Abstract:
Background:Anterior mediastinal tumours account for 50% of all mediastinal masses. Surgical intervention is the standard approach for their diagnosis or treatment. Minimally invasive techniques have gained significant popularity in the last few decades due to the obvious advantages that they offer. We will describe a series composed of the first 20 patients who were submitted to a new minimally invasive video-assisted technique, which uses an inframammary incision approach involving a Thoratrak rib spreader and a Rultract Skyhook retractor. Methods:A retrospective study was undertaken, involving all the patients in our department who were submitted to a resection of their anterior mediastinal masses by inframammary incision, using a Thoratrak rib spreader, a Rultract Skyhook retractor and video assistance. Results:A total of 20 patients were included, with a mean age of 52.6. The mean surgery duration was 47 minutes, with an intraoperative blood loss of 70 mL. The mean period of hospitalisation was 2.9 days. No patients underwent conversion to open surgery, and there were no major complications. The mean size of the masses that were excised was 13.9 cm, with a mean weight of 77.3 g. The surgical margins were all free of tumour tissue, and no early recurrence was observed during the postoperative follow-up period. Conclusions:Video-assisted thoracoscopic surgery (VATS) and robot assisted thoracic surgery (RATS) account for most of the minimally invasive procedures. However, VATS has certain limitations in terms of deep perception and manoeuvrability, and RATS has the disadvantage of lacking tactile and force feedback for the surgeon. The inframammary technique allows for safe direct dissection around the vascular and nervous structures, ensuring a complete observation of the anterior mediastinum and its structures. The findings in the present study suggest that this technique is useful. We had good surgical results, short surgery times and very low blood loss, and all tumours were totally resected, with tumour-free surgical margins. The size and the right lateralisation of the mass did not present any contraindications, and the learning curve and investment were minimal. In conclusion, the inframammary approach could be a safe and useful approach for treating anterior mediastinal pathology.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Ferreira R,Junqueira N,Rodrigues M,Nobre Âdoi
10.21037/jtd-19-3310bsubject
Has Abstractpub_date
2020-05-01 00:00:00pages
2077-2081issue
5eissn
2072-1439issn
2077-6624pii
jtd-12-05-2077journal_volume
12pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to detect the feasibility, safety, and effectiveness of mediastinoscopic esophagectomy for early esophageal cancer. METHODS:The clinical data of 194 patients who underwent mediastinoscopic esophagectomy for early esophageal cancer in our center from December 2005 to October 2014...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.07.20
更新日期:2015-07-01 00:00:00
abstract::Aortic stenosis is the most common valvular disease worldwide. With transcatheter aortic valve replacement (TAVR) being increasingly expanded to lower-risk populations, several challenging issues remain to be solved. The present review aims at discussing modern approaches to such issues as well as the current status o...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2020.01.10
更新日期:2020-04-01 00:00:00
abstract::Patients with locally advanced esophageal cancer are treated with definitive chemoradiation (dCXRT) for a number of reasons. Some patients are never referred to a surgeon for a con-versation about surgery, others decline surgery, and some are not candidates for surgery due to a sag in performance status secondary to t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.03.29
更新日期:2014-05-01 00:00:00
abstract::Cardiac amyloidosis is thought to be a rare group of diseases caused by extracellular deposition of misfolded proteins in the extracellular cardiac matrix resulting in heart failure with preserved ejection fraction (HFpEF). This review focuses on the similarities and differences between the pathophysiology, clinical p...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.03.134
更新日期:2018-03-01 00:00:00
abstract::Lung cancer invading the superior vena cava (SVC) is a locally advanced condition, for which poor prognosis is expected with conservative treatment alone. Surgical resection of the lesion can rapidly relieve the symptoms and significantly improve survival for some patients. Replacement, repair and partial resection of...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.01.55
更新日期:2016-03-01 00:00:00
abstract:Background:It is important to identify patients with esophageal squamous cell carcinoma (ESCC) in T1b stage that are the least likely to metastasize on the lymph nodes, to undergo endoscopic resection, especially for the patients unfit for esophagectomy. The relationship between endoscopic morphology and frequency of n...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.11.77
更新日期:2018-12-01 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:BACKGROUND AND OBJECTIVE:Chronic obstructive pulmonary disease (COPD) represents an increasing healthcare concern as a leading cause of morbidity and mortality worldwide. Our objective was to predict the outcome of COPD patients associated with multiple organ dysfunction syndrome (MODS) by scoring models. METHODS:A re...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.11.27
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Spontaneous pneumothoraces (SP) tend to occur in clusters which have been related to atmospheric pressure variations and thunderstorm insurgence. We examined the influence of standard meteorological parameter variations and concentrations of the major air pollutants on incidence of spontaneous pneumothorax (...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:
更新日期:2010-03-01 00:00:00
abstract::Endobronchial tumors are a rare entity that presents with different pathological findings. The interventional pulmonologist, but also the thoracic surgeon have at their disposal the same techniques for diagnosis, however; the two modalities differentiate in the treatment approach. Diagnosis evaluation should include l...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.06.22
更新日期:2013-09-01 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:BACKGROUND:Cancer staging systems are designed to predict survival and stratify patients. The 7(th) edition of the American Joint Commission on Cancer (AJCC7) staging system for esophageal cancer was modeled using survival data on patients who underwent esophagectomy without induction or adjuvant therapy. In the United...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.04.30
