tochii sachiko

We report a case of single-incision bilateral partial lung resection using the subxiphoid approach. This approach requires a 3-cm incision in the abdomen, making it aesthetically favorable. In addition, it does not cause postoperative intercostal neuropathy, and postoperative pain is minimal because the intercostal space is bypassed. Moreover, this technique enables exposure to both lungs through a single incision and has potential for widespread use if maneuverability can be increased by improving the instruments used. (C) 2014 by The Society of Thoracic Surgeons

We retrospectively assessed the utility of continuous paravertebral block in patients undergoing thoracoscopic lung resection. Among 92 consecutive patients, 32 received additional paravertebral block (PVB group) with 0.2% Ropivacaine hydrochloride hydrate, continuous at a rate of 3 ml/h for 3 days starting immediately after surgery. All patients received oral NSAIDS for baseline pain relief and either a rescue dose of Diclofenac sodium at 50 mg enterally or Pentazocine at 15 mg intravenously when necessary. Pain was assessed using a visual analogue scale, with 0 representing no pain and 100 for the worst pain possible. Intraoperative thoracoscopic catheterization was straightforward, and there were no complications associated with paravertebral block. The mean pain score within the first 2 days following surgery was significantly lower in the PVB group (28±16 vs. 43±18, p<0.01). The total doses of the abovementioned rescue analgesics were both lower in the PVB group. Continuous paravertebral block is a simple, safe, and effective method of postoperative analgesia in patients undergoing thoracoscopic lung resection.

We report a surgical procedure in which a port and devices designed for single-incision endoscopic surgery are employed for thymectomy through an infrasternal approach. As this single-port thymectomy procedure can be performed through a single 3.5-cm incision in the abdominal region usually concealed under clothes, it is esthetically excellent and is among the least invasive thymectomy procedures because no sternal incision is applied and no intercostal nerve is injured. Investigation of the safety of this procedure and long-term therapeutic outcomes for myasthenia gravis and anterior mediastinal tumors is necessary. (Ann Thorac Surg 2012;93:334-6) (C) 2012 by The Society of Thoracic Surgeons