![]() Tubeless uniportal VATS for pulmonary wedge resection can be safely performed in selected patients. ![]() Primary spontaneous pneumothorax was independently associated with a higher risk of postoperative abnormal CXRs. Among them, 3 (2.5%) patients developed clinically significant abnormal CXRs and required intercostal drainage. Among 122 patients in which a tubeless procedure was performed, 26 (21.3%) and 47 (38.5%) had abnormal CXR findings on OP day and postoperative day 1, respectively. ![]() The factors associated with abnormal CXR findings were studied.Īmong 135 attempts to avoid chest drain insertion, 13 (9.6%) patients ultimately required a postoperative chest drain. For those candidates in whom a tubeless procedure was performed, postoperative chest X-rays (CXRs) were taken on the day of the surgery, on postoperative day 1 and 1-2 weeks later. The decision to avoid chest drain insertion was made in selected candidates. We reviewed consecutive patients undergoing non-intubated uniportal VATS for pulmonary wedge resection at 2 medical centres between August 2016 and October 2019. However, to date, the safety of the procedure has not been studied. Tubeless uniportal video-assisted thoracic surgery (VATS), using a uniportal approach and non-intubated anaesthesia while avoiding postoperative chest drain insertion, for patients undergoing thoracoscopic surgery has been demonstrated to be feasible in selected cases. Hybrid sutures seem to be a good compromise. This suggests a safer employment in case of small defects or diastasis ( W1 in accord to EHS classification) where the expected tissutal displacement is maximal. Stapled sutures can resist high loads, but are less deformable and rigid than handsewn suture. Handsewn and hybrid sutures showed significantly higher dissipated specific energy (handsewn 0.99 mJ-mm³, stapled 0.73 mJ-mm³, hybrid 1.35 mJ-mm³). Stapled and hybrid sutures had fourfold higher Young’s modulus as compared to handsewn sutures (handsewn 1.779 MPa, stapled 7.374 MPa, hybrid 6.964 MPa). Stapled and hybrid suture showed a significantly higher strength (handsewn 0.83 MPa, stapled 2.10 MPa, hybrid 2.68 MPa) and a trend toward a lower ultimate strain as compared to manual sutures (handsewn 344%, stapled 249%, hybrid 280%). The data on strength (maximal stress), ultimate strain (deformability), Young’s modulus (rigidity), and dissipated specific energy (ability to absorb mechanical energy up to the breaking point) were recorded for each type of specimens and analyzed. Human cadaver fascia lata specimens, sutured (handsewn, stapled, or hybrid) or not, underwent tensile tests. From the results obtained, we tried to draw indications for their use in a clinical context. This study aims to investigate the biomechanics of stapled sutures, simple (stapled), or oversewn (hybrid), in comparison with handsewn suture. However, to the knowledge of the authors, there are little data in the literature about the outcomes of stapled sutures adoption for midline reconstruction. Recently, in the field of abdominal wall repair surgery, some minimally invasive procedures introduced the use of staplers to provide a retromuscular prosthetic repair.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |