Results. RR in Group C was higher than in Group P at postoperative 1st and 2nd hours. Both VASr and VASc scores in Group P were lower than in Group C at postoperative 1st, 2nd, and 4th hours. Patient’s demand and pump’s delivery count for bolus dose in Group P were lower than in Group C in all measurement times. Total analgesic requirements on postoperative 1st and 24th hours in Group P were lower than in Group C.Conclusion. We consider that preemptive TEA may offer better analgesia after thoracotomy.
8
Naylor, Margaret F., Nolan Karstaedt, Sanford J. Finck, and Omer L. Burnett. "Noninvasive methods of diagnosing thoracic splenosis." Annals of Thoracic Surgery 68, no. 1 (July 1999): 243–44. http://dx.doi.org/10.1016/s0003-4975(99)00492-0.
Full text
9
Park, MiHye, Hyun Joo Ahn, Jie Ae Kim, Mikyung Yang, Burn Young Heo, Ji Won Choi, Yung Ri Kim, et al. "Driving Pressure during Thoracic Surgery." Anesthesiology 130, no. 3 (March 1, 2019): 385–93. http://dx.doi.org/10.1097/aln.0000000000002600.
Full textAbstract:
Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Recently, several retrospective studies have suggested that pulmonary complication is related with driving pressure more than any other ventilatory parameter. Thus, the authors compared driving pressure–guided ventilation with conventional protective ventilation in thoracic surgery, where lung protection is of the utmost importance. The authors hypothesized that driving pressure–guided ventilation decreases postoperative pulmonary complications more than conventional protective ventilation. Methods In this double-blind, randomized, controlled study, 292 patients scheduled for elective thoracic surgery were included in the analysis. The protective ventilation group (n = 147) received conventional protective ventilation during one-lung ventilation: tidal volume 6 ml/kg of ideal body weight, positive end-expiratory pressure (PEEP) 5 cm H2O, and recruitment maneuver. The driving pressure group (n = 145) received the same tidal volume and recruitment, but with individualized PEEP which produces the lowest driving pressure (plateau pressure–PEEP) during one-lung ventilation. The primary outcome was postoperative pulmonary complications based on the Melbourne Group Scale (at least 4) until postoperative day 3. Results Melbourne Group Scale of at least 4 occurred in 8 of 145 patients (5.5%) in the driving pressure group, as compared with 18 of 147 (12.2%) in the protective ventilation group (P = 0.047, odds ratio 0.42; 95% CI, 0.18 to 0.99). The number of patients who developed pneumonia or acute respiratory distress syndrome was less in the driving pressure group than in the protective ventilation group (10/145 [6.9%] vs. 22/147 [15.0%], P = 0.028, odds ratio 0.42; 95% CI, 0.19 to 0.92). Conclusions Application of driving pressure–guided ventilation during one-lung ventilation was associated with a lower incidence of postoperative pulmonary complications compared with conventional protective ventilation in thoracic surgery.
10
Tough, Daniel, Joel Dunning, Jonathan Robinson, John Dixon, Jonathan Ferguson, Ian Paul, and Samantha L. Harrison. "Investigating balance, gait, and physical function in people who have undergone thoracic surgery for a diagnosis of lung cancer: A mixed-methods study." Chronic Respiratory Disease 18 (January 2021): 147997312110522. http://dx.doi.org/10.1177/14799731211052299.
Full textAbstract:
Objectives Symptoms associated with lung cancer and thoracic surgery might increase fall risk. We aimed to investigate: 1) balance, gait and functional status in people post-thoracic surgery compared to healthy controls; 2) perceptions of balance, gait and functional status. Methods Recruitment targeted older adults (≥50 years) who had undergone thoracic surgery for a diagnosis of lung cancer in the previous 3 months, and healthy age-matched controls. Dynamic and static balance, gait velocity, knee-extension strength and physical activity levels were assessed using the BESTest, Kistler force plate, GAITRite system, Biodex System 3 and CHAMPS questionnaire, respectively. Two-part semi-structured interviews were conducted post-surgery. Results Individuals post-surgery ( n = 15) had worse dynamic balance and gait, and lower levels of moderate/vigorous physical activity (MVPA) (all p<0.05) versus healthy controls ( n = 15). Strength did not differ between groups ( p > 0.05). No associations between BESTest and strength or physical activity existed post-surgery ( p > 0.05). Three themes were identified: 1) Symptoms affect daily activities; 2) Functional assessments alter perceptions of balance ability and 3) Open to supervised rehabilitation. Conclusion Balance, gait and MVPA are impaired post-thoracic surgery, yet balance was not viewed to be important in enabling activities of daily living. However, supervised rehabilitation was considered acceptable.
11
Jurado, Julissa E., and Brendon Stiles. "Noteworthy Literature Published in 2016 for Thoracic Surgery." Seminars in Cardiothoracic and Vascular Anesthesia 21, no. 1 (January 29, 2017): 36–44. http://dx.doi.org/10.1177/1089253216688689.
Full textAbstract:
The past year has produced several important articles in the field of thoracic surgery, spanning many different diseases. Thoracic surgeons continue to investigate methods to perform complex operations and procedures less invasively, with the least possible morbidity to our patients. We also continue to critically evaluate new technology and procedures to ensure that they meet our rigorous standards for oncologic efficacy and for management of benign disease. Importantly, as we continue to evolve, thoracic surgeons have remained focused on optimizing processes of care, both inside and outside the operating room. The purpose of this review is to highlight the major advances in thoracic surgical disease in the year 2016.
12
Nesbitt, Jonathan C., Stephen Deppen, Richard Corcoran, Shari Cogdill, Sarah Huckabay, Drew McKnight, Breanne F. Osborne, Kristin Werking, Megan Gardner, and Laurel Perrigo. "Postoperative ambulation in thoracic surgery patients: standard versus modern ambulation methods." Nursing in Critical Care 17, no. 3 (January 30, 2012): 130–37. http://dx.doi.org/10.1111/j.1478-5153.2011.00480.x.
Full text
13
Donohue, Miriam L., Ross R. Moquin, Amit Singla, and Blair Calancie. "Is in vivo manual palpation for thoracic pedicle screw instrumentation reliable?" Journal of Neurosurgery: Spine 20, no. 5 (May 2014): 492–96. http://dx.doi.org/10.3171/2014.1.spine13197.
Full textAbstract:
Object Previous reports on the accuracy of manual palpation for thoracic pedicle screw placement have been restricted to cadaveric studies. Authors of the present novel study assessed the accuracy of manual palpation for the detection of medial and lateral pedicle breaches during thoracic spine surgery in living adult humans. Methods Pedicle tracks were created freehand and manually palpated using a ball-tipped probe. Postoperative CT scans of all implanted thoracic and L-1 screws were evaluated with respect to screw position and the pedicle wall. Results Five hundred twenty-five pedicle track/screw placements were compared. There were 21 pedicles with medial breaches measuring ≥ 2 mm. The surgeon correctly identified only 4 of these pedicle tracks as having a medial breach. The surgeon correctly identified 17 of 128 pedicles with a significant (≥ 2 mm) lateral breach. One hundred two screw placements had no measurable breach in any direction (medial, lateral, or foraminal). The surgeon correctly identified 98% of these ideally placed screws. Conclusions In this real-time study of thoracic pedicle screw placement, the accuracy of manual palpation for detecting medial or lateral breaches that were ≥ 2 mm was disturbingly low. These findings are consistent with those in recent cadaveric evaluations of palpation accuracy and point to the critical need for more reliable alternative methods to assess pedicle integrity during the placement of thoracic pedicle screws for spine instrumentation surgery.
14
Jheon, Sanghoon, Aneez DB Ahmed, Vincent WT Fang, Woohyun Jung, Ali Zamir Khan, Jang-Ming Lee, Alan DL Sihoe, et al. "Thoracic cancer surgery during the COVID-19 pandemic: a consensus statement from the Thoracic Domain of the Asian Society for Cardiovascular and Thoracic Surgery." Asian Cardiovascular and Thoracic Annals 28, no. 6 (July 2020): 322–29. http://dx.doi.org/10.1177/0218492320940162.
