ABSTRACT
Objetivo: Estudio descriptivo de pacientes del Hospital Universitario de La Princesa con diagnóstico de tumoración endobronquial benigna. Material y métodos: Se analizan las características de pacientes del Servicio de Cirugía Torácica del Hospital Universitario de La Princesa desde el año 2002 a 2012. Resultados: Presentamos 9 casos diagnosticados, 8 de ellos tratados mediante broncoscopia láser y uno mediante cirugía abierta. El láser fue aplicado a través de broncoscopia flexible y broncoscopia rígida. La mayoría fueron tratados con una única sesión, siendo dados de alta el mismo día del procedimiento sin complicaciones. A los 2 años de seguimiento se objetiva una remisión del 100%. Conclusiones: Consideramos que el tratamiento deber ser individualizado, teniendo en cuenta como terapia de primera línea la aplicación de láser endoscópico
Aims: A descriptive study of patients of the La Princesa University Hospital diagnosed with benign endobronchial tumor. Material and methods: The characteristics of patients admitted to the La Princesa University Hospital - Thoracic Surgery Unit during 2002-2012 were analyzed. Results: We present 9 diagnosed cases, 8 of them treated by laser bronchoscopy and one open surgery. The laser was applied via flexible bronchoscopy, rigid bronchoscopy. Most were treated with one session being discharged the same day of the procedure without complications. At 2 years of follow remission of 100% objective. Conclusions: We believe that treatment should be individualized, taking into account as first-line therapy application of endoscopic laser
Subject(s)
Female , Humans , Male , Laser Therapy/methods , Laser Therapy/standards , Bronchial Neoplasms/metabolism , Bronchial Neoplasms/pathology , Lipoma/pathology , Hematoma/blood , Hematoma/metabolism , Ambulatory Surgical Procedures/methods , Papilloma/diagnosis , Laser Therapy/trends , Laser Therapy , Bronchial Neoplasms/complications , Lipoma/genetics , Hematoma/complications , Hematoma/pathology , Ambulatory Surgical Procedures/standards , Papilloma/metabolismABSTRACT
No disponible
Subject(s)
Adult , Female , Humans , Male , Thoracic Surgery, Video-Assisted/trends , Thoracic Surgery, Video-Assisted , Thoracic Surgery/trendsABSTRACT
BACKGROUND: Atypical carcinoids (AC) of the lung are rare intermediate-grade neuroendocrine neoplasms. Prognostic factors for these tumours are undefined. METHODS: Our cooperative group retrieved data on 127 patients operated between 1980 and 2009 because of an AC. Several clinical and pathological features were studied. RESULTS: In a univariable analysis, T-status (p=0.005), N-status (p=0.021), preoperative M-status (previously treated) (p=0.04), and distant recurrence developed during the outcome (p<0.001) presented statistically significant differences related to survival of these patients. In a multivariable analysis, only distant recurrence was demonstrated to be an independent risk factor for survival (p<0.001; HR: 13.1). During the monitoring, 25.2% of the patients presented some kind of recurrence. When we studied recurrence factors in a univariable manner, sublobar resections presented significant relationship with locoregional recurrence (p<0.001). In the case of distant recurrence, T and N status presented significant differences. Patients with preoperative M1 status presented higher frequencies of locoregional and distant recurrence (p=0.004 and p<0.001, respectively). In a multivariable analysis, sublobar resection was an independent prognostic factor to predict locoregional recurrence (p=0.002; HR: 18.1). CONCLUSIONS: Complete standard surgical resection with radical lymphadenectomy is essential for AC. Sublobar resections are related to locoregional recurrence, so they should be avoided except for carefully selected patients. Nodal status is an important prognostic factor to predict survival and recurrence. Distant recurrence is related to poor outcome.
