Resection of costal exostosis using piezosurgery associated with uniportal video-assisted thoracoscopy

The Annals of Thoracic Surgery
Mario SantiniGian Paolo Tartaro

Abstract

We report a case of a 35-year-old woman affected by costal exostosis, originating from the posterior arc of the left fifth rib, who complained of a persistent intractable neuralgia in the left T5 dermatome. Both pain and the risk of visceral injury led us to resect exostosis. The procedure was performed using a uniportal videothoracoscopic approach without additional incisions. For bone resection, we used Piezosurgery, a soft tissue-sparing system based on ultrasound vibrations. Piezosurgery allowed the complete resection of exostosis without injuring the intercostal nerve and vessels. The histologic analysis confirmed the diagnosis of osteochondroma and showed no sign of malignancy. The patient was discharged 2 days after the operation. Considering the lack of symptoms, the low risk of degeneration, and the absence of recurrence at 12-month follow-up, the simple resection of exostosis without performing a more extensive rib resection was judged to be optimal.

References

Feb 28, 2003·The Annals of Thoracic Surgery·Waseem M HajjarKhaled M Al-Kattan
Jun 28, 2003·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marco AlifanoJean François Regnard
Sep 15, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alfonso FiorelliMario Santini
Dec 24, 2010·International Journal of Oral and Maxillofacial Surgery·G PavlíkováJ Sedý
Aug 24, 2012·Interactive Cardiovascular and Thoracic Surgery·Tomoyuki NakanoKenji Tetsuka

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Citations

Nov 24, 2016·Journal of Cardiothoracic Surgery·Francesco Paolo CaroniaAttilio Ignazio Lo Monte

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