The utility of 99mTc-EDDA/HYNIC-TOC scintigraphy for assessment of lung lesions in patients with neuroendocrine tumors.

UNLABELLED: Our aim was to assess clinical utility of 99mTc-EDDA/HYNIC-TOC scintigraphy for evaluation of lung lesions in patients with neuroendocrine tumors (NETs). Single photon emission computed tomography (SPECT) of the thorax and whole body scintigraphy were performed in 34 patients using 99mTc-EDDA/HYNIC-TOC. Visual assessment was complemented by semiquantitative evaluation based on tumor to non-tumor (T/NT) ratio. Clinical, laboratory, and histological findings served as the standard for comparison. Enhanced tracer uptake was observed on both SPECT and whole body scintigraphy in 29 of 34 patients (88% sensitivity). T/NT ratios were significantly higher on SPECT than whole body images (2.96+/-1.07 vs.1.70+/-0.43, p KEYWORDS: 99mTc-EDDA/Hynic-TOC, lung involvement of NETs, T/NT ratio.

[Transthoracic ultrasonography in diagnosis and treatment of acute pleural empyema].

The aim of this study was to estimate validity of transthoracic ultrasonography in diagnosis and evaluation of the results of initial surgical therapy of acute pleural empyema. The study included 49 patients with II stage acute pleural empyema. Initial surgical tretament was indicated according to CT and transthoracic ultrasonography findings. Evaluation of initial therapy results has been made by transthoracic ultrasonography (TUS). Clinical significance of standard x-ray, CT and TUS in different stages of diagnostic and therapeutic procedure has been analyzed. Chest drainage was initial treatment in 10 (20.4%) patients, thoracentesis in 39 (79.6%). Complete cure with this two methods was achieved in 22 (44.9%) patients. In 27 (55.1%) patients initial treatment failed. TUS was sufficient for adequate estimate of initial treatment results in 41 (83.6%). Additional CT was indicated in 8 (16.3%) patients. Transthoracic ultrasonography has impotrant role in choice of initial surgical therapy of acute pleural empyema. If initial estimate of therapy results is made by TUS, CT is rarely necessary.

[Bronchoplasty surgery]. / Mogucnost primene bronhoplasticnih operacija.

Bronchoplastic operations are analysed in 114 patients: 76 (66.67%) with bronchial carcinoma, 33 (28.94%) bronchial adenoma, 4 (3.51%) bronchial rupture or stenosis and bronchial hondroma in one case. Sleeve resection was done in 99 (86.84%) and other kind of bronchoplastic operations in 15 (13.16%). Preoperative diagnostic procedures were focused on: clinical course and symptomatology, exact location of bronchial lesion, type of tumor, mediastinal lymph nodes, bronchial three distal from the lesion and respiratory lung tests. Intraoperatively attention was toward to the evidence of peribronchial growth of tumor, mediastinal lymph nodes and lung tissue. Early postoperative course was without complications in 85 (75.89%), with complications in 26 (23.21%) but two patients died. Incomplete reexpansion or athelectasis of the entire lung or lobe but easily treated, were the commonest complications. There was no evidence of bronchial fistula or bronchial sutura at the level of submucosal growth of tumor. In certain indications bronchoplastic operations are good operative choice for surgical treatment of bronchial tumors and traumatic bronchial rupture or its sequelas-stenosis. For malignant tumors, late results, are, after this kind of operations, equivalent to those achieved after classic resections and they do not depend of the kind of surgical procedures but correlate to the nature of the tumor. For benign and slowly growing malignant tumors late results after these operations are excellent.

[Modern surgical treatment of pulmonary tuberculosis]. / Savremeno hirursko lecenje tuberkuloze pluca.

Correctly performed antituberculous chemotherapy, together with the early diagnostics of tuberculosis, significantly lowered the need for surgery. Surgery is limited to patients with poor or no response to chemotherapy. In the period between 1983-1992 212 tuberculous patients were operated in the Clinic for Thoracic surgery, the Institute for the Pulmonary Disease the operated patients had the following form of the disease: primary tuberculosis in 4 patients (1.87%), 104 patients (49.06%) had the postprimary form of the disease, 67 patients (31.60%) had tuberculoma (causative lesion) cavernous tuberculosis existed in 33 patients (15.57%), while only 4 patients (1.87%) had diffuse pulmonary lesion. Diagnosis of post-tuberculous syndrome was made in 68 patients (32.08%). Secondary aspergylloma existed in 36 patients while the frequency of bronchial stenosis and bronchiectasis was the same -m 31 patients (16.98% and 14.63% respectively). One patient had broncho-oesophageal fistula. Tuberculous empiema, complicating the disease, existed in 36 patients (16.98%). Comparing the two 5-years periods, (1983-87 and 1988 to 1992) the authors conclude that the number of operations for tuberculosis is decreasing. Treatment was successful in all patients except in a patient with a broncho-esophageal fistula, who died postoperatively slow lung reexpansion existed in 5 patients, and in two cases partial upper thoracoplasty had to be done in order to solve the complication of the initial treatment. In all cases postoperative antituberculous chemotherapy was performed taking in consideration the problem of possible drug-resistance. There were no recurrences.

[Diagnostic and surgical approaches in the treatment of tracheal diseases]. / Dijagnosticki i hirurski stavovi u lecenju oboljenja traheje.

The authors present 100 patients operate for diseases of the trachea during a period ranging from 1972-1991. Stricture of the trachea was observed in 75% of pts. and tumours in the remaining 25%. Stricture resulting from tracheostomy was the most frequent. The majority of patients underwent end-to-end anastomosis. A Nevill prosthesis was implanted in 5 patients. The results were good in 93.34% of pts. The mortality was 6.6%. The most frequent operation for malignant tumours was resection of the trachea and end-to-end anastomosis. The length of the respected segment ranged from 3-6 cm. There was no mortality. The authors conclude that adequate preoperative diagnostic procedures unable good assessment of a lesions and a well planed operation with good results and no mortality.