Full textAbstract:
Objectives Healthcare resources have been mobilized to combat the COVID-19 pandemic of 2020. The Thoracic Domain of the Asian Society for Cardiovascular and Thoracic Surgery reports a consensus statement on the provision of thoracic cancer surgery during this pandemic. Methods A Thoracic Experts Panel was convened by the Society. A consensus on the provision, safety, and setting of thoracic cancer surgery during the pandemic was obtained through a Delphi process. Results Responses were received from 26 panel members (96% response rate) from 10 regions across Asia. The Society recommended that elective thoracic cancer surgery services may need to be reduced or postponed if medical resources were needed for COVID-19 patients, especially intensive care unit beds and ventilators. However, thoracic cancer surgery should proceed as normal for all solid tumors, without restrictions based on disease stage, availability of non-surgical treatment options, or patient condition (unless there is a high likelihood of postoperative intensive care unit stay). Aerosol-forming procedures should be avoided intra- and perioperatively. The surgical approach does not make a difference in terms of safety. Services for thoracic cancer patients should be offered only in hospitals that maintain isolation wards for patients with confirmed or suspected COVID-19. Conclusions Services for patients with thoracic cancer should be maintained during the COVID-19 pandemic. The position of the Society is that thoracic surgeons have a responsibility to perform good surgical management of thoracic cancer during the pandemic, to advocate for patients’ rights to receive it, and to safeguard patients and staff from infection.
15
Musgrove, Kelsey A., Jeremiah A. Hayanga, Sari D. Holmes, Alexander Leung, and Ghulam Abbas. "Robotic versus Video-Assisted Thoracoscopic Surgery Pulmonary Segmentectomy." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 13, no. 5 (September 2018): 338–43. http://dx.doi.org/10.1097/imi.0000000000000557.
Full textAbstract:
Objective Pulmonary segmentectomy using robotic assistance is often perceived as being more expensive than segmentectomy using video-assisted thoracic surgery. The robotic technique allows for meticulous dissection during segmentectomy, potentially leading to fewer parenchymal injuries, fewer air leaks, and shorter length of stay. This study compared pulmonary segmentectomy costs using video-assisted thoracic surgery versus robotic with manual staplers versus robotic with robotic staplers. Methods Retrospective analyses were performed evaluating our early experience with robotic pulmonary segmentectomy for 30 months compared with the video-assisted thoracic surgery approach. All 50 anatomical segmentectomies performed since introduction of robotic technique in the practice were included. Twenty-eight procedures were robotic-assisted and 22 were video-assisted thoracic surgery. Procedure-specific evaluation of direct costs was performed, including cost of robotic instruments, staplers, and average length of stay in the hospital. Results The mean ± SD age was 70 ± 10 years (range = 43–91 years). There were 12 males in the robotic group and eight in the video-assisted thoracic surgery group ( P = 0.642). The mean age was 69 years in the robotic group and 71 years in the video-assisted thoracic surgery group ( P = 0.367). The median length of stay was 2 (2–4) days in the robotic group (range = 1–9) and 4 (2–5) days in the video-assisted thoracic surgery group (range = 1–20, P = 0.089). The cost of robotic segmentectomy with manual staplers was less than that with robotic staplers. Both robotic techniques cost less than video-assisted thoracic surgery. Conclusions In this small series, cost and outcomes in our early experience with robotic-assisted segmentectomy were comparable with our video-assisted thoracic surgery approach with trends toward shorter length of stay and fewer complications. Larger series are needed to validate these results.
16
Bayman, Emine O. "Pain-Related Limitations in Daily Activities Following Thoracic Surgery in a United States Population." Pain Physician 3, no. 20;3 (March 10, 2017): E367—E378. http://dx.doi.org/10.36076/ppj.2017.e378.
Full textAbstract:
Background: Ringsted et al created a statistically validated questionnaire to assess painrelated limitations in daily activities following thoracic surgery and translated it to English. We utilized the questionnaire to assess the impact of pain impairing certain daily activities in a United States thoracic surgery population. Objectives: Examine if the questionnaire developed and translated to English by Ringsted et al to assess the effects of chronic pain after thoracic surgery on daily activities would be applicable in a sample of thoracic surgery patients in the United States. Study Design: Cross-sectional study by mailed questionnaire. Setting: All patients who had thoracic surgery between 6 months and 3 years ago at a university hospital. Methods: We sent questionnaires to patients who had undergone thoracic surgery between 6 months and 3 years ago, yielding a sample of 349 eligible patients. Questionnaire results were statistically assessed for item fit, dimensionality, and internal reliability. Results: The response rate was 26.4%. Of the responders, 36% (95% CI: 26.1% to 46.5%) identified themselves as having chronic pain related to their thoracic surgery. Activities such as lying on the operated side, coughing, and carrying groceries were impaired in more than 50% of the patients who had thoracic surgery related pain (P < 0.05). Patients with chronic pain were more likely to report pain in other body locations. Few activities were limited in the patients identifying themselves as not having chronic pain. Statistical measures indicate high internal reliability. Limitations: This was a retrospective questionnaire with 26.4% response rate. Conclusions: Pain continues to impair the daily activities of a significant proportion of patients after thoracic surgery in a sample from the United States. Despite cultural differences, the Danish procedure-specific questionnaire provides an applicable and similar assessment of functional impairment after thoracic surgery in American patients. Key words: Thoracic surgery, chronic pain, impairment, daily life, questionnaire
17
Dützmann, Stephan, Roli Rose, and Daniel Rosenthal. "Revision surgery in thoracic disc herniation." European Spine Journal 29, S1 (November 16, 2019): 39–46. http://dx.doi.org/10.1007/s00586-019-06212-w.
Full textAbstract:
Abstract Purpose Surgical treatment failures or strategies for the reoperation of residual thoracic disc herniations are sparsely discussed. We investigated factors that led to incomplete disc removal and recommend reoperation strategies. Methods As a referral centre for thoracic disc disease, we reviewed retrospectively the clinical records and imaging studies before and after the treatment of patients who were sent to us for revision surgery for thoracic disc herniation from 2013 to 2018. Results A total of 456 patients were treated from 2013 to 2018 at our institution. Twenty-one patients had undergone previously thoracic discectomy at an outside facility and harboured residual, incompletely excised and symptomatic herniated thoracic discs. In 12 patients (57%), the initial symptoms that led to their primary operation were improved after the first surgery, but recurred after a mean of 2.8 years. In seven patients (33%) they remained stable, and in two cases they were worse. All patients were treated via all dorsal approaches. In all 21 cases, the initial excision was incomplete regarding medullar decompression. All of the discs were removed completely in a single revision procedure. After mean follow-up of 24 months (range 12–57 months), clinical neurological improvement was demonstrated in seven patients, while three patients suffered a worsening and 11 patients remained stable. Conclusion Our data suggest that pure dorsal decompression provides a short relief of the symptoms caused by spinal cord compression. Progressive myelopathy (probably due to mechanical and vascular deficits) and scar formation may cause worsening of symptoms. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.
18
Amar, David, Nancy Roistacher, Hao Zhang, Michael S. Baum, Ilana Ginsburg, and Jonathan S. Steinberg. "Signal-averaged P-wave Duration Does Not Predict Atrial Fibrillation after Thoracic Surgery." Anesthesiology 91, no. 1 (July 1, 1999): 16–23. http://dx.doi.org/10.1097/00000542-199907000-00007.
Full textAbstract:
Background Atrial fibrillation (AF) is the most common dysrhythmia seen early after major thoracic surgery but occurs infrequently after minor thoracic or other operations. A prolonged signal-averaged P-wave duration (SAPWD) has been shown to be an independent predictor of AF after cardiac surgery. The authors sought to determine whether a prolonged SAPWD alone or in combination with clinical or echocardiographic correlates predicts AF after elective noncardiac thoracic surgery. Methods Of the 250 patients enrolled, 228 were included in the final analysis. Preoperative SAPWD was obtained in 155 patients who had major thoracic surgery and in 73 patients undergoing minor thoracic or other operations who served as comparison control subjects. The SAPWD was recorded from three orthogonal leads using a sinus P-wave template. The filtered vector composite was used to measure total P-wave duration. Clinical, surgical, and echocardiographic parameters were collected and patients followed for 30 days after surgery for the development of symptomatic AF. Results Symptomatic AF developed in 18 of 155 (12%) patients undergoing major thoracic surgery and in 1 of 73 (1%) patients having minor thoracic or abdominal surgery, most commonly 2 or 3 days after surgery. In comparison with similar patients undergoing major thoracic surgery without AF, those who developed AF were older (66+/-8 vs. 62+/-10 yr; P = 0.04) but did not differ in SAPWD (145+/-17 vs. 147+/-16, ms) in standard electrocardiographic P-wave duration (105+/-7 vs. 107+/-10 mns), incidence of left-ventricular hypertrophy on 12-lead electrocardiography, male sex, history of hypertension, diabetes, or coronary heart disease. Thoracic-surgery patients at risk for postoperative AF did not differ from all other patients at low risk for AF in clinical or SAPWD parameters. Conclusions Under the conditions of this study, SAPWD did not differentiate patients who did or did not develop AF after noncardiac thoracic surgery, and therefore its measurement cannot be recommended for the routine evaluation of these patients. Older age continues to be a risk factor for AF after thoracic surgery.
