Uniportal VATS left lower lobectomy: Fissure first technique

2021 ◽  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Chest Wall ◽  
Anterior Part ◽  
Posterior Part ◽  
Video Tutorial ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Nodal Dissection ◽  
Lateral Chest

This video tutorial describes a left lower lobectomy performed by the uniportal approach. A single 2-cm incision in the lateral chest wall is used as the utility port. The procedure begins with division of the inferior pulmonary ligament and isolation of the inferior pulmonary vein. This patient has densely adherent interlobar nodes, which are then dissected to demonstrate the interlobar pulmonary artery. Then we proceed to divide the anterior part of the fissure after identifying and safeguarding the lingular branches of the pulmonary artery. This step is followed by the division of the posterior part of the fissure after identification of the posterior branches of the pulmonary artery to the upper lobe. Then we identify the basilar trunk and divide it using endostaplers. Other branches of the interlobar artery are clearly identified, and the apicobasal artery is taken separately. This is followed by division of the inferior pulmonary vein and a systematic mediastinal nodal dissection.

Video-assisted left lower lobectomy with intrapericardial pulmonary vein isolation

2020 ◽  
Keyword(s):  
Pulmonary Vein ◽  
Lower Lobe ◽  
Radical Resection ◽  
Hemodynamic Instability ◽  
Uneventful Recovery ◽  
Thoracoscopic Approach ◽  
Video Tutorial ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Operative Planning

The thoracoscopic approach to lobectomy is now the gold standard in cases of pulmonary malignancies because it is associated with a significant reduction in both postoperative hospital stay and pain. Even in cases of complex resection, as in the case reported here, the procedure can be performed safely after careful pre-operative planning. This video tutorial describes our technique for the intrapericardial isolation of the left inferior pulmonary vein in a patient affected by a left lower lobe metastasis from a colonic carcinoma. The lesion was retracting the inferior vein to such an extent that an intrapericardial approach was required in order to obtain a radical resection. The operation was carried out using a 3-port technique to allow for safe and unhindered manipulation of the hilar structures and the parenchyma. The pericardial sac was easily opened and the feasibility of the procedure was readily confirmed. The patient made an uneventful recovery; specifically, we did not record any arrhythmia or hemodynamic instability. She was discharged home on the 4th postoperative day.

scholarly journals Acute limb ischemia by a pulmonary vein stump thrombus after left lower lobectomy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuri Fujimoto ◽  
Ryosuke Hamachi ◽  
Yoshimasa Motoyama ◽  
Etsuko Kanna ◽  
Masako Murakami ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Thrombus Formation ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Common Symptom ◽  
Acute Limb Ischemia ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Enhanced Computed Tomography ◽  
Pulmonary Vein Stump

Abstract Background Cases of systemic thromboembolism due to thrombus formation in the pulmonary vein stump after lobectomy have been reported recently. Cerebral infarction after left upper lobectomy is a common symptom in these cases. We encountered a rare case of acute limb ischemia caused by a thrombus formed in the left inferior pulmonary vein stump after left lower lobectomy. Case presentation A 62-year-old man underwent video-assisted left lower lobectomy under general anesthesia with epidural anesthesia. On postoperative day 2, he suddenly developed pain in the left calf. Contrast-enhanced computed tomography showed left popliteal artery occlusion and thrombus formation in the left inferior pulmonary vein stump. Anticoagulant therapy was started immediately, and emergent endovascular thrombectomy was performed. The patient recovered without complications. Conclusions Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism. Early detection and treatment are the keys to minimize complications.

Anatomy of inferior pulmonary vein should be clarified in lower lobectomy

1998 ◽  
Vol 66 (5) ◽  
pp. 1799-1800 ◽  
Author(s):  
Satoru Sugimoto ◽  
Osamu Izumiyama ◽  
Akio Yamashita ◽  
Masahito Baba ◽  
Tadashi Hasegawa
Keyword(s):  
Pulmonary Vein ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy

Fine structure of the rectal papillae of the oriental fruuit fly, Dacus dorsalis Hendel (Tephritidae, Diptera Insecta)

1990 ◽  
Vol 48 (3) ◽  
pp. 498-499
Author(s):  
Len Wen-Yung ◽  
Mei-Jung Lin
Keyword(s):  
Fine Structure ◽  
Cell Membrane ◽  
Intercellular Space ◽  
Anterior Part ◽  
Apical Cell ◽  
Posterior Part ◽  
Apical Cell Membrane ◽  
Dacus Dorsalis ◽  
Radial Cell ◽  
Circular Base

Four cone-shaped rectal papillae locate at the anterior part of the rectum in Dacus dorsalis fly. The circular base of the papilla protrudes into the haemolymph (Fig. 1,2) and the rest cone-shaped tip (Fig. 2) inserts in the rectal lumen. The base is surrounded with the cuticle (Fig. 5). The internal structure of the rectal papilla (Fig. 3) comprises of the cortex with the columnar epithelial cells and a rod-shaped medulla. Between them, there is the infundibular space and many trabeculae connect each other. Several tracheae insert into the papilla through the top of the medulla, then run into the cortical epithelium and locate in the intercellular space. The intercellular sinuses distribute in the posterior part of the rectal papilla.The cortex of the base divides into about thirty segments. Between segments there is a radial cell (Fig. 4). Under the cuticle, the apical cell membrane of the cortical epithelium is folded into a regular border of leaflets (Fig. 5).

