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1.
G Chir ; 40(3): 170-173, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484004

RESUMO

INTRODUCTION: Prolonged air leak (PAL) is one of the most common postoperative complications after lung surgery. It is associated with increased significant morbidity, lower quality of life, longer hospital stay and higher hospital costs. Since its great clinical and economic burden, it is important to establish the feasibility and the effectiveness of the routinary preventive use of a fibrin sealant in order to reduce the incidence of prolonged air leaks. PATIENTS AND METHODS: This is a randomized study on 189 adult patients - 118 men (62.4%) and 71 women (37.6%) aged from 39 to 87 y.o. (mean age 68.3 y.o.) - who underwent lung surgery (lobectomy or bilobectomy) with intraoperatory detection of air leakage, from January 2013 to December 2017, at Department of Thoracic Surgery in "Ospedale Maggiore Carlo Alberto Pizzardi" (Bologna, Italy) and Department of Thoracic Surgery in "Paolo Giaccone" Teaching Hospital (Palermo, Italy). Patients were randomly assigned to the "Glue" arm (90 patients) or the "Control" group (99 patients). We only used stapler or manual suture to achieve aerostasis. In addition, we used a fibrin sealant ("glue") to cover the suture line on patients in the "Glue" arm. The primary endpoints were incidence of prolonged air leaks, days with chest tube and mean hospital stay. RESULTS: In the "Glue" arm we experienced only 1 prolonged air leak (1.1%), while in the "Control" group there were 8 leaks (8.1%). Patients kept chest tube for average 4.15 days in the "Glue" arm and 4.45 days in the "Control" group. The mean hospital stay was average 7.4 days for the "Glue" arm, while 9.1 days in the "Control" group. CONCLUSIONS: According to our experience it seems that the routinary preventive use of a fibrin sealant results in a lower incidence of prolonged air leaks, a shorter hospital stay with lower hospital costs, representing a cost-effective, feasible and effective system to decrease morbility and mortality among surgical patients.


Assuntos
Ar , Fístula Anastomótica/prevenção & controle , Adesivo Tecidual de Fibrina/uso terapêutico , Pneumonectomia/efeitos adversos , Adesivos Teciduais/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Tubos Torácicos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pneumonectomia/métodos , Qualidade de Vida , Técnicas de Sutura
2.
G Chir ; 40(3): 208-212, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484010

RESUMO

Primary leiomyosarcomas of the lung are tumors. We report a case of 49-year old female with history of cough, breathless at rest, right sided chest pain. Chest CT showed a huge (16 cm) mediastinal mass located on the right mediastinum encasing the right main pulmonary artery and infiltrating the main right bronchus and pericardium. The tumor was resected with combined pericardiectomy and pnemonectomy via hemiclamshell incision. This surgical access provided an adequate exposure of the chest "blind zones" and it allowed a radical and safe surgical resection of lung, pleura, pericardium and diaphragm. The final diagnosis showed a low grade differentiation leiomyosarcoma.


Assuntos
Leiomiossarcoma/cirurgia , Neoplasias do Mediastino/cirurgia , Feminino , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/patologia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/patologia , Ilustração Médica , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Carga Tumoral
3.
G Chir ; 40(2): 115-119, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31131810

RESUMO

AIM: Thoracoscopic lobectomy is superior to thoracotomy, but the evidence for this assumption is low. We present a comparison between thoracotomy and thoracoscopy in term of postoperative complications, mortality, postoperative pain, hospital stay and quality of life. PATIENTS AND METHODS: This is a retrospective analysis of 224 lobectomies in 24-months. 128 patients (57.1%) were operated by thoracotomy; 96 patients (42.9%) by videothoracoscopy. RESULTS: Major complications were observed in 4/128 (3.1%) in thoracotomy group and in 1/96 (1%) in thoracoscopy. Minor complications were observed in 38/128 patients (29.7%) in the thoracotomy, and in 16/96 (16.7%) thoracoscopy. Thoracoscopy patients had a shorter hospital stay. CONCLUSION: Our study shows an advantage of thoracoscopy over thoracotomy but further studies are needed.


