Thoracoscopic Operation for Secondary Pneumothorax Under Local and Epidural Anesthesia in High-Risk Patients
Background. Video-assisted thoracic operations usually require single-lung ventilation under general anesthesia. However, for high-risk patients with other underlying pulmonary diseases, one has to consider risks of general anesthesia itself. Methods. Four high-risk patients (4 men; mean age, 73 yea...
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| Veröffentlicht in: | The Annals of thoracic surgery 1998-04, Vol.65 (4), p.924-926 |
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| container_title | The Annals of thoracic surgery |
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| creator | Mukaida, Takahiro Andou, Akio Date, Hiroshi Aoe, Motoi Shimizu, Nobuyoshi |
| description | Background. Video-assisted thoracic operations usually require single-lung ventilation under general anesthesia. However, for high-risk patients with other underlying pulmonary diseases, one has to consider risks of general anesthesia itself.
Methods. Four high-risk patients (4 men; mean age, 73 years) with intractable secondary pneumothorax and other underlying pulmonary diseases were treated by video-assisted thoracic operations under local and epidural anesthesia. Absorbable polyglycolic acid sheets and fibrin glue were used to control the air leakage.
Results. The mean duration of the procedure was 108 minutes. Pain and cough reflex were well controlled, and spontaneous breathing and hemodynamics were well maintained during the operation. The mean duration of the postoperative chest drainage was 5 days. No significant postoperative complication was encountered. No pneumothorax had recurred at a mean follow-up of 16 months.
Conclusions. Video-assisted thoracic operations can be performed safely under local and epidural anesthesia for the treatment of intractable secondary pneumothorax in high-risk patients. The air leakage can be controlled with the use of polyglycolic acid sheets and fibrin glue without bullectomy. |
| doi_str_mv | 10.1016/S0003-4975(98)00108-8 |
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Methods. Four high-risk patients (4 men; mean age, 73 years) with intractable secondary pneumothorax and other underlying pulmonary diseases were treated by video-assisted thoracic operations under local and epidural anesthesia. Absorbable polyglycolic acid sheets and fibrin glue were used to control the air leakage.
Results. The mean duration of the procedure was 108 minutes. Pain and cough reflex were well controlled, and spontaneous breathing and hemodynamics were well maintained during the operation. The mean duration of the postoperative chest drainage was 5 days. No significant postoperative complication was encountered. No pneumothorax had recurred at a mean follow-up of 16 months.
Conclusions. Video-assisted thoracic operations can be performed safely under local and epidural anesthesia for the treatment of intractable secondary pneumothorax in high-risk patients. The air leakage can be controlled with the use of polyglycolic acid sheets and fibrin glue without bullectomy.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(98)00108-8</identifier><identifier>PMID: 9564902</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Local ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Chest Tubes ; Contraindications ; Cough - physiopathology ; Cough - prevention & control ; Endoscopy ; Fibrin Tissue Adhesive - therapeutic use ; Follow-Up Studies ; Hemodynamics - physiology ; Humans ; Intraoperative Care ; Lung Diseases - complications ; Lung Diseases - physiopathology ; Male ; Medical sciences ; Pain - physiopathology ; Pain - prevention & control ; Pneumothorax - surgery ; Polyglycolic Acid - chemistry ; Pulmonary Gas Exchange - physiology ; Recurrence ; Respiration, Artificial - methods ; Risk Factors ; Surgical Mesh ; Thoracic and cardiovascular surgery. Cardiopulmonary bypass ; Thoracoscopy ; Time Factors ; Tissue Adhesives - therapeutic use</subject><ispartof>The Annals of thoracic surgery, 1998-04, Vol.65 (4), p.924-926</ispartof><rights>1998 The Society of Thoracic Surgeons</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-3f79d72d22457ab609932d80f768f7bad8ddf33bd68fd21bd73bc34878ab70c93</citedby><cites>FETCH-LOGICAL-c542t-3f79d72d22457ab609932d80f768f7bad8ddf33bd68fd21bd73bc34878ab70c93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(98)00108-8$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2214731$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9564902$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mukaida, Takahiro</creatorcontrib><creatorcontrib>Andou, Akio</creatorcontrib><creatorcontrib>Date, Hiroshi</creatorcontrib><creatorcontrib>Aoe, Motoi</creatorcontrib><creatorcontrib>Shimizu, Nobuyoshi</creatorcontrib><title>Thoracoscopic Operation for Secondary Pneumothorax Under Local and Epidural Anesthesia in High-Risk Patients</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. Video-assisted thoracic operations usually require single-lung ventilation under general anesthesia. However, for high-risk patients with other underlying pulmonary diseases, one has to consider risks of general anesthesia itself.
