Abstract:
Background:Prolonged air leak is the most common complication after pulmonary resection surgery. Water submersion test (WST) has been used to check for air leak. However, it is cumbersome under the circumstances of video-assisted thoracic surgery (VATS). This study aimed to devise a new air leak detection method that is suitable for the VATS. Methods:We decided to utilize the properties of the surfactants to overcome the disadvantages of WST. To find the optimal surfactant, ex-vivo porcine lung experiments were prepared with a custom-made large glass vessel mimicking a human thoracic cavity. A fresh lung was put inside the glass vessel and connected with the ventilator. We made a needle injury on the lung surface and dropped various kinds of liquid surfactants to create air bubbles during the lung ventilation. The appearances of bubbles were recorded through 5mm thoracoscope. Results:Considering the bubble forming ability, Pluronic F-127 solution (PF127), a well-known non-toxic and non-ionic colorless surfactant, was chosen as candidate substance. To find the optimal condition, various concentrations of PF127 (30%, 25%, 20%, 15%, 10%) were tested. Greater than 20% concentration of PF127 were not feasible due to its high viscosity; the bubbles kept increasing in size without popping and blocked the thoracoscopic vision. The 10% PF127 did not form any bubbles. On the contrary, the 15% PF127 formed bubbles that are 1-2 cm in size with dynamic movement allowing for clear visibility of the air leak point. We finally made a green colored 15% PF127 by mixing an indocyanine green to increase its visibility. All of the components in the solution are FDA approved and permissible to be used in the human body. Conclusions:Our bubble solution can easily detect the air leak even in small quantities and is expected to be useful in VATS with limited vision. However, in order for its full-scale clinical use, its safety in the human body must be verified.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Yang HC,Chang HYdoi
10.21037/jtd.2018.11.34subject
Has Abstractpub_date
2018-12-01 00:00:00pages
6472-6474issue
12eissn
2072-1439issn
2077-6624pii
jtd-10-12-6472journal_volume
10pub_type
杂志文章abstract:BACKGROUND:Sporadic case reports have shown that wedge resection and lobectomy can be performed via nonintubated video-assisted thoracoscopic surgery (VATS) with a single incision. We report the feasibility and safety of nonintubated uniportal VATS for resection of various lung lesions. METHODS:From January 2014 to Ju...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2016.02.09
更新日期:2016-03-01 00:00:00
abstract::Fatal hemoptysis is a serious complication of pulmonary tuberculosis, which can rarely be due to a bronchial aneurysm. Here, we present a case of fatal hemoptysis due to bronchial aneurysm occurred in a 59-year-old patient of Han ethnicity suffering from active pulmonary tuberculosis. Meanwhile, we perform a literatur...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.04.07
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Bronchoplastic and broncho-arterioplastic lobectomy is technically demanding. Present study performed a prognostic analysis of lobectomy patient based on 10-year data in a high-volume center. METHODS:Overall, 161 non-small cell lung cancer (NSCLC) cases underwent bronchoplastic and broncho-arterioplastic lo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.12.59
更新日期:2015-12-01 00:00:00
abstract:Background:Arterial desaturations experienced during endotracheal intubation (ETI) may lead to poor outcomes. Thus, our primary aim was to identify predictors of arterial desaturation (pulse oximetry <90%) during the peri-intubation period and to assess outcomes of those who developed arterial hypoxemia. Methods:Adult...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.08.138
更新日期:2017-10-01 00:00:00
abstract::Patients with end-stage lung disease who are candidates for lung transplantation may acutely decompensate before a donor organ becomes available. In this scenario, extracorporeal life support (ECLS) may be considered as a bridge to transplant or as a bridge to decision. In the current chapter, we review the indication...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.08.117
更新日期:2017-09-01 00:00:00
abstract:Background:Persistent cardiac hypertrophy threatens health worldwide. Long non-coding RNAs (lncRNAs) attracted lots of attention in cardiac diseases such as cardiac hypertrophy. In this study, we aimed to study the function of KCNQ1OT1 in cardiac hypertrophy. Methods:We first used qRT-PCR to detect the expression of K...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-203
更新日期:2020-09-01 00:00:00
