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Clinical application of single incision thoracoscopic surgery: early experience of 264 cases

BACKGROUND: Single incision thoracoscopic surgery (SITS) is recognized as a difficult procedure and surgeons hesitate to perform this technique. We describe our experience of SITS and determine whether SITS can be a routine approach in minimally invasive surgery. METHODS: From May 2011 to April 2013...

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Autores principales: Song, In-Hag, Yum, Sungwon, Choi, Wonsuk, Cho, Sukki, Kim, Kwhanmien, Jheon, Sanghoon, Yang, Hee Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984723/
https://www.ncbi.nlm.nih.gov/pubmed/24607000
http://dx.doi.org/10.1186/1749-8090-9-44
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author Song, In-Hag
Yum, Sungwon
Choi, Wonsuk
Cho, Sukki
Kim, Kwhanmien
Jheon, Sanghoon
Yang, Hee Chul
author_facet Song, In-Hag
Yum, Sungwon
Choi, Wonsuk
Cho, Sukki
Kim, Kwhanmien
Jheon, Sanghoon
Yang, Hee Chul
author_sort Song, In-Hag
collection PubMed
description BACKGROUND: Single incision thoracoscopic surgery (SITS) is recognized as a difficult procedure and surgeons hesitate to perform this technique. We describe our experience of SITS and determine whether SITS can be a routine approach in minimally invasive surgery. METHODS: From May 2011 to April 2013, a single operator attempted SITS for 264 cases. Their medical records were retrospectively reviewed with regard to age, sex, diagnosis, operation time, hospital stay, need of additional incision, morbidity, and early outcome. RESULTS: A number of thoracic diseases and procedures were attempted with SITS including primary (n = 172) or secondary (n = 22) spontaneous pneumothorax, biopsy for lung (n = 29), pleura (n = 3), and mediastinal lymph node (n = 3), mediastinal mass excision (n = 11), empyema decortication (n = 11), lobectomy (n = 6), pulmonary metastasectomy (n = 3), pericardial window formation (n = 3), and hematoma evacuation (n = 1). Of these, 237 cases underwent SITS successfully. However, additional incision was needed in 10.2% (n = 27). Reasons for conversions were as follows: extensive pleural adhesion (n = 14), difficulty in endoscopic stapling (n = 11), bleeding (n = 1), and intolerance of one lung ventilation (n = 1). Conversion rate of empyema was 54.5%, which was the most difficult for SITS. In contrast, the conversion rate of PSP was 4.7%, which means PSP was the most applicable for SITS. Postoperative complications included air leak (≥3 days) (n = 1), wound problem (n = 4), delayed pleural effusion (n = 1), and postoperative bleeding (n = 1). CONCLUSIONS: SITS can be a routine approach from simple to more complicated diseases. However, we still have difficulties in cases with extensive pleural adhesion or location of lesion with difficult accessibility for endoscopic stapling.
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spelling pubmed-39847232014-04-14 Clinical application of single incision thoracoscopic surgery: early experience of 264 cases Song, In-Hag Yum, Sungwon Choi, Wonsuk Cho, Sukki Kim, Kwhanmien Jheon, Sanghoon Yang, Hee Chul J Cardiothorac Surg Research Article BACKGROUND: Single incision thoracoscopic surgery (SITS) is recognized as a difficult procedure and surgeons hesitate to perform this technique. We describe our experience of SITS and determine whether SITS can be a routine approach in minimally invasive surgery. METHODS: From May 2011 to April 2013, a single operator attempted SITS for 264 cases. Their medical records were retrospectively reviewed with regard to age, sex, diagnosis, operation time, hospital stay, need of additional incision, morbidity, and early outcome. RESULTS: A number of thoracic diseases and procedures were attempted with SITS including primary (n = 172) or secondary (n = 22) spontaneous pneumothorax, biopsy for lung (n = 29), pleura (n = 3), and mediastinal lymph node (n = 3), mediastinal mass excision (n = 11), empyema decortication (n = 11), lobectomy (n = 6), pulmonary metastasectomy (n = 3), pericardial window formation (n = 3), and hematoma evacuation (n = 1). Of these, 237 cases underwent SITS successfully. However, additional incision was needed in 10.2% (n = 27). Reasons for conversions were as follows: extensive pleural adhesion (n = 14), difficulty in endoscopic stapling (n = 11), bleeding (n = 1), and intolerance of one lung ventilation (n = 1). Conversion rate of empyema was 54.5%, which was the most difficult for SITS. In contrast, the conversion rate of PSP was 4.7%, which means PSP was the most applicable for SITS. Postoperative complications included air leak (≥3 days) (n = 1), wound problem (n = 4), delayed pleural effusion (n = 1), and postoperative bleeding (n = 1). CONCLUSIONS: SITS can be a routine approach from simple to more complicated diseases. However, we still have difficulties in cases with extensive pleural adhesion or location of lesion with difficult accessibility for endoscopic stapling. BioMed Central 2014-03-08 /pmc/articles/PMC3984723/ /pubmed/24607000 http://dx.doi.org/10.1186/1749-8090-9-44 Text en Copyright © 2014 Song et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Song, In-Hag
Yum, Sungwon
Choi, Wonsuk
Cho, Sukki
Kim, Kwhanmien
Jheon, Sanghoon
Yang, Hee Chul
Clinical application of single incision thoracoscopic surgery: early experience of 264 cases
title Clinical application of single incision thoracoscopic surgery: early experience of 264 cases
title_full Clinical application of single incision thoracoscopic surgery: early experience of 264 cases
title_fullStr Clinical application of single incision thoracoscopic surgery: early experience of 264 cases
title_full_unstemmed Clinical application of single incision thoracoscopic surgery: early experience of 264 cases
title_short Clinical application of single incision thoracoscopic surgery: early experience of 264 cases
title_sort clinical application of single incision thoracoscopic surgery: early experience of 264 cases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984723/
https://www.ncbi.nlm.nih.gov/pubmed/24607000
http://dx.doi.org/10.1186/1749-8090-9-44
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