更新日期:2015-04-01 00:00:00
abstract:Background:To improve periprocedural outcomes of transcatheter aortic valve implantation (TAVI), transcatheter mechanical resection devices were tested for prior ablation of the aortic cusps. Methods:Three mechanical transcatheter resection devices were tested in a series of native porcine (n=30) and reassembled calci...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-2036
更新日期:2020-11-01 00:00:00
abstract::Lung cancer is the leading cause of cancer related death throughout the world. Lung cancer is an example of a disease for which a large percentage of the high-risk population can be easily identified via a smoking history. This has led to the investigation of lung cancer screening with low-dose helical/multi-detector ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.08.43
更新日期:2014-09-01 00:00:00
abstract::This review provides an update on the current role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and mediastinoscopy (Med) in assessment of patients with non-small cell lung cancer (NSCLC). Invasive mediastinal lymph node (LN) staging is the major application for both of these techniq...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.03.102
更新日期:2017-03-01 00:00:00
abstract:Background:Aberrant epithelial remodeling and/or abnormalities in mucociliary apparatus in airway epithelium contribute to infection and inflammation. It is uncertain if these changes occur in both large and small airways in non-cystic fibrosis bronchiectasis (non-CF bronchiectasis). In this study, we aim to investigat...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.02.13
更新日期:2018-03-01 00:00:00
abstract::Histological characteristics and clinical behaviour define lung neuroendocrine tumors (NETs), which are classified into four groups: typical (TC) and atypical carcinoids (AC), large-cell neuroendocrine carcinomas (LCNCs) and small-cell lung cancers (SCLCs). Historically, outcome and treatment of these rare neoplasms h...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.04.104
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:To evaluate the feasibility of a combined strategy including conventional-trans-bronchial needle aspiration biopsy (C-TBNA) and endobronchial ultrasounds transbronchial needle aspiration (EBUS-TBNA) for sampling mediastinal adenopathies in patients with lung cancer in order to determinate whether in the era ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.04.13
更新日期:2017-05-01 00:00:00
abstract:Background:There are several techniques for robotic-assisted pulmonary resection, depending on the number and position of ports and utility incisions. We developed a technique for three-incision robotic-assisted pulmonary resection, and here we reported our initial results. Methods:Three-incision pulmonary resection w...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.12.116
更新日期:2020-03-01 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::Obstructive sleep apnea (OSA) is probably the most common respiratory disorder, with recent data from the United States and Europe suggesting that between 14% and 49% of middle-aged men have clinically significant OSA. The intimate relationship between OSA and obesity means that its prevalence will only increase as th...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2015.04.52
更新日期:2015-05-01 00:00:00
abstract:Background:Calcific aortic valve disease (CAVD) is the most common type of valvular heart disease in the elderly. This study is aimed to explore molecular mechanism of CAVD via bioinformatics analysis. Methods:The gene expression profiles of GSE51472 (including 5 normal aortic valve and 5 calcified aortic valve) and G...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.57
更新日期:2019-12-01 00:00:00
abstract:Background:The technical concepts of thoracoscopic segmentectomy are still evolving. In this study we present a simple bronchoscopy-based intersegmental demarcation technique with short- and mid-term outcomes compared between thoracoscopic segmentectomy and lobectomy. Methods:All 105 consecutive patients with lung can...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-656
更新日期:2020-06-01 00:00:00
abstract::A 69-year-old male patient with a history of melanoma and prostate cancer was found to have a 2.6 cm PET-avid, slowly enlarging, left upper lobe lung nodule that was suspicious for either metastasis or primary lung cancer. Due to the deep location of the nodule, a wedge resection was not recommended. A diagnostic and ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.07.61
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Surgical use of robots has evolved over the last 10 years. However, the academic experience with robotic lung segmentectomy remains limited. We aimed to analyze our lung segmentectomy experience with robot-assisted thoracoscopic surgery. METHODS:Prospectively recorded clinical data of 21 patients who underwe...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.06.40
更新日期:2014-07-01 00:00:00
abstract:Background:Retrospective compared the results of root reconstruction and root replacement for acute type A aortic dissection (ATAAD) patients and observed the rate of aortic insufficiency (AI) and aortic root dilation in the midterm follow-up period. Methods:From 2008-2016, 427 ATAAD patients received surgical therapy...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.10.62
更新日期:2019-11-01 00:00:00
abstract:Background:The purpose of this study is to evaluate outcomes in upfront local response and survival of patients with esophageal cancer and distant metastasis. Methods:This retrospective study included 34 patients (25 males) aged 42-92 years (median, 70 years) with a histological diagnosis of esophageal squamous cell c...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.45
更新日期:2018-03-01 00:00:00
abstract::Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.10.22
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The characteristics of patients with urinothorax (UT) are poorly defined. METHODS:A systematic review was performed searching for studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of UT. Case descriptions and retrospective studies were included. RESUL...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.04.22
更新日期:2017-05-01 00:00:00
abstract::Since 1995, video-assisted thoracoscopic oesophagectomy (VATS), according the same surgical principles as the Japanese open surgery, has been completed in 700 patients with oesophageal cancer. Our indication for VATS is (I) no extensive pleural adhesion; (II) no contiguous tumor spread; (III) pulmonary function capabl...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.05.25
更新日期:2017-07-01 00:00:00