Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Dec 2010
Novel silicone stent to treat tracheobronchial lesions: results of 35 patients.
We describe a case series of 35 patients with either benign (14) or malignant (21) tracheal stenosis who were treated using a novel silicone stent, the HCPA-1, designed to prevent migration. Between March 2001 and September 2008, 13 women and 22 men received 41 HCPA-1 stents. The median duration of stenting in benign cases was 457 days (range, 4-2,961 days). ⋯ Twelve patients with malignant lesions died with the stent in place. At the end of the study, 3 patients with malignant disease remained alive; 2 were lost to follow-up. The HCPA-1 stent proved to be safe, with no severe complications during the study period, and effective in improving quality of life with relief of dyspnea.
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The bidirectional Glenn shunt operation is conventionally performed under cardiopulmonary bypass. Between June 2007 and September 2009, 218 consecutive patients underwent off-pump bidirectional Glenn shunt institution for single ventricle with pulmonary stenosis complex. Their mean age was 4.72 ± 1.80 years (range, 4 months to 6 years) and median weight was 10.12 kg (range, 4.1-19 kg). ⋯ Four (1.83%) patients died in the immediate postoperative period due to low cardiac output syndrome. Venoatrial shunt-assisted bidirectional Glenn shunt surgery can be performed safely by optimizing intraoperative management strategies. It is economical and avoids the deleterious effects cardiopulmonary bypass.
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Asian Cardiovasc Thorac Ann · Oct 2010
Is epidural analgesia necessary after video-assisted thoracoscopic lobectomy?
Most studies have shown that thoracic epidural analgesia reduces postoperative pain, but it carries potential risks. Recently, video-assisted thoracoscopic surgery has become an established technique that causes minimal postoperative pain. This report shows that thoracic epidural analgesia is not always necessary after video-assisted thoracoscopic lobectomy. ⋯ All patients made uneventful postoperative recoveries. There is no need for thoracic epidural analgesia after every video-assisted thoracoscopic lobectomy because our patients recovered with no serious complication. Less invasive surgical approaches should require simpler postoperative pain management.