title: Preoperative saline-filled computed tomography thoracography for awake video-assisted thoracic surgery: report of three cases.
abstract: Awake video-assisted thoracic surgery (VATS) is a therapeutic option for patients with intractable secondary spontaneous pneumothorax (SSP) complicated by impaired pulmonary function. The preoperative identification of air leak points is one of the keys to the success of this procedure. We describe how we performed saline-filled computed tomography (CT) thoracography to detect pleural fistulae in three patients with intractable SSP. Saline-filled CT thoracography showed bubble signs in two patients and an air-water level in bulla in one patient. The preoperative identification of air leak points resulted in successful awake VATS for all three patients. Our experience demonstrates that saline-filled CT thoracography is a useful diagnostic tool for SSP, especially when used in preparation for awake VATS when minimally invasive procedures are desirable.
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. tatsuaki_watanabe@yahoo.co.jp.
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Noda
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Okazaki
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Hisakatsu
authors.initials: H
authors.lastname: Tsukidate
authors.affiliation: Division of Chest Surgery, Center of Respiratory Medicine, Ohta Nishinouchi Hospital, Koriyama, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Notsuda
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Niikawa
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Division of Chest Surgery, Center of Respiratory Medicine, Ohta Nishinouchi Hospital, Koriyama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D057234:Preoperative Period; D013902:Radiography, Thoracic / Q000379:methods*; D012965:Sodium Chloride; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014851:Wakefulness / Q000502:physiology*
chemical_list: D012965:Sodium Chloride
keywords: Awake video-assisted thoracic surgery; Intractable secondary spontaneous pneumothorax; Saline-filled computed tomography thoracography