Assuntos
Neoplasias Pulmonares/cirurgia , Pneumonectomia/métodos , Complicações Pós-Operatórias/epidemiologia , Qualidade de Vida , Cirurgia Torácica Vídeoassistida , Toracotomia , Humanos , Dor Pós-Operatória/epidemiologia , Estudos Retrospectivos
4.
G Chir ; 40(2): 137-140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31131814

RESUMO

The choroid is the most common site for intraocular metastatic di sease. Orbital metastasis as metastatic site of lung adenocarcinoma is very rare and in literature a very exiguous number of cases is present. This is a case report of a woman with history of lung adenocarcinoma and, after surgery, detection of a choroidal mass described as lung metastasis, responding to Gefinitib therapy. However a biopsy was not performed. After two years there was a great dimension decrement of the lung metastasis but she is still suffering from recurrent pleural effusion, with pleural thickenings biopsied and diagnosed as recurrences of disease.


Assuntos
Adenocarcinoma de Pulmão/secundário , Neoplasias da Coroide/secundário , Feminino , Humanos , Pessoa de Meia-Idade
5.
G Chir ; 40(5): 389-397, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32003717

RESUMO

BACKGROUND: Quality of care and provider's experience seem to be strictly connected in any field of surgery. Aim of this study is to identify a method to classify the centers on the basis of the number of thyroidectomies and parathyroidectomies performed. METHODS: We listed 666 centers performing endocrine neck surgery in 2015, from the database of the Italian Health Ministry. We performed a descriptive statistic analysis with a dedicated software. We identified the outliers, according to a previous literature review, in those centers performing >1000 and < 10 thyroidectomies, >100 and < 3 parathyroidectomies and we excluded them to our analysis. The remaining centers were grouped in a box-plot. Third quartile, median, procedures performed/3rd quartile value ratio (Standardized Hospitalization Ratio, SHR, superior cut-off), Romamedian/3rd quartile values ratio (inferior cut-off) were calculated. These centers were charted in a bar graph and three zones were identified: "excellence" (SHR>1.1), "SHR", "alert" (between the two cut-offs) and "risk" (under the lower cut-off). RESULTS: 35743 thyroidectomies and 2306 parathyroidectomies were performed in Italy in 2015. After the outliers' exclusion, 407 and 157 centers performing respectively thyroidectomies and parathyroidectomies were analysed. A median value of respectively 37 thyroidectomies and 6 parathyroidectomies, and a 3rd quartile cut-off of respectively 85 and 12 were calculated. Concerning all the 666 centers, we found: 95 excellence centers for thyroidectomy and 33 for parathyroidectomy, respectively 18 and 17 falling into superior cut-off line, 100 and 29 in the alert zone, 453 and 587 in the risk zone. CONCLUSIONS: Our method, according to the literature data, highlighted a number of thyroidectomies and parathyroidectomies performed in low volume centers. Looking for an optimization in health organization, we can consider some measures such as a net of tutorship of the "alert" hospitals by the excellence ones and a discouragement of the "risk" hospitals in performing endocrine neck surgery.


Assuntos
Hospitais/estatística & dados numéricos , Hospitais/normas , Paratireoidectomia/estatística & dados numéricos , Tireoidectomia/estatística & dados numéricos , Humanos , Itália
6.
G Chir ; 38(5): 243-249, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29280705

RESUMO

Parathyroid carcinoma (PC) is a very rare endocrine tumour, usually characterized by symptoms such as a neck mass, dysphonia, severe hypercalcemia exceeding 140 mg/L and elevated serum parathyroid hormone levels, even more than 5 times the upper limit of normal. Non-functioning parathyroid cancer is extremely rare and, in this case, its pre-operative diagnosis is often difficult. A 54-year old female patient, referring dysphagia and dysphonia, underwent neck ultrasound and neck CT. A left thyroid nodule, probably cystic, was found. It presented caudal extent on anterior mediastinum causing compression of the left lateral wall of the trachea. The preoperative calcemia was into the normal range. The patient underwent left thyroid lobectomy. Histological exam showed a cystic lesion, immunohistochemically originating from parathyroid that oriented for carcinoma. The 18 months follow-up did not show a residual-recurrent disease. The parathyroid origin of a neck lesion could not be suspected before surgery when specific laboratory tests are not available and clinical effects of hyperparathyroidism syndrome are not present. Histological features are not always sufficient for the differential diagnosis between the parathyroid adenoma and carcinoma. The immunohistochemistry is an useful tool that can aid to reach the definite diagnosis.


