ABSTRACT
Bronchoplastic lobectomy is a lung-saving procedure indicated for central tumors, for which the alternative is pneumonectomy. We compared operative mortality and complications between bronchoplastic lobectomy and pneumonectomy in lung cancer patients. From March 1993 through December 2005, 1,461 patients were surgically resected for non-small cell lung cancer, including 73 who underwent bronchoplastic lobectomy and 258 who underwent pneumonectomy. Bronchoplastic lobectomy was performed on any lesion that could be completely resected by this technique, whereas pneumonectomy was only performed on lesions that could not be removed by bronchoplastic lobectomy. Operative deaths occurred in 1 of 73 (1.4%) bronchoplastic lobectomy and 26 of 258 (10.1%) pneumonectomy patients (p=0.014). Major complications occurred in 16 of 73 (21.9%) bronchoplastic lobectomy and 58 of 258 (22.5%) pneumonectomy patients (p=1.0). Bronchoplastic lobectomy has a lower risk of operative mortality than pneumonectomy. Although the complication rates were similar, bronchoplastic lobectomy was associated with improved postoperative cardiopulmonary status and a low prevalence of fatal complications after bronchial anastomosis. These findings indicate that bronchoplastic lobectomy is a valuable alternative to pneumonectomy for anatomically appropriate patients, regardless of underlying cardiopulmonary function.
Subject(s)
Middle Aged , Male , Humans , Female , Aged , Adult , Adolescent , Retrospective Studies , Postoperative Complications/epidemiology , Pneumonectomy/adverse effects , Lung Neoplasms/mortality , Lung/surgeryABSTRACT
BACKGROUND: Thymoma occurs in approximately 10% of myasthnia gravis patients. The thymus or a thymoma plays a role in the pathogenesis of myasthenia gravis. However, there is currently no definitive position about the effect of thymectomy on patients' symptoms and prognosis. We retrospectively studied the effect of thymoma on remission in patients who underwent thymectomy for myasthenia gravis. MATERIAL AND METHOD: From July, 1992 to December, 2002, we performed extended thymectomy due to myasthenia gravis for 100 patients. The thymoma group included 30 people, the non-thymoma group included 70 people and the change of the Ossermann stage between the two groups after surgery was compared. RESULT: For the non-thymoma group, the average age was 34.7 years (range: 12.7~47.7). Before the surgical operation, the Ossermann stage for the non-thymoma group was an average of 3.06, and this was reduced to an average of 1.41 after operation. For the thymoma group, the average age was 50.9 years (range: 37.3~64.5). Before the surgical operation, the Ossermann stage for the thymoma group was an average of 3.00, and this was reduced to an average of 1.47 after operation. The non-thymoma patients had a higher proportion of males than the thymoma patients (35% vs 30%, respectively). The Masaoka stage was stage of the thymoma group was I for 27 patients and stage II for 3 patients. There was no statistically significant Ossermann stage change between the thymoma and non-thymoma groups. CONCLUSION: Whether thymoma was present or not, there was no significant difference on remission and improvement of myasthenia symptoms after thymectomy in the myasthenia gravis patients.
Subject(s)
Humans , Male , Myasthenia Gravis , Prognosis , Retrospective Studies , Thymectomy , Thymoma , Thymus GlandABSTRACT
BACKGROUND: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. MATERIAL AND METHOD: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. RESULT: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. CONCLUSION: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.
Subject(s)
Humans , Colonic Neoplasms , Colorectal Neoplasms , Disease-Free Survival , Lung , Lung Neoplasms , Multivariate Analysis , Neoplasm Metastasis , Recurrence , Retrospective Studies , Risk Factors , Survival RateABSTRACT
The vasodilatory shock after cardiopulmonary bypass is defined as the condition involving severe and persistent form of hypotension, tachycardia, normal or increased cardiac output and decreased systemic vascular resistance. Because of the unsuccessful response to infusion of fluids or catecholamine vasopressors, a sustained systemic shock state occurs and results in a high morbidity and mortality. We successfully treated this syndrome of 3 patients after open heart surgery with low dose of arginine vasopressin(AVP). Therefore,we report these cases with a review of related articles.
