Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report

Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic ad...
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Autor*in:	Masaya Aoki [verfasserIn] Tadashi Umehara [verfasserIn] Shoichiro Morizono [verfasserIn] Yasuhiro Tokuda [verfasserIn] Go Kamimura [verfasserIn] Takuya Tokunaga [verfasserIn] Souichi Suzuki [verfasserIn] Aya Harada Takeda [verfasserIn] Koki Maeda [verfasserIn] Toshiyuki Nagata [verfasserIn] Naoya Yokomakura [verfasserIn] Kota Kariatsumari [verfasserIn] Kazuhiro Ueda [verfasserIn] Masami Sato [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography

Übergeordnetes Werk:	In: Surgical Case Reports - SpringerOpen, 2015, 5(2019), 1, Seite 6
Übergeordnetes Werk:	volume:5 ; year:2019 ; number:1 ; pages:6

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s40792-019-0731-5

Katalog-ID:	DOAJ009491899

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520			\|a Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema.
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allfields	10.1186/s40792-019-0731-5 doi (DE-627)DOAJ009491899 (DE-599)DOAJaffb0885067344a3995c684f4203d9fa DE-627 ger DE-627 rakwb eng RD1-811 Masaya Aoki verfasserin aut Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema. Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography Surgery Tadashi Umehara verfasserin aut Shoichiro Morizono verfasserin aut Yasuhiro Tokuda verfasserin aut Go Kamimura verfasserin aut Takuya Tokunaga verfasserin aut Souichi Suzuki verfasserin aut Aya Harada Takeda verfasserin aut Koki Maeda verfasserin aut Toshiyuki Nagata verfasserin aut Naoya Yokomakura verfasserin aut Kota Kariatsumari verfasserin aut Kazuhiro Ueda verfasserin aut Masami Sato verfasserin aut In Surgical Case Reports SpringerOpen, 2015 5(2019), 1, Seite 6 (DE-627)818040475 (DE-600)2809613-7 21987793 nnns volume:5 year:2019 number:1 pages:6 https://doi.org/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/article/affb0885067344a3995c684f4203d9fa kostenfrei http://link.springer.com/article/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/toc/2198-7793 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 6
spelling	10.1186/s40792-019-0731-5 doi (DE-627)DOAJ009491899 (DE-599)DOAJaffb0885067344a3995c684f4203d9fa DE-627 ger DE-627 rakwb eng RD1-811 Masaya Aoki verfasserin aut Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema. Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography Surgery Tadashi Umehara verfasserin aut Shoichiro Morizono verfasserin aut Yasuhiro Tokuda verfasserin aut Go Kamimura verfasserin aut Takuya Tokunaga verfasserin aut Souichi Suzuki verfasserin aut Aya Harada Takeda verfasserin aut Koki Maeda verfasserin aut Toshiyuki Nagata verfasserin aut Naoya Yokomakura verfasserin aut Kota Kariatsumari verfasserin aut Kazuhiro Ueda verfasserin aut Masami Sato verfasserin aut In Surgical Case Reports SpringerOpen, 2015 5(2019), 1, Seite 6 (DE-627)818040475 (DE-600)2809613-7 21987793 nnns volume:5 year:2019 number:1 pages:6 https://doi.org/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/article/affb0885067344a3995c684f4203d9fa kostenfrei http://link.springer.com/article/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/toc/2198-7793 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 6
allfields_unstemmed	10.1186/s40792-019-0731-5 doi (DE-627)DOAJ009491899 (DE-599)DOAJaffb0885067344a3995c684f4203d9fa DE-627 ger DE-627 rakwb eng RD1-811 Masaya Aoki verfasserin aut Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema. Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography Surgery Tadashi Umehara verfasserin aut Shoichiro Morizono verfasserin aut Yasuhiro Tokuda verfasserin aut Go Kamimura verfasserin aut Takuya Tokunaga verfasserin aut Souichi Suzuki verfasserin aut Aya Harada Takeda verfasserin aut Koki Maeda verfasserin aut Toshiyuki Nagata verfasserin aut Naoya Yokomakura verfasserin aut Kota Kariatsumari verfasserin aut Kazuhiro Ueda verfasserin aut Masami Sato verfasserin aut In Surgical Case Reports SpringerOpen, 2015 5(2019), 1, Seite 6 (DE-627)818040475 (DE-600)2809613-7 21987793 nnns volume:5 year:2019 number:1 pages:6 https://doi.org/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/article/affb0885067344a3995c684f4203d9fa kostenfrei http://link.springer.com/article/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/toc/2198-7793 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 6