Assuntos
Cistos/diagnóstico , Doenças das Paratireoides/diagnóstico , Neoplasias das Paratireoides/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade
7.
G Chir ; 38(1): 15-22, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28460198

RESUMO

Although the surgical procedures concerning the thyroid and the parathyroid glands are considered safe, the possible occurrence of complications (mainly hematoma and hypocalcemia) limit the short stay surgery. At our institution a 23-hour-surgery with overnight hospital stay for endocrine neck surgical procedures was introduced since 2004. The present case series analyses the institutional results. Over 1913 endocrine neck surgery procedures, 1730 patients (90,2%) were managed according to this model. Among these patients, 92 suffered from hypocalcemia, 12 from airways obstruction due to the hematoma, 5 from bilateral nerve palsy. 15 more patients had unpredictable general disease compromising the short-stay surgery management. The goal of the discharge after 23 hours was achieved in 92,8% of cases with a mean hospital stay of 1,1days. The 23-hour observation with an overnight surgery is feasible and safe if the correct indications are observed. A considerable volume of specific activity is needed.


Assuntos
Monitorização Fisiológica/estatística & dados numéricos , Paratireoidectomia , Cuidados Pós-Operatórios/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Tireoidectomia , Humanos , Tempo de Internação/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento
8.
G Chir ; 38(1): 41-45, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28460203

RESUMO

AIM: Mesh-mediated groin hernia repair is considered the goldstandard procedure. It has low recurrence rate. Rarely a deep Surgical Site Infection (SSI) is seen when a synthetic prosthesis is used. CASE REPORT: We describe a rare case of bilateral deep SSI after mesh-mediated groin hernia repair. Diagnosis was performed through the physical examination and radiological exams. Microbiological samples identified a methicillin-resistant Staphylococcus aureus responsible of the infection. Target therapy was performed and re-operation performed in order to remove the infected prosthesis and to apply a biological one to create the fibrous scaffold. During follow-up time, right side recurrence was observed. Tru-cut biopsy of fascia was obtained in order to identify the responsible of the recurrence. CONCLUSION: Combination of antibiotic therapy and surgical reoperation seems to be the correct way to approach the deep SSI after mesh-mediated groin hernia repair. The use of biological mesh after synthetic removal seems to improve the final outcome.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia , Telas Cirúrgicas , Infecção da Ferida Cirúrgica/terapia , Serviço Hospitalar de Emergência , Herniorrafia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
9.
G Chir ; 37(5): 193-199, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28098054

RESUMO

BACKGROUND: Patients undergoing thyroidectomy often complain aerodigestive disorders. In a previous study we showed the associations between voice impairment and proximal acid reflux, swallowing impairment and Upper Esophageal Sphyncter (UES) incoordination and the decrease in UES pressure in thirty-six patients observed before and soon afterwards uncomplicated thyroidectomy. This study investigated the state of post-thyroidectomy esophageal motility changes and its associations with these disorders after 18-24 months. PATIENTS AND METHODS: The thirty-six patients prospectively recruited according to selection criteria (thyroid volume ≤60 ml, benign disease, age 18-65 years, previous neck surgery, thyroiditis, pre- or postoperative vocal cord palsy) underwent voice (VIS) and swallowing (SIS) impairment scores, esophageal manometry and pH monitoring once again. RESULTS: After 18-24 months, both VIS and SIS recovered (respectively: p=0,022; p=0,0001); UES pressure increased (p=0,0001) nearing the preoperative values. The persistence of swallowing complaints were associated with the persistence of esophageal incoordination (p=0,03); the association between voice impairment and proximal acid reflux was confirmed (p<0,001). CONCLUSIONS: Our study confirms that aerodigestive disorders after uncomplicated thyroidectomy, largely transient, are strictly connected with upper esophageal motility changes. In this viewpoint, the innervation of upper aerodigestive anatomical structures (larynx, pharynx, upper esophagus) and its variations should be focused.


