[Show abstract][Hide abstract] 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.
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.
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.
The frequency of unexpected bleeding was relatively high in this series, but its management and outcomes were satisfactory in terms of safety.
Surgery Today 09/2015; DOI:10.1007/s00595-015-1253-9 · 1.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Duodenal duplication cysts are relatively rare congenital anomalies that occur most often in infants and children. We report a case of a 13-year-old boy who presented with duodenal obstruction caused by bleeding of a duodenal duplication cyst. Operative findings and hispathological examination confirmed the diagnosis. We treated him with subtotal excision of the duodenal duplication cyst and mucosal stripping and ablation of the remaining mucosa