Subject(s)
Humans , Arginine Vasopressin , Arginine , Cardiac Output , Cardiopulmonary Bypass , Hypotension , Mortality , Shock , Tachycardia , Thoracic Surgery , Vascular Resistance , Vasodilation , VasopressinsABSTRACT
Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.
Subject(s)
Cough , Drinking , Eating , Empyema , Fistula , Hemoptysis , Respiratory Tract InfectionsABSTRACT
Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.
Subject(s)
Cough , Drinking , Eating , Empyema , Fistula , Hemoptysis , Respiratory Tract InfectionsABSTRACT
BACKGROUND: Video-thoracoscopy is known to be an useful method to provide accurate pre-resectional staging in patients with lung cancer in addition to the conventional radiologic studies and mediastinoscopy, for the pleural cavity is inspected directly and biopsy specimens can be obtained. This study is undertaken to evaluate how video-thoracoscopy can be used in deciding pre-resectional stage. MATERIAL AND METHOD: Video-thoracoscopy was performed in patients with lung cancer who were scheduled for surgical resection based on the radiologic staging and mediastinoscopic biopsy. 37 patients were included in this study. Pre-thoracoscopically 18 cases were in TNM stage 1, 7 in stage 2, and 12 in stage 3. RESULT: In 15 of 37 cases, video-thoracoscopy could not be performed effectively due to heavy adhesions in the pleural cavity, diaphragmatic and chest wall invasion of tumor and bulky tumor mass es. Mediastinal lymph nodes were positive postresectionally in 6 of these 15 cases. In 22 cases, video-thoracoscopy was performed as usual. Positive mediastinal lymph nodes were identified in 2 cases and exploratory thoracotomy was prevented. Surgical resection were carried out in remaining 20 cases and 5 cases among them had positive mediastinal lymph nodes. CONCLUSION: We believe that it is difficult to perform pre-thoracotomy video-thoracoscopy for all lung cancer patients for there were many cases that thoracoscopy could not be undertaken due to heavy adhesions in the pleural cavity, tumor involvement of the chest wall and/or diaphragm and bulky tumor mass. However we think it is helpful in preventing unnecessary exploratory thoracotomy for some patients with lung cancer whom pre-thoracotomy video-thoracoscopy was carried out.
Subject(s)
Humans , Biopsy , Diaphragm , Lung Neoplasms , Lung , Lymph Nodes , Mediastinoscopy , Pleural Cavity , Thoracic Wall , Thoracoscopy , ThoracotomyABSTRACT
Coronary artery involvement in Takayasu's arteritis is a relatively rare, and potentially lethal but surgically correctable disease. A 28-year-old female was admitted for the evaluation of headache associated with dizziness, palpitation and claudication of left arm. Her aortogram and coronary angiogram showed Takayasu's arteritis with bilateral coronary ostial stenosis. We performed bilateral coronary ostioplasty with saphenous vein patch graft. The patient was discharged in good condition. We report this case with literature review.
Subject(s)
Adult , Female , Humans , Angioplasty , Arm , Constriction, Pathologic , Coronary Disease , Coronary Vessels , Dizziness , Headache , Saphenous Vein , Takayasu Arteritis , TransplantsABSTRACT
We successfully treated a 59-year-old male with adenocarcinoma in the right lower lobe who had developed a dead space with prolonged air-leak, which continued for 21 days after lower and middle lobectomy, by creating artificial pneumoperitoneum. He had a history of subtotal gastrectomy due to stomach cancer 5 years ago. Artificial pneumoperitoneum was made after introducing a peritoneal dialysis catheter into the right upper quardrant. The chest tube was removed 14 days after creating pneumoperitoneum.
