Preoperative saline-filled computed tomography thoracography for awake video-assisted thoracic surgery: report of three cases

Awake video-assisted thoracic surgery (VATS) is a therapeutic option for patients with intractable secondary spontaneous pneumothorax (SSP) complicated by impaired pulmonary function. The preoperative identification of air leak points is one of the keys to the success of this procedure. We describe...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2015-12, Vol.45 (12), p.1579-1582
Main Authors: Watanabe, Tatsuaki, Noda, Masafumi, Okazaki, Toshimasa, Tsukidate, Hisakatsu, Sato, Kota, Notsuda, Hirotsugu, Niikawa, Hiromichi, Okada, Yoshinori, Matsumura, Yuji, Kondo, Takashi
Format: Article
Language:English
Subjects:
Adolescent
Aged
Aged, 80 and over
Female
Humans
Male
Medicine
Medicine & Public Health
Pneumothorax - diagnostic imaging
Pneumothorax - etiology
Pneumothorax - surgery
Preoperative Period
Radiography, Thoracic - methods
Short Communication
Sodium Chloride
Surgery
Surgical Oncology
Thoracic Surgery, Video-Assisted - methods
Tomography, X-Ray Computed - methods
Treatment Outcome
Wakefulness - physiology
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Summary:Awake video-assisted thoracic surgery (VATS) is a therapeutic option for patients with intractable secondary spontaneous pneumothorax (SSP) complicated by impaired pulmonary function. The preoperative identification of air leak points is one of the keys to the success of this procedure. We describe how we performed saline-filled computed tomography (CT) thoracography to detect pleural fistulae in three patients with intractable SSP. Saline-filled CT thoracography showed bubble signs in two patients and an air–water level in bulla in one patient. The preoperative identification of air leak points resulted in successful awake VATS for all three patients. Our experience demonstrates that saline-filled CT thoracography is a useful diagnostic tool for SSP, especially when used in preparation for awake VATS when minimally invasive procedures are desirable.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-015-1204-5