Displaying publications 1 - 20 of 25 in total

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  1. Dublin N, Chow HK, Lim YC
    JUMMEC, 1999;4:117-118.
    A case of penetrating cardiac injury is reported where cardiorrhaphy is done without cardiopulmonary bypass and via a right thoracotomy even though median stelnotoluy is the usual approach. It is also stressed that all precordial stab wounds must be carefully explored. KEYWORDS: Penetrating cardiac injury, Without cardiopulmonary bypass, Right posterolateral thoracotomy, Centrally placed chest injury.
    Matched MeSH terms: Thoracotomy
  2. Khandasamy, Y., Nani Harlina, M.L., Saladina, J.J., Rohaizak, M.
    MyJurnal
    The decision for median sternotomy for retrosternal goiter is complex and proper consensus are lacking. Generally, it is based on clinical, radiological and intraoperative assessment. Among the few known features include primary mediastinal goiter, posterior mediastinal goiter and recurrent retrosternal goiter. We present a patient with posterior mediastinal, secondary goiter that extended until the tracheal bifurcation. The goiter was removed successfully via a low cervical incision and this was achieved by dissecting along the anatomical plane close to the thyroid capsule using blunt dissection with fingers. It is possible for these kinds of high risk retrosternal goitres to be safely removed without the need for thoracotomy when the surgery was performed along the proper plane.
    Matched MeSH terms: Thoracotomy
  3. Chan L, Yik YI, Subramaniam KN, Ramanujam TM
    JUMMEC, 2002;7:150-151.
    A case of an unusual foreign body aspiration in a child was managed T&ently. The mainstay in treahnen! is urgent extraction of the aspirated foreign body via a bronchoscope under general anaesthesia. A thoracotomy may sometimes be required when endoscopic retrieval fails, as illustrated by this case. She had an increased hospital Slay of 16 days, was ventilated for 8 days and her most serious complication was septic shock from which she recovered. KEYWORDS: Foreign body aspiration, children.
    Matched MeSH terms: Thoracotomy
  4. Sachithanandan A, Fahmi PA, Faisal I, Badmanaban B, Abdul Muis J, Mohd Arif MN
    Med J Malaysia, 2013 Jun;68(3):227-30.
    PMID: 23749011 MyJurnal
    Emergency lung resection for chest trauma is a rare event with a reported incidence of 0.08-1.3% but is associated with a high morbidity and mortality especially if a pneumonectomy is required, if due to blunt chest trauma or when concomitant injuries are present. We report three cases of young adult males with penetrating chest injuries that required emergency thoracotomy (ET) and anatomical lung resection to achieve definitive control of life threatening pulmonary haemorrhage. All patients survived to hospital discharge and remained well on follow-up. Indications for an ET and what constitutes the optimal operative management of such patients is discussed.
    Matched MeSH terms: Thoracotomy*
  5. Than DJ, Perumall VV, Johan S, Lee XL, Karim KA, Hayati F
    Einstein (Sao Paulo), 2023;21:eRC0078.
    PMID: 37436267 DOI: 10.31744/einstein_journal/2023RC0078
    Post-thoracotomy paraplegia after non-aortic surgery is an extremely uncommon complication. A 56-year-old woman presented with a 1-year history of progressive shortness of breath. Computed tomography revealed a locally advanced posterior mediastinal mass involving the ribs and the left neural foramina. Tumor excision with a left pneumonectomy was performed. Post-resection, bleeding was noted in the vicinity of the T4-T5 vertebral body, and the bleeding point was packed with oxidized cellulose gauze (Surgicel®). Postoperatively, the patient complained of bilateral leg numbness extending up to the T5 level, with bilateral paraplegia. An urgent laminectomy was performed, and we noted that the spinal cord was compressed by two masses of Surgicel® with blood clots measuring 1.5 × 1.5cm at T4 and T5 levels. The paraplegia did not improve despite the removal of the mass, sufficient decompression, and aggressive postoperative physiotherapy. Surgeons operating in fields close to the intervertebral foramen should be aware of the possible threat to the adjacent spinal canal as helpful hemostatic agents can become a preventable threat.
    Matched MeSH terms: Thoracotomy/adverse effects
  6. Michael A, Yahya ZO, Mdrazali I, Hanif H
    Med J Malaysia, 2017 02;72(1):75-76.
    PMID: 28255150 MyJurnal
