Subject(s)
Arthritis, Rheumatoid/complications , Pneumothorax/etiology , Adult , Humans , Male , RecurrenceABSTRACT
OBJECTIVE: To compare mortality and loco-regional recurrence rates in patients treated surgically for stage I non-small cell lung cancer by either lobectomy or sublobar lung resection (pulmonary wedge) from 1994 to 1998. PATIENTS AND METHODS: Seventy-eight patients who underwent lung resection for stage I non-small cell lung cancer from January 1994 to December 1998 were reviewed retrospectively. Fifty patients underwent lobectomy and 28 limited resection (pulmonary wedge). We reviewed oncologic history, tumor histology, loco-regional recurrence and tumor-related mortality during the follow-up period. RESULTS: Histology, lobectomies: 36 (72%) squamous cell carcinomas, 12 (24%) adenocarcinomas and 2 (4%) large cell carcinomas. Histology, wedge resection: 12 (42.8%) squamous cell carcinomas and 16 (57.2%) adenocarcinomas. Staging, lobectomies: 15 Ia (30%) and 35 Ib (70%). Staging, wedge resections: 16 Ia (57.2%) and 12 Ib (42.8%). Loco-regional recurrence: lobectomies 9 (18%) and wedge resections 4 (14.3%) plus 1 remote metastasis (3.6%). Mortality during follow-up: lobectomies 8 (16%) and wedge resections 4 (14.3%). Accumulated survival rate (in months): lobectomies 62.38 and wedge resections 63.92. The rates of loco-regional recurrence and accumulated survival in the two groups were not significantly different. CONCLUSIONS: The rates of loco-regional recurrence and accumulated survival in this study agree with those from other retrospective studies. We found no statistically significant differences between patients undergoing lobectomy and those undergoing sublobar resection. Wedge resection is an appropriate technique for patients with stage I non-small cell lung cancer who can not tolerate lobectomy.
Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Pneumonectomy/methods , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Survival RateABSTRACT
OBJETIVO: Comparar la tasa de mortalidad y recidiva locorregional de nuestra serie de pacientes intervenidos por un cáncer pulmonar no microcítico en estadio I durante el período 1994-1998, divididos en dos grupos: a) intervenidos de lobectomía, y b) intervenidos de resección pulmonar sublobar (cuña pulmonar).PACIENTES Y MÉTODOS: Se han revisado retrospectivamente 78 casos de resección pulmonar por cáncer pulmonar no microcítico en estadio I realizada entre enero de 1994 y diciembre de 1998: 50 sometidos a lobectomía y 28 a resección sublobar (cuña pulmonar). Se recogieron antecedentes oncológicos, histología de los tumores, recidiva locorregional y mortalidad relacionada con el tumor durante el período de seguimiento. RESULTADOS: El estudio histológico de las lobectomías evidenció 36 carcinomas escamosos (72 por ciento), 12 adenocarcinomas (24 por ciento) y dos carcinomas de células grandes (4 por ciento). En el caso de las cuñas puso de manifiesto 12 carcinomas escamosos (42,8 por ciento) y 16 adenocarcinomas (57,2 por ciento). En cuanto a los estadios, en las lobectomías, en 15 (30 por ciento) era Ia y en 35 (70 por ciento) Ib, y en las cuñas, en 16 (57,2 por ciento) era Ia y en 12 (42,8 por ciento), Ib. Hubo recidiva locorregional en 9 lobectomías (18 por ciento) y en 4 cuñas (14,3 por ciento), más un caso de metástasis a distancia (3,6 por ciento).En cuanto a la mortalidad durante el seguimiento, fallecieron 8 pacientes (16 por ciento) sometidos a lobectomías y 4 (14,3 por ciento) sometidos a cuñas. La tasa de supervivencia acumulada (en meses) fue de 62,38 y 63,92 en lobectomías y cuñas, respectivamente. Los datos obtenidos no presentaron diferencias estadísticamente significativas en lo que se refiere a recidiva locorregional y supervivencia acumulada entre ambos grupos. CONCLUSIONES: En este trabajo las tasas de recidiva locorregional y supervivencia acumulada son concordantes con las de otros estudios retrospectivos. En nuestra serie no hallamos diferencias estadísticamente significativas entre los pacientes sometidos a lobectomía y los sometidos a resección sublobar. La resección en cuña resulta una técnica adecuada para aquellos pacientes con un carcinoma pulmonar no microcítico en estadio I que no pueden tolerar una lobectomía. (AU)
Subject(s)
Middle Aged , Male , Female , Humans , Survival Rate , Pneumonectomy , Retrospective Studies , Neoplasm Staging , Carcinoma, Non-Small-Cell Lung , Lung NeoplasmsABSTRACT
OBJECTIVE: To analyze the efficacy of an iodo-povidone hydroalcoholic solution for the chemical pleurodesis of spontaneous pneumothorax. MATERIAL AND METHOD: A descriptive, retrospective study of 81 patients with spontaneous pneumothorax. The patients were treated by video-assisted thoracoscopy and chemical pleurodesis with an iodo-povidone hydroalcoholic solution at the thoracic surgery unit of Hospital de la Santa Creu i Sant Pau in Barcelona (Spain) between January 1993 and December 1999. RESULTS: Eighty-one patients, 59 men (73%) and 22 women (27%), between 14 and 82 years old (mean age 33 years) were treated. Pneumothorax was most often on the right side (43 cases, 53%). The main indications for surgery were recurrence (52 cases, 64%) and persistent air leaks (25 cases, 31%). All were treated by video-assisted thoracoscopy, with resection of the pulmonary parenchyma in 30 cases (37%) and pleural instillation of the iodo-povidone hydroalcoholic solution as the irritant in all cases. Air leaks were observed during early postoperative recovery in 10 patients (12.3%), self-limited fever in 5 (6.1%) and infection of drainage openings in 2 (2.4%). During the postoperative follow-up period of 6 to 67 months (mean 24 months), 5 recurrences (6.1%) were seen. CONCLUSIONS: An iodo-povidone hydroalcoholic solution is easy to apply by video-assisted thoracoscopy and is highly effective for pleurodesis in cases of spontaneous pneumothorax.
Subject(s)
Pleurodesis , Pneumothorax/drug therapy , Povidone-Iodine/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Ethanol , Female , Humans , Male , Middle Aged , Pneumothorax/surgery , Povidone-Iodine/administration & dosage , Solutions , Thoracic Surgery, Video-Assisted/instrumentation , WaterABSTRACT
Traumatic rupture of the diaphragm is a rare event that is usually found in polytrauma cases or after violent attacks. Patients are usually males between 20 and 50 years old, and car accidents are the main causes. Diagnosis can be difficult and injuries may go unnoticed, leading to serious delayed complications. We present 8 cases from 1991 through 2000. All patients came to the emergency department of our hospital with a diagnosis of traumatic rupture of the diaphragm. We analyze the reasons for admission, signs and symptoms, diagnostic approach, associated lesions, treatment and course, comparing our experience with reports in the literature.