19
Sagiroglu, Gonul, Fazli Yanik, Yekta A. Karamusfaoglu, and Elif Copuroglu. "May awake video-assisted thoracoscopic surgery with thoracic epidural anesthesia use routinely for minimaly invasive thoracic surgery procedures in the future?" International Surgery Journal 5, no. 5 (April 21, 2018): 1602. http://dx.doi.org/10.18203/2349-2902.isj20181578.
Full textAbstract:
Background: In the last years thoracic surgery developed in greater extent with equipments and techniques in one lung ventilation. Still general anesthesia in one lung ventilation approved as gold standard. In thoracic surgery most performed surgeries are plerural decortication and lung biopsy. Avoidance of intubation in Video Assisted Thoracoscopic Surgery (VATS) procedures gains us some advantages in postoperative period; a better respiratory parameters, survival and morbidity mortality rates, reduced hospitalization time and costs, reduced early stress hormone and immune response. Methods: In this study, we reported our experience of 24 consecutive patients undergoing VATS with Thoracic Epidural Anesthesia (TEA) between December 2015 through July 2016 to evaluate the feasibility, safety and indication of this innovative technique whether it will be a gold standart in thoracic surgeries or not in the future.Results: Operation procedures included wedge resection in 11 (46%) patients (eight of them for pneumothorax, three of them for diagnosis), in 10 (42%) patients pleural biopsy (eight of them used talc pleurodesis), in two (8%) patients air leak control with fibrin glue and in one (4%) patient bilateral thoracal sympathectomy for hyperhidrosis. We used T4-5 TEA space for 17 (72%) of patients, while we used T4-6 TEA space for 7 (28%) of patients. TEA block reached the desired level after the mean 26.4±4.3 minutes (range 21-34 min). There was no occurrence of hypotension and bradycardia during and after TEA. One (4%) patient required conversion to general anesthesia and tracheal intubation because of significant diaphragmatic contractions and hyperpne. Conversion to thoracotomy was not needed in any patient.Conclusions: We conclude that nVATS procedure with aid of TEA is feasibile and safety with minimal adverse events. The procedure can have such advantages as early mobilization, opening of early oral intake, early discharge, patient satisfaction, low pain level. Nevertheless, there is a need for randomized controlled trials involving wider case series on the subject.
20
Bashar, Md Abul, Mohammad Ali, Kazi lsrat Jahan, Zahidur Rahman, and Mahbub Murshed. "Breast Surgery under Thoracic Epidural Analgesia." Journal of Surgical Sciences 21, no. 1 (November 17, 2019): 29–32. http://dx.doi.org/10.3329/jss.v21i1.43836.
Full textAbstract:
Background: Operations on breast are routinely performed under general anesthesia. Avariety of local and regional techniques have been described for breast surgery with thegoal of reducing the complications associated with general anaesthesia.
Objective: To assess the feasibility of thoracic epidural anaesthesia as sole anesthetictechnique for breast surgery.
Methods: This study was conducted on 32 cooperative female patients of age group42-55 year. T5-T6 or T4-T5 space was used for insertion of epidural catheter. lnjLidocaine 2% 12 ml was injected through the catheter as anaesthetic agent. lnj Tramadol50- 100 mg used epidurally for postoperative relief till 48 hours postoperatively.Demographic characteristics of the study population, any coexisting disease, type ofsurgery performed, duration of surgery, degree of intraoperative analgesia, incidence ofcomplications related to TEA, and its efficacy in postoperative pain relief were observedand analysed.
Results: Out of 32 patients most of them (11) were in between 51-55 years. 10 out of32 had coexisting disease. 5 patient had hypertension and one had asthma. Modifiedradical mastectomy (MRM) was most frequently performed operation (24). 21 patientcomplained no pain during the operation and 5 patient complained mild discomforttowards end of operation. 4 patient developed bradycardia during the operation whichwas managed by inj. Atropin. Post operative analgesia was satisfactory.
Conclusion: Midthoracic epidural anaesthesia technique is a safe alternative acceptablemethod for various breast surgery with excellent postoperative pain relief and earlyrecovery.
Journal of Surgical Sciences (2017) Vol. 21 (1) :29-32
21
Belov, Sergei, and Alexander Grigoryuk. "Application of Polypropylene Mesh Implants in Thoracic Surgery." Journal of Experimental and Clinical Surgery 13, no. 2 (June 29, 2020): 146–51. http://dx.doi.org/10.18499/2070-478x-2020-13-2-146-151.
Full textAbstract:
The widespread introduction of synthetic grafts into the clinical practice became possible after recent advances in fundamental sciences and production technologies. Now implants are in common use in angiosurgery, orthopedics, gynecology, abdominal and thoracic surgery. Most often, synthetic materials are used in mesh prostheses. The results of literature review demonstrate rapid development and advances of the polypropylene mesh implant techniques in thoracic surgery. The authors highlight the application of polypropylene mesh in the reconstruction of the chest wall, the creation of lung compression, closing the diaphragm defect. The main reason for mesh transplant use in thoracic surgery is an increase in the effectiveness of surgical treatment methods, elimination of the mechanism of respiratory problems and associated complications. The study of the biological properties of mesh implants and reparative processes can considerably expand opportunities and prospects for their further application in thoracic surgery, both in resection and plastic directions, and during collapse surgery. Combinations of various types of synthetic materials provide not only mechanical support in chest surgery, but also ensure good functional results of the organs.
22
Rifa'i, Ahmad Sabili, Gadis Meinar Sari, and Vicky Sumarki Budipramana. "Pre-Operative Enhanced Recovery After Surgery (ERAS) Protocol Compliance Towards Major Surgery Patients at Dr. Soetomo General Hospital, Surabaya." Biomolecular and Health Science Journal 3, no. 1 (June 12, 2020): 28. http://dx.doi.org/10.20473/bhsj.v3i1.19064.
Full textAbstract:
Introduction: The implementation of ERAS protocol can optimize patients after surgery, which in turn can reduce burdens both for patient and hospital. The purpose of this study is to describe the compliance and consistency of ERAS in the pre-operative period of surgery patients in Dr. Soetomo General Hospital Surabaya. Methods: We conducted consecutive observation of major surgical patients for 4 weeks. The type of surgery observed was digestive, thoracic and cardiovascular, and gynecological surgery. The pre-operative period will be calculated for compliance based on the ERAS international protocol. All data of compliance presented descriptively.s.Results: A total of 36 major surgery patients of which 7 (19,4%) were digestive surgeries, 14 (38,9%) were thoracic and cardiovascular surgeries, and 15 (41,7%) were gynecological surgeries. Overall compliance of the ERAS protocol in the pre-operative period of major surgery patients was 91%. The compliance of ERAS protocol in the pre-operative period of digestive surgery patients was 80%, in thoracic and cardiovascular surgery patients was 93,4% and gynecologic surgery patients was 84.3%. Major surgery patients with ≥90% compliance was 25%. Digestive surgery patients with ≥90% compliance was 0%. Thoracic and cardiovascular surgery patients with ≥90% compliance was 64,3%. Gynecologic surgery patients with ≥90% compliance was 0%.Conclusion: : Pre-operative elements of ERAS protocol in major surgery including digestive, thoracic and cardiovascular, and gynecologic surgery in Dr. Soetomo General Hospital, Surabaya needs to be improved.
