Techniques of mediastinal surgery:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
1996
|
| Series: | Chest surgery clinics of North America
6,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XII, 159 S. zahlr. Ill. |
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MARC
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| 245 | 1 | 0 | |a Techniques of mediastinal surgery |c Mark K. Ferguson, guest ed. |
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Record in the Search Index
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| adam_text | TECHNIQUES OF MEDIASTINAL SURGERY
CONTENTS
Preface xi
Mark K. Ferguson
Cervical Mediastinoscopy 1
Paul A. Kirschner
The continuity of cervicomediastinal fascial planes provides the
anatomic basis for cervical mediastinoscopy and its derivatives.
There are two such planes, both accessible through a single small
neck incision: the retrovascular paratracheal plane (for standard
cervical mediastinoscopy) and the prevascular retrosternal plane
(the zone of extended mediastinal exploration). This article de¬
scribes the evolution, technique, indications, applications, and
complications of cervical mediastinoscopy in the diagnosis and
therapy of thoracic diseases.
Extended Cervical Mediastinoscopy 21
Robert J. Ginsberg
The technique of extended cervical mediastinoscopy is described
in detail as well as its indications for use. The author has found
extended cervical mediastinoscopy extremely valuable in staging
lung carcinoma with regard to level V and VI lymph node
involvement if a standard cervical mediastinoscopy fails to dem¬
onstrate metastatic disease and a CT scan suggests subaortic
lymph node involvement. This technique has been found to be
safe and accurate and only adds minimal operating time to a
cervical mediastinoscopy without the need for a second incision.
CHEST SURGERY CLINICS OF NORTH AMERICA
VOLUME 6 • NUMBER 1 • FEBRUARY 1996 V
Parasternal Mediastinotomy (Chamberlain Procedure) 31
Jemi Olak
The indications for and technical considerations related to the
performance of a parasternal mediastinotomy (Chamberlain pro¬
cedure) are described. The results, including diagnostic yield,
morbidity, and mortality of the procedure, are reviewed. Its cur¬
rent role in the thoracic surgeons armamentarium is discussed.
Thoracoscopic Resection of Mediastinal Tumors and the
Thymus 41
Larry R. Kaiser
Lesions in the anterior mediastinum may be readily approached
for either biopsy or often complete excision using video assisted
thoracic surgical techniques. Transcervical thymectomy remains
the minimally invasive procedure of choice for excision of a non
thymomatous gland in the patient with myasthenia gravis. An
encapsulated thymoma may be excised, and a total thymectomy
completed with a video assisted thoracoscopic approach may be
useful for some lesions. For invasive lesions median sternotomy
or thoracotomy remains the procedure of choice to assure com¬
plete excision.
Thoracoscopic Management of Posterior Mediastinal Tumors 53
David A. Canvasser and Keith S. Naunheim
Thoracoscopy provides a minimally invasive technique for the
diagnosis and management of many posterior mediastinal
masses. Benign neurogenic tumors, esophageal tumors, and bron
chogenic cysts all can be approached using video assisted thoracic
surgical (VATS) techniques. Malignant lesions are still best ap¬
proached via open thoracotomy. VATS techniques allow for less
pain and dysfunction and can result in shortened hospital stays.
Thoracoscopic Sympathectomy 69
Thomas M. Daniel
Thoracoscopic sympathectomy has become the most widely used
approach to cervicothoracic sympathectomy. Appropriate selec¬
tion of cases and a knowledge of the regional anatomy are essen¬
tial in achieving good clinical results. The physiology and anat¬
omy of the upper thoracic sympathectomy system and the
indications, contraindications, and complications of the operation
are described. The technique of the operation as done at the
University of Virginia is then presented in a step by step manner.
The Combined Cervical and Partial Sternotomy Approach for
Thymectomy 85
Joseph LoCicero III
Removal of a normal appearing thymus gland may be necessary,
particularly in patients with myasthenia gravis. Complete re
Vi CONTENTS
moval is a basic tenet of this type of operation. A combined
cervical and upper sternotomy incision is described. This is ap¬
propriate for thymectomy in such patients because of the minimal
morbidity and excellent exposure for the thoracic portion of the
thymus gland.
Extended Transsternal Thymectomy 95
Donald G. Mulder
Extended transsternal thymectomy allows for the safe excision of
the gross thymus as well as perithymic and anterior mediastinal
fat and lymphatic tissue that may harbor foci of aberrant thymus.
