Home
|
Inbox
|
Search
|
View Abstract
Thoracoscopic Laser Metastasectomy: The Republic of Ireland’s Initial Experience
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A7322 - Thoracoscopic Laser Metastasectomy: The Republic of Ireland’s Initial Experience
Author Block: J. Mc Loughlin, K. O' Sullivan, R. Brown, D. Eaton; Thoracic Surgery, Mater Misercordiae University Hospital, Dublin, Ireland.
Introduction
Pulmonary metastasectomy and indeed redo-pulmonary metastasectomy are now commonly performed thoracic surgical procedures. Surgical approaches aim to achieve clear resection margins with minimal lung tissue loss. The air-sealant, haemostatic and necrotic properties of the Limax Nd:YAG laser make it an ideal tool for limited lung resection such as metastasectomy. Avoidance of techniques such as stapled resection allow for more accurate interpretation of follow-up imaging and reduces the volume of adhesions at any future redo-surgery. Additionally, some studies have suggested that laser resection of tumor produces sterilization of the resection margin up to 5mm from neoplastic cells1. We reviewed our initial experience of thoracoscopic laser metastasectomy.
Methods
We reviewed the data of the first 5 patients in our unit to undergo Thoracoscopic metastasectomy. In particular we reviewed: patient age, gender, primary malignancy, primary treatment, complications, length of stay (LOS), final histopathology and repeat CT findings. All procedures were performed using a 2 or 3 port thoracoscopic technique. In patients where the lesion was small or deep a CT guided wire was used to ensure accurate localization of the lesion. The Purastat® haemostatic agent was applied to the resected lung tissue to reduce likelihood of air leak in all cases except for one. A single drain was inserted via the camera port site and was removed upon confirmation that there was no air leak.
Results
Five patients underwent thoracoscopic laser wedge metastasectomy of 6 lesions in our center between February 2017 and October 2017. The median age was 60 years. The primary disease was colorectal carcinoma in three cases, eccrine carcinoma in one and high-grade uterine leiomyosarcoma in one case.Only one patient had a prolonged air leak in the other 4 cases the drain was removed on post-operative day 1. In the case with a postoperative air leak the Purastat® haemostatic agent was not used at the resection site. The median post-operative LOS was 1 day. All patients had clear resection margins on histopathology.
Conclusions
In our early experience, thoracoscopic laser wedge metastasectomy is a safe and efficient method for performance of pulmonary metastasectomy. We experienced a low complication rate and a short post-operative stay. Additionally we anticipate that laser resection will improve the interpretation of our follow-up imaging and reduce the presence of adhesions at any subsequent surgery.
References
1. Moghissi, K. Local excision of pulmonary nodular (coin) lesion with noncontact yttrium-aluminum-garnet laser. J Thorac Cardiovasc Surg. 1989; 97: 147-151
Author Block: J. Mc Loughlin, K. O' Sullivan, R. Brown, D. Eaton; Thoracic Surgery, Mater Misercordiae University Hospital, Dublin, Ireland.
Introduction
Pulmonary metastasectomy and indeed redo-pulmonary metastasectomy are now commonly performed thoracic surgical procedures. Surgical approaches aim to achieve clear resection margins with minimal lung tissue loss. The air-sealant, haemostatic and necrotic properties of the Limax Nd:YAG laser make it an ideal tool for limited lung resection such as metastasectomy. Avoidance of techniques such as stapled resection allow for more accurate interpretation of follow-up imaging and reduces the volume of adhesions at any future redo-surgery. Additionally, some studies have suggested that laser resection of tumor produces sterilization of the resection margin up to 5mm from neoplastic cells1. We reviewed our initial experience of thoracoscopic laser metastasectomy.
Methods
We reviewed the data of the first 5 patients in our unit to undergo Thoracoscopic metastasectomy. In particular we reviewed: patient age, gender, primary malignancy, primary treatment, complications, length of stay (LOS), final histopathology and repeat CT findings. All procedures were performed using a 2 or 3 port thoracoscopic technique. In patients where the lesion was small or deep a CT guided wire was used to ensure accurate localization of the lesion. The Purastat® haemostatic agent was applied to the resected lung tissue to reduce likelihood of air leak in all cases except for one. A single drain was inserted via the camera port site and was removed upon confirmation that there was no air leak.
Results
Five patients underwent thoracoscopic laser wedge metastasectomy of 6 lesions in our center between February 2017 and October 2017. The median age was 60 years. The primary disease was colorectal carcinoma in three cases, eccrine carcinoma in one and high-grade uterine leiomyosarcoma in one case.Only one patient had a prolonged air leak in the other 4 cases the drain was removed on post-operative day 1. In the case with a postoperative air leak the Purastat® haemostatic agent was not used at the resection site. The median post-operative LOS was 1 day. All patients had clear resection margins on histopathology.
Conclusions
In our early experience, thoracoscopic laser wedge metastasectomy is a safe and efficient method for performance of pulmonary metastasectomy. We experienced a low complication rate and a short post-operative stay. Additionally we anticipate that laser resection will improve the interpretation of our follow-up imaging and reduce the presence of adhesions at any subsequent surgery.
References
1. Moghissi, K. Local excision of pulmonary nodular (coin) lesion with noncontact yttrium-aluminum-garnet laser. J Thorac Cardiovasc Surg. 1989; 97: 147-151
|
Home
|
Inbox
|
Search
|