23
Hendrix, Holger, Vladimir Kamlak, Georgi Prisadov, and Katrin Welcker. "Schmerztherapie nach thoraxchirurgischen Eingriffen." Allgemein- und Viszeralchirurgie up2date 12, no. 02 (April 2018): 155–65. http://dx.doi.org/10.1055/a-0583-8249.
Full textAbstract:
The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy.There are a number of different pain therapy methods, non-medicamentous and drug-based methods, whose effectiveness is described in the literature partially different. For the treatment of acute postoperative pain after thoracic surgery, mainly drug-related procedures are used, except for physiotherapy as a non-medicamentous method. Increasingly, alternative procedures for the peridural catheter as a therapeutic gold standard in the treatment of pain after thoracic surgery are used. Their application can be integrated into a therapeutic algorithm.
24
Hossain, SM Shahadat, Farhana Israt Jahan, Md Shahinur Rahman, Md Neazul Islam Majumdar, and Khan Nazmul Islam. "Role of Video-Assisted Thoracoscopic Surgery in the Management of Pleural Empyema." Journal of Armed Forces Medical College, Bangladesh 18, no. 1 (October 16, 2022): 19–22. http://dx.doi.org/10.3329/jafmc.v18i1.61251.
Full textAbstract:
Background: Video-assisted thoracoscopic surgery (VATS) has revolutionized surgical management of patients with empyema. Thoracoscopic management of empyema includes VATS debridement and decortication. VATS debridement has been employed by many centres as the primary treatment option for early-stage empyema. Objective: To evaluate the outcome of VATS over open thoracotomy. Methods: This cross-sectional study was conducted in the department of Thoracic Surgery of Combined Military Hospital Dhaka from 01 January 2017 to 30 May 2018 among 30 patients (20 patients underwent VATS and 10 patients underwent open decortication/OD). The results were viewed with respect to baseline characteristics, preoperative management, operative and postoperative course. Results: Operative time and median in-hospital length of stay were shorter for the VATS group: 128 vs 140 minutes (p < .001), and 14 vs 11 days (p .03), respectively. The median postoperative length of stay was 12 days for the VATS group vs15 days for the OD group (p < .001). Complications after Video Assisted Thoracic Surgery is less like prolonged air leakage, infection and atelectasis. Conclusions: VATS decortications for empyema thoracis, complex effusion, haemothorax yields better results than open decortications. Patients treated with VATS have less postoperative complications. VATS debridement and decortication is safe and effective treatment in the management of empyema thoracis. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 19-22
25
Yoshida, Takeshi, Bunpachi Kakii, Masato Furui, and Gaku Uchino. "Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection." Thoracic and Cardiovascular Surgeon 66, no. 03 (February 20, 2018): 227–32. http://dx.doi.org/10.1055/s-0038-1623479.
Full textAbstract:
Objective Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection. Methods This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017. Results There were 17 patients included in the analyses, with a mean age at surgery of 71.0 ± 10.5 years; 11 were men. In-hospital mortality was observed in five patients (29.4%). Conclusions Graft-sparing surgery for thoracic prosthetic graft infection is an alternative option particularly for early graft infection after hemiarch replacement.
26
Kozian, Alf, Thomas Schilling, Hartmut Schütze, Mert Senturk, Thomas Hachenberg, and Göran Hedenstierna. "Ventilatory Protective Strategies during Thoracic Surgery." Anesthesiology 114, no. 5 (May 1, 2011): 1025–35. http://dx.doi.org/10.1097/aln.0b013e3182164356.
Full textAbstract:
Background The increased tidal volume (V(T)) applied to the ventilated lung during one-lung ventilation (OLV) enhances cyclic alveolar recruitment and mechanical stress. It is unknown whether alveolar recruitment maneuvers (ARMs) and reduced V(T) may influence tidal recruitment and lung density. Therefore, the effects of ARM and OLV with different V(T) on pulmonary gas/tissue distribution are examined. Methods Eight anesthetized piglets were mechanically ventilated (V(T) = 10 ml/kg). A defined ARM was applied to the whole lung (40 cm H(2)O for 10 s). Spiral computed tomographic lung scans were acquired before and after ARM. Thereafter, the lungs were separated with an endobronchial blocker. The pigs were randomized to receive OLV in the dependent lung with a V(T) of either 5 or 10 ml/kg. Computed tomography was repeated during and after OLV. The voxels were categorized by density intervals (i.e., atelectasis, poorly aerated, normally aerated, or overaerated). Tidal recruitment was defined as the addition of gas to collapsed lung regions. Results The dependent lung contained atelectatic (56 ± 10 ml), poorly aerated (183 ± 10 ml), and normally aerated (187 ± 29 ml) regions before ARM. After ARM, lung volume and aeration increased (426 ± 35 vs. 526 ± 69 ml). Respiratory compliance enhanced, and tidal recruitment decreased (95% vs. 79% of the whole end-expiratory lung volume). OLV with 10 ml/kg further increased aeration (atelectasis, 15 ± 2 ml; poorly aerated, 94 ± 24 ml; normally aerated, 580 ± 98 ml) and tidal recruitment (81% of the dependent lung). OLV with 5 ml/kg did not affect tidal recruitment or lung density distribution. (Data are given as mean ± SD.) Conclusions The ARM improves aeration and respiratory mechanics. In contrast to OLV with high V(T), OLV with reduced V(T) does not reinforce tidal recruitment, indicating decreased mechanical stress.
27
Sathiamurthy, Narasimman, Narendran Balasubbiah, and Benedict Dharmaraj. "Aerosol-generating procedures in thoracic surgery in the COVID-19 era in Malaysia." Asian Cardiovascular and Thoracic Annals 28, no. 8 (August 12, 2020): 495–99. http://dx.doi.org/10.1177/0218492320950898.
Full textAbstract:
Background The Covid-19 pandemic has caused changes in the surgical treatment of non-Covid patients, especially in thoracic surgery because most procedures are aerosol generating. Hospital Kuala Lumpur, where thoracic procedures are performed, was badly affected. We describe our experience in performing aerosol generating procedures safely in thoracic surgery during the Covid-19 era. Methods Medical records of patients who underwent thoracic surgery from March 18, 2020 to May 17, 2020 were reviewed retrospectively. All patients undergoing thoracic surgery were tested for Covid-19 using the reverse transcriptase polymerase chain reaction method. Patients with malignancy were observed for 10 to 14 days in the ward after testing negative. The healthcare workers donned personal protective equipment for all the cases, and the number of healthcare workers in the operating room was limited to the minimum required. Results A total of 44 procedures were performed in 26 thoracic surgeries. All of these procedures were classified as aerosol generating, and the mean duration of the surgery was 130 ± 43 minutes. None of the healthcare workers involved in the surgery were exposed or infected by Covid-19. Conclusion Covid-19 will be a threat for a long time and thoracic surgeons must continue to provide their services, despite having to deal with aerosol generating procedures, in the new normal. Covid-19 testing of all surgical candidates, using the reverse transcriptase polymerase chain reaction, donning full personal protective equipment for healthcare workers, and carefully planned procedures are among the measures suggested to prevent unnecessary Covid-19 exposure in thoracic surgery.
28
Baba, Satoshi, Ryutaro Shiboi, Jyunichi Yokosuka, Yasushi Oshima, Yuichi Takano, Hiroki Iwai, Hirohiko Inanami, and Hisashi Koga. "Microendoscopic Posterior Decompression for Treating Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum: Case Series." Medicina 56, no. 12 (December 10, 2020): 684. http://dx.doi.org/10.3390/medicina56120684.