Methods. Four high-risk patients (4 men; mean age, 73 years) with intractable secondary pneumothorax and other underlying pulmonary diseases were treated by video-assisted thoracic operations under local and epidural anesthesia. Absorbable polyglycolic acid sheets and fibrin glue were used to control the air leakage.
Results. The mean duration of the procedure was 108 minutes. Pain and cough reflex were well controlled, and spontaneous breathing and hemodynamics were well maintained during the operation. The mean duration of the postoperative chest drainage was 5 days. No significant postoperative complication was encountered. No pneumothorax had recurred at a mean follow-up of 16 months.
Conclusions. Video-assisted thoracic operations can be performed safely under local and epidural anesthesia for the treatment of intractable secondary pneumothorax in high-risk patients. The air leakage can be controlled with the use of polyglycolic acid sheets and fibrin glue without bullectomy.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia, Epidural</subject><subject>Anesthesia, General</subject><subject>Anesthesia, Local</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Chest Tubes</subject><subject>Contraindications</subject><subject>Cough - physiopathology</subject><subject>Cough - prevention & control</subject><subject>Endoscopy</subject><subject>Fibrin Tissue Adhesive - therapeutic use</subject><subject>Follow-Up Studies</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Intraoperative Care</subject><subject>Lung Diseases - complications</subject><subject>Lung Diseases - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pain - physiopathology</subject><subject>Pain - prevention & control</subject><subject>Pneumothorax - surgery</subject><subject>Polyglycolic Acid - chemistry</subject><subject>Pulmonary Gas Exchange - physiology</subject><subject>Recurrence</subject><subject>Respiration, Artificial - methods</subject><subject>Risk Factors</subject><subject>Surgical Mesh</subject><subject>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><subject>Thoracoscopy</subject><subject>Time Factors</subject><subject>Tissue Adhesives - therapeutic use</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtPJCEURsnEibaPn2DCwhhd1AyPooCVMcZX0olm1DWhgJpGq6GEKuP8-6HtTm9dkS_33Mu9B4BjjH5hhJvfTwghWtWSszMpzhHCSFTiB5hhxkjVECZ3wGyL7IH9nF9LJKW8C3Yla2qJyAz0z4uYtInZxMEb-DC4pEcfA-xigk_OxGB1-gcfg5uWcVyxn_AlWJfgPBrdQx0svB68nVIJl8HlceGy19AHeOf_Lqo_Pr_BxzLShTEfgp-d7rM72rwH4OXm-vnqrpo_3N5fXc4rw2oyVrTj0nJiCakZ122DpKTECtTxRnS81VZY21Ha2hItwa3ltDW0FlzoliMj6QE4Xc8dUnyfyk5q6bNxfa-Di1NWXAokKBMFZGvQpJhzcp0akl-WgxVGamVZfVlWK4VKCvVlWa36jjcfTO3S2W3XRmupn2zqOhdLXdLB-LzFCME1p7hgF2vMFRkf3iWVTRFlnPXJmVHZ6L9Z5D9RNJov</recordid><startdate>19980401</startdate><enddate>19980401</enddate><creator>Mukaida, Takahiro</creator><creator>Andou, Akio</creator><creator>Date, Hiroshi</creator><creator>Aoe, Motoi</creator><creator>Shimizu, Nobuyoshi</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980401</creationdate><title>Thoracoscopic Operation for Secondary Pneumothorax Under Local and Epidural Anesthesia in High-Risk Patients</title><author>Mukaida, Takahiro ; Andou, Akio ; Date, Hiroshi ; Aoe, Motoi ; Shimizu, Nobuyoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-3f79d72d22457ab609932d80f768f7bad8ddf33bd68fd21bd73bc34878ab70c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia, Epidural</topic><topic>Anesthesia, General</topic><topic>Anesthesia, Local</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Chest Tubes</topic><topic>Contraindications</topic><topic>Cough - physiopathology</topic><topic>Cough - prevention & control</topic><topic>Endoscopy</topic><topic>Fibrin Tissue Adhesive - therapeutic use</topic><topic>Follow-Up