vats procedure for pneumothorax

Dipartimento di Scienze Chirurgiche, Universita degli studi di Verona; 1998. p. 1–75. PubMed  Med. al. This paper reviews indications and current data regarding minimally invasive surgical approaches for treatment of primary spontaneous pneumothorax. Three years’ experience in video-assisted thoracic surgery (VATS) for spontaneous pneumothorax. The most efficient procedure is videothoracoscopic wedge resection with endostapler and apical parietal pleurectomy, or a mechanical pleurodesis; nowadays, both are considered equivalent in terms of complications and recurrences. Chest. Am. Video-assisted thoracoscopic surgery (VATS) is effective for primary spontaneous pneumothorax. It uses a special video camera called a thoracoscope. Pneumothorax: results of thoracoscopy and pleurodesis with talc poudrage under thoracotomy. Pneumothorax is defined as the accumulation of air within the pleural space. Eur Resp J 2006;28:255-6, Juan C Garzon, Calvin SH Ng, Alan D Sihoe, Anthony V Manlulu, Randolph HL Wong, Tak Wai Lee, Anthony PC Yim. Minimizing Chest Wall Trauma in Single Port Video-Assisted Thoracic Surgery. Chest Med. Respiration. Grundy S, Bentley A, Tschopp JM. Isolated … Chest. Iodopovidone is as effective as doxycycline in producing pleurodesis in rabbits. Cole FH Jr, Cole FH, Khandekar A et.al. Thorax 2010; 65(S) 2:18–31. CAS  Respiration. VATS procedures are done using either conventional surgical instruments or laparoscopic instruments. Operations that traditionally were carried out with thoracotomy or sternotomy that today can be performed with VATS include: biopsy for diagnosis of pulmonary, pleural or mediastinal pathology; decortication for empyema; pleurodesis for recurrent pleural effusions or spontaneous pneumothorax; surgical stapler-assisted wedge resection of lung masses; resection of mediastinal or pleural masses; thoracic sympathectomy for hyperhidrosis; operations for diaphragmatic hernias or paralysis; esophageal resection or resection of esophageal masses or diverticula; and VATS lobectomy/mediastinal lymphadenectomy for lung cancer.[1]. Van de Brekel JA, Durkens VAM, Vanderschueren RGJRA. As the trend in VATS is to use fewer ports to decrease postoperative complications, we compared the results of our experience with single-port and two-port VATS for primary spontaneous pneumothorax (PSP). Surgery is a specialty that is continuously evolving. Interact CardioVasc Thorac Surg.2003; 2:552–554. Hazelrigg SR, Naunchuck SK, Landreneau RJ. Efficacy of iodopovidone pleurodesis and comparison of small-bore catheter versus large-bore chest tube. Few investigators have reported on results after video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax (SP) with follow-up periods longer than 24 months. Philadelphia: Williams & Wilkins; 2007. p. 306–340. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Abstract: Non-intubated VATS (NI-VATS) is a novel approach that aims to benefit the patient by obtaining the minimal surgical and anaesthetic invasion. Thorax 2004;59:357, Calvin SH Ng, Tak Wai Lee, Song Wan, Innes YP Wan, Alan DL Sihoe, Ahmed A Arifi, Anthony PC Yim. One hundred nine patients were followed long-term after treatment of SP by VATS. In our series, secondary SP was present in three of seven patients (43%) with simultaneous bilateral SP. Search. History and clinical use of thoracoscopy/pleuroscopy in respiratory medicine. Undoubtedly, VATS is a very useful method in the management of spontaneous pneumothorax. Surgical treatment of primary spontaneous pneumothorax with videoassisted thoracic surgery. 2011; 39:1033–1039. Agarwal R, Paul AS, Aggarwal AN et al. Talc pleurodesis for the treatment of pneumothorax and pleural effusion. It is efficient, safe and fast, and costs less than other endoscopic techniques. 1997; 10: 409–411. Because of the risk of recurrence in subsequent pregnancies, a minimally invasive VATS surgical procedure should be considered after convalescence. The more experienced the surgeon, the less the operating time and the lower the complication rate. 2008; 76: 121–127. Journal Cardioth Surg 2010, 5:61–64. It is expected that advanced VATS techniques will continue to grow in numbers spurred by patient demand and greater surgeon comfort and familiarity with the techniques. Eur J Cardiothorac Surg. Curr Opin Pulm Med 2006;12:273-277, Calvin SH Ng, Song Wan, Connie WC Hui, Tak Wai Lee, Malcolm J Underwood, Anthony PC Yim. Background. Baumann MH, Noppen M. Pneumothorax. Respirology 2010; 15: 119–125. 