Full textAbstract:
Background and Objectives: Ossification of the ligamentum flavum (OLF) is a relatively common cause of thoracic myelopathy. Surgical treatment is recommended for patients with myelopathy. Generally, open posterior decompression, with or without fusion, is selected to treat OLF. We performed minimally invasive posterior decompression using a microendoscope and investigated the efficacy of this approach in treating limited type of thoracic OLF. Materials and Methods: Microendoscopic posterior decompression was performed for 19 patients (15 men and four women) with thoracic OLF with myelopathy aged between 35 to 81 years (mean age, 61.9 years). Neurological examination and preoperative magnetic resonance imaging (MRI) and computed tomography (CT) were used to identify the location and morphology of OLF. The surgery was performed using a midline approach or a unilateral paramedian approach depending on whether the surgeon used a combination of a tubular retractor and endoscope. The numerical rating scale (NRS) and modified Japanese Orthopedic Association (mJOA) scores were compared pre- and postoperatively. Perioperative complications and the presence of other spine surgeries before and after thoracic OLF surgery were also investigated. Results: Four midline and 15 unilateral paramedian approaches were performed. The average operative time per level was 99 min, with minor blood loss. Nine patients had a history of cervical or lumbar spine surgery before or after thoracic spine surgery. The mean pre- and postoperative NRS scores were 6.6 and 5.3, respectively. The mean recovery rate as per the mJOA score was 33.1% (mean follow-up period, 17.8 months), the recovery rates were significantly different between patients who underwent thoracic spine surgery alone (50.5%) and patients who underwent additional spine surgeries (13.7%). Regarding adverse events, one patient experienced dural tear, another experienced postoperative hematoma, and one other underwent reoperation for adjacent thoracic stenosis. Conclusion: Microendoscopic posterior decompression was applicable in limited type of thoracic OLF surgery including beak-shaped type and multi vertebral levels. However, whole spine evaluation is important to avoid missing other combined stenoses that may affect outcomes.
29
Maduri, Rodolfo, Daniele Starnoni, Juan Barges-Coll, Steven David Hajdu, and John Michael Duff. "Bone cylinder plug and coil technique for accurate pedicle localization in thoracic spine surgery: A technical note." Surgical Neurology International 10 (June 19, 2019): 104. http://dx.doi.org/10.25259/sni-258-2019.
Full textAbstract:
Background: Intraoperative identification of the correct level during thoracic spine surgery is essential to avoid wrong-level procedures. Despite technological progress, intraoperative imaging modalities for identifying the correct thoracic spine level remain unreliable and often lead to wrong-level surgery. To counter potential wrong-level operations, here, we have proposed a novel pedicle/bone cylinder marking technique for use in the thoracic spine utilizing biplanar fluoroscopy and confirmed with computed tomography (CT). Methods: First, under fluoroscopic guidance, a bone cylinder is removed from the correct thoracic pedicle. Next, endovascular coils are packed into the cancellous bone defect followed by reinsertion of the bony plug. The patient then undergoes a CT scan of the entire thoracolumbosacral spine to precisely identify the marked level before surgery. Results: We utilized this bone cylinder plug/coil technique to identify the T9-T10 level in a 56-year-old female with a soft thoracic disc herniation. The index thoracic pedicle was successfully localized before performing the unilateral minimally invasive laminectomy followed by the transpedicular thoracic disc excision. Conclusion: The bone cylinder plug/coil technique is a safe and effective method for marking the correct level in thoracic spine surgery, while also reducing the operative time.
30
Li, Cuilian, Zhenling Cai, Meixia Wu, Guijiao Li, and Yingmin Xie. "Health Management of Enhanced Recovery After Surgery in Thoracic Surgery." Journal of Medical Imaging and Health Informatics 10, no. 6 (June 1, 2020): 1301–8. http://dx.doi.org/10.1166/jmihi.2020.3057.
Full textAbstract:
Objective: Although the concept of Enhanced Recovery After Surgery (ERAS) has gradually become familiar with surgeons and applied in clinical practice in recent years, the current status of the experience and application of ERAS in Chinese mainland thoracic surgeons is still not clear. This study is based on the results of a questionnaire survey of ERAS-related issues among participating thoracic surgeons and nurses, and analyzes the current status of accelerated rehabilitation surgery in thoracic surgery using bioinformatics. Methods: We analyze the 720 valid questionnaires that participated in the first session of the ERAS West China Forum. The content of the questionnaire mainly includes two parts: one is the situation of the respondent’s unit and the basic situation of the individual; the other is to accelerate the 10 problems related to rehabilitation surgery. Results: (1) The clinical application status of ERAS is more than practice, and 68.3% of doctors and 57.8% of nurses agree with this view; 87.9% of doctors and 86.2% of nurses believe that the ERAS concept applies to all surgical procedures. (2) The main reason for the poor compliance of ERAS clinical application was that the program was immature, without consensus and norms (56.4% of doctors and 68.8% of nurses). (3) The best team combination for ERAS clinical implementation is surgical-based discipline collaboration and healthcare (61.5% of physicians and 72.2% of nurses). (4) 75.1% of doctors and 82.6% of nurses believe that the evaluation criteria of ERAS should be: comprehensive evaluation of average hospitalization days, patient experience and social satisfaction. Conclusions: Accelerated rehabilitation surgery in the application of thoracic surgery is still the idea is greater than practice, the main reason is the lack of clinically available norms and programs. We can achieve the findings and verify them using statistical study.
31
Matsuwaka, R. "Evaluation of the adjunctive methods in surgery for aneurysm of thoracic aorta." Japanese Journal of Cardiovascular Surgery 18, no. 3 (1988): 435–37. http://dx.doi.org/10.4326/jjcvs.18.435.
Full text
32
Lu, Pham Huu, Nguyen Huu Uoc, and Doan Quoc Hung. "Results of video-assisted thoracoscopic surgery approach to mediastinal tumor at Viet Duc hospital." Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam 3 (November 3, 2020): 28–32. http://dx.doi.org/10.47972/vjcts.v3i.306.
Full textAbstract:
Objective: The application of endoscopic surgical treatment of thoracic disease are beginning to flourish in Vietnam. The study aimed to evaluate the results of endoscopic thoracic surgical treatment of mediastinal tumors in Viet Duc Hospital. Methods: The retrospective study describes 50 patients mediastinal tumors were treated with endoscopic thoracic surgery from 12/2007 to 8/2012, of the parameters before, during and after surgery and the anatomy pathological results. Results: of 25 male and 25 female. Mean age 44.76 ± 16.52 (13-78). The main symptom is chest pain on admission (74%). Tumor size 5.893 ± 1.686 cm (2.7 to 11.0). Surgery time 100 ± 24.82 minutes (60-180). There is a case conversed to classical surgery (2%). Number of hospital days 4.48 ± 1.5 days (3-12). No mortality and major complications after surgery. Anatomy-pathological results: 49 cases of benign, 01 malignant cases of stage I (Masaoka). Conclusion: Treatment of mediastinal tumors by endoscopic thoracic surgery is a method of safe and feasible, bring good results after surgery.
33
Liang, Hongliu, Jing Huang, Jijia Tong, and Jinyue Wang. "Application of Rapid Rehabilitation Nursing in Thoracic Surgery Nursing." Journal of Healthcare Engineering 2021 (September 2, 2021): 1–9. http://dx.doi.org/10.1155/2021/6351170.
Full textAbstract:
To study the application effect of rapid rehabilitation nursing intervention in thoracic surgery nursing, this paper researches controlled trials. First, this paper sets up a control group and a test group. The control group uses traditional nursing methods for thoracic surgical nursing intervention, and the test group adds rapid rehabilitation nursing intervention based on traditional nursing intervention. In addition, the operation and rehabilitation conditions of the control group and the test group are the same. Moreover, this paper records rehabilitation information in real time, performs data processing through statistical methods, and conducts follow-up surveys on the rehabilitation process of patients. In addition, this paper compares nursing effects through data comparison and histogram comparison. From the research results, various parameters of the patient’s recovery process and the user satisfaction of the rapid rehabilitation can be seen. Furthermore, nursing is higher than those of the control group, which shows that the rapid rehabilitation nursing method can positively affect the nursing of thoracic surgery.
34
Bayman, Emine Ozgur, Kalpaj R. Parekh, John Keech, Atakan Selte, and Timothy J. Brennan. "A Prospective Study of Chronic Pain after Thoracic Surgery." Anesthesiology 126, no. 5 (May 1, 2017): 938–51. http://dx.doi.org/10.1097/aln.0000000000001576.
Full textAbstract:
Abstract Background The goal of this study was to detect the predictors of chronic pain at 6 months after thoracic surgery from a comprehensive evaluation of demographic, psychosocial, and surgical factors. Methods Thoracic surgery patients were enrolled 1 week before surgery and followed up 6 months postsurgery in this prospective, observational study. Comprehensive psychosocial measurements were assessed before surgery. The presence and severity of pain were assessed at 3 and 6 months after surgery. One hundred seven patients were assessed during the first 3 days after surgery, and 99 (30 thoracotomy and 69 video-assisted thoracoscopic surgery, thoracoscopy) patients completed the 6-month follow-up. Patients with versus without chronic pain related to thoracic surgery at 6 months were compared. Results Both incidence (P = 0.37) and severity (P = 0.97) of surgery-related chronic pain at 6 months were similar after thoracotomy (33%; 95% CI, 17 to 53%; 3.3 ± 2.1) and thoracoscopy (25%; 95% CI, 15 to 36%; 3.3 ± 1.7). Both frequentist and Bayesian multivariate models revealed that the severity of acute pain (numerical rating scale, 0 to 10) is the measure associated with chronic pain related to thoracic surgery. Psychosocial factors and quantitative sensory testing were not predictive. Conclusions There was no difference in the incidence and severity of chronic pain at 6 months in patients undergoing thoracotomy versus thoracoscopy. Unlike other postsurgical pain conditions, none of the preoperative psychosocial measurements were associated with chronic pain after thoracic surgery.
35
Beckman, Joshua M., Gisela Murray, Konrad Bach, Armen Deukmedjian, and Juan S. Uribe. "Percutaneous Minimally Invasive (MIS) Guide Wire-less Self-Tapping Pedicle Screw Placement in the Thoracic and Lumbar Spine: Safety and Initial Clinical Experience: Technical Note." Operative Neurosurgery 11, no. 4 (August 19, 2015): 530–36. http://dx.doi.org/10.1227/neu.0000000000000977.
Full textAbstract:
Abstract BACKGROUND Multiple methods for minimally invasive (MIS) thoracic and lumbar pedicle screw placement exist. The guide wire is almost universally used for most insertion techniques; however, its use is not without complication and potentially prolongs surgical procedures. OBJECTIVE To evaluate the safety of percutaneous MIS guide wire-less pedicle screw placement in the thoracic and lumbar spine at a single institution over a 3-year experience. METHODS Forty-one patients who underwent posterior instrumentation with 110 transpedicular MIS thoracic and lumbar screws by a single surgeon from 2011 to 2014 were analyzed. The mean age was 63 years at the time of surgery. Etiological diagnoses were adult spinal deformity, trauma, spondylosis/spondylolisthesis, and other spinal diseases. Pedicle screws were inserted with the use of a guide wire-free technique in which anatomy-specific entry sites and fluoroscopic landmarks were used to guide the surgeon. A square, sharp-tipped pedicle screw was carefully advanced under biplanar fluoroscopic image (anteroposterior and lateral) down the pedicle into the body. No tapping or any type of electromonitoring was performed. An independent spine surgeon using medical records and thoracic/lumbar computed tomography taken during the postoperative period reviewed all patients. RESULTS The number of the screws inserted at each level was as follows: total, 110; thoracic, 30; and lumbar, 80. All screws were evaluated by computed tomography to assess screw position. Seven screws (6.3%) were inserted with moderate cortical perforation, including 3 screws (2.7%) that violated the medial wall. There were no neurological, vascular, or visceral complications with up to 3 years of follow-up. CONCLUSION The percutaneous MIS guide wire-less technique of lumbar and thoracic pedicle screw placement performed using a biplanar fluoroscopic guidance in a stepwise, consistent manner is an accurate, safe, and reproducible method of insertion to treat a variety of spinal disorders.
36
D'Oro, Anthony, Mark J. Spoonamore, Jeremiah R. Cohen, Frank L. Acosta, Patrick C. Hsieh, John C. Liu, Thomas C. Chen, Zorica Buser, and Jeffrey C. Wang. "Effects of fusion and conservative treatment on disc degeneration and rates of subsequent surgery after thoracolumbar fracture." Journal of Neurosurgery: Spine 24, no. 3 (March 2016): 476–82. http://dx.doi.org/10.3171/2015.7.spine15442.
Full textAbstract:
OBJECT The objective of this study was to compare the incidence of degeneration and need for subsequent fusion surgery between patients who were treated nonsurgically and patients treated with fusion after a diagnosis of thoracic-or lumbar-level fracture without degenerative disease. METHODS The authors performed a retrospective study of Orthopedic United Healthcare patients diagnosed with thoracic or lumbar fracture. Patients were filtered into thoracic and lumbar fracture groups using diagnostic codes and then assigned to one of 2 treatment subgroups (fusion surgery or no surgery) on the basis of procedural codes. Disc degeneration and follow-up surgery were recorded. Chi-square statistical analysis was used. RESULTS Of 3699 patients diagnosed with a thoracic fracture, 117 (3.2%) underwent thoracic fusion and 3215 (86.9%) were treated nonsurgically. Within 3 years, 147 (4.6%) patients from the nonsurgical subgroup and fewer than 11 (0.9%–8.5%) from the fusion subgroup were diagnosed with thoracic disc degeneration. From the nonsurgical subgroup, 11 (0.3%) patients underwent a thoracic surgery related to disc degeneration compared with zero from the fusion group (p > 0.05). Of 5016 patients diagnosed with lumbar fracture, 150 (3.0%) underwent fusion and 4371 (87.1%) had no surgery. Within 3 years, 503 patients (11.5%) from the nonsurgical subgroup and 35 (23.3%) from the fusion subgroup were diagnosed with lumbar disc degeneration (p < 0.05). From the nonsurgical subgroup, 42 (1.0%) went on to have surgery related to disc degeneration, compared with fewer than 11 (0.7%–6.7%) from the fusion subgroup (values not precise due to privacy limitations). CONCLUSIONS Fusion surgery for thoracic fracture does not appear to increase the likelihood of undergoing future surgery. In the lumbar region, initial fusion surgery appears to increase the incidence of disc degeneration and could potentially necessitate future surgeries.
37
Heward, Elliot, Syed F. Hashmi, Ignacio Malagon, Rajesh Shah, Julian Barker, and Kandadai S. Rammohan. "The role of thoracic surgery in extracorporeal membrane oxygenation services." Asian Cardiovascular and Thoracic Annals 26, no. 3 (February 14, 2018): 183–87. http://dx.doi.org/10.1177/0218492318760710.
Full textAbstract:
Background Recent evidence surrounding the use of venovenous extracorporeal membrane oxygenation in treating acute respiratory failure has led to the expansion of extracorporeal membrane oxygenation services worldwide. The high rate of complications related to venovenous extracorporeal membrane oxygenation often requires intervention by specialist thoracic surgeons. This study aimed to investigate the role of specialist thoracic surgeons within the multidisciplinary team managing these high-risk patients. Methods We retrospectively reviewed 90 patients who received venovenous extracorporeal membrane oxygenation at our tertiary referral center between December 2011 and May 2015. Four patients who underwent lung transplantation were excluded. Results We found that 29.1% (25/86) of patients on venovenous extracorporeal membrane oxygenation had undergone a thoracic intervention. A total of 82 interventions were performed: 11 thoracotomies, 49 chest drains, 13 rigid bronchoscopies, 4 flexible bronchoscopies, 4 temporary endobronchial blockers, and 1 sternotomy. Of the 11 thoracotomies, 3 were reexplorations. Survival to discharge for patients who underwent thoracic surgical interventions was 72% (18/25). Conclusions Our experience has demonstrated that a large proportion of patients receiving venovenous extracorporeal membrane oxygenation require a thoracic intervention, many of which are major intraoperative procedures. Patients on venovenous extracorporeal membrane oxygenation have benefited from rapid on-site access to thoracic surgical services to manage these challenging life-threatening complications.
38
Oskouian, Rod J., and J. Patrick Johnson. "Endoscopic thoracic microdiscectomy." Neurosurgical Focus 18, no. 3 (March 2005): 1–8. http://dx.doi.org/10.3171/foc.2005.18.3.12.
Full textAbstract:
Object The purpose of this investigation was to evaluate surgical and neurological outcomes in thoracic disc surgery in a prospective fashion. Methods Quantifiable outcome data such as operating time, blood loss, duration of chest tube drainage, narcotic drug use, length of hospital stay (LOS), and long-term follow up of neurological function and pain-related symptoms were collected prospectively. In patients with myelopathy there was an improvement of two Frankel grades in the thoracoscopic discectomy group and one Frankel grade in the patients treated with thoracotomy; however, patients in the thoracotomy group were significantly worse preoperatively. None of the patients experienced worsened pain, and pain related to radiculopathy was improved by 75% in the thoracoscopic group. Conclusions Thoracoscopic discectomy yields acceptable surgical results and has several distinct advantages, with reduced postoperative pain, morbidity, and LOS.
