ABSTRACT
The objective of this study was to describe the use of CT volume quantification assessment of candidates for LLDLT. Six pediatric candidates for LDLLT and their donors were investigated with helical chest CT, as part of the preoperative assessment. The CT images were analyzed as per routine and additional post-processing with CT volume quantification (CT densitovolumetry) was performed to assess volume matching between the lower lobes of the donors and respective lungs of the receptors. CT images were segmented by density and region of interest, using post-processing software. Size matching was also assessed using the FVC formula. Compatible volumes were found in three cases. The other three cases were considered incompatible. All three recipients with compatible sizes survived the procedure and are alive and well. One patient with incompatible size was submitted to the procedure and died because of complications attributed to the incompatible volumes. One patient with incompatible size has subsequently grown and new measurements are to be taken to check the current volumes. Different donors are being sought for the remaining patient whose lung volumes were considered too big for the prospective transplant donor lobes. Under FVC formula criteria, all cases were considered compatible. CT volume quantification is an easy to perform, non-invasive technique that uses CT images for the preassessment of candidates for LDLLT, to compare the volume of the lower lobes from the donors with volume of each lung in the prospective recipients. Size matching based on CT densitovolumetry and FVC may differ.
Subject(s)
Living Donors , Lung Diseases/surgery , Lung Transplantation , Lung/diagnostic imaging , Tomography, Spiral Computed , Adolescent , Child , Chronic Disease , Humans , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Lung/anatomy & histology , Organ Size , Preoperative CareABSTRACT
The authors present the results obtained with the development of an experimental model of bronchial fistula and compared different forms of post-pneumonectomy bronchial fistula protection. Forty rats were submitted to left pneumonectomy and bronchial stumps were protected with either pedicled muscle ( N=20 ) or pedicled fat ( N=20 ). The results showed that it was possible to develop a fistula model in 65 por cento of animals and that there was no statistical difference ( p>0.05 ) between the tissues used for bronchial protection
Subject(s)
Research Design , Bronchial FistulaABSTRACT
A desmoid tumor of the mediastinum was diagnosed and terated in a 35 year-old white male who presented with a right supraclavicular mass. He was treated with resection, which involved several vascular structures, requiring multiple vascular reconstructions followed by postoperative radiotherapy. The authors concluded that, when located in tha mediastinum, the invasive character of such tumors and its tendency to recur may pose a considerable surgical challenge, requiring careful preoperative planing and postoperative planning follow-up. The role of radiation therapy is limited to the control of local recurrences
Subject(s)
Humans , Female , Adult , Fibromatosis, Aggressive , Mediastinal NeoplasmsABSTRACT
Säo revisados de modo sumário dados históricos, epidemiológicos, patogenia e achados anatomopatológicos das bronquiectasias. Discutem-se os métodos diagnósticos e, com mais detalhe, o tratamento, destacando-se o papel atual da cirurgia no manejo dessa afecçäo
Subject(s)
Humans , Male , Female , Bronchiectasis , Bronchiectasis/classification , Bronchiectasis/diagnosis , Bronchiectasis/surgery , Bronchiectasis/therapy , Bronchi/anatomy & histology , BronchographyABSTRACT
Os autores apresentam uma breve revisao da literatura e expoem suas ideias e procedimentos praticos sobre o tema. Propoem um roteiro de avaliacao de risco operatorio e sugerem medidas uteis para reduzir complicacoes pos-operatorias
