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Preoperative detection of pleural adhesions by respiratory dynamic computed tomography

BACKGROUND: Video-assisted thoracic surgery (VATS) plays an important role in thoracic surgery because it is less invasive. However, the existence of severe pleural adhesions may make VATS difficult and complicated. The aim of this study was to assess the utility of inspiration and expiration comput...

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Autores principales: Tokuno, Junko, Shoji, Tsuyoshi, Sumitomo, Ryota, Ueda, Yuichiro, Yamanashi, Keiji, Huang, Cheng-long
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709962/
https://www.ncbi.nlm.nih.gov/pubmed/29191241
http://dx.doi.org/10.1186/s12957-017-1280-7
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author Tokuno, Junko
Shoji, Tsuyoshi
Sumitomo, Ryota
Ueda, Yuichiro
Yamanashi, Keiji
Huang, Cheng-long
author_facet Tokuno, Junko
Shoji, Tsuyoshi
Sumitomo, Ryota
Ueda, Yuichiro
Yamanashi, Keiji
Huang, Cheng-long
author_sort Tokuno, Junko
collection PubMed
description BACKGROUND: Video-assisted thoracic surgery (VATS) plays an important role in thoracic surgery because it is less invasive. However, the existence of severe pleural adhesions may make VATS difficult and complicated. The aim of this study was to assess the utility of inspiration and expiration computed tomography (respiratory dynamic CT (RD-CT)) in evaluation of pleural adhesions preoperatively. METHODS: RD-CT was performed on 107 patients undergoing thoracotomies (both VATS and open). We assessed synchronous motion during respiration on RD-CT. Comparing the results of RD-CT and intraoperative findings, we assessed the utility of preoperative evaluation. RESULTS: A negative correlation between sliding score and adhesion grade was revealed. Sliding score in adhesion negative patients was significantly higher than that in adhesion positive patients (P < 0.0001). The sensitivity of RD-CT was 63.6%, specificity was 74.1%, and accuracy was 72%. Among 62 patients with a CT-Respiration Ratio of less than 0.65, the sensitivity of RD-CT was 77.8%, specificity was 86.8%, and accuracy was 85.5%. CONCLUSIONS: RD-CT may be clinically useful for detecting the presence of pleural adhesions. It can be adopted as one of the criteria for deciding the surgical approach.
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spelling pubmed-57099622017-12-06 Preoperative detection of pleural adhesions by respiratory dynamic computed tomography Tokuno, Junko Shoji, Tsuyoshi Sumitomo, Ryota Ueda, Yuichiro Yamanashi, Keiji Huang, Cheng-long World J Surg Oncol Research BACKGROUND: Video-assisted thoracic surgery (VATS) plays an important role in thoracic surgery because it is less invasive. However, the existence of severe pleural adhesions may make VATS difficult and complicated. The aim of this study was to assess the utility of inspiration and expiration computed tomography (respiratory dynamic CT (RD-CT)) in evaluation of pleural adhesions preoperatively. METHODS: RD-CT was performed on 107 patients undergoing thoracotomies (both VATS and open). We assessed synchronous motion during respiration on RD-CT. Comparing the results of RD-CT and intraoperative findings, we assessed the utility of preoperative evaluation. RESULTS: A negative correlation between sliding score and adhesion grade was revealed. Sliding score in adhesion negative patients was significantly higher than that in adhesion positive patients (P < 0.0001). The sensitivity of RD-CT was 63.6%, specificity was 74.1%, and accuracy was 72%. Among 62 patients with a CT-Respiration Ratio of less than 0.65, the sensitivity of RD-CT was 77.8%, specificity was 86.8%, and accuracy was 85.5%. CONCLUSIONS: RD-CT may be clinically useful for detecting the presence of pleural adhesions. It can be adopted as one of the criteria for deciding the surgical approach. BioMed Central 2017-12-01 /pmc/articles/PMC5709962/ /pubmed/29191241 http://dx.doi.org/10.1186/s12957-017-1280-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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
Tokuno, Junko
Shoji, Tsuyoshi
Sumitomo, Ryota
Ueda, Yuichiro
Yamanashi, Keiji
Huang, Cheng-long
Preoperative detection of pleural adhesions by respiratory dynamic computed tomography
title Preoperative detection of pleural adhesions by respiratory dynamic computed tomography
title_full Preoperative detection of pleural adhesions by respiratory dynamic computed tomography
title_fullStr Preoperative detection of pleural adhesions by respiratory dynamic computed tomography
title_full_unstemmed Preoperative detection of pleural adhesions by respiratory dynamic computed tomography
title_short Preoperative detection of pleural adhesions by respiratory dynamic computed tomography
title_sort preoperative detection of pleural adhesions by respiratory dynamic computed tomography
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709962/
https://www.ncbi.nlm.nih.gov/pubmed/29191241
http://dx.doi.org/10.1186/s12957-017-1280-7
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