abstract:Background:Tracheobronchopathia osteochondroplastica (TPO) is characterized by the presence of diffuse cartilaginous or bony submucosal nodules that lead to airway lumen narrowing. So far, there was no study in South Korea analysing a large number of TPO patients. We aimed to elucidate its treatment strategy and clinic...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-1898
更新日期:2020-10-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) primarily affects the lungs but due to the accompanying chronic systematic inflammation and the symptoms associated with the disease there are many extrapulmonary effects which include complex physical and metabolic adaptations. These changes have been associated with reduc...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.10.41
更新日期:2019-10-01 00:00:00
abstract:Background:The objectives of this study were to evaluate the feasibility and safety of robot-assisted thoracic surgery (RATS) using the da Vinci robotic system for mediastinal mass resection and to describe the surgical approach for masses in different mediastinal regions. Methods:We retrospectively reviewed data from...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.08.105
更新日期:2020-02-01 00:00:00
abstract:Background:Modern left ventricular assist devices (LVAD) have evolved to become standard of care in severe heart failure (HF) patients. Right HF (RHF) is a major complication responsible for early mortality. Several techniques for temporary right ventricular assist device (t-RVAD) have been described before, baring rel...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.11.121
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Red cell distribution width (RDW) might be a novel biomarker that reflects multiple physiological impairments related to atherosclerosis and coronary artery diseases (CAD). We conducted this systematic review and meta-analysis to evaluate the association of RDW between all-cause mortality and fatal/non-fatal...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.09.10
更新日期:2014-10-01 00:00:00
abstract::Concomitant occurrence of atrial myxoma and esophageal carcinoma is an extremely rare entity. Here we present two cases of synchronously suffered left atrial myxoma and esophageal carcinoma. Both patients underwent simultaneous resection of two tumors via the right thoraco-abdominal approach and recovered well. ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.05.89
更新日期:2016-07-01 00:00:00
abstract:Background:In previous study, we found elevated serum total lactate dehydrogenase (LDH) before correction of pectus excavatum and a decrease in total LDH after the deformity correction. In the present study, we analyzed total LDH activity and its isoenzyme patterns to investigate the causes of these laboratory findings...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.09.49
更新日期:2019-10-01 00:00:00
abstract:Background:Recent studies incorporating dose escalated radiation identified heart dose as a predictor of cardiac toxicity in unresectable lung cancer patients. Whether conventionally dosed radiation impacts cardiac events remains unclear. Methods:Stage III lung cancer patients undergoing definitive chemoradiation to 6...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.06.29
更新日期:2019-06-01 00:00:00
abstract::Obstructive sleep apnea (OSA) is a disorder which afflicts a large number of individuals around the world. OSA causes sleepiness and is a major cardiovascular risk factor. Since its inception in the early 1980's, continuous positive airway pressure (CPAP) has emerged as the major treatment of OSA, and it has been show...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2015.07.30
更新日期:2015-08-01 00:00:00
abstract::Surgery is the gold standard treatment of lung cancer. The minimally invasive technique does not only concern access to the chest but also the limits of parenchymal resection. The study debates on the safety and oncological adequacy of sublobar resections in bronchogenic carcinoma patients. A systematic analysis of th...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2020.02.54
更新日期:2020-06-01 00:00:00
abstract::Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.03.84
更新日期:2018-03-01 00:00:00
abstract::More than half of primary lung cancers are not resectable at diagnosis and 40% of deaths may be secondary to loco-regional disease. Many of these patients suffer from symptoms related to airways obstruction. Indications for therapeutic endoscopic treatment are palliation of dyspnea and other obstructive symptoms in ad...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.07.68
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Recurrence of pectus excavatum (PE) is not an uncommon problem after open repair using the Ravitch technique. The optimal approach for redo surgery is still under debate, especially in adults with less chest wall pliability. Aim of this study was to investigate the usefulness and efficacy of the minimally in...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.06.60
