[Initial results with video-controlled pulmonary lobectomy in 6 patients in The Netherlands]. / De eerste ervaringen met pulmonale lobectomie onder video-controle bij 6 patiënten in Nederland.

In the period from May to September 1993 six patients underwent video-assisted lobectomy of the lung. Owing to the development of video optics and endoscopic devices video-assisted lobectomy is now possible; it appears to be a promising alternative to posterolateral thoracotomy. Potential advantages of this method in comparison with posterolateral thoracotomy are: less pain and improved pulmonary function in the first 24 hours postoperatively, better preservation of shoulder girdle strength and movement, shorter recovery period and hospital stay, and a better cosmetic result. Many aspects of this new technique need further prospective investigation, however.

Systemic to pulmonary vascular malformation.

A case is reported of life-threatening haemoptysis as a result of an anomalous communication between a bronchial artery and pulmonary vein, demonstrated by angiography. The patient recovered following bilobectomy of the right lower and middle lobes. When a systemic artery is involved in an arteriovenous malformation of the lung, haemodynamics are different compared with those present in malformations fed by the pulmonary artery. This implicates other clinical features, options for surgical intervention and prognosis. In reviewing the literature, a relationship with Rendu-Osler-Weber disease is absent in these specific malformations.

Pulmonary hypertension and fenfluramine.

Fenfluramine is a widely prescribed anorectic drug as adjuvant therapy for obesity. Pulmonary vascular hypertension after use of fenfluramine is rarely reported. We present a patient with pulmonary hypertension and right heart failure after treatment with fenfluramine. Pulmonary hypertension resolved after withdrawal of the drug.