RESUMO
Although pericardiectomy remains an established method for pericardial resection, the choice of surgical approach is not definitive. Within South Africa, surgical referral for tuberculosis-induced chronic constrictive pericarditis has not declined. Anecdotal reports have indicated good operative results that appear to show an association with choice of surgical technique used. This study aimed to provide a functional anatomical perspective for performance and recovery of the heart during pericardiectomy based on anatomical dissection and surgical notes. En bloc specimens were harvested from 16 fresh cadavers and pericardial segments were measured in terms of percentage cover over surface area of the myocardium. Retrospective analysis of 116 surgical reports of pericardiectomy performed over a period of 20 years was conducted. Surgical notes were compared for median sternotomy and anterolateral left thoracotomy. Results from anatomical study indicated that although the anterior pericardium between the phrenic nerves constitutes about 58% of total selected pericardial area, total pericardium accessible over left ventricle from that approach was only 26%. When orientated in left anterolateral position, total accessible area of left ventricular pericardium was 37%. Standard deviations were found to be comparable. Means were significantly different, indicating that the left anterolateral approach allows wider access to the left ventricle. This paper provides a functional anatomical perspective for the choice of left anterolateral thoracotomy as a surgical approach for pericardiectomy.
Assuntos
Pericardiectomia/métodos , Pericárdio/anatomia & histologia , Pericárdio/cirurgia , Toracotomia/métodos , Adulto , Feminino , Ventrículos do Coração/anatomia & histologia , Ventrículos do Coração/cirurgia , Humanos , Masculino , Pericardite Constritiva/cirurgia , Pericardite Tuberculosa/cirurgia , Estudos Retrospectivos , África do Sul , Esterno/cirurgiaRESUMO
Massive thymic hyperplasia is an extremely rare form of true thymic hyperplasia most often described in infants and children. Hyperplasia of this order is not known to occur in any other organ, and its etiology and prognostic significance remain unknown. As there is no accurate way of preoperatively differentiating massive thymic hyperplasia from other tumors of the thymus and anterior mediastinum, we advise excision in all cases for histological analysis and relief of mediastinal compression. This description of 4 cases updates the 30 previously reported cases, and includes a literature review.
Assuntos
Hiperplasia do Timo/patologia , Pré-Escolar , Feminino , Humanos , Lactente , Linfocitose/patologia , Masculino , Timo/patologiaAssuntos
Governo , Medicina , Política , Saúde Pública , África do Sul , Reino Unido , Estados UnidosAssuntos
Traumatismos Torácicos/cirurgia , Ferimentos Perfurantes/cirurgia , Adulto , Feminino , HumanosRESUMO
Pseudosarcoma is a malignant, polypoid tumour which has been described in the oesophagus, mouth, fauces and larynx. The tumour consists of a special variety of squamous cell carcinoma. Although squamous carcinoma of the oesophagus is especially prevalent in the East London area, there does not appear to be a corresponding increase in the incidence of pseudosarcoma. We report a case of pseudosarcoma encountered in a series of 5 000 cases of squamous carcinoma of the oesophagus.