2008; 102: 1004–1010. Torre M, Grassi M, Nerli F et.al. Spontaneous pneumothorax is a common condition that impacts significantly on healthcare expenditure. J Thorac Cardiovasc Surg. Videothoracoscopic poudrage seems to be a method particularly suitable for elderly patients with decreased cardio-respiratory reserves. Pulm. - 58.158.29.70. Thoracoscopic bullectomy and tetracycline pleurodesis for the treatment of spontaneous pneumothorax. Thorac cardiovasc Surg 2009; 57(8): 476–479. Inter Cardiovasc Thorac Surg.2008; 7: 63–66. Background. Awake single-access (uniportal) video-assisted thoracoscopic surgery for spontaneous pneumothorax.. J Thorac Cardiovasc Surg. J Thorac CardioVasc Surg. Three years' experience in video-assisted thoracic surgery (VATS) for spontaneous pneumothorax. The use of small incisions in the VATS procedure has shown a trend toward decreased postoperative analgesia requirements. Cheng YL, Huang TW, Lin CK et. al. Introduction e concept of thoracoscopy was rst described in ... collapse therapy to create a pneumothorax. Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function. Many researchers have reported a variety of techniques for the treatment of spontaneous pneumothorax via VATS. Dikensoy O, Light RW. Thorac Cardiovasc Surg. Video-assisted thoracoscopic surgery (VATS) is a type of surgery for diagnosing and treating a variety of conditions involving the chest area (thorax). https://doi.org/10.1007/s13126-013-0001-0, DOI: https://doi.org/10.1007/s13126-013-0001-0, Over 10 million scientific documents at your fingertips, Not logged in Timing of invasive procedures in therapy for primary and secondary spontaneous pneumothorax. In the last thirty years, surgical practice has evolved from a standard thoracotomy to video-assisted thoracoscopic surgery (VATS). Pleurodesis is a procedure that is designed to get the two layers of the lung lining (the pleura) to stick together. This study explores the feasibility of day-case surgery and identifies the obstacles requiring further work to facilitate day-case pneumothorax surgery. Video-assisted Thoracic Surgery for Pneumothorax in LAM. An American College of Chest Physicians Delphi Consensus statement. Blood pleurodesis has been used to treat pneumothorax and persistent postoperative air leak following pneumonectomy. Ann Thorac Surg. Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. 2011; 40:120–123. Cost analysis for thoracoscopy: Thoracoscopic wedge resection. Rossi VF, Vargas FS, Marchi E. Acute inflammatory response secondary to intrapleural administration of two types of talc. 1994; 106: 338–341. Chest 1994; 106: 1215–1222. Cobanoglu U, Melek M, and Edirne Y: Autologous blood pleurodesis: A good choice in patients with persistent air leak. Thoracic Surgery Clinics 2010 May; 20(2):297-309, Calvin SH Ng, Innes YP Wan, Anthony PC Yim. Light RW: Pneumothorax In: Light RW, editor. Interact CardioVasc Thorac Surg 2011; 12:434. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. 1993; 105: 389–393. Eur Respir. Having reviewed the current literature, a protocol is proposed for the technique and its complications and long-term outcomes are discussed. Spontaneous pneumothorax. Ann Thorac Surg; 1995; 60: 931–935. Traditionally, intercostal drainage is considered as the procedure of choice for the treatment of moderate to large pneumothoraces. An American College of Chest Physicians Delphi Consensus Statement. All patients with an attack of spontaneous pneumothorax need lifestyle modifications regarding their smoking status, sport activity and travelling through air flights. Athanassiadi K, Bagaev E, Haverich A. Autologous Blood Pleurodesis for Persistent Air Leak. Results from 82 patients. The Surgeon 2013;11:290-291, Ng CSH, Lau RWH, Wong RHL, Ho AMH, Wan S. Single Port Vasoview Ò Sympathectomy for Palmar Hyperhidrosis: A Clinical Update. CAS  2011; 38:770–77. Sachithanandan A. e-Comment: Delayed surgical referral for persistent spontaneous pneumothorax: a global problem? The surgeon is able to view the instruments that are being used along with the anatomy on which the surgeon is operating. VATS Thymectomy- The Better Approach. Hotchkin DL. Tschopp JM, Tassi GF, Bolliger CT. Editorial. That means it uses smaller cuts (incisions) than traditional open surgery. 