Résumé
BACKGROUND: This study examined the role of superficial vein surgery in patients with combined superficial venous reflux and segmental popliteal vein reflux. METHODS: We retrospectively reviewed 42 limbs in 38 patients with combined superficial venous reflux and segmental popliteal vein reflux who underwent saphenous vein ablation between January 2014 and February 2017. Patients underwent outpatient follow-up duplex ultrasonography at 3, 6, and 12 months postoperatively. Resolution of deep vein reflux was defined as reversed blood flow in a popliteal segment for less than 1.0 second and a decrease in the reflux time of more than 20% of the preoperative reflux time. RESULTS: The mean follow-up period was 9 months (range, 3–23 months). Saphenous vein ablations were performed by stripping in 24 limbs and radiofrequency ablation in 18 limbs. Preoperative segmental popliteal vein reflux resolved in 21 of the 42 limbs (50%). CONCLUSION: This study demonstrated that superficial venous surgery corrected segmental popliteal vein reflux in 50% of limbs with combined superficial venous reflux and segmental popliteal vein reflux. Other prospective studies are necessary to elucidate the etiology of the non-reversible cases.
Sujets)
Humains , Ablation par cathéter , Membres , Études de suivi , Patients en consultation externe , Veine poplitée , Études prospectives , Études rétrospectives , Veine saphène , Échographie , Veines , Insuffisance veineuseRésumé
BACKGROUND: This study was conducted to determine the efficacy of staple line coverage using a polyglycolic acid patch and fibrin glue without pleural abrasion to prevent recurrent postoperative pneumothorax. METHODS: A retrospective analysis was carried out of 116 operations performed between January 2011 and April 2013. During this period, staple lines were covered with a polyglycolic acid patch and fibrin glue in 58 cases (group A), while 58 cases underwent thoracoscopic bullectomy only (group B). RESULTS: The median follow-up period was 33 months (range, 22 to 55 months). The duration of chest tube drainage was shorter in group A (group A 2.7±1.2 day vs. group B 3.9±2.3 day, p=0.001). Prolonged postoperative air leakage occurred more frequently in group B than in group A (43% vs. 19%, p=0.005). The postoperative recurrence rate of pneumothorax was significantly lower in group A (8.6%) than in group B (24.1%) (p=0.043). The total cost of treatment during the follow-up period, including the cost for the treatment of postoperative recurrent pneumothorax, was not significantly different between the two groups (p=0.43). CONCLUSION: Without pleural abrasion, staple line coverage with a medium-sized polyglycolic acid patch and fibrin glue after thoracoscopic bullectomy for primary spontaneous pneumothorax is a useful technique that can reduce the duration of postoperative pleural drainage and the postoperative recurrence rate of pneumothorax.
Sujets)
Drains thoraciques , Drainage , Colle de fibrine , Fibrine , Études de suivi , Pneumothorax , Acide polyglycolique , Récidive , Études rétrospectivesRésumé
BACKGROUND: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. METHODS: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. RESULTS: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. CONCLUSION: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.
Sujets)
Humains , Jambe , Ligature , Complications postopératoires , Récidive , Veine saphène , VaricesRésumé
Intravascular papillary endothelial hyperplasia is a rare tumor-like lesion caused by hyperplastic proliferation of endothlial cells that is usually an incidental findings within thrombosed dilated blood vessels or vascular tumor. We report the sonographic appearance and pathological correlation of intravascular papillary endothelial hyperplasia that presented as an intramuscular solitary mass in chest wall.
Sujets)
Vaisseaux sanguins , Hyperplasie , Résultats fortuits , Paroi thoracique , ThoraxRésumé
Epithelioid hemangioendothelioma (EHE) is a rare tumor of vascular origin. While it can be found in any tissue, it is most often found in lung and liver and usually has an intermediate behavior. EHEs originating from pleural tissue have been less frequently described than those from other sites. Furthermore, to date, all of the cited pleural EHEs were described as highly aggressive. In the present report, we describe a rare case of pleural EHE extending to lung and bone in a 31-year-old woman. The histological diagnosis was confirmed by both conventional examination and immunohistochemistry. Her disease stabilized during the 4th course of adriamycin (45mg/m2, day 1-3), dacarbazine (300mg/m2, day 1-3) and ifosfamide (2,500mg/m2, day 1-3) with mesna, and she survived for 10 months after the diagnosis.
Sujets)
Adulte , Femelle , Humains , Protocoles de polychimiothérapie antinéoplasique/usage thérapeutique , Diagnostic différentiel , Facteur VIII/métabolisme , Hémangioendothéliome épithélioïde/diagnostic , Immunohistochimie , Kératines/métabolisme , Tumeurs du poumon/diagnostic , Tumeurs de la plèvre/diagnostic , Vimentine/métabolismeRésumé
BACKGROUND: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. MATERIAL AND METHOD: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of preoperative empyema, operation timing, the side of operation, duration of operation, and operation type. RESULT: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculous empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10.7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative of empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity. If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. CONCLUSION: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.