ABSTRACT
Anastomotic leakage frequently complicates esophagectomy and can trigger a rare life- threatening complication, a tracheoesophageal fistula. No guideline has yet addressed this complication. Plastic surgeons play a crucial role for salvage surgery. When a re-operation is chosen the possibilities of flap interposition depend on how the thoracotomy was initially performed. This study tried to identify key techniques in order help thoracic or general surgeons to preserve all the local flaps available for TEF if it occurs. These techniques improve flap conservation, helping plastic surgeons when a later transposition flap is required.
Subject(s)
Esophageal Neoplasms/surgery , Esophagectomy/methods , Postoperative Complications/surgery , Surgical Flaps/transplantation , Thoracotomy/methods , Tracheoesophageal Fistula/surgery , Anastomotic Leak , Esophagectomy/adverse effects , Humans , Medical Errors , Medical Illustration , Organ Sparing Treatments/methods , Postoperative Complications/etiology , Superficial Back Muscles , Thoracotomy/adverse effects , Tracheoesophageal Fistula/etiology , Wound Closure TechniquesABSTRACT
The history of infective endocarditis (IE) is a good example of medical progress. Initially incurable, endocarditis, when diagnosed, was synonym of death. After significant diagnostic progress, thanks to Osler's contribution especially, the first surgeries and antibacterial drugs obtained very few successful cures. We had to wait until Flamming's discovery to observe frequent cures thanks to antibiotics. Surgery manages to push possibilities of cure a bit further. However, paravalvular extensions, described since the first surgical case of IE, was a real technical matter. Thus, the second half of 20th century was devoted to overcoming this surgical challenge. In this historical review, we describe the story of severe IE, especially with paravalvular involvement, by highlighting major progress - clinical and surgical, that allows its current management.
Subject(s)
Cardiology/history , Endocarditis/history , Thoracic Surgery/history , England , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th CenturyABSTRACT
Primitive tumors of the trachea are rare, accounting for 0.1% of the airway tumors. Cystic adenoid carcinoma (or cylindroma) represents the second most frequent type of tracheal cancers. Histologically speaking, this tumor type is divided in three patterns: cribriform, tubular and solid; it presents a slow growth, perineural invasion and potential local recurrence and metastasis. We presented herein the case of a 56-year-old female suffering from a cystic adenoid carcinoma of the low trachea. She has been treated by carinal resection with negative airway margin and complete reconstruction, with the help of an extra corporeal membrane oxygenation (ECMO).