39
Johnson, J. Patrick, Chinyere Obasi, Michael S. Hahn, and Paul Glatleider. "Endoscopic thoracic sympathectomy." Journal of Neurosurgery: Spine 91, no. 1 (July 1999): 90–97. http://dx.doi.org/10.3171/spi.1999.91.1.0090.
Full textAbstract:
Object. Thoracic sympathectomy has evolved as a treatment option for patients with hyperhidrosis and pain disorders. In the past, surgical procedures were highly invasive and caused significant morbidity, but the minimally invasive thoracoscopic procedure provides detailed visualization of the sympathetic ganglia and is associated with minimal postoperative morbidity. Methods. The authors performed 112 thoracoscopic sympathectomy procedures in 65 patients, and the outcomes were equivalent to those previously established for open surgical techniques; however, the rate of surgery-related morbidity, length of hospital stay, and time until return to normal activity were substantially reduced. Complications and recurrence of symptoms were comparable with those demonstrated in previous reports. Overall patient satisfaction and willingness to undergo a repeated operative procedure ranged from 66 to 99%. Postoperatively, higher satisfaction rates were observed in patients with hyperhidrosis whereas in those with pain syndromes, satisfaction rates were lower. Conclusions. Minimally invasive thoracoscopic sympathectomy procedures are useful in treating sympathetically mediated disorders, and the results indicate that the procedure is associated with reduced morbidity and similar outcome when compared with results obtained after open surgery. Hyperhidrosis is well treated, but patients with pain syndromes have significantly poorer outcomes.
40
Gupta, Vaibhav, Jordan Levy, Biniam Kidane, Alyson Mahar, Jolie Ringash, Rinku Sutradhar, Gail Elizabeth Darling, and Natalie Coburn. "Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centers." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 343. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.343.
Full textAbstract:
343 Background: Ontario regionalized thoracic surgery to designated centers to provide high-volume care for patients undergoing esophageal cancer resection. The objective of this study was to assess variation in treatment patterns and outcomes across thoracic centers, and to compare their performance to non-thoracic centers. Methods: A retrospective, population-based cohort study (2002-2014) was conducted in Ontario, Canada (population 13.6 million). Adults with resected esophageal cancer were identified through the PRESTO database. Case mix, use of neoadjuvant therapy, surgical outcomes (lymph node yield and margin rates) and survival were described across thoracic centers. Multivariable regression was used to estimate the effect of having surgery at a regionalized thoracic surgery center on perioperative (in-hospital & 90-day post-discharge) mortality and long-term survival, adjusting for case mix. Results: Of 3,880 patients meeting study criteria, 2,213 had pathology data available and were included in the analysis. Average age was 64 years, 85.7% had adenocarcinoma, 50.2% were pT3, and 38.4% were pN0. Most (82.6%) had surgery at one of 15 thoracic centers. Across thoracic centers, rates of neoadjuvant therapy varied 16.4-81.6%, positive margin rates varied 8.2-29.6%, median lymph node harvest varied from 7-20 nodes, perioperative mortality varied 2.6-20.5%, and 2-year survival varied from 48-80%. There was a trend toward reduced perioperative mortality, but no difference in long-term survival, with having surgery at a thoracic center. Conclusions: Even at designated thoracic centers, there is significant variability in treatment patterns, surgical outcomes, and survival. Looking beyond center volume, and translating best practices from high-performing hospitals to other hospitals, may improve patient outcomes.
41
Seder, Christopher W., Stephen D. Cassivi, and Dennis A. Wigle. "Navigating the Pathway to Robotic Competency in General Thoracic Surgery." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 8, no. 3 (May 2013): 184–89. http://dx.doi.org/10.1097/imi.0b013e3182a05788.
Full textAbstract:
Objective Although robotic technology has addressed many of the limitations of traditional videoscopic surgery, robotic surgery has not gained widespread acceptance in the general thoracic community. We report our initial robotic surgery experience and propose a structured, competency-based pathway for the development of robotic skills. Methods Between December 2008 and February 2012, a total of 79 robot-assisted pulmonary, mediastinal, benign esophageal, or diaphragmatic procedures were performed. Data on patient characteristics and perioperative outcomes were retrospectively collected and analyzed. During the study period, one surgeon and three residents participated in a triphasic, competency-based pathway designed to teach robotic skills. The pathway consisted of individual preclinical learning followed by mentored preclinical exercises and progressive clinical responsibility. Results The robot-assisted procedures performed included lung resection (n = 38), mediastinal mass resection (n = 19), hiatal or para-esophageal hernia repair (n = 12), and Heller myotomy (n = 7), among others (n = 3). There were no perioperative mortalities, with a 20% complication rate and a 3% readmission rate. Conversion to a thoracoscopic or open approach was required in eight pulmonary resections to facilitate dissection (six) or to control hemorrhage (two). Fewer major perioperative complications were observed in the later half of the experience. All residents who participated in the thoracic surgery robotic pathway perform robot-assisted procedures as part of their clinical practice. Conclusions Robot-assisted thoracic surgery can be safely learned when skill acquisition is guided by a structured, competency-based pathway.
42
Miller, Daniel, Diego Gonzalez Rivas, Kellie L. Meyer, Ryan S. Clark, and Tadasu Kohno. "The Impact of Endoscopic Linear Stapling Device Stability in Thoracic Surgery: A Delphi Panel Approach." Journal of Health Economics and Outcomes Research 3, no. 1 (October 28, 2016): 73–82. http://dx.doi.org/10.36469/9843.
Full textAbstract:
Objectives: To develop consensus statements outlining the impact of endoscopic linear stapling device stability on potential complications of thoracic surgery and the stress/concern of thoracic surgeons. Methods: Eight thoracic surgeons representing 8 countries participated in a Delphi panel process using 2 anonymous surveys. The first included binary, multiple-response, and Likert scale-type questions, which were converted into affirmative statements for survey 2 if an adequate number of respondents answered similarly. Consensus was defined a priori when ≥70% agreed with the affirmative statement in survey 2. Results: All panelists completed both surveys. Panelists unanimously agreed that: 1) an endoscopic linear stapling device with improved stability would result in less stress/concern for critical firings, surgeries where a fellow is trained, and robot-assisted surgeries requiring an assistant; 2) reduced unintentional tissue/structure damage and reduced tension on tissue being fired upon may result from use of an endoscopic linear stapling device that provides improvement in stability; and 3) endoscopic linear stapling device stability had more clinical importance in video-assisted thoracic surgery compared to open thoracic surgery. Conclusions: Improved endoscopic linear stapling device stability is a critical component of thoracic surgery likely to result in more frequent positive surgical outcomes when compared to a device with greater instability.
43
Hansdottir, Vigdis, Julia Philip, Monika Fagevik Olsen, Christina Eduard, Erik Houltz, and Sven-Erik Ricksten. "Thoracic Epidural versus Intravenous Patient-controlled Analgesia after Cardiac Surgery." Anesthesiology 104, no. 1 (January 1, 2006): 142–51. http://dx.doi.org/10.1097/00000542-200601000-00020.
Full textAbstract:
Background Perioperative thoracic epidural analgesia reduces stress response and pain scores and may improve outcome after cardiac surgery. This prospective, randomized trial was designed to compare the effectiveness of patient-controlled thoracic epidural analgesia with patient-controlled analgesia with intravenous morphine on postoperative hospital length of stay and patients' perception of their quality of recovery after cardiac surgery. Methods One hundred thirteen patients undergoing elective cardiac surgery were randomly assigned to receive either combined thoracic epidural analgesia and general anesthesia followed by patient-controlled thoracic epidural analgesia or general anesthesia followed by to patient-controlled analgesia with intravenous morphine. Postoperative length of stay, time to eligibility for hospital discharge, pain and sedation scores, degree of ambulation, lung volumes, and organ morbidities were evaluated. A validated quality of recovery score was used to measure postoperative health status. Results Length of stay and time to eligibility for hospital discharge were similar between the groups. Study groups differed neither in postoperative global quality of recovery score nor in five dimensions of quality of recovery score. Time to extubation was shorter (P < 0.001) and consumption of anesthetics was lower in the patient-controlled thoracic epidural analgesia group. Pain relief, degree of sedation, ambulation, and lung volumes were similar between the study groups. There was a trend for lower incidences of pneumonia (P = 0.085) and confusion (P = 0.10) in the patient-controlled thoracic epidural analgesia group, whereas cardiac, renal, and neurologic outcomes were similar between the groups. Conclusions In elective cardiac surgery, thoracic epidural analgesia combined with general anesthesia followed by patient-controlled thoracic epidural analgesia offers no major advantage with respect to hospital length of stay, quality of recovery, or morbidity when compared with general anesthesia alone followed by to patient-controlled analgesia with intravenous morphine.
