Endobronchial carcinoid tumor in a 15 years old patient

Endobronchial carcinoid tumor is an extremely rare neoplasm in children and adolescence. Herein, a case of endobronchial carcinoid tumor in a 15 year old female presented with recurrent chest infection for a long time and after a careful examination and investigation, the case was diagnosed.

Blood patch technique for persistent air leak after pulmonary resection

Persistent air leak after operation on the lung is one of the most common problems encountered by thoracic surgeons. The present study done to evaluate the efficacy and risks of autologous 'blood patch' pleurodesis in patients with persistent air leak after pulmonary resection. Department of Cardiothoracic Surgery, Suez Canal University Hospital. Patients operated on between December 2003 and December 2006 and presenting with a persistent air leak after pulmonary resection divided into two groups: Group [A]: The patients received autologous blood patch pleurodesis. Group [B]: The patients connected to -20Cm H[2]O suction. There were 15 patients in each group had an air leak at the completion of surgery. The two groups were evenly matched for age, sex, operation performed, severity of lung disease, and nutritional status. The duration of the air leak was shorter in the group [A] than in the group [B] [p=0.05]. We have obtained a 100% success rate in all patients with persistent air leak in the group [A] who has been treated with this technique. Most air leaks [73.3%] ceased within 12h of blood injection. The mean times to removal of chest tubes were 3.3+0.35 days in the group [A] and 5.5+0.98 days in the group [B] [p=0.05]. Hospitalization time was significantly longer in group [B] compared to group [A] [p=0.03]. No patient developed empyema or tension pneumothorax. Pleurodesis with autologous blood is a safe and effective method for treating persistent air leak after a thoracic surgical procedure

Surgical experience of fracture bronchus

Bronchial fractures are rare, but life threatening. Their successful diagnosis and treatment require a high level of suspicion and early surgical repair. We reviewed our experience in managing these injuries over the past 10 years. Patients who were admitted to the Cardiothoracic Surgery Department, Suez Canal University Hospital and treated for bronchial fractures from 1995 to 2005 were included in this study. Clinical presentation, diagnosis, management and outcome were reviewed. Bronchoscopy identified the location of injury as fracture of the right mainstem bronchus [n=4], fracture of the left mainstem bronchus [n=3] and fracture of the right intermediate bronchus [n=2]. All patients survived after thoracotomy and primary surgical repair except two patients who died due to associated head and intra-abdominal injuries. Bronchial fracture is an unusual complication of blunt chest trauma, and the diagnosis can be delayed unless the treating medical staff has a high index of clinical suspicion in addition to the correct interpretation of clinical and radiological findings. Where the diagnosis is suspected, bronchoscopy should be performed then, progress to thoracotomy and primary surgical repair to minimize the morbidity and mortality of such injuries

Thoracoscopic sympathectomy as a treatment for palmar hyperhidrosis

Hyperhidrosis can cause significant professional and social handicaps. Thoracic endoscopic sympathectomy has become the surgical technique of choice for treating intractable palmar hyperhidrosis and is usually considered as a simple and safe procedure. A retrospective study was undertaken to determine the effectiveness of this procedure. Between January 2003 and December 2004, 30 consecutive patients were operated on for palmar hyperhidrosis. There were 12 men and 18 women, ranging in age from 18 to 40 years [mean 29 years]. In all cases, the procedure was bilateral. The procedure was performed in one stage in all patients. All patients were seen 1 month and follow-up to one year after the operation. Successful sympathectomies were performed in 100% of the patients; the follow-up was from 1 to 12 months [mean 6 +/- 3.4 months]. There was no recurrence of palmar hyperhidrosis. No Horner's syndrome was reported. No mortality or serious complications were observed, nor the need to convert to thoracotomy. There was compensatory sweating in 6 patients [20%]. Two patients [6.7%] had residual pneumothorax which didn't require drainage. One patient [3.3%] had hemothorax which was minimal and didn't need drainage. Thoracoscopic sympathectomy is a safe and effective method for managing palmar hyperhidrosis

Video-assisted thoracic surgery is effective in treatment of the first episode primary spontaneous pneumothorax

Is video-assisted thoracic surgery [VATS] is effective treatment of the first episode primary spontaneous pneumothorax [PSP]. Department of Cardiothoracic Surgery, Suez Canal University hospital. During the period from January 2000 to January 2004, Eighty patients with PSP were admitted in our cardiothoracic surgery department. Group [A] 40 patients were treated by pleural drainage or observation. Group [B] 40 patients were treated by VATS. Patients with known underlying pulmonary disease were excluded. The following variables were recorded in both groups: Age, sex, smoking, complications, drainage time and hospitalization time. Patients characteristics were similar in both groups. The complication rate in Group A [30%] was significantly higher than in Group B [20%] [p=0.05]. Drainage time of patients in Group [A] was significantly longer compared to patients in Group [B] [p<0.0001]. Hospitalization time was significantly longer in Group [A] compared to Group [B] [p=0.03]. Video-assisted thoracoscopy is a valid alternative to open thoracotomy for the treatment of spontaneous primary pneumothorax. Thoracoscopy for the first episode of PSP is safe, effective, and cosmetically excellent with less morbidity and total costs as compared to conservative therapy

Neurogenic mediastinal tumours, a ten-year experience

Neurogenic tumours represent 20% of mediastinal tumors in adults and 35% of such tumours in children; as shown in most of previous studies. We reviewed the patients in whom we found surgical mediastinal tumours in our unit from 1[st] May, 1995 through June 2005. The aim is to evaluate management of cases proved to be neurogenic mediastinal tumours. During the last ten years, we admitted into our unit 132 patients with surgical mediastinal tumours. Full investigations including CT-scanning with contrast and CT- guided biopsy or ultrasound guided biopsy were performed. Thirty-three patients were proved to have neurogenic tumours. From these 132 patients with surgically-treatable mediastinal masses, we found 33 cases of neurogenic pathology [25% are neurogenic tumours]. All neurogenic tumours were in the posterior mediastinum, and represent 75% of all posterior mediastinal masses. There were 29 adults and 6 children [aged <16 years] Mean age was 36.4 years ranging from 5 to 67 years. Nineteen patients were females and only 14 were males. At operation, 27 had complete surgical resection while six patients had only biopsy. We did not find any dumbbell tumour among our patients. After pathological examination there were 14 benign schwannomas, 3 neurofibromas 2 ganglioneuromas, 4 malignant schwannomas, 3 neurobalstomas and one ganglioneuroblastoma. All patients with malignant lesions were from North Sinai. In our series, neurogenic tumours represented 25% of all mediastinal tumours, 39.4% in children and 21.3% in adults included in the study [132 patients]. Benign tumours had an excellent prognosis after resection and a five-year-follow up. In our series, malignant ones represented 22% of all neurogenic masses. Prognosis of these malignant tumours in children was better than in adults. The higher the grade of malignancy the poorer is the prognosis even after radio and/or chemotherapy. Neurogenic tumours are more frequent in females. They should be treated early to get a better prognosis. Incidence of tumours is markedly higher among patients from North Sinai. High resolution CT and/or US studies were quite enough for accurate diagnosis. MRI studies were not essential to diagnose any of our cases