allfieldsGer	10.1186/s40792-019-0731-5 doi (DE-627)DOAJ009491899 (DE-599)DOAJaffb0885067344a3995c684f4203d9fa DE-627 ger DE-627 rakwb eng RD1-811 Masaya Aoki verfasserin aut Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema. Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography Surgery Tadashi Umehara verfasserin aut Shoichiro Morizono verfasserin aut Yasuhiro Tokuda verfasserin aut Go Kamimura verfasserin aut Takuya Tokunaga verfasserin aut Souichi Suzuki verfasserin aut Aya Harada Takeda verfasserin aut Koki Maeda verfasserin aut Toshiyuki Nagata verfasserin aut Naoya Yokomakura verfasserin aut Kota Kariatsumari verfasserin aut Kazuhiro Ueda verfasserin aut Masami Sato verfasserin aut In Surgical Case Reports SpringerOpen, 2015 5(2019), 1, Seite 6 (DE-627)818040475 (DE-600)2809613-7 21987793 nnns volume:5 year:2019 number:1 pages:6 https://doi.org/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/article/affb0885067344a3995c684f4203d9fa kostenfrei http://link.springer.com/article/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/toc/2198-7793 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 6
allfieldsSound	10.1186/s40792-019-0731-5 doi (DE-627)DOAJ009491899 (DE-599)DOAJaffb0885067344a3995c684f4203d9fa DE-627 ger DE-627 rakwb eng RD1-811 Masaya Aoki verfasserin aut Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema. Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography Surgery Tadashi Umehara verfasserin aut Shoichiro Morizono verfasserin aut Yasuhiro Tokuda verfasserin aut Go Kamimura verfasserin aut Takuya Tokunaga verfasserin aut Souichi Suzuki verfasserin aut Aya Harada Takeda verfasserin aut Koki Maeda verfasserin aut Toshiyuki Nagata verfasserin aut Naoya Yokomakura verfasserin aut Kota Kariatsumari verfasserin aut Kazuhiro Ueda verfasserin aut Masami Sato verfasserin aut In Surgical Case Reports SpringerOpen, 2015 5(2019), 1, Seite 6 (DE-627)818040475 (DE-600)2809613-7 21987793 nnns volume:5 year:2019 number:1 pages:6 https://doi.org/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/article/affb0885067344a3995c684f4203d9fa kostenfrei http://link.springer.com/article/10.1186/s40792-019-0731-5 kostenfrei https://doaj.org/toc/2198-7793 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 6
language	English
source	In Surgical Case Reports 5(2019), 1, Seite 6 volume:5 year:2019 number:1 pages:6
sourceStr	In Surgical Case Reports 5(2019), 1, Seite 6 volume:5 year:2019 number:1 pages:6
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography Surgery
isfreeaccess_bool	true
container_title	Surgical Case Reports
authorswithroles_txt_mv	Masaya Aoki @@aut@@ Tadashi Umehara @@aut@@ Shoichiro Morizono @@aut@@ Yasuhiro Tokuda @@aut@@ Go Kamimura @@aut@@ Takuya Tokunaga @@aut@@ Souichi Suzuki @@aut@@ Aya Harada Takeda @@aut@@ Koki Maeda @@aut@@ Toshiyuki Nagata @@aut@@ Naoya Yokomakura @@aut@@ Kota Kariatsumari @@aut@@ Kazuhiro Ueda @@aut@@ Masami Sato @@aut@@
publishDateDaySort_date	2019-01-01T00:00:00Z
hierarchy_top_id	818040475
id	DOAJ009491899
language_de	englisch
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callnumber-first	R - Medicine
author	Masaya Aoki
spellingShingle	Masaya Aoki misc RD1-811 misc Multiple loculated organizing empyema misc Debridement misc Video-assisted thoracoscopic surgery misc C-arm cone-beam computed tomography misc Surgery Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report
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topic_title	RD1-811 Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report Multiple loculated organizing empyema Debridement Video-assisted thoracoscopic surgery C-arm cone-beam computed tomography