Subject(s)
Carcinoid Tumor/pathology , Lung Neoplasms/pathology , Neoplasm Metastasis/pathology , Neoplasm Recurrence, Local/pathology , Biopsy , Bronchoscopy , Carcinoid Tumor/surgery , Female , Humans , Lung Neoplasms/surgery , Lymph Node Excision , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Prognosis , Risk Factors , Survival AnalysisABSTRACT
No disponible
Subject(s)
Humans , Mesothelioma/surgery , Pleural Neoplasms/surgery , Pleural Effusion, Malignant/surgery , Pneumonectomy , Lung Neoplasms/surgery , Neoplasm InvasivenessABSTRACT
La fibrosis quística (FQ) es una enfermedad multisistémica que afecta a glándulas sudoríparas, aparatos respiratorio, digestivo y reproductor, siendo la afectación de las vías respiratorias la principal causa de morbi-mortalidad. La frecuencia de aparición de neumotórax va aumentando con la edad del paciente, siendo la edad media de presentación de 21,9 años. El principal factor de riesgo para la producción de neumotórax es la obstrucción bronquial, originándose el 75% de los neumotórax en pacientes con un FEV1 menor del 40%. Entre otros factores que aumentan la probabilidad de padecer un neumotórax se han descrito: la colonización crónica por Pseudomonas aeruginosa, Burkholderia cepacia y Aspergillus, la aspergilosis broncopulmonar alérgica (ABPA), el recibir alimentación enteral por desnutrición, la hemoptisis masiva, la insuficiencia pancreática y la terapia con tobramicina o DNasa inhalada. Presentamos el caso de un paciente que ha sufrido 10 neumotórax en el transcurso de un año (AU)
Cystic fibrosis (CF) is a multisystem disease that affects sweat glands, respiratory, digestive and reproductive systems. The respiratory disease is the leading cause of morbidity and mortality. The frequency of occurrence of pneumothorax increases depending on the age of the patient being the average age of onset of 21.9 years. The main risk factor for the production of pneumothorax is chronic bronchial obstruction occur 75% of patients with a spirometry with a value in FEV1 less than 40% of the expected value. Among other factors that increase the likelihood of suffering a pneumothorax include colonization of patients by Pseudomonas aeruginosa, Burkholderia cepacia or Aspergillus, allergic bronchopulmonary aspergillosis (ABPA), enteral feeding for malnutrition, massive hemoptysis, pancreatic insufficiency and the therapy with inhaled tobramycin or dornase. We present the case of a patient who has undergone 10 pneumothorax in one year (AU)
Subject(s)
Humans , Male , Young Adult , Cystic Fibrosis/complications , Pneumothorax/complications , Pleurodesis , Risk Factors , Pseudomonas aeruginosa/pathogenicity , Pulmonary Aspergillosis/complications , Staphylococcus aureus/pathogenicity , RecurrenceABSTRACT
No disponible
Subject(s)
Humans , Minimally Invasive Surgical Procedures/methods , Carcinoma, Bronchogenic/surgery , Lung Neoplasms/surgeryABSTRACT
No disponible
Subject(s)
Humans , Pneumothorax/diagnosis , Hemothorax/diagnosis , Empyema, Pleural/diagnosis , Pneumothorax/therapy , Hemothorax/therapy , Empyema, Pleural/therapyABSTRACT
Bronchial benign tumors comprise fewer than 4% of pulmonary neoplasms. Endobronchial lipoma is an extremely rare benign neoplasm accounting for only 0.1% to 0.5% of all lung tumors. Clinical symptoms of lipoma depend on the location of the tumor, the severity of bronchial obstruction, and the functional and anatomical effects on the parenchyma distal to the obstruction. Computed axial tomography usually reveals the adipose composition of the lipomatous tumor. We report the case of an 83-year-old man diagnosed with community-acquired pneumonia that led to complications: pleural empyema caused by Haemophilus influenzae infection and atelectasis of the right middle and lower lobes secondary to a lipomatous endobronchial obstruction. Removal of the bronchial lipoma was performed by laser resection.
Subject(s)
Bronchial Neoplasms/complications , Empyema, Pleural/etiology , Lipoma/complications , Aged , Aged, 80 and over , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms/diagnostic imaging , Bronchial Neoplasms/surgery , Bronchoscopy , Community-Acquired Infections/complications , Empyema, Pleural/complications , Empyema, Pleural/diagnostic imaging , Haemophilus Infections/complications , Haemophilus influenzae , Humans , Laser Therapy , Lipoma/diagnosis , Lipoma/diagnostic imaging , Lipoma/surgery , Male , Pneumonia/complications , Pulmonary Atelectasis/etiology , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
Los tumores benignos broncopulmonares representan menos del 4% de las neoplasias de origen pulmonar. El lipoma endobronquial es una neoplasia benigna extremadamente rara, cuya incidencia oscila entre el 0,1 y el 0,5% de todos los tumores del pulmón. Los síntomas clínicos dependen de su localización, del grado de obstrucción bronquial y de las consecuencias morfofuncionantes de dicha obstrucción sobre el parénquima distal. La tomografía axial computarizada suele poner de manifiesto el contenido adiposo del tumor. Presentamos el caso clínico de un varón de 83 años diagnosticado de neumonía adquirida en la comunidad, que se complicó con un empiema pleural por Haemophilus influenzae y atelectasia de lóbulos medio e inferior derecho, secundaria a obstrucción endobronquial por lipoma. Se realizó extirpación del lipoma bronquial mediante fotorresección con láser
