ABSTRACT
Tuberculosis is still a worldwide disease. Medical treatment is essential but surgery still has a role in the diagnosis and treatment of several various thoracic tuberculous lesions [both pulmonary and extra-pulmonary]. We aim to present and analyzethe results of surgical treatment of thoracic tuberculous cases in Al-Assad University Hospital in Damascus. Also, we purpose to determine the indications of thoracoscopic and traditional surgical interventions in this field, and studying their complications. The study consists of two sections: retrospective [from 1992 till end of 2007], prospective [from 2008 till end of 2010], includes all patients with thoracic tuberculous infections _ pulmonary or extra-pulmonary_diagnosed and treated in the department of thoracic Surgery in Al-Assad University Hospital in Damascus [301 patients], who underwent thoracoscopic and traditional thoracic surgical interventions. Pulmonary tuberculous cases compose 34.5% vs. 65.5% extra-pulmonary tuberculous cases [pleural 39.6%, mediastinal lymph nodes 12.9%, chest wall 9.3%, pericardial 3.6%]. The proportion of thoracoscopic interventions was 36.5%: majority of them were diagnostic [61.8%], whereas the proportion of traditional thoracic interventions was 63.5%: majority of them were therapeutic [75.9%] to management complicated or neglected or incorrectly treated cases. The diagnosis of tuberculosis was not confirmed in80% of patients at admittance. Majority of cases [88.4%] had active tuberculosis vs. 11.6% only had sequelae of previous tuberculous infection.Morbidity rate was 7.3%, and mortality rate was 1.3%. Surgery still plays an important role in diagnosis and treatment of thoracic tuberculosis-pulmonary or extra-pulmonary-and management of their complications. Also, We consider thoracoscopy as a selective mini-invasive option for diagnosing and treating these cases
ABSTRACT
Bronchial Carcinoid tumors account 1-2% for all lung malignancies, and [WHO] described two different groups of carcinoid tumors: typical carcinoid [TC] and atypical carcinoid [AC]. This study demonstrates the experience of Alassad university hospital in Damascus with patients treated surgically for typical and atypical carcinoid tumors of the Lung. We retrospectively reviewed data of 60 patient who underwent surgery for carcinoid tumor from [1993-2010] in the department of thoracic surgery in Alassad university hospital, Several variables were reviewed in all patient. There were 60 cases of pulmonary carcinoid tumors 53 typical carcinod 88.33% and 7 atypical 11.66%. There were 22 female 36.66% and 38 male 63.33% with median age of 42 years, and the ratio of carcinoid tumors to other primary lung cancer was 3,3%. Surgery consisted of 39 formal lung resection 19 lobectomies 31.66%, 12 bilobectomies 20%, 9 pneumonectomy 15%,18 sleeve or bronchoplastic resection 30%.there were lymph node involvement in 9 patients 16%, 7 ipsilateral hilar lymph -nodes N1 and 2 ipsilateral mediastinal lymph node N2. No perioperative mortality occurred, and the overall 5 year survival was 100%. Pulmonary carcinoid is an uncommon tumor, and typical carcinoid is more common than atypical, Parenchyma-sparing procedures are the treatment of choice with excellent long term survival.