更新日期:2016-08-01 00:00:00
abstract::Immunotherapy agents in metastatic non-small cell lung cancer (NSCLC) can result in improved quality of life and survival when compared with platinum-based chemotherapy. Novel response patterns such as pseudoprogression and hyperprogression, however, have been described and pose a challenge to treating physicians. Pre...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.01.79
更新日期:2018-02-01 00:00:00
abstract:Background:The purpose of this study is to develop a radiomics approach to predict brain metastasis (BM) for stage III/IV ALK-positive non-small cell lung cancer (NSCLC) patients. Methods:Patients with ALK-positive III/IV NSCLC from 2014 to 2017 were enrolled retrospectively. Their pretreatment thoracic CT images were...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.01
更新日期:2019-11-01 00:00:00
abstract::Pulmonary embolism (PE) by occlusion of the pulmonary arterial bed may lead to acute life-threatening but potentially reversible right ventricular failure, one of the most severe complications of thoracic surgery. Still, the incidence of acute pulmonary embolism after surgery is reduced by comprehensive anticoagulant ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2011.10.02
更新日期:2012-02-01 00:00:00
abstract:Background:Obstructive sleep apnea (OSA) is an independent risk factor for hypertension. OSA-related hypertension is common and treatment of OSA can reduce blood pressure (BP). However, few studies have been conducted on this type of hypertension in the Chinese occupational population. Methods:We conducted a field inv...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.09.83
更新日期:2019-10-01 00:00:00
abstract::The left internal mammary artery (LIMA) to the left anterior descending artery bypass remains the gold standard for coronary artery bypass grafting. This review focuses on the three major options for LIMA takedown when using minimal access options to achieve this bypass, namely standard minimally invasive direct coron...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.11.02
更新日期:2013-11-01 00:00:00
abstract::Esophagectomy is a complex surgical procedure associated with high rates of mortality and morbidity, mainly dominated by pulmonary complications. Minimally invasive approaches have been developed in order to decrease postoperative morbidity, including totally minimally invasive esophagectomy (MIE) and hybrid esophagec...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.12.92
更新日期:2019-04-01 00:00:00
abstract:Background:The aim of this study was to retrospectively investigate the diagnostic accuracy of ultrasound-guided pleural cutting needle biopsy (US-guided PCNB) and the potential factors influencing diagnostic yield. Methods:From July 2014 to June 2016, a total of 147 percutaneous US-guided PCNBs in 144 patients were r...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.94
更新日期:2018-06-01 00:00:00
abstract::During the last decades lung cancer is the leading cause of death worldwide for both sexes. Even though cigarette smoking has been proved to be the main causative factor, many other agents (e.g., occupational exposure to asbestos or heavy metals, indoor exposure to radon gas radiation, particulate air pollution) have ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.03.06
更新日期:2014-03-01 00:00:00
abstract:Background:Pulmonary sequestration is a rare disease whose development begins in the embryonic stage. Surgery is the definitive treatment for eliminating respiratory symptoms and preventing complications. Reports of uniportal video-assisted thoracoscopic surgery (VATS) lobectomy and segmentectomy for pulmonary sequestr...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.151
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Cyclooxygenase-2 (COX-2) has been implicated in tumorigenesis and metastasis, and it presumably mediates the proliferation of endothelial cells and promotes vascular permeability. However, the prognostic value of COX-2 overexpression in patients with non-small cell lung cancer (NSCLC) remains controversial. ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2013.01.02
更新日期:2013-02-01 00:00:00
abstract::The severity of the clinical condition and co-morbidities of the patients for esophagectomy require a complex assessment and risk stratification before the operation, and most of the cases need complex management. We did a literature search and considered the data on risk stratification and complex management of patie...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.12.11
更新日期:2019-04-01 00:00:00