ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Aortic Dissection/diagnosis , Celiac Artery/physiopathology , Abdomen, Acute/etiologySubject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Lung Neoplasms/diagnosis , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/epidemiology , Carcinoma, Non-Small-Cell Lung/pathology , Cigarette Smoking/adverse effects , Combined Modality Therapy , Comorbidity , Diagnostic Techniques, Respiratory System , Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/pathology , Lung Neoplasms/therapy , Mass Screening , Neoplasm Staging , Oxidative Stress , Pneumonectomy/methods , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Medicine , Radiotherapy/methods , Risk Factors , Smoking Cessation , Societies, Medical , Spain , Thoracic SurgeryABSTRACT
La Sociedad Española de Neumología y Cirugía Torácica (SEPAR), a través de las áreas de Cirugía Torácica y de Oncología Torácica, ha promovido la realización de un manual de recomendaciones para el diagnóstico y el tratamiento del cáncer de pulmón de células no pequeñas. Las elevadas incidencia y mortalidad de esta patología hacen necesaria una constante actualización de las mejores evidencias científicas para su consulta por parte de los profesionales de la salud. Para su confección se ha contado con un amplio grupo de profesionales de distintas especialidades que han elaborado una revisión integral, que se ha concretado en 4 apartados principales. En el primero se ha estudiado la prevención y el cribado de la enfermedad, incluyendo los factores de riesgo, el papel de la deshabituación tabáquica y el diagnóstico precoz mediante programas de cribado. En un segundo apartado se ha analizado la presentación clínica, los estudios de imagen y el riesgo quirúrgico, incluyendo el cardiológico y la evaluación funcional respiratoria. Un tercero trata sobre los estudios de confirmación cito-histológica y de estadificación, con un análisis de las clasificaciones TNM e histológica, métodos no invasivos y mínimamente invasivos, así como las técnicas quirúrgicas para el diagnóstico y estadificación. En un cuarto y último capítulo se han abordado aspectos del tratamiento, como el papel de las técnicas quirúrgicas, la quimioterapia, la radioterapia, el abordaje multidisciplinar por estadios y otros tratamientos dirigidos frente a dianas específicas, terminando con recomendaciones acerca del seguimiento del cáncer de pulmón y los tratamientos paliativos quirúrgicos y endoscópicos en estadios avanzados
The Thoracic Surgery and Thoracic Oncology groups of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) have backed the publication of a handbook on recommendations for the diagnosis and treatment of non-small cell lung cancer. Due to the high incidence and mortality of this disease, the best scientific evidence must be constantly updated and made available for consultation by healthcare professionals. To draw up these recommendations, we called on a wide-ranging group of experts from the different specialties, who have prepared a comprehensive review, divided into 4 main sections. The first addresses disease prevention and screening, including risk factors, the role of smoking cessation, and screening programs for early diagnosis. The second section analyzes clinical presentation, imaging studies, and surgical risk, including cardiological risk and the evaluation of respiratory function. The third section addresses cytohistological confirmation and staging studies, and scrutinizes the TNM and histological classifications, non-invasive and minimally invasive sampling methods, and surgical techniques for diagnosis and staging. The fourth and final section looks at different therapeutic aspects, such as the role of surgery, chemotherapy, radiation therapy, a multidisciplinary approach according to disease stage, and other specifically targeted treatments, concluding with recommendations on the follow-up of lung cancer patients and surgical and endoscopic palliative interventions in advanced stages
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Practice Patterns, Physicians' , Evidence-Based Practice , Smoking CessationABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Adult , Headache/diagnosis , Headache/etiology , Headache/pathology , Arteriovenous Malformations/complications , Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/pathology , Physical Examination/instrumentation , Physical Examination/methods , Physical Examination , Magnetic Resonance Spectroscopy/instrumentation , Magnetic Resonance Spectroscopy/methods , Magnetic Resonance Spectroscopy/therapeutic use , Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/pathology , Cerebral HemorrhageABSTRACT
The Thoracic Surgery and Thoracic Oncology groups of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) have backed the publication of a handbook on recommendations for the diagnosis and treatment of non-small cell lung cancer. Due to the high incidence and mortality of this disease, the best scientific evidence must be constantly updated and made available for consultation by healthcare professionals. To draw up these recommendations, we called on a wide-ranging group of experts from the different specialties, who have prepared a comprehensive review, divided into 4 main sections. The first addresses disease prevention and screening, including risk factors, the role of smoking cessation, and screening programs for early diagnosis. The second section analyzes clinical presentation, imaging studies, and surgical risk, including cardiological risk and the evaluation of respiratory function. The third section addresses cytohistological confirmation and staging studies, and scrutinizes the TNM and histological classifications, non-invasive and minimally invasive sampling methods, and surgical techniques for diagnosis and staging. The fourth and final section looks at different therapeutic aspects, such as the role of surgery, chemotherapy, radiation therapy, a multidisciplinary approach according to disease stage, and other specifically targeted treatments, concluding with recommendations on the follow-up of lung cancer patients and surgical and endoscopic palliative interventions in advanced stages.
Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy , Biomarkers, Tumor/blood , Bronchoscopy , Carcinoma, Non-Small-Cell Lung/prevention & control , Chemoradiotherapy , Diagnostic Techniques, Respiratory System/standards , Early Detection of Cancer , Humans , Lung Neoplasms/prevention & control , Neoplasm Staging , Palliative Care , Pneumonectomy/standards , Positron Emission Tomography Computed Tomography , Pulmonary Medicine/organization & administration , Salvage Therapy , Smoking Cessation , Societies, Medical , Spain , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Societies, Medical/organization & administration , Societies, Medical/standards , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/prevention & control , Societies, Medical/ethics , Societies, Medical/legislation & jurisprudence , Risk Factors , Tobacco Smoke Pollution/prevention & control , Smoking/epidemiology , Smoking/prevention & control , Smoking Cessation/methods , Mass Screening/methodsABSTRACT
Los carcinoides tímicos son una entidad poco frecuente que puede asociarse a enfermedades endocrinológicas como el síndrome de Cushing o el síndrome de neoplasia endocrina múltiple tipo I (MEN1). Suponen el 4% de los tumores del mediastino anterior y se caracterizan por tener un comportamiento muy agresivo. Presentamos el caso de un paciente diagnosticado de síndrome MEN1 a quien durante el seguimiento de su enfermedad se detectó una imagen torácica compatible con carcinoide tímico. Tras intervenirle quirúrgicamente mediante timectomía ampliada a grasa peritímica, se confirmó el diagnóstico clínico. A los 14 meses de seguimiento se halló en las pruebas de imagen una lesión sospechosa de recidiva local, motivo por el que fue reintervenido. El informe anatomopatológico de dicha intervención fue de fibrosis rádica. Así mismo, presentamos una revisión del manejo diagnóstico y terapéutico actual en pacientes con síndrome MEN1 diagnosticados de carcinoide tímico(AU)
Thymic carcinoids are a rare entity that may be associated with endocrine diseases like Cushing's syndrome or multiple endocrine neoplasia syndrome type I (MEN1). These tumors represent 4% of anterior mediastinal tumors and are characterized by their very aggressive behavior. We present the case of a patient with a previous MEN 1 diagnosis in whom, during the follow up of his disease, a thoracic image compatible with thymic carcinoid was detected. After an extended thymectomy that included peri-thymic fat resection, the clinical diagnosis was confirmed. A follow-up examination 14 months later revealed a suspicious lesion that suggested local recurrence, therefore the patient was reoperated on. The pathology report of this surgery indicated post-radiation fibrosis. Likewise, we present a review of the current diagnostic and therapeutic management of patients with MEN1 syndrome who are diagnosed with thymic carcinoid(AU)
Subject(s)
Humans , Thymoma/complications , Thymus Neoplasms/complications , Multiple Endocrine Neoplasia/complications , Thymectomy , Risk FactorsABSTRACT
Thymic carcinoids are a rare entity that may be associated with endocrine diseases like Cushing's syndrome or multiple endocrine neoplasia syndrome type I (MEN1). These tumors represent 4% of anterior mediastinal tumors and are characterized by their very aggressive behavior. We present the case of a patient with a previous MEN 1 diagnosis in whom, during the follow up of his disease, a thoracic image compatible with thymic carcinoid was detected. After an extended thymectomy that included peri-thymic fat resection, the clinical diagnosis was confirmed. A follow up examination 14 months later revealed a suspicious lesion that suggested local recurrence, therefore the patient was reoperated on. The pathology report of this surgery indicated post-radiation fibrosis. Likewise, we present a review of the current diagnostic and therapeutic management of patients with MEN1 syndrome who are diagnosed with thymic carcinoid.