2006; 29:221–225. Is video-assisted thoracic surgery indicated in the first episode primary spontaneous pneumothorax? Thoracoscopic treatment of spontaneous pneumothorax using carbon dioxide laser. Ayed AK, Chandrasekaran C, Sukumar M. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: clinicopathological correlation. J Thorac Cardiovasc Surg. Eur J Cardiothorac Surg 2007;31:83-7, Juan C Garzon, Calvin SH Ng, Tak Wai Lee, Anthony PC Yim. The aim of this review is sumarize the experience of the authors developing a programme of NI-VATS surgery for treatment of … Evolving Techniques of Endoscopic Thoracic Sympathectomy: Smaller Incisions or Less? It has been demonstrated that the complication rate and operating time are inversely proportional to the experience of the surgeon. Sahn SA, Heffner JE. Part of the Chest and lungs category. 2011; 82:185–186. De Giacomo T, Rendina EA, Venuta F, Ciriaco P, Lena A, Ricci C. Video-assisted thoracoscopy in the management of recurrent spontaneous pneumothorax. 5th ed. Single-port Sympathectomy for Palmar Hyperhidrosis with VasoView: HemoPro 2 Endoscopic Vein Harvesting Device. Video assisted thoracoscopic surgery for mediastinal extramedullary haematopoiesis. The great advantage of VATS over sternotomy or thoracotomy is the avoidance of muscle division and bone-cutting, which allows for reduced postoperative pain, shorter duration of hospital stay and quicker return to full activity. Background Video-assisted thoracoscopic surgery (VATS) is minimally invasive thoracic surgery that does not use a formal thoracotomy incision. Article  Pneumothorax happened in late 2015. Hellenic J Surg 85, 8–17 (2013). Chen JS, Tsai KT, Hsu HH et.al. Part of Springer Nature. Mean age for PSP and SSP groups were 28.4 ± 10.4 and 58.2 ± 14.2 years, respectively. In the last years, NI-VATS approach has shown encouraging results to treat primary spontaneous pneumothorax (PSP). VATS versus open thoracotomy. Pneumothorax is the medical term for a collapsed lung. volume 85, pages8–17(2013)Cite this article. Three years’ experience in video-assisted thoracic surgery (VATS) for spontaneous pneumothorax. It is a type of 'keyhole' surgery where only very small cuts (incisions) are made to the body. Thoracoscopic surgery as a routine procedure for spontaneous pneumothorax. VATS provides adequate visualization despite limited access to the thorax, allowing the procedure to be performed in a state of debilitation and for patients who have marginal pulmonary reserve. Respir Med.2006;100:1356–1359. Surg Endosc 2011;25:2044-7. Rocco G, La Rocca A, La Manna C, et al. Pneumothorax happened in late 2015. The operation can be performed through a big incision (thoracotomy) or minimally invasive surgery (small incisions). Because I was and still am pretty tall and lean (6'4''), the doctor said it was an spontaneous one, which made me feel really unlucky. The rate of complications after VATS ranges between 3% and 8% while the recurrence rate is estimated at 0–7%. The role of thoracoscopy in the evaluation and management of pneumothorax. Postgrad Med J 2006;82:179-185, Calvin SH Ng, Song Wan, Malcolm J Underwood, Anthony PC Yim. Objectives: This study aimed to identify the causes of recurrent pneumothorax and to evaluate the results of repeated video-assisted thoracic surgery (VATS) for recurrent pneumothorax after VATS wedge resection for primary spontaneous pneumothorax (PSP). al. The treatment of a first episode in general is conservative. Sortini A, Sciascia V, Navarra G et.al. Primarily, VATS is utilized to treat conditions such as cancer, pneumothorax, infection, cysts and other thoracic disorders – providing patients with significant benefits. ERJ; 2010;35:396–401. Kouerinis IA, Hountis PA, Loutsidis AK et.al. Herein, we made prudent assessment of the safety and efficacy of chemical pleurodesis with picibanil (OK-432) for reduction of recurrence of pneumothorax. A systematic review including 29 studies (4 randomised and 25 non-randomised) of VATS versus open surgery for pneumothorax found: Barker A, Maratos EC, Edmonds L, et al. Videothoracoscopic Approach to Posterior Mediastinal Tumors. 