scholarly journals The prevalence of pulmonary hypertension assessed using the pulmonary vein‐to‐right pulmonary artery ratio and its association with survival in West Highland white terriers with canine idiopathic pulmonary fibrosis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Elodie Roels ◽  
Aline Fastrès ◽  
Anne-Christine Merveille ◽  
Géraldine Bolen ◽  
Erik Teske ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Survival Data ◽  
Study Objective ◽  
Time Motion ◽  
Co Morbidity ◽  
Right Pulmonary Artery

Abstract Background Pulmonary hypertension (PH) is a known co-morbidity in West Highland white terriers (WHWTs) affected with canine idiopathic pulmonary fibrosis (CIPF). The pulmonary vein-to-right pulmonary artery ratio (PV/PA) has recently been described for the detection of pre-capillary PH in dogs. The objective of the present study was to estimate the prevalence of PH at diagnostic, in WHWTs affected with CIPF, by using PV/PA, in comparison with a group of healthy breed-matched controls (CTRLs). Additional study objective was to explore whether the presence of PH at initial diagnosis of CIPF impacted survival time in dogs treated with sildenafil. Results Twenty-five client-owned WHWTs presented with CIPF and 19 CTRLs were included in the study. PV/PA in either two-dimensional mode (2D) or time-motion mode or both were measured from cineloops in each dog. Dogs were classified according to PV/PA value into non/mild PH (PV/PA measured in 2D ≥ 0.7) or moderate/severe PH (PV/PA < 0.7). Survival data of WHWTs affected with CIPF were extracted from medical record to assess association between presence of PH at diagnosis and outcome. 60 % overall prevalence for moderate/severe PH was estimated in this cohort of WHWTs presented with CIPF vs. 5 % in CTRLS (P = 0.0002). The presence of moderate/severe PH at initial presentation was not associated with survival. Conclusions Results of the present study confirm a high prevalence of PH at diagnosis in WHWTs affected with CIPF and highlight the utility of PV/PA as a non-invasive surrogate for assessment of PH in this population.

Anatomic predictors of late right inferior pulmonary vein reconnection in the setting of second‐generation cryoballoon ablation

2019 ◽  
Vol 30 (11) ◽  
pp. 2294-2301
Author(s):  
Muryo Terasawa ◽  
Gian‐Battista Chierchia ◽  
Ken Takarada ◽  
Alessandro Rizzo ◽  
Riccardo Maj ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Inferior Pulmonary Vein ◽  
Pulmonary Vein Reconnection

scholarly journals Metastatic renal cell carcinoma extending to the left atrium through the inferior pulmonary vein

2021 ◽  
Author(s):  
Alan G Dawson ◽  
Cathy J Richards ◽  
Leonidas Hadjinikolaou ◽  
Apostolos Nakas
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Pulmonary Veins ◽  
Lower Lobe ◽  
Inferior Pulmonary Vein ◽  
The Right

Abstract Metastatic renal cell carcinoma with involvement through the pulmonary veins to the left atrium is very rare. We report the case of a 70-year-old male with metastatic renal cell carcinoma to the right lower lobe of the lung abutting the inferior pulmonary vein with extension to the left atrium without pre-operative evidence. Surgical resection was achieved through a posterolateral thoracotomy. Lung masses that abut the pulmonary veins should prompt further investigation with a pre-operative transoesophageal echocardiogram to minimize unexpected intraoperative findings.

scholarly journals The genus Gennadas (Benthesicymidae: Decapoda): morphology of copulatory characters, phylogeny and coevolution of genital structures

2017 ◽  
Vol 4 (12) ◽  
pp. 171288 ◽  
Author(s):  
Alexander L. Vereshchaka ◽  
Anastasia A. Lunina ◽  
Jørgen Olesen
Keyword(s):  
New Species ◽  
Anterior Part ◽  
Phylogenetic Analyses ◽  
Posterior Part ◽  
Key To Species ◽  
Internal Part ◽  
Species Groups ◽  
Aristaeomorpha Foliacea ◽  
External Part ◽  
Scanning Electron

Species within Gennadas differ from each other largely only in male (petasma) and female (thelycum) copulatory characters, which were restudied in scanning electron microscopy and used as a basis for phylogenetic analyses. Twenty-six petasma characters and 49 thelycum characters were identified. All 16 recognized species of Gennadas and Aristaeomorpha foliacea (outgroup) were included as terminals. Four robust monophyletic clades were retrieved, described and diagnosed as new species groups. The thelycum characters had greater impact on tree topology and supported deeper nodes than did the petasma characters. We hypothesize that features of the thelycum evolved first followed by aspects of the petasma. Relatively more conservative characters include parts of the sternites of the thelycum and of the petasma, while the scuti and protuberances on the thelycum and the shape and subdivisions of the petasma lobes are evolutionarily plastic. We identified two groups of copulatory characters, which are likely coupled functionally and interlinked evolutionarily: (i) the external part of the petasma and the posterior part of the thelycum and (ii) the internal part of the petasma and anterior part of the thelycum. We reconstruct possible mating position during copulation for each of the new species groups presented here. We also present an updated key to genera of Benthesicymidae and key to species of Gennadas .

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