Subject(s)
Carcinoid Tumor/diagnosis , Neoplasms, Multiple Primary/diagnosis , Thymus Neoplasms/diagnosis , Adult , Humans , Male , Multiple Endocrine Neoplasia Type 1Subject(s)
Foreign Bodies , Thoracic Wall , Drainage/instrumentation , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Humans , Male , RadiographyABSTRACT
La correcta elección de la vía de abordaje al tórax es fundamental para obtener el éxito quirúrgico y un postoperatorio favorable. Debe adaptarse tanto a la patología como a la experiencia del cirujano torácico, buscando el equilibrio entre agresividad y seguridad de la técnica. En este artículo se describirán las características de las incisiones quirúrgicas al tórax desde las clásicas toracotomías, esternotomías y sus variantes hasta llegar a la videotoracoscopia y cirugía de mínima invasión. Recordaremos también las diferentes técnicas que se utilizan para abordar las áreas linfáticas del mediastino, incluyendo las más novedosas linfadenectomía mediastínica videoasistida y linfadenectomía mediastínica transcervical extendida (AU)
The correct choice of the incision to the chest is essential for surgical success and a favorable postoperative course. The route of access to the thorax must be adapted both to the disease and to the thoracic surgeons experience, striking a balance between aggressiveness and the safety of the technique. This article describes the characteristics of surgical incisions, including classical thoracotomy, sternotomy and its variants, thoracoscopy and minimally-invasive surgery. The distinct techniques used to explore mediastinal lymphatic areas, including video-assisted mediastinal lymphadenectomy and transcervical extended mediastinal lymphadenectomy, are also described (AU)
Subject(s)
Humans , Thoracic Diseases/surgery , Thoracic Surgical Procedures/methods , Lymph Node Excision/methods , Minimally Invasive Surgical Procedures/methodsSubject(s)
Middle Aged , Humans , Neurilemmoma/embryology , Neurilemmoma/epidemiology , Neurilemmoma/pathology , Neurilemmoma , Neurilemmoma/surgery , Vagus Nerve/pathology , Mediastinal Neoplasms/classification , Mediastinal Neoplasms/epidemiology , Thoracotomy/trends , Thoracic Surgery, Video-Assisted/trendsABSTRACT
La localización intratorácica más frecuente para los tumores germinales no metastáticos, es el mediastino anterior. Los tumores de células germinales primarios de pulmón son una excepción en la literatura limitándose a algunos casos de coriocarcinomas y raros casos de tumores del seno endodérmico. En este artículo, se presenta un caso de tumor del seno endodérmico primario de pulmón de características atípicas en cuanto a la manera de diagnostico y al tratamiento practicado(AU)
The most frequent location for non-metastatic germ cell tumors is the anterior mediastinum. Primary lung germ cell tumors are an exception in medical literature being limited to just a few cases of choriocarcinomas and rare cases of yolk-sac tumors. In this paper, we report a case of a pulmonary yolk-sac tumor with atypical characteristic as regards its diagnosis and treatment(AU)
Subject(s)
Humans , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/therapy , Obesity/complications , Obesity Hypoventilation Syndrome/diagnosis , Obesity Hypoventilation Syndrome/therapy , Practice Patterns, Physicians'ABSTRACT
The most frequent location for non-metastatic germ cell tumors is the anterior mediastinum. Primary lung germ cell tumors are an exception in medical literature being limited to just a few cases of choriocarcinomas and rare cases of yolk-sac tumors. In this paper, we report a case of a pulmonary yolk-sac tumor with atypical characteristic as regards its diagnosis and treatment.
Subject(s)
Endodermal Sinus Tumor/pathology , Lung Neoplasms/pathology , Adenocarcinoma , Aged , Biomarkers, Tumor/analysis , Carcinoma, Basal Cell , Endodermal Sinus Tumor/chemistry , Endodermal Sinus Tumor/diagnosis , Endodermal Sinus Tumor/epidemiology , Endodermal Sinus Tumor/surgery , Facial Neoplasms , Humans , Incidental Findings , Lung Neoplasms/chemistry , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/surgery , Male , Neoplasms, Second Primary , Pneumonectomy , Rectal Neoplasms , Skin Neoplasms , ThoracotomyABSTRACT
The correct choice of the incision to the chest is essential for surgical success and a favorable postoperative course. The route of access to the thorax must be adapted both to the disease and to the thoracic surgeon's experience, striking a balance between aggressiveness and the safety of the technique. This article describes the characteristics of surgical incisions, including classical thoracotomy, sternotomy and its variants, thoracoscopy and minimally-invasive surgery. The distinct techniques used to explore mediastinal lymphatic areas, including video-assisted mediastinal lymphadenectomy and transcervical extended mediastinal lymphadenectomy, are also described.