    Penetrating chest wounds is less common but more deadly then blunt trauma. Majority of penetrating chest trauma can be managed conservatively with observation and simple thoracotomy. This case report highlights a bizarre occupational hazard causing a penetrating chest injury and the option of non-invasive management with the aid of computed tomography with 3D reconstruction.
    Matched MeSH terms: Thoracotomy
  7. Ho C, Ismail AR
    Med J Malaysia, 2014 Oct;69(5):234-5.
    PMID: 25638240 MyJurnal
    Haemothorax is one of the less common presentations that requires hospital admission. Most cases are associated with underlying causes, but there is such an entity called spontaneous haemothorax. Spontaneous haemothorax is commonly associated with adhesions within the pleural cavity. Here, we reported two cases of young adults who presented with massive spontaneous haemothorax and required emergency thoracotomy for haemostasis purpose.
    Matched MeSH terms: Thoracotomy
  8. Faisham WI, Mohammad P, Juhara H, Munirah NM, Shamsulkamaruljan H, Ziyadi GM
    Malays J Med Sci, 2011 Apr;18(2):74-7.
    PMID: 22135591
    We report a case of open fracture of the clavicle with subclavian artery and vein laceration and perforation of the parietal pleural below the first rib that caused massive haemothorax. Emergency thoracotomy and exploration followed by repair of both vessels were able to salvage the patient and the extremity.
    Matched MeSH terms: Thoracotomy
  9. Sivalingam S, Krishnasamy S, Yakub MA
    Asian Cardiovasc Thorac Ann, 2015 Jun;23(5):612-4.
    PMID: 24962807 DOI: 10.1177/0218492314540667
    A 9-year-old boy was referred with a perimembranous ventricular septal defect. At birth, he had undergone a right thoracotomy with ligation of a tracheoesophageal fistula, cervical esophagostomy, and feeding gastrostomy. At 2 years of age, he had gastric tube reconstruction with a pull-through retrosternally, anterior to the heart, and an end-to-end esophagogastric anastomosis. Via a right anterolateral thoracotomy through the previous scar, the entire gastric tube was mobilized away from the sternum to facilitate a median sternotomy. With the patient supine, a median sternotomy was performed without difficulty, and the ventricular septal defect was closed under cardiopulmonary bypass.
    Matched MeSH terms: Thoracotomy/methods*
  10. Tan JH, Ng ZQ, Tan HCL, Vendargon S
    BMJ Case Rep, 2018 Jun 27;2018.
    PMID: 29950501 DOI: 10.1136/bcr-2018-224741
    A 72-year-old Chinese man presented with mild symptoms of heart failure. Transthoracic echocardiography showed signs of cardiac tamponade though clinically he was relatively well. The option of pericardiocentesis was not carried out due to a narrow window for aspiration with only a thin layer of effusion seen surrounding the apex and right ventricle on subcostal view.Pericardial window was done via a left anterolateral thoracotomy. Intraoperatively, 500 cm3 of purulent fluid was drained. Microbiology screens were all negative. We present the atypical clinical course of this elderly man presenting with a large pyopericardium.
    Matched MeSH terms: Thoracotomy/methods
  11. Majid AA
    Chest, 1993 May;103(5):1512-4.
    PMID: 8486035 DOI: 10.1378/chest.103.5.1512
    This article describes a technique which allows the patent ductus arteriosus (PDA) to be closed through a minithoracotomy. It combines a simple method of inducing atelectasis with Ligaclip closure of the PDA through a subaxillary incision. It was used successfully in 11 children and adolescents.
    Matched MeSH terms: Thoracotomy/methods*
  12. Henry Tan Chor Lip, Tan Jih Huei, Simon Jerome Vendargon
    MyJurnal
    Iatrogenic diaphragmatic entry following thoracic surgery is rare with only two cases reported till date. This case reports on a 46-year-old male with persistent pleural sepsis due to right empyema thoracis despite best medical ef- forts. Following a right thoracotomy and decortication, the right diaphragm was inadvertently incised due to dense adhesions between the diaphragm and thickened cortex. To our knowledge, this is the third case reported of iatro- genic diaphragmatic entry following thoracic surgery for empyema thoracis. The pearls from this case report is that any evidence of empyema thoracis involving the lower lobe on imaging should warn the surgeons to be aware of inadvertent entry into the peritoneal cavity, as the diaphragm can be adherent to the cortex trapping the lower lobe.