topic	misc RD1-811 misc Multiple loculated organizing empyema misc Debridement misc Video-assisted thoracoscopic surgery misc C-arm cone-beam computed tomography misc Surgery
topic_unstemmed	misc RD1-811 misc Multiple loculated organizing empyema misc Debridement misc Video-assisted thoracoscopic surgery misc C-arm cone-beam computed tomography misc Surgery
topic_browse	misc RD1-811 misc Multiple loculated organizing empyema misc Debridement misc Video-assisted thoracoscopic surgery misc C-arm cone-beam computed tomography misc Surgery
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title	Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report
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title_full	Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report
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author_browse	Masaya Aoki Tadashi Umehara Shoichiro Morizono Yasuhiro Tokuda Go Kamimura Takuya Tokunaga Souichi Suzuki Aya Harada Takeda Koki Maeda Toshiyuki Nagata Naoya Yokomakura Kota Kariatsumari Kazuhiro Ueda Masami Sato
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title_sort	computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report
callnumber	RD1-811
title_auth	Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report
abstract	Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema.
abstractGer	Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema.
abstract_unstemmed	Abstract Background Video-assisted thoracoscopic surgery (VATS) for organizing empyema is challenging because fibrous septa and peel within the cavity are thickened and hardened. Some patients have multiple isolated empyema cavities that require debridement individually because firm intrathoracic adhesion was developed during this phase. If the debridement was incomplete as a result of worrying about an accidental injury of the surrounding organ, additional interventions may be required due to the persistent empyema cavity or insufficient expansion of the ipsilateral lung. We here describe a representative case with multiple loculated organizing empyema that could safely and reliably perform VATS debridement under C-arm cone-beam computed tomography (CBCT). Case presentation A 67-year-old woman was admitted to our department for the treatment of right empyema. Chest computed tomography showed fluid collection in three independent spaces within the right thoracic cavity. It was assumed that a firm adhesion between the lung and chest wall was developed because about 7 weeks passed since the onset. Therefore, we decided to use CBCT to completely debride three empyema cavities separately by VATS. One cavity was only in a narrow range with the chest wall, and it was located on the back of cost rib cartilage. By clicking any intended anatomical structures on CBCT images, the position was readily depicted by lase projection on the body surface, which helped to place the best skin incision. Moreover, in other cavities, CBCT after initial debridement showed insufficiently dissected cavity. Additional debridement resulted in a successful shrinkage of the empyema cavity. Conclusion We believe that VATS debridement under CBCT guidance is one of the useful treatment options for multiple loculated organizing empyema.
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title_short	Computed tomography-guided thoracoscopic debridement for multiple loculated organizing empyema: a case report
url	https://doi.org/10.1186/s40792-019-0731-5 https://doaj.org/article/affb0885067344a3995c684f4203d9fa http://link.springer.com/article/10.1186/s40792-019-0731-5 https://doaj.org/toc/2198-7793
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author2	Tadashi Umehara Shoichiro Morizono Yasuhiro Tokuda Go Kamimura Takuya Tokunaga Souichi Suzuki Aya Harada Takeda Koki Maeda Toshiyuki Nagata Naoya Yokomakura Kota Kariatsumari Kazuhiro Ueda Masami Sato
author2Str	Tadashi Umehara Shoichiro Morizono Yasuhiro Tokuda Go Kamimura Takuya Tokunaga Souichi Suzuki Aya Harada Takeda Koki Maeda Toshiyuki Nagata Naoya Yokomakura Kota Kariatsumari Kazuhiro Ueda Masami Sato
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