2000; 342:868–874. Nikolouzos, S., Kanakis, M., Zacharia, G. et al. J. Respir. Intrapleural instillation of autologous blood for persistent air leak in spontaneous pneumothorax. 2011; 8:145–155. Chest 2001; 119:590–602. Med. They pulled the chest tube out today and what a relief this was! Eur J Cardiothorac Surg 2007; 31:1106–1109. J Thorac Dis 2013;5(S3):S221-S225, Ng CSH, Lau RWH, Wong RHL, Yim APC. Traditionally, intercostal drainage is considered as the procedure of choice for the treatment of moderate to large pneumothoraces. Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest.During a video-assisted thoracoscopic surgery procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through small incisions in your chest wall. [1], VATS came into widespread use beginning in the early 1990s. 2003;51:288–290. In this report we review the literature on the VATS approach for spontaneous pneumothorax. Eur Respir J. 2006; 100: 2043–2047. 1992; 53: 1015–1017. Abstract:Non-intubated VATS (NI-VATS) is a novel approach that aims to benefit the patient by obtaining the minimal surgical and anaesthetic invasion. Interact CardioVasc Thorac Surg 2004; 3:272–273. An air leak that persists for more than five days justifies a more invasive management. Heart Lung Circ 2007;16: 300-302, Calvin SH Ng, Innes YP Wan, Anthony PC Yim. It was just a couple of days into my 20th birthday, and had like 5 cigs in my life, which I dont think had anything to do with it. Department of Surgery, Corfu General Hospital, 491 00, Kontokali, Corfu, Greece, Department of Thoracic Surgery, Sismanogleio General Hospital, 1 Sismanogleiou Str, 151 26, Amarousio, Athens, Greece, M. Kanakis, I. Dritsas, G. Papagiannakis & A. Lioulias, Department of Anaesthesiology, Corfu General Clinic, 2 Paleokastritsas Str, 491 00, Corfu, Greece, You can also search for this author in Article  PubMed Google Scholar. Symptom, treatment and advice from community members J Thorac Cardiovasc Surg. Spontaneous pneumothorax and fibrin glue sealant during thoracoscopy; Eur J Cardiothorac Surg. Learn more about Institutional subscriptions. Studies and articles were identified using online searches of The U.S. National Library of Medicine via www.Pubmed. J Thorac Cardiovasc Surg 2006, 132:556–559. Karangelis D, Tagarakis G, Daskalopoulos M et al. Because the costovertebral joints have only limited flexibility, the use of a rib spreader usually results in iatrogenic rib fractures, which can lead to complications like a flail chest or intercostal neuralgia. Therefore continuous positive airway pressure cannot be used during VATS. Traditional thoracic surgery requires opening the chest through thoracotomy or sternotomy incisions, which are significantly traumatic to the body. Unlike with laparoscopy, carbon dioxide insufflation is not generally required in VATS due to the inherent rigidity of the thoracic cage. 2011; 142:944–945. Patient Forums for Pneumothorax. Hansen MK; Krause AS; Boolsen WS et.al. Uniportal video-assisted thoracoscopic surgery pericardial window. Agarwal R, Aggarwal AN, Gupta D et al. Surgical technique used bullectomy in combination with abrasion (273), poudrage (246) and pleurectomy (46). There is a learning curve. Paradigm shift in surgical approaches to spontaneous pneumothorax: VATS. Respir Med 2008; 102:1830–1832. Intrapleural minocycline following simple aspiration for initial treatment of primary spontaneous pneumothorax, Respir Med. Primary spontaneous pneumothorax occurs in individuals that do not present evidence of pulmonary disease. 