Studies</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Intraoperative Care</topic><topic>Lung Diseases - complications</topic><topic>Lung Diseases - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pain - physiopathology</topic><topic>Pain - prevention & control</topic><topic>Pneumothorax - surgery</topic><topic>Polyglycolic Acid - chemistry</topic><topic>Pulmonary Gas Exchange - physiology</topic><topic>Recurrence</topic><topic>Respiration, Artificial - methods</topic><topic>Risk Factors</topic><topic>Surgical Mesh</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><topic>Thoracoscopy</topic><topic>Time Factors</topic><topic>Tissue Adhesives - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mukaida, Takahiro</creatorcontrib><creatorcontrib>Andou, Akio</creatorcontrib><creatorcontrib>Date, Hiroshi</creatorcontrib><creatorcontrib>Aoe, Motoi</creatorcontrib><creatorcontrib>Shimizu, Nobuyoshi</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mukaida, Takahiro</au><au>Andou, Akio</au><au>Date, Hiroshi</au><au>Aoe, Motoi</au><au>Shimizu, Nobuyoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thoracoscopic Operation for Secondary Pneumothorax Under Local and Epidural Anesthesia in High-Risk Patients</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1998-04-01</date><risdate>1998</risdate><volume>65</volume><issue>4</issue><spage>924</spage><epage>926</epage><pages>924-926</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. Video-assisted thoracic operations usually require single-lung ventilation under general anesthesia. However, for high-risk patients with other underlying pulmonary diseases, one has to consider risks of general anesthesia itself.
Methods. Four high-risk patients (4 men; mean age, 73 years) with intractable secondary pneumothorax and other underlying pulmonary diseases were treated by video-assisted thoracic operations under local and epidural anesthesia. Absorbable polyglycolic acid sheets and fibrin glue were used to control the air leakage.
Results. The mean duration of the procedure was 108 minutes. Pain and cough reflex were well controlled, and spontaneous breathing and hemodynamics were well maintained during the operation. The mean duration of the postoperative chest drainage was 5 days. No significant postoperative complication was encountered. No pneumothorax had recurred at a mean follow-up of 16 months.
Conclusions. Video-assisted thoracic operations can be performed safely under local and epidural anesthesia for the treatment of intractable secondary pneumothorax in high-risk patients. The air leakage can be controlled with the use of polyglycolic acid sheets and fibrin glue without bullectomy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9564902</pmid><doi>10.1016/S0003-4975(98)00108-8</doi><tpages>3</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Aged Anesthesia Anesthesia depending on type of surgery Anesthesia, Epidural Anesthesia, General Anesthesia, Local Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Chest Tubes Contraindications Cough - physiopathology Cough - prevention & control Endoscopy Fibrin Tissue Adhesive - therapeutic use Follow-Up Studies Hemodynamics - physiology Humans Intraoperative Care Lung Diseases - complications Lung Diseases - physiopathology Male Medical sciences Pain - physiopathology Pain - prevention & control Pneumothorax - surgery Polyglycolic Acid - chemistry Pulmonary Gas Exchange - physiology Recurrence Respiration, Artificial - methods Risk Factors Surgical Mesh Thoracic and cardiovascular surgery. Cardiopulmonary bypass Thoracoscopy Time Factors Tissue Adhesives - therapeutic use |
| title | Thoracoscopic Operation for Secondary Pneumothorax Under Local and Epidural Anesthesia in High-Risk Patients |
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