Bronchial benign tumors comprise fewer than 4% of pulmonary neoplasms. Endobronchial lipoma is an extremely rare benign neoplasm accounting for only 0.1% to 0.5% of all lung tumors. Clinical symptoms of lipoma depend on the location of the tumor, the severity of bronchial obstruction, and the functional and anatomical effects on the parenchyma distal to the obstruction. Computed axial tomography usually reveals the adipose composition of the lipomatous tumor. We report the case of an 83-year-old man diagnosed with community-acquired pneumonia that led to complications: pleural empyema caused by Haemophilus influenzae infection and atelectasis of the right middle and lower lobes secondary to a lipomatous endobronchial obstruction. Removal of the bronchial lipoma was performed by laser resection
Subject(s)
Male , Aged , Humans , Empyema, Pleural/etiology , Lipoma/complications , Bronchial Neoplasms/complications , Pulmonary Atelectasis/etiology , Bronchoscopy , Community-Acquired Infections/complications , Empyema, Pleural/complications , Empyema, Pleural , Haemophilus Infections/complications , Haemophilus influenzae , Laser Therapy , Lipoma/diagnosis , Lipoma , Lipoma/surgery , Pneumonia/complications , Radiography, Thoracic , Tomography, X-Ray Computed , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms , Bronchial Neoplasms/surgeryABSTRACT
No disponible
Subject(s)
Humans , Solitary Pulmonary Nodule , Diagnosis, Differential , Lung NeoplasmsABSTRACT
OBJECTIVE: In spite of improvements in imaging techniques, surgical procedures are often needed to diagnose and definitively treat mediastinal masses. The range of application of video-assisted thoracic surgery (VATS) in this context is still poorly defined. The present study describes and analyzes the experience of the Cooperative Group for Video-assisted Thoracoscopic Surgery of the Spanish Society of Pneumology and Thoracic Surgery (GCCVT-SEPAR), with the aim of determining the usefulness of the technique for treating mediastinal cysts and tumors. METHOD: For 2 years we gathered information prospectively on 1,573 consecutive VATS procedures in 17 hospitals. The data from 64 procedures performed for diagnosis and treatment of mediastinal cysts and tumors are analyzed. RESULTS: A definitive diagnosis was reached in all cases. Nineteen were malignant tumors and 45 were benign lesions. Twenty-five complete resections (39%) were performed: 6 pleuropericardial cysts, 4 bronchogenic cysts, 8 neurogenic tumors and other benign lesions. Radiologically poorly defined masses and those located in the anterior and median parts of the mediastinum were most often the object of diagnostic procedures, whereas cysts and well-defined solid lesions on the posterior mediastinum were usually the object of therapeutic interventions. Eleven percent of the cases required conversion to thoracotomy, mainly due to pleural adhesions. Four complications (6.3%) were recorded and no deaths occurred. The median hospital stay after surgery was 2.5 days; 7.8% of the procedures were performed on outpatients. CONCLUSIONS: VATS is performed on many mediastinal lesions in Spain. Cysts and benign tumors are selected for resection. Poorly defined and malignant lesions were diagnosed by biopsy. The experience reported demonstrates the efficacy and safety of this technique for selected cases.
Subject(s)
Mediastinal Cyst/surgery , Mediastinal Neoplasms/surgery , Thoracic Surgery, Video-Assisted/statistics & numerical data , Adolescent , Adult , Aged , Diagnosis, Differential , Female , Humans , Male , Mediastinal Cyst/diagnosis , Mediastinal Cyst/epidemiology , Mediastinal Cyst/pathology , Mediastinal Neoplasms/diagnosis , Mediastinal Neoplasms/epidemiology , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/secondary , Middle Aged , Prospective Studies , Safety , Spain/epidemiologyABSTRACT
OBJETIVO: A pesar del perfeccionamiento de las técnicas de la imagen, se requiere con frecuencia algún procedimiento quirúrgico para la valoración diagnóstica y el tratamiento definitivo de las masas mediastínicas. El alcance de la cirugía videotoracoscópica (CVT) en este campo no está todavía bien definido. En el presente estudio se describe y se analiza la experiencia del Grupo Cooperativo de Cirugía Videotoracoscópica SEPAR (GCCVT-SEPAR), con el objetivo de conocer la utilidad de esta técnica en el tratamiento de quistes y tumores mediastínicos. MÉTODO: Durante 2 años y de forma prospectiva se han recogido datos de 1.573 procedimientos videotoracoscópicos consecutivos de 17 hospitales. Se analizan los datos completos de 64 procedimientos practicados para el diagnóstico y tratamiento de quistes y tumores del mediastino. RESULTADOS: Se obtuvo el diagnóstico definitivo en todos los casos. Hubo 19 tumores malignos y 45 lesiones benignas.Se realizaron 25 resecciones completas (39 per cent): seis quistes pleuropericárdicos, cuatro quistes broncogénicos, ocho tumores neurogénicos y otras lesiones benignas. Las masas radiológicamente mal definidas y las de localización en el mediastino anterior y medio fueron operadas con más frecuencia con fines diagnósticos, mientras que las lesiones quísticas y las sólidas bien delimitadas del mediastino posterior lo fueron más bien con intenciones terapéuticas. El 11 per cent de los casos precisó una conversión a toracotomía, debido principalmente a adherencias pleurales. Hubo cuatro complicaciones (6,3 per cent) y no hubo mortalidad en la serie. La mediana de hospitalización posquirúrgica fue de 2,5 días. El 7,8 per cent de los procedimientos se realizó mediante cirugía ambulatoria. CONCLUSIONES: La CVT se llevó a cabo en múltiples lesiones mediastínicas en España. Se seleccionaron las lesiones quísticas y los tumores benignos para la resección. Las lesiones mal delimitadas y malignas fueron diagnosticadas mediante biopsia. La experiencia demuestra la eficacia y la seguridad de esta técnica para los casos seleccionados (AU)