44
Oliveira, Marcio Aparecido, Milena Carlos Vidotto, Oliver Augusto Nascimento, Renato Almeida, Ilka Lopes Santoro, Evandro Fornias Sperandio, José Roberto Jardim, and Mariana Rodrigues Gazzotti. "Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgery." Sao Paulo Medical Journal 133, no. 5 (October 2015): 388–93. http://dx.doi.org/10.1590/1516-3180.2014.00252601.
Full textAbstract:
CONTEXT AND OBJECTIVE: Studies have shown that physiopathological changes to the respiratory system can occur following thoracic and abdominal surgery. Laminectomy is considered to be a peripheral surgical procedure, but it is possible that thoracic spinal surgery exerts a greater influence on lung function. The aim of this study was to evaluate the pulmonary volumes and maximum respiratory pressures of patients undergoing cervical, thoracic or lumbar spinal surgery. DESIGN AND SETTING: Prospective study in a tertiary-level university hospital. METHODS: Sixty-three patients undergoing laminectomy due to diagnoses of tumors or herniated discs were evaluated. Vital capacity, tidal volume, minute ventilation and maximum respiratory pressures were evaluated preoperatively and on the first and second postoperative days. Possible associations between the respiratory variables and the duration of the operation, surgical diagnosis and smoking status were investigated. RESULTS: Vital capacity and maximum inspiratory pressure presented reductions on the first postoperative day (20.9% and 91.6%, respectively) for thoracic surgery (P = 0.01), and maximum expiratory pressure showed reductions on the first postoperative day in cervical surgery patients (15.3%; P = 0.004). The incidence of pulmonary complications was 3.6%. CONCLUSIONS: There were reductions in vital capacity and maximum respiratory pressures during the postoperative period in patients undergoing laminectomy. Surgery in the thoracic region was associated with greater reductions in vital capacity and maximum inspiratory pressure, compared with cervical and lumbar surgery. Thus, surgical manipulation of the thoracic region appears to have more influence on pulmonary function and respiratory muscle action.
45
Quinlan, JF, JA Harty, and JM O'Byrne. "The Need for Multidisciplinary Management of Patients with Upper Thoracic Spine Fractures Caused by High-Velocity Impact: A Review of 32 Surgically Stabilised Cases." Journal of Orthopaedic Surgery 13, no. 1 (April 2005): 34–39. http://dx.doi.org/10.1177/230949900501300106.
Full textAbstract:
Purpose. To analyse the characteristics of patients who underwent surgery for fractures of the upper thoracic spine (T1–T6) in our institution. The thoracic spine is supported by the rib cage and associated ligaments; therefore, displacement and fracture of the upper thoracic spine in healthy young adults require a great force. The relatively narrow spinal canal around the spinal cord in this area could result in severe neurological deficit should fractures occur. Methods. The treatment course of 32 patients (26 men and 6 women) who underwent surgery for fractures of the upper thoracic spine between February 1995 and March 2001 was retrospectively reviewed. Parameters of injuries and treatment methods were evaluated. Results. Of the 32 patients, 29 were injured in traffic accidents (15 motorcycle and 14 vehicle), 2 in falls, and one by a heavy door falling on his back. 29 patients had spinal fractures at more than one level. 23 patients had complete, 7 had incomplete, and 2 had no neurological deficit. 30 patients required multiple modalities of radiological imaging (in addition to plain radiography) for diagnosis. 20 patients sustained other injuries apart from spinal fractures, 15 of them had associated chest injuries. Conclusion. High-velocity fractures of the upper thoracic spine are injuries with devastating consequences, and can result in severe neurological deficit and concomitant injuries. These patients are best treated by a multidisciplinary approach.
46
Leon, Boukassa, Ngackosso Olivier Brice, Kinata Bambino Sinclair Brice, and Ekouele Mbaki Hugues Brieux. "Tandem Spinal Stenosis at the Brazzaville Academic Hospital." Iranian Journal of Neurosurgery 5, no. 3 And 4 (July 1, 2020): 125–32. http://dx.doi.org/10.32598/irjns.5.3.5.
Full textAbstract:
Background and Aim: Tandem Spinal Stenosis (TSS) can be defined as simultaneous stenosis of two distinct spinal (cervical, thoracic and lumbar) areas. Characterized by an association of the spinal, radicular and medullary signs of the limbs, the planning of his surgery remains controversial. We reported the one that was set up on the cases observed at the Brazzaville Academic Hospital. Methods and Materials/Patients: A retrospective study of 16 patients operated for TSS, from June 2009 to May 2019, was conducted. We analyzed the demographic, clinical, paraclinical, therapeutic and evolutionary data of these patients. Results: For ten years, a total of 16 patients (9 men and 7 women) with SST have been received. The average age was 57 years (ranged 41-72 years). The signs evolved for 17.6 months (13 and 30 months). These were lombo-sciatalgias in 15 cases, signs of medullary compression: cervical in 14 cases and thoracic in 2 cases. Medical imaging had objective 13 cervico-lumbar associations, two thoraco-lumbar associations and one cervico-thoracic. The surgery was performed in one stage in two cases and two stages in 14 cases. These were laminectomies for lumbar and thoracic disorders, discectomy or somatotomy in the cervical segment. The order of surgical management was cervico-thoraco-lumbar (cranio- caudal order). Signs improved in 13 patients and stabilized in 3 patients. Conclusion: TSS is not uncommon. It should be researched in a patient with bifocal spinal and radiculo-medullary signs. Their early surgical treatment, in one or two stages, yields satisfactory results.
47
IWATA, Hiroshi, Tomohiro SHIRASAWA, Masanobu NISHIDA, Masahiro INOUE, Hisakazu SENO, Rie YOSHIKATA, Yukihiro BANDO, and Akira YANAI. "Our Methods of Reconstruction to the Dehesitence and Fistula after the Thoracic Surgery." Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 23, no. 1 (1998): 95–100. http://dx.doi.org/10.4030/jjcs1979.23.1_95.
Full text
48
Bertolaccini, Luca, Alessandro Pardolesi, and Piergiorgio Solli. "Tips and tricks of the propensity score methods in the thoracic surgery research." Journal of Thoracic Disease 9, no. 4 (April 2017): 920–23. http://dx.doi.org/10.21037/jtd.2017.03.60.
Full text
49
Urbas, Lucy, J. Exley, M. Shaw, and G. Russell. "Comparison of invasive and non-invasive temperature methods in patients undergoing thoracic surgery." Journal of Cardiothoracic and Vascular Anesthesia 32 (August 2018): S89. http://dx.doi.org/10.1053/j.jvca.2018.08.163.
Full text
50
Oskouian, Rod J., and J. Patrick Johnson. "Endoscopic thoracic microdiscectomy." Journal of Neurosurgery: Spine 3, no. 6 (December 2005): 459–64. http://dx.doi.org/10.3171/spi.2005.3.6.0459.
Full textAbstract:
Object. The purpose of this clinical study was to evaluate prospectively surgical and neurological outcomes after endoscopic thoracic disc surgery. Methods. The authors assessed the following quantifiable outcome data in 46 patients: operative time, blood loss, duration of chest tube insertion, narcotic use, hospital length of stay (LOS), and long-term follow-up neurological function and pain-related symptoms. In patients who presented with myelopathy there was a postoperative improvement of two Frankel grades. Pain related to radiculopathy was improved by 75% and in one patient it worsened postoperatively. The authors also present operative data, surgical outcomes, and complications. Conclusions. Thoracoscopic discectomy can be used to achieve acceptable results. It has several distinct advantages such as reduced postoperative pain, morbidity, and LOS compared with traditional open procedures.