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Korean J Thorac Cardiovasc Surg 2010; 43(4): 399-403

Published online August 5, 2010 https://doi.org/10.5090/kjtcs.2010.43.4.399

Copyright © Journal of Chest Surgery.

Ultrasound for Detecting Pleural Adhesion before Video-Assisted Thoracic Surgery

Jin Yong Jeong, M.D.*, Hyung Joo Park, M.D.*, Jae Seung Shin, M.D.*, Won Min Jo, M.D.*, In Sung Lee, M.D.*

Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center

Received: March 24, 2010; Revised: June 28, 2010; Accepted: July 7, 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Video-Assisted Thoracic Surgery can be performed with the lung collapsed. During the procedure, pleural adhesion may result in lung injury, bleeding, and thoracotomy conversion. Identifying the presence of pleural adhesion before surgery can make it easy to plan trocar introduction and perform the procedure. Material and Method: Between June 2009 and November 2009, we performed ultrasound in 24 patients to detect pleural adhesion before surgery and compared the results with the operative findings. We primarily examined the lateral chest, where the trocar would be inserted, and, occasionally, the anterior or posterior chest. Result: Patient diseases were: 6 hyperhidroses, 8 interstitial lung diseases, 5 lung cancers, 2 mediastinal tumors, 1 peripheral pulmonary embolism, 1 metastatic lung cancer, and 1 sarcoidosis. Of the 22 patients who did not have pleural adhesions on ultrasound, four revealed mild adhesions not related to the trocar insertion sites. However, ultrasound showed pleural adhesions in two patients, consistent with the operative findings. There was no air leak or thoracotomy conversion related with trocar insertion. Conclusion: Ultrasound requires only a few minutes to detect the presence of the pleural adhesion and was very useful in identifying the pleural adhesion before VATS. (Korean J Thorac Cardiovasc Surg 2010;43:399-403)

Keywords: 1. Video-assisted thoracic surgery (VATS), 2. Ultrasound, 3. Adhesions

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Clinical Analysis

Korean J Thorac Cardiovasc Surg 2010; 43(4): 399-403

Published online August 5, 2010 https://doi.org/10.5090/kjtcs.2010.43.4.399

Copyright © Journal of Chest Surgery.

Ultrasound for Detecting Pleural Adhesion before Video-Assisted Thoracic Surgery

Jin Yong Jeong, M.D.*, Hyung Joo Park, M.D.*, Jae Seung Shin, M.D.*, Won Min Jo, M.D.*, In Sung Lee, M.D.*

Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center

Received: March 24, 2010; Revised: June 28, 2010; Accepted: July 7, 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Video-Assisted Thoracic Surgery can be performed with the lung collapsed. During the procedure, pleural adhesion may result in lung injury, bleeding, and thoracotomy conversion. Identifying the presence of pleural adhesion before surgery can make it easy to plan trocar introduction and perform the procedure. Material and Method: Between June 2009 and November 2009, we performed ultrasound in 24 patients to detect pleural adhesion before surgery and compared the results with the operative findings. We primarily examined the lateral chest, where the trocar would be inserted, and, occasionally, the anterior or posterior chest. Result: Patient diseases were: 6 hyperhidroses, 8 interstitial lung diseases, 5 lung cancers, 2 mediastinal tumors, 1 peripheral pulmonary embolism, 1 metastatic lung cancer, and 1 sarcoidosis. Of the 22 patients who did not have pleural adhesions on ultrasound, four revealed mild adhesions not related to the trocar insertion sites. However, ultrasound showed pleural adhesions in two patients, consistent with the operative findings. There was no air leak or thoracotomy conversion related with trocar insertion. Conclusion: Ultrasound requires only a few minutes to detect the presence of the pleural adhesion and was very useful in identifying the pleural adhesion before VATS. (Korean J Thorac Cardiovasc Surg 2010;43:399-403)

Keywords: 1. Video-assisted thoracic surgery (VATS), 2. Ultrasound, 3. Adhesions

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