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      Outcomes of the Tower Crane Technique with a 15-mm Trocar in Primary Spontaneous Pneumothorax

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          Abstract

          Background

          Video-assisted thoracoscopic surgery (VATS) pulmonary wedge resection has emerged as the standard treatment for primary spontaneous pneumothorax. Recently, single-port VATS has been introduced and is now widely performed. This study aimed to evaluate the outcomes of the Tower crane technique as novel technique using a 15-mm trocar and anchoring suture in primary spontaneous pneumothorax.

          Methods

          Patients who underwent single-port VATS wedge resection in Chungnam National University Hospital from April 2012 to March 2014 were enrolled. The medical records of the enrolled patients were reviewed retrospectively.

          Results

          A total of 1,251 patients were diagnosed with pneumothorax during this period, 270 of whom underwent VATS wedge resection. Fifty-two of those operations were single-port VATS wedge resections for primary spontaneous pneumothorax performed by a single surgeon. The median age of the patients was 19.3±11.5 years old, and 43 of the patients were male. The median duration of chest tube drainage following the operation was 2.3±1.3 days, and mean postoperative hospital stay was 3.2±1.3 days. Prolonged air leakage for more than three days following the operation was observed in one patient. The mean duration of follow-up was 18.7±6.1 months, with a recurrence rate of 3.8%.

          Conclusion

          The tower crane technique with a 15-mm trocar may be a promising treatment modality for patients presenting with primary spontaneous pneumothorax.

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          Most cited references13

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          Uniportal VATS wedge pulmonary resections.

          Since 2000, 15 patients have undergone single port (uniportal) video-assisted thoracic surgery for wedge pulmonary resection either for diagnosis of interstitial lung diseases (10 patients) or for treatment of primary spontaneous pneumothoraces (5 patients). Diagnosis was obtained in all patients and no recurrences of pneumothorax were seen at follow-up. This initial experience shows that, for specific indications, uniportal video-assisted thoracic surgery for wedge pulmonary resections can be safe and effective.
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            One-port (uniportal) video-assisted thoracic surgical resections--a clear advance.

            One-port (uniportal) video-assisted thoracic surgery (VATS) consists of approaching an intrathoracic target lesion through a sagittal, craniocaudal plane through 1 single-port incision. The use of articulating instruments inserted parallel to the videothoracoscope enables the surgeon to mimic inside the chest the maneuvers that are usually performed during open surgery. Through this VATS approach, several thoracic conditions can be addressed, including lung cancer in selected patients. Unlike conventional, 3-port VATS, the uniportal VATS technique enables the surgeon to bring the operative fulcrum inside the chest when the target lunge lesion is approached through a sagittal plan, thanks to articulating instruments. Uniportal wedge VATS resections of peripheral nodules can help in solving diagnostic dilemmas, be of therapeutic benefit, and provide tissue for biomolecular studies. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
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              Staple line coverage after bullectomy for primary spontaneous pneumothorax: a randomized trial.

              Thoracoscopic wedge resection is generally accepted as a standard surgical procedure for primary spontaneous pneumothorax. Because of the relatively high recurrence rate after surgery, additional procedures such as mechanical pleurodesis or visceral pleural coverage are usually applied to minimize recurrence, although mechanical pleurodesis has some potential disadvantages. The aim of this study was to clarify whether an additional coverage procedure on the staple line after thoracoscopic bullectomy prevents postoperative recurrence compared with additional pleurodesis.
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                Author and article information

                Journal
                Korean J Thorac Cardiovasc Surg
                Korean J Thorac Cardiovasc Surg
                The Korean Journal of Thoracic and Cardiovascular Surgery
                The Korean Society for Thoracic and Cardiovascular Surgery
                2233-601X
                2093-6516
                April 2016
                05 April 2016
                : 49
                : 2
                : 80-84
                Affiliations
                Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine
                Author notes
                Corresponding author: Min-Woong Kang, Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea, (Tel) 82-42-280-7375 (Fax) 82-42-280-7373 (E-mail) dreamerkang@ 123456hanmail.net
                Article
                kjtcv-49-080
                10.5090/kjtcs.2016.49.2.80
                4825907
                27066430
                17d23a36-3854-4c61-8382-6a3a6b852949
                Copyright © 2016 by The Korean Society for Thoracic and Cardiovascular Surgery. All rights Reserved.

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creative-commons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 May 2015
                : 04 August 2015
                : 05 August 2015
                Categories
                Clinical Research

                Surgery
                pneumothorax,video-assisted thoracic surgery
                Surgery
                pneumothorax, video-assisted thoracic surgery

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