RESUMEN
Primary malignant fibrous histiocytoma (MFH) of the chest wall is extremely rare and is characterized by aggressive features, including a high incidence of local recurrence and distant metastasis. Surgical resection of the chest wall is the primary modality of management. However, surgical treatment is not generally recommended in patients with evidence of distant metastasis. Here, we present a case of chest wall MFH along with a schwannoma mimicking distant metastasis in the right upper arm. The patient was treated by radical en bloc resection and survived for more than 9 years without recurrence.
Asunto(s)
Humanos , Brazo , Histiocitoma Fibroso Maligno , Incidencia , Metástasis de la Neoplasia , Neurilemoma , Tomografía de Emisión de Positrones , Recurrencia , Pared Torácica , TóraxRESUMEN
Primary malignant fibrous histiocytoma (MFH) of the chest wall is extremely rare and is characterized by aggressive features, including a high incidence of local recurrence and distant metastasis. Surgical resection of the chest wall is the primary modality of management. However, surgical treatment is not generally recommended in patients with evidence of distant metastasis. Here, we present a case of chest wall MFH along with a schwannoma mimicking distant metastasis in the right upper arm. The patient was treated by radical en bloc resection and survived for more than 9 years without recurrence.
RESUMEN
BACKGROUND: This study was designed to assess the effects of pneumoperitoneum and positional changes on the autonomic nervous system (ANS) in laparoscopy-assisted vaginal hysterectomy (LAVH) patients. METHODS: Systolic blood pressures and R-R interval were recorded for 5 minutes in 22 patients, and then power spectral analyses were conducted to evaluate the ANS. The following variables were measured at various positions: preinduction (BASE), prepneumoperitoneum (PREPP), pneumoperitoneum at head-down (PP), normoperitoneum at supine (POSTPP). RESULTS: High frequency of heart rate variability (HRVHF), Low frequency of heart rate variability (HRVLF), Low frequency of blood pressure variability (BPVLF), LF/HF ratios of HRV (LFHFr) were significantly lower than that of BASE at PREPP. HRVHF, HRVLF, BPVLF were significantly lower than that of BASE at PP. At PP, normalized HF of HRV (nuHF) is significantly lower than that of BASE and normalized LF of HRV (nuLF) is significantly higher than that of BASE and PREPP (P < 0.05). LFHFr was significantly lower than that of BASE and significantly higher than that of PREPP at PP. At POSTPP, HRVHF, HRVLF, BPVLF were significantly lower than that of BASE. But, BPVLF at POSTPP was higher than that of PP. CONCLUSIONS: We conclude that the pneumoperitoneum and trendelenburg positions caused sympathetic activation in LAVH patients.
Asunto(s)
Femenino , Humanos , Sistema Nervioso Autónomo , Presión Sanguínea , Corazón , Frecuencia Cardíaca , Histerectomía Vaginal , Éteres Metílicos , NeumoperitoneoRESUMEN
We performed a hybrid procedure for a 58-year-old man with coronary artery disease and a left subclavian artery stenosis. He underwent left subclavian artery stenting and off-pump coronary artery bypass surgery, including grafting the in situ left internal mammary artery to the left anterior descending coronary artery. The post-operative coronary angiogram and computed tomography showed good patency of the graft and stent. He discharged at postoperative 8 days and he has been followed up for six month with an excellent clinical condition.
Asunto(s)
Humanos , Persona de Mediana Edad , Quimera , Puente de Arteria Coronaria Off-Pump , Enfermedad de la Arteria Coronaria , Vasos Coronarios , Arterias Mamarias , Stents , Arteria Subclavia , Síndrome del Robo de la Subclavia , TrasplantesRESUMEN
BACKGROUND: When it comes to esophageal cancer operations, the prevalence of anastomotic complications that adversely affect quality of life is related to the type of anastomotic procedure and the operative site. We studied outcomes related to a safe anastomotic method used in Ivor Lewis esophagogastrectomy for preventing anastomotic leakage and stricture formation. MATERIAL AND METHOD: Between May 2003 and April 2007, 18 patients with esophageal cancer underwent this type of esophagogastrectomy. Four people were lost to follow-up. There were 17 men (94.4%) and 1 woman. The mean patient age was 61 years (range, 46~73 years). RESULT: The mean follow-up period was 17.2 months (range, 1~45 months). There was no anastomotic leakage. There was one benign anastomotic stricture (5.6%) requiring esophageal balloon dilatation, which was accomplished with a 25 mm circular stapler. CONCLUSION: We experienced relatively good postoperative results using a safe anastomotic method in the Ivor Lewis operation for preventing anastomotic complications. These results suggest that this anastomotic method is effective in reducing the incidence of benign anastomotic complications.
Asunto(s)
Femenino , Humanos , Masculino , Fuga Anastomótica , Constricción Patológica , Dilatación , Neoplasias Esofágicas , Estudios de Seguimiento , Incidencia , Perdida de Seguimiento , Prevalencia , Calidad de VidaRESUMEN
Although intrathoracic liver in association with a congenital diaphragmatic hernia has been well documented, the finding of intrathoracic ectopic liver tissue in the presence of an intact diaphragm is an extremely rare congenital anomaly. We have experienced a case of intrathoracic ectopic liver without any diaphragmatic hernia. A 37-year-old woman was admitted for the treatment of an incidentally detected right lung mass. A chest computed tomography scan revealed a right lower lobe lung mass close to the diaphragm, and this was suspicious for bronchial carcinoid tumor. Upon surgery, 2 round solid masses 3.5x3.5 cm and a 2.0x2.0 cm in size were noted, with their bottoms attached to the diaphragm dome. The masses were completely resected. Histologically, they were confirmed to be intrathoracic ectopic livers. The patient had an uncomplicated postoperative course.
Asunto(s)
Adulto , Femenino , Humanos , Tumor Carcinoide , Coristoma , Diafragma , Hernia Diafragmática , Hígado , Pulmón , TóraxRESUMEN
Although intrathoracic liver in association with a congenital diaphragmatic hernia has been well documented, the finding of intrathoracic ectopic liver tissue in the presence of an intact diaphragm is an extremely rare congenital anomaly. We have experienced a case of intrathoracic ectopic liver without any diaphragmatic hernia. A 37-year-old woman was admitted for the treatment of an incidentally detected right lung mass. A chest computed tomography scan revealed a right lower lobe lung mass close to the diaphragm, and this was suspicious for bronchial carcinoid tumor. Upon surgery, 2 round solid masses 3.5x3.5 cm and a 2.0x2.0 cm in size were noted, with their bottoms attached to the diaphragm dome. The masses were completely resected. Histologically, they were confirmed to be intrathoracic ectopic livers. The patient had an uncomplicated postoperative course.