Tags

Type your tag names separated by a space and hit enter

Management of unexpected intraoperative bleeding during thoracoscopic pulmonary resection: a single institutional experience.
Surg Today 2016; 46(8):901-7ST

Abstract

PURPOSE

Unexpected intraoperative bleeding during thoracoscopic surgery, necessitating emergency conversion to thoracotomy, is gradually being reported. We reviewed our experience of encountering unexpected bleeding during thoracoscopic surgery.

METHODS

We defined "unexpected intraoperative bleeding" as the need for hemostatic procedures with angiorrhaphy, with or without a sealant. The location, cause, and management of injured vessels, and perioperative outcomes were investigated and compared with those for patients without injured vessels.

RESULTS

Between 2007 and 2014, a total of 241 thoracoscopic anatomical pulmonary resections were performed at our hospital. Twenty (8.3 %) of these patients required hemostatic procedures with angiorrhaphy, with or without a sealant. The main injured vessels were the pulmonary artery (n = 13) and vein (n = 3) and the main causes of injury were related to technical issues with energy devices and staplers. There were no morbidities related to intraoperative bleeding. The operation time and blood loss were significantly greater in the patients with vessel injury than in those without vessel injury, but perioperative morbidities and the duration of chest tube insertion (4.5 vs. 3.5 days, average, p = 0.20) and postoperative hospital stay (12.7 vs. 11.0 days, average, p = 0.08) were not significantly different.

CONCLUSIONS

The frequency of unexpected bleeding was relatively high in this series, but its management and outcomes were satisfactory in terms of safety.

Authors+Show Affiliations

Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. miyataku@nagasaki-u.ac.jp.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26411432

Citation

Miyazaki, Takuro, et al. "Management of Unexpected Intraoperative Bleeding During Thoracoscopic Pulmonary Resection: a Single Institutional Experience." Surgery Today, vol. 46, no. 8, 2016, pp. 901-7.
Miyazaki T, Yamasaki N, Tsuchiya T, et al. Management of unexpected intraoperative bleeding during thoracoscopic pulmonary resection: a single institutional experience. Surg Today. 2016;46(8):901-7.
Miyazaki, T., Yamasaki, N., Tsuchiya, T., Matsumoto, K., Hatachi, G., Kitamura, Y., ... Nagayasu, T. (2016). Management of unexpected intraoperative bleeding during thoracoscopic pulmonary resection: a single institutional experience. Surgery Today, 46(8), pp. 901-7. doi:10.1007/s00595-015-1253-9.
Miyazaki T, et al. Management of Unexpected Intraoperative Bleeding During Thoracoscopic Pulmonary Resection: a Single Institutional Experience. Surg Today. 2016;46(8):901-7. PubMed PMID: 26411432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of unexpected intraoperative bleeding during thoracoscopic pulmonary resection: a single institutional experience. AU - Miyazaki,Takuro, AU - Yamasaki,Naoya, AU - Tsuchiya,Tomoshi, AU - Matsumoto,Keitaro, AU - Hatachi,Go, AU - Kitamura,Yuka, AU - Obata,Tomohiro, AU - Doi,Ryoichiro, AU - Machino,Ryusuke, AU - Nagayasu,Takeshi, Y1 - 2015/09/28/ PY - 2015/06/01/received PY - 2015/08/21/accepted PY - 2015/9/29/entrez PY - 2015/9/29/pubmed PY - 2017/3/9/medline KW - Bleeding KW - Non-small cell lung cancer KW - Thoracoscopic surgery SP - 901 EP - 7 JF - Surgery today JO - Surg. Today VL - 46 IS - 8 N2 - PURPOSE: Unexpected intraoperative bleeding during thoracoscopic surgery, necessitating emergency conversion to thoracotomy, is gradually being reported. We reviewed our experience of encountering unexpected bleeding during thoracoscopic surgery. METHODS: We defined "unexpected intraoperative bleeding" as the need for hemostatic procedures with angiorrhaphy, with or without a sealant. The location, cause, and management of injured vessels, and perioperative outcomes were investigated and compared with those for patients without injured vessels. RESULTS: Between 2007 and 2014, a total of 241 thoracoscopic anatomical pulmonary resections were performed at our hospital. Twenty (8.3 %) of these patients required hemostatic procedures with angiorrhaphy, with or without a sealant. The main injured vessels were the pulmonary artery (n = 13) and vein (n = 3) and the main causes of injury were related to technical issues with energy devices and staplers. There were no morbidities related to intraoperative bleeding. The operation time and blood loss were significantly greater in the patients with vessel injury than in those without vessel injury, but perioperative morbidities and the duration of chest tube insertion (4.5 vs. 3.5 days, average, p = 0.20) and postoperative hospital stay (12.7 vs. 11.0 days, average, p = 0.08) were not significantly different. CONCLUSIONS: The frequency of unexpected bleeding was relatively high in this series, but its management and outcomes were satisfactory in terms of safety. SN - 1436-2813 UR - https://www.unboundmedicine.com/medline/citation/26411432/Management_of_unexpected_intraoperative_bleeding_during_thoracoscopic_pulmonary_resection:_a_single_institutional_experience L2 - https://dx.doi.org/10.1007/s00595-015-1253-9 DB - PRIME DP - Unbound Medicine ER -