    Matched MeSH terms: Thoracotomy
  13. Mohd Esa NY, Mohd Radzi AA, Bakar NS, Mohd Khalid MS, Ismail AI, Abdul Rani MF
    Respirol Case Rep, 2016 May;4(3):e00155.
    PMID: 27516884 DOI: 10.1002/rcr2.155
    Teratomas of anterior mediastinum are rare. They are often slow growing, asymptomatic, and detected incidentally on chest imaging. Mycobacterium abscessus (M. abscessus) is an acid-fast bacillus that is classified as a pathogenic "rapid growing" non-tuberculous mycobacteria. It is an uncommon cause of human pathology, which may cause skin and soft tissue infection after skin injury following inoculation, minor trauma, and surgery. Here, we present an unusual case of benign cystic teratoma mimicking recurrent pleural effusion, which was subsequently complicated by M. abscessus infection following thoracotomy. Cystic teratoma is rare, but it needs to be considered whenever clinical and investigative work-up fails to provide a convincing diagnosis. A combined clinical, radiological, surgical, and histopathological assessment is important to arrive at the correct diagnosis. Rapidly growing mycobacteria needs to be included in the differential diagnosis of patients with non-resolving infected post-thoracotomy wound and who do not respond to broad-spectrum antibiotics.
    Matched MeSH terms: Thoracotomy
  14. Yong, J.F., Zulkifli, H.I., Che' Zuraifah, A.Z.
    MyJurnal
    Background - Cardiac mumurs are common in childhood and are often innocent in nature. With careful examination, most innocent murmurs can be reliably diagnosed by a paediatric cardiologist, thus obviating the need for further investigations.

    Aim - To look at the prevalence of cardiac murmurs amongst standard one schoolchildren in an urban setting, and calculate the sensitivity, specificity, positive and negative predictive values of clinical diagnosis in differentiating innocent from pathological murmurs.

    Methods - One thousand three hundred and fourteen students from 7 primary schools in the district of Gombak were examined during a routine school health examination. Those who were found to have murmurs were referred for echocardiography. A diagnosis was made at the time of clinical examination and following echocardiography. Children with median sternotomy, lateral or posterior thoracotomy scars or those with previously diagnosed cardiac lesions were excludedfrom the study.

    Results - Thirty six children were referred for echocardiography out of which 2 were confirmed to have underlying cardiac disease on echocardiography. The prevalence of previously undiagnosed cardiac mumurs in this study was 3%. The sensitivity of clinical examination in diagnosing pathological murmurs was 100% while the specificity was 75%. Positive predictive value was 25% and negative predictive value was 100%. Forty three percent of the students who underwent echocardiography were found to have trivial pulmonary regurgitatibn on Doppler echocardiography.

    Conclusion - The prevalence of previously undiagnosed cardiac murmurs is low in this study. This may be due to the fact that they are detected and treated at an earlier age. There is need to conduct a similar study in a rural setting to compare the results.
    Matched MeSH terms: Thoracotomy
  15. Abdul Rahman MR, Yaman MN, Dimon MZ, Zabir AF, Min JO, Hamid HA
    Ann Thorac Surg, 2011 Aug;92(2):714-5.
    PMID: 21801925 DOI: 10.1016/j.athoracsur.2011.02.028
    We present a 35-year-old man with a preoperative diagnosis of a right lower lobe cystic mass. Misled by a radiological suggestion of an intraparenchymal lesion, he had a thoracotomy and right lower lobectomy. An intraoperative finding of a pedunculated cyst arising from the parietal pleural with subsequent histopathology confirmation of a benign bronchogenic cyst, however, would have made a less invasive surgical excision more appropriate.
    Matched MeSH terms: Thoracotomy/adverse effects
  16. Majid AA, Hamzah H
    Chest, 1992 Apr;101(4):981-4.
    PMID: 1555472
    This study was undertaken to determine whether an infusion of local anesthetic (LA) delivered through an extrapleural tunnel could provide satisfactory control of pain in the postthoracotomy period. Twelve patients undergoing thoracotomy were studied. A T-shaped tunnel was created by elevating the parietal pleura at the posteromedial end of the thoracotomy wound. An irrigation catheter was then inserted and an infusion of bupivacaine commenced, initially at 5 mg/kg/24 h and subsequently at 3 mg/kg/24 h. Pain was well controlled in eight patients and satisfactory in four patients. The latter required one dose of opiate analgesia each in the 48-h postoperative period. We conclude that an infusion of bupivacaine into the extrapleural space is an effective means of control of pain after thoracotomy.
    Matched MeSH terms: Thoracotomy*
  17. Mohtar S, Hui TWC, Irwin MG
    Paediatr Anaesth, 2018 11;28(11):1035-1042.
    PMID: 30281181 DOI: 10.1111/pan.13502
    BACKGROUND: Video-assisted thoracoscopic surgery has dramatically increased over the last decade because of both medical and cosmetic benefits. Anesthesia for video-assisted thoracoscopic surgery in small children is more challenging compared to adults due to the considerable problems posed by small airway dimensions and ventilation. The optimal technique for one-lung ventilation has yet to be established and the use of remifentanil infusion in this setting is not well described.