Additionally, it permits direct inspection of each pulmonary hi
lum for suspicious thymic remnants and even small thymomas
not visualized on the CT scan. It achieves the objective of a
safe, well tolerated operation and provides the best chance for
remission or improvement in the patient with myasthenia gravis.
Transcervical Thymectomy 105
Mark K. Ferguson
Transcervical thymectomy has been used in the management of
myasthenia gravis for more than 20 years. Contraindications to
this operation include advanced age, poorly controlled neurologic
symptoms, and evidence for a thymoma. The procedure is associ¬
ated with negligible morbidity and requires only a brief hospital
ization. Remission rates are comparable with those reported for
more extensive thymectomy operations.
Open Approaches to Posterior Mediastinal Tumors and
the Spine 117
Richard J. Thurer and Kenneth Herskowitz
The open approach to the posterior mediastinum continues to be
favored for many lesions residing there and to provide access to
the spine. Knowledge of the likely pathology to be encountered,
as well as the specific anatomic details of the region, is essential
to avoid disabling neurologic injuries and to allow appropriate
surgical management. The relative roles of open and thoracos
copic techniques in the management of mediastinal and spinal
pathology will continue to evolve as experience with the newer
technique increases.
Diagnosis and Management of Chylothorax 139
Joseph I. Miller, Jr
Chylothorax is the presence of lymphatic fluid in the pleural
space resulting from a leak of the thoracic duct or one of its major
divisions. This condition is being recognized more frequently
after both cardiac and general thoracic surgical procedures. In¬
creased understanding of the physiology, pathogenesis, diagno
CONTENTS vii
sis, and management of chylothorax has significantly decreased
the initial mortality in the majority of medical centers.
Transverse Sternothoracotomy 149
Cameron Wright
Transverse sternothoracotomy (the clamshell incision) has been
resurrected from the early days of cardiac surgery and is now
used for double lung transplantation, bilateral pulmonary tumors,
and selected mediastinal tumors. Bulky mediastinal tumors that
project into the pleural space are exposed well with this incision.
Index 157
Subscription Information Inside back cover
viii CONTENTS
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| physical | XII, 159 S. zahlr. Ill. |
| publishDate | 1996 |
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| series | Chest surgery clinics of North America |
| series2 | Chest surgery clinics of North America |
| spelling | Techniques of mediastinal surgery Mark K. Ferguson, guest ed. Philadelphia [u.a.] Saunders 1996 XII, 159 S. zahlr. Ill. txt rdacontent n rdamedia nc rdacarrier Chest surgery clinics of North America 6,1 Médiastin - Chirurgie Mediastinum surgery Mediastinoskopie (DE-588)4278392-6 gnd rswk-swf Mediastinaltumor (DE-588)4123730-4 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Mediastinaltumor (DE-588)4123730-4 s DE-604 Mediastinoskopie (DE-588)4278392-6 s Ferguson, Mark K. Sonstige oth Chest surgery clinics of North America 6,1 (DE-604)BV005455558 6,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007173574&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Techniques of mediastinal surgery Chest surgery clinics of North America Médiastin - Chirurgie Mediastinum surgery Mediastinoskopie (DE-588)4278392-6 gnd Mediastinaltumor (DE-588)4123730-4 gnd |
| subject_GND | (DE-588)4278392-6 (DE-588)4123730-4 (DE-588)4143413-4 |
| title | Techniques of mediastinal surgery |
| title_auth | Techniques of mediastinal surgery |
| title_exact_search | Techniques of mediastinal surgery |
| title_full | Techniques of mediastinal surgery Mark K. Ferguson, guest ed. |
| title_fullStr | Techniques of mediastinal surgery Mark K. Ferguson, guest ed. |
| title_full_unstemmed | Techniques of mediastinal surgery Mark K. Ferguson, guest ed. |
| title_short | Techniques of mediastinal surgery |
| title_sort | techniques of mediastinal surgery |
| topic | Médiastin - Chirurgie Mediastinum surgery Mediastinoskopie (DE-588)4278392-6 gnd Mediastinaltumor (DE-588)4123730-4 gnd |
| topic_facet | Médiastin - Chirurgie Mediastinum surgery Mediastinoskopie Mediastinaltumor Aufsatzsammlung |
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