[Spontaneous pneumothorax. Apropos 2507 cases]. / Neumotórax espontáneo. A propósito de 2.507 casos.

This retrospective study of 2,507 cases of spontaneous pneumothorax (SP) involves 1,873 patients treated at our hospital over nearly 20 years. Men represented 92.4% and most patients were between 16 and 30 years old (56.2%). Presenting more than one episode were 29.7%. The treatment of choice was placement of a pleural drain whenever SP had led to lung collapse amounting to more than 10% of volume. Thoracotomy was performed when the patient had experienced three or more episodes of SP; when a pleural drain had not resolved the condition 10 days after placement; in hemo-SP with severe hemorrhage; and in 2 cases in which SP was bilateral. A total of 419 thoracotomies were performed on 384 patients (20.7%). All episodes were resolved and complications were few. Six patients died (0.32%), three following thoracotomy. All of these had antecedents of chronic obstructive lung disease and all were over 70, excepting one who was 56.

Nd:YAG laser photoresection of low-grade malignant tumors of the tracheobronchial tree.

Nineteen patients with low-grade malignant tumors of the tracheobronchial tree received Nd:YAG laser treatment. They were referred for palliation of symptomatic airway obstruction due to carcinoid (14 cases) or adenocystic carcinoma (five cases). In all patients, laser treatment was followed by symptomatic relief. Fifteen patients have done well and remain in good condition between six months and four years after laser photoresection. Two of the five patients with adenocystic carcinoma died because of hemoptysis at one and 49 months after laser therapy. In the group of 14 patients with carcinoids, two episodes of bleeding (more than 250 ml) occurred that were controlled by tamponade with the tube and coagulation by the laser beam itself. Two patients with carcinoid died of unrelated causes (stroke and gastric carcinoma).

[Treatment of obstructive tracheobronchial disease with the Yag-Nd laser: 400 procedures in a 4-year experience]. / Tratamiento con láser Yag-Nd en patología traqueobronquial obstructiva: 400 administraciones en 4 años de experiencia.

Overall, 400 procedures with the Yag-Nd laser were carried out in 252 patients with tracheobronchial disease susceptible to photoresection during a 4-year period. Most procedures were carried out under general anesthesia and with a rigid bronchoscope. 149 tumors were treated. Of these, 118 were malignant, 16 had low malignancy and 15 were benign. These patients received overall 203 procedures. 92 patients with 113 tracheal stenoses underwent overall 185 procedures. Finally, a miscellaneous group of 11 patients with several conditions underwent 12 procedures. Immediate results were classified as excellent, good or poor, depending on the achieved tracheal or bronchial diameter. No significant complications were found. After a 4-year experience, the authors believe that laser photoresection is currently the most effective and safe procedure to relieve obstruction in the stenoses caused by malignant proliferative tracheal or bronchial diseases not amenable to surgery. It is also the ideal substitute for surgery in benign tumors and in some cases of non-tumoral tracheal stenosis.