    AIMS: This study investigated the use of extraluminal bronchial blocker placement for one-lung ventilation and the effect of infusion of remifentanil in infants and small children undergoing video-assisted thoracoscopic surgery.

    METHODS: We retrospectively reviewed the technique of one-lung ventilation and the hemodynamic effects of remifentanil infusion in 31 small children during elective video-assisted thoracoscopic surgery for congenital lung lesions under anesthesia with sevoflurane or isoflurane, oxygen, and air. Patients' heart rate, blood pressure, and endtidal carbon dioxide at baseline (after induction of anesthesia), immediately after one-lung ventilation, during carbon dioxide insufflation, and at the end of one-lung ventilation were extracted from the database and analyzed. The use of vasopressors or dexmedetomidine was also recorded and analyzed.

    RESULTS: Extraluminal placement of a bronchial blocker alongside the tracheal tube was successfully performed in 90.3% of cases (28 patients) without any serious complications or arterial oxygen desaturation. There was no significant rise in blood pressure or heart rate even with the rise of endtidal carbon dioxide concentration during video-assisted thoracoscopic surgery. In 58% of patients (18 patients), phenylephrine was administered to maintain the blood pressure within 20% of the baseline value. There was no significant change in the heart rate of all patients at each time point.

    CONCLUSION: One-lung ventilation with an extraluminal parallel blocker was used effectively in this series of young children undergoing thoracoscopic excision of congenital pulmonary lesions. Remifentanil infusion attenuated surgical stress effectively in infants and small children undergoing video-assisted thoracoscopic surgery.

    Matched MeSH terms: Thoracotomy/methods
  18. Alwi M
    Ann Pediatr Cardiol, 2008 Jan;1(1):38-45.
    PMID: 20300236 DOI: 10.4103/0974-2069.41054
    Ductal stenting is an attractive alternative to conventional shunt surgery in duct dependent congenital heart disease as it avoids thoracotomy and its related problems. With today's generation of coronary stents which have better profile, flexibility and trackability, ductal stenting may be achieved safely and with considerably less difficulty than previously described.As in Blalock-Taussig (BT) shunt, ductal stenting is indicated mainly in duct-dependent cyanotic lesions chiefly in the neonatal period. Unlike the Patent ductus arteriosus (PDA) as an isolated lesion, the ductus in cyanotic heart disease has a remarkable morphologic variability. The ductus tends to arise more proximally under the aortic arch, giving rise to a vertical ductus or occasionally it may arise from the subclavian artery. It also tends to be long and sometimes very tortuous, rendering stent implantation technically impossible. The ductus in these patients may also insert onto one of the branch pulmonary arteries with some stenosis at the site of insertion. The ductus in Tetralogy of Fallot with pulmonary atresia (TOF-PA) tend to exhibit these morphologic features and to a lesser degree in transposition of great arteries with ventricular septal defect and pulmonary atresia (TGA-VSD-PA) and the more complex forms of univentricular hearts. In the preliminary angiographic evaluation, it is important to delineate these morphologic features as the basis for case selection.Ductal stenting may be done by the retrograde femoral artery route or the antegrade transvenous route depending on the ductus morphology and the underlying cardiac lesion. The detailed techniques and essential hardware are described. Finally, major potential complications of the procedure are described. Acute stent thrombosis is the most serious and potentially catastrophic. Emergent treatment with thrombolytic therapy and mechanical disruption of thrombus are required. With proper case selection, appropriate technique and the right hardware ductal stenting provides reasonable short-medium term palliation in duct-dependent cyanotic heart disease.
    Matched MeSH terms: Thoracotomy
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