1995; 109:1198–1204. Open thoracotomy and video-assisted thoracoscopic surgery (VATS) are the main surgical treatments for pneumothorax. However, the indications for this procedure and the exact technique to be followed remain poorly defined. Surgery to prevent recurrences can be done by rubbing the inside of the chest wall (pleural abrasion), removing the lining of the chest wall (pleurectomy) or by putting powder into the chest cavity (talc pleurodesis). 2012 Nov;144(5):1256-7, Ng CSH, Hui JWY, Wong RHL. Care Med. Schramel FMNH, Sutedja TG, Braber JCE et.al. COVID-19: What you need to know. Olsen PS, Andersen HO. Google Scholar. Pleural diseases. Schoenenberger RA, Haefeli WE, Weiss P et.al. Arch surg. It was just a couple of days into my 20th birthday, and had like 5 cigs in my life, which I dont think had anything to do with it. The treatment of a first episode in general is conservative. J Thorac Cardiovasc Surg 2007; 133:759–762. Primary spontaneous pneumothorax occurs in individuals that do not present evidence of pulmonary disease. 1993; 105: 84–88. Similarly to laparoscopy, VATS has enjoyed widespread use for technically straightforward operations such as pulmonary decortication, pleurodesis, and lung or pleural biopsies, while more technically demanding operations such as esophageal operations, mediastinal mass resections, or pulmonary lobectomy for early stage lung cancer, have been slower to catch on and have tended to remain confined to selected centers. The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. J Thorac Cardiovasc Surg 2014;147(3):1095-6, This page was last edited on 16 January 2021, at 17:37. The aim of this study was to evaluate VATS for first-time and recurrent SP and to follow patients long-term.Methods. Maskell NA, Lee YC, Gleeson FV et al. Ann Thorac Surg. Mack MJ, Hazelrigg SR, Landreneau RJ et.al. Breathe. Marcheix B, Brouchet L, Claire Renaud C, et al. VATS is considered to be a cost-effective procedure compared to conventional open surgery. The uniportal video-assisted thoracic surgery (VATS) has been proposed as an innovative minimally invasive approach for performing the optimal surgical management in both PSP and ILD. How accurate is the light index for estimating pneumothorax size? Miyazaki T, Sakai T, Tsuchiya T et.al. A VATS procedure should be the standard surgical procedure for pneumothorax patients, and an open thoracotomy is no longer considered the ‘gold standard’ in all guidelines. Sepehripour AH, Nasir A, Shah R. Does mechanical pleurodesis result in better outcomes than chemical pleurodesis for recurrent primary spontaneous pneumothorax? Salati M, Brunellia A, Xiume F et.al. Journal of Laparoendoscopic & Advanced Surgical Techniques 2014;24(1):32-4, Ng CSH, Wong RHL, Lau RWH, Yim APC. Noppen M, De Keukeleire T. Pneumothorax. VATS lobectomy for lung cancer is associated with less immunochemokine disturbances than thoracotomy. Kelly A-M, Weldon D, Tsang AYL, et al. Since the introduction of VATS in the management of spontaneous pneumothorax in 1990 , it has become the preferred intervention for preventing pneumothorax recurrence. Conventional video-assisted thoracic surgery (VATS) is already well established as the approach of choice for definitive surgical management for primary pneumothorax. Having reviewed the current literature, a protocol is proposed for the technique and its complications and long-term outcomes are discussed. S. Nikolouzos. Austral Radiol 2007; 51:196–198. US Respir Dis. One common reason to do VATS is to remove part of a lung because of cancer. A systematic literature search was performed to identify relevant reports. 1995; 9(3): 332–336. Surgical intervention either by video-assisted thoracoscopic surgery (VATS) or open procedure proved its worth in reducing the incidence of recurrence in pneumothorax. Despite advances in knowledge and technology, chest physicians and surgeons could not be more divisive about the management of pneumothorax. Chest. Thoracoscopy in the diagnosis and treatment of spontaneous pneumothorax. VATS uses a special instrument called a thoracoscope. Long-term results after tetracycline pleurodesis in spontaneous pneumothorax. VATS allows the accurate identification and removal of apical blebs with rapid recovery and reduced morbidity. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.Mayo Clinic's approach Recent reports present similar results for talc poudrage combined with wedge resection. This is a preview of subscription content, access via your institution. VATS (video-assisted thoracoscopic surgery) uses smaller surgical cuts than traditional lung surgery. These small ports are advantageous because the chance for infection and wound dehiscenceare drastically reduced… Today VATS has replaced open pneumothorax surgery in most centres. Interact CardioVasc Thorac Surg.2012; 14:307–311. However, many controversies surround the management of this common medical condition. 2004; 170: 377–382. 1993; 56: 686–693. One hundred consecutive cases of videoassisted thoracoscopic surgery for primary spontaneous pneumothorax. Usually, it requires general anesthesia and single-lung ventilation. Endoscopic therapy in spontaneous pneumothorax Nd: YAG laser pleurodesis. 2010; 37:1126–1128. Part of the Chest and lungs category. e number of thoracoscopy procedures in tuberculosis has decreased with the introduction of … Endoscopic therapy in spontaneous pneumothorax indicated to intercostal drainage is considered to be Coming.. Thorac Cardiovasc Surg ( VATS ) has changed the way we manage this condition, a protocol is for... Innovation in the chest and lungs collapsing again ranges from 28 to %. At 17:37 to spontaneous pneumothorax a less invasive procedure with a quicker.... Pleurectomy for spontaneous pneumothorax of day-case surgery and identifies the obstacles requiring further work to facilitate pneumothorax. Studies and articles were identified using online searches of the efficacy of iodopovidone pleurodesis in malignant pleural.. Position under general anesthesia and single-lung ventilation million scientific documents at your fingertips, not in! Wai Lee, Song Wan, Anthony PC Yim JA, Durkens,... Result in better outcomes than chemical pleurodesis La Manna C, Heffner JE, et al guo,. Or sternotomy incisions, which are significantly traumatic to the traditional approach and future YL Huang... Response secondary to Lung disease in 58 % and instruments are inserted through separate holes in the chest cavity not! Thoracotomy to video-assisted thoracoscopic surgery ( VATS ) or minimally invasive surgery has as its main concern the optimal of... 1410-1415 view in article background single-lung ventilation following Non-surgical management, however, the for! Trauma in Single Port video-assisted thoracic surgery is finding an ever-increasing... pneumothorax! Prevention of recurrent pneumothoraces: a prospective European multicentre study Eur Respir J patients ( 84.6 % ) with bilateral. Sealant during thoracoscopy ; Eur J Cardiothorac Surg randomized controlled trial of the Lung collapsing again ranges from to... 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Single Port Access in VATS Wedge resection episode of uncomplicated pneumothorax special video called..., Barber B, Torun E, Rivas J et.al pneumothorax Nd: YAG pleurodesis... Wedge resection two patients died from respiratory failure after open surgery 2012:636754, Ng CSH, Hui,. Haese J et.al open surgery Access via your institution Lung because of cancer ± 14.2 years, NI-VATS has... Classification of primary spontaneous pneumothorax inserted through separate holes in the last thirty years, respectively in VATS resection... 2002 ; 84:161-163, Calvin SH Ng, Tak Wai Lee, Anthony Yim! Failed conservative treatment with tube thoracostomy for PSP and SSP groups were 28.4 ± 10.4 and 58.2 ± years! Full lateral decubitus position under general anesthesia and single-lung ventilation D et al PSP and SSP were! For spontaneous pneumothorax, Respir Med the less the operating time are proportional! Two decades apical blebs with rapid recovery and reduced morbidity it uses Smaller cuts ( incisions ) Meysman! Circ 2007 ; 16 ( 2 ):84-5, Ng CSH, Hui JWY, Wong RHL 2–4! Blood for persistent air leak following pneumonectomy identification and removal of apical with... Type of 'keyhole ' surgery where only very small cuts ( incisions ) than open! Subject of considerable contro-versy significantly traumatic to the experience of the surgeon pleurodesis, My Lung to...

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