Background: We have performed transxiphoid hand-assisted videothoracoscopy since 1995 to allow manual palpation in bilateral lung metastasectomy. This approach was extended to other thoracoscopic procedures requiring a handport. No extensive report about early and late results has yet been published. Methods: We retrospectively reviewed the first 100 consecutive patients undergoing transxiphoid hand-assisted videothoracoscopy. Acute and chronic postoperative pain, respiratory function, patient's satisfaction score (1 to 5), quality of life (Short Form-36), and survival rate were evaluated. Results: Seventy-four patients had lung metastases, 5 had primary lung cancers, 16 had benign nodules, and 5 had Morgani's hernia. Five patients needed conversion to thoracotomy, whereas 7 successfully underwent a second transxiphoid operation. Sixty-five metastatic patients were bilaterally explored, 44 were without radiologic evidence of controlateral lesions, discovering 23 occult metastases and 10 patients with occult controlateral disease. A total of 207 minimal resections and 11 lobectomies were performed. Mean operative time was 103 ± 35 minutes. We had no intraoperative mortality or major complications. Thirty-day postoperative morbidity documented arrhythmia (n = 4) and acute pneumonia (n = 4). Visual Analogue Scale pain, C-reactive protein, fibrinogen, and serum interleukin-6, -8, and -10 normalized within 72 hours. Respiratory function and most of the Short Form-36 domains recovered within 3 months. Six-month mean patient satisfaction score was 4.0 ± 0.8. Three- and 5-year survival rates for metastatic patients were 52% and 43%, respectively. Mean disease-free interval was 12 ± 5.8 months. Conclusions: Transxiphoid hand-assisted videothoracoscopy proved a good alternative to conventional approaches, and provided rapid recovery without affecting the survival rate in those patients with metastatic lesions. We recommend it whenever a handport during video-assisted procedure is required. © 2007 The Society of Thoracic Surgeons.

Mineo, T.c., Ambrogi, V., Mineo, D., Pompeo, E. (2007). Transxiphoid hand-assisted videothoracoscopic surgery. ANNALS OF THORACIC SURGERY, 83(6), 1978-1984 [10.1016/j.athoracsur.2007.02.021].

Transxiphoid hand-assisted videothoracoscopic surgery

MINEO, TOMMASO CLAUDIO;AMBROGI, VINCENZO;MINEO, DAVIDE;POMPEO, EUGENIO
2007-01-01

Abstract

Background: We have performed transxiphoid hand-assisted videothoracoscopy since 1995 to allow manual palpation in bilateral lung metastasectomy. This approach was extended to other thoracoscopic procedures requiring a handport. No extensive report about early and late results has yet been published. Methods: We retrospectively reviewed the first 100 consecutive patients undergoing transxiphoid hand-assisted videothoracoscopy. Acute and chronic postoperative pain, respiratory function, patient's satisfaction score (1 to 5), quality of life (Short Form-36), and survival rate were evaluated. Results: Seventy-four patients had lung metastases, 5 had primary lung cancers, 16 had benign nodules, and 5 had Morgani's hernia. Five patients needed conversion to thoracotomy, whereas 7 successfully underwent a second transxiphoid operation. Sixty-five metastatic patients were bilaterally explored, 44 were without radiologic evidence of controlateral lesions, discovering 23 occult metastases and 10 patients with occult controlateral disease. A total of 207 minimal resections and 11 lobectomies were performed. Mean operative time was 103 ± 35 minutes. We had no intraoperative mortality or major complications. Thirty-day postoperative morbidity documented arrhythmia (n = 4) and acute pneumonia (n = 4). Visual Analogue Scale pain, C-reactive protein, fibrinogen, and serum interleukin-6, -8, and -10 normalized within 72 hours. Respiratory function and most of the Short Form-36 domains recovered within 3 months. Six-month mean patient satisfaction score was 4.0 ± 0.8. Three- and 5-year survival rates for metastatic patients were 52% and 43%, respectively. Mean disease-free interval was 12 ± 5.8 months. Conclusions: Transxiphoid hand-assisted videothoracoscopy proved a good alternative to conventional approaches, and provided rapid recovery without affecting the survival rate in those patients with metastatic lesions. We recommend it whenever a handport during video-assisted procedure is required. © 2007 The Society of Thoracic Surgeons.
2007
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - CHIRURGIA TORACICA
English
Con Impact Factor ISI
C reactive protein; fibrinogen; interleukin 10; interleukin 6; interleukin 8; adult; aged; article; convalescence; diaphragm hernia; disease free interval; female; heart arrhythmia; human; human tissue; lobar pneumonia; lobectomy; lung cancer; lung metastasis; lung nodule; major clinical study; male; morbidity; morgani hernia; operation duration; patient satisfaction; postoperative pain; postoperative period; priority journal; protein blood level; quality of life; respiratory function; retrospective study; scoring system; Short Form 36; survival rate; thoracotomy; thorax surgery; transxiphoid hand assisted videothoracoscopic surgery; visual analog scale; Adult; Aged; Biological Markers; Female; Hernia, Diaphragmatic; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Pain, Postoperative; Palpation; Patient Satisfaction; Quality of Life; Respiratory Function Tests; Retrospective Studies; Survival Analysis; Thoracic Surgery, Video-Assisted; Thoracoscopy; Xiphoid Bone
Mineo, T.c., Ambrogi, V., Mineo, D., Pompeo, E. (2007). Transxiphoid hand-assisted videothoracoscopic surgery. ANNALS OF THORACIC SURGERY, 83(6), 1978-1984 [10.1016/j.athoracsur.2007.02.021].
Mineo, Tc; Ambrogi, V; Mineo, D; Pompeo, E
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/36547
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