ABSTRACT
To evaluate comparatively lobectomy and wedge resection for carcinoma of the lung, we reviewed retrospectively 1,000 consecutive cases of lung cancer at a Veterans Administration Hospital. Of these cases, 252 were operable; 199 were resectable. Thirty-three patients underwent resection of their lesion as primary treatment. The indications for wedge resection were (1) insufficient pulmonary reserve, (2) resectable cerebral metastasis, (3) frozen-section results reportedly benign. One hundred twelve patients underwent standard lobectomy procedures. Of these patients, 40 were comparable to those patients undergoing wedge resection on the basis of age, histopathological examination, tumor size and location, and the presence of metastatic disease. One, 2, and 5 year survival rates were 85%, 58%, and 26%, respectively, for wedge resection and 75%, 55%, and 25%, respectively, for lobectomy. The operative mortality rate was 0% for wedge resection and 5% for lobectomy. These results indicate that for the patient with a peripheral lung carcinoma and no evidence of metastatic disease a wedge resection offers comparable survival rates with minimal risk of death.
Subject(s)
Carcinoma/surgery , Lung Neoplasms/surgery , Pneumonectomy/methods , Adenocarcinoma/surgery , Adenocarcinoma, Bronchiolo-Alveolar/surgery , Adult , Aged , Carcinoma, Small Cell/surgery , Carcinoma, Squamous Cell/surgery , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Retrospective StudiesABSTRACT
Esophagorespiratory communication developed in 46 patients among 570 with esophageal cancer. Therapy was basically palliative and aimed at mechanical interruption of the fistula, restoration of esophageal continuity, and avoidance of external tubes and appliances. Supportive therapy, gastrostomy, tracheostomy, and esophageal exclusion and diversion procedures resulted in little prolongation of life and poor palliation of the patient. Permanent endoesophageal intubation with tubes of the Celestin variety resulted in best palliation with minimal operative risk for most terminal patients. Colon bypass and occasional resection can accomplish the same goal and possibly provide long-term survival in good-risk, young patients with small tumors.
Subject(s)
Esophageal Fistula/surgery , Esophageal Neoplasms/complications , Fistula/surgery , Respiratory Tract Diseases/surgery , Tracheoesophageal Fistula/surgery , Adenocarcinoma/complications , Adult , Aged , Carcinoma, Squamous Cell/complications , Esophageal Fistula/etiology , Esophageal Fistula/mortality , Female , Humans , Intubation, Gastrointestinal , Male , Middle Aged , Palliative Care , Radiography , Tracheoesophageal Fistula/diagnostic imagingABSTRACT
A technic suitable for long-term study of the human thoracic duct circulation under physiological conditions is described. The results and observations obtained in ten patients studied for three to twenty-one days are presented.