Assuntos
Transtornos de Deglutição/etiologia , Tireoidectomia/efeitos adversos , Distúrbios da Voz/etiologia , Adolescente , Adulto , Idoso , Transtornos da Motilidade Esofágica/etiologia , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo
10.
G Chir ; 37(1): 37-41, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27142824

RESUMO

The typical complications of Crohn's disease concerns small and large bowel. The full thickness inflammation of the intestinal wall develops in strictures, fistulas and abdominal abscesses. Nowadays the most accepted therapeutic for intra-abdominal abscess option is antibiotic therapy and, in case of need, percutaneous drainage of the abscess. If the abscess passes through the pelvic foramen the abscess can involve the inferior limbs. We report a case a perforation of terminal ileum in Crohn's disease complicated by a large abscess of the right iliac fossa reaching the spaces between the anterior lateral muscles of the right thigh as far as the anterior lateral pre-tibial region. We discuss the diagnostic and therapeutic options in a multidisciplinary context.


Assuntos
Abscesso Abdominal/etiologia , Doença de Crohn/complicações , Doenças do Íleo/etiologia , Perfuração Intestinal/etiologia , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/tratamento farmacológico , Abscesso Abdominal/cirurgia , Adulto , Falso Aneurisma/etiologia , Coinfecção/tratamento farmacológico , Drenagem , Fasciite/etiologia , Humanos , Doenças do Íleo/diagnóstico por imagem , Comunicação Interdisciplinar , Perfuração Intestinal/diagnóstico por imagem , Laparotomia , Perna (Membro)/diagnóstico por imagem , Masculino , Peritonite/tratamento farmacológico , Peritonite/etiologia , Peritonite/microbiologia , Reoperação , Espaço Retroperitoneal/diagnóstico por imagem , Sepse/tratamento farmacológico , Sepse/etiologia , Tomografia Computadorizada por Raios X
11.
J Cardiovasc Surg (Torino) ; 43(5): 723-7, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12386592

RESUMO

BACKGROUND: The aims of the present study were: 1) to study the type and extent of resection in patients with pathological stage I lung cancer; 2) to evaluate the results of surgical treatment; 3) to assess prognostic factors. SETTING: a tertiary referral general hospital. METHODS: Retrospective review of clinical records of 296 patients operated on for pathologic stage I lung cancer between 1989 and 1998. Mean follow-up period was 33.1+/-28.1 months. Survivals were calculated by the actuarial method and compared by the long-rank test. Age, sex, tumor size, type and extent of resection and histologic type were evaluated by univariate and multivariate analisis. RESULTS: Two hundred and forty-five lobectomies, 39 pneumonectomies, 5 segmental resections and 7 wedge resections were performed. Overall actuarial 5- and 10-year survivals were 62 and 49%, respectively. Stage Ia patients showed significantly better 5- and 10-year survivals (76 and 54%, respectively) as compared to Stage Ib patients (57 and 46%, p=0.007). Univariate analysis showed no significant difference in survival according to the age, the sex or the extent of resection. The histological type influenced the outcome (p=0.05): 5-year survival rate were 57, 67, 75% in squamous cell carcinoma, adenocarcinoma and bronchoalveolar carcinoma, respectively. At multivariate analysis stage and histology were identified as independent prognostic factors. CONCLUSIONS: Satisfactory results in terms of suvival can be achieved following surgery for stage I lung cancer. The T status and the histologic type significantly influence survival.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adenocarcinoma Bronquioloalveolar/mortalidade , Adenocarcinoma Bronquioloalveolar/cirurgia , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Análise de Sobrevida
12.
J Cardiovasc Surg (Torino) ; 43(1): 127-8, 2002 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11803344

RESUMO

We report the case of a 15-year-old boy with primary high grade angiosarcoma of the 6th rib. The patient underwent chest wall resection (3 ribs) and reconstruction by using a sandwich of Marlex mesh with strips of methyl methacrylate. No adjuvant treatment was administered. A favourable outcome was observed, with no recurrence at 6-year follow-up. Functional results were excellent as well, with complete return of the patient to normal activities.


Assuntos
Hemangiossarcoma/cirurgia , Costelas/cirurgia , Neoplasias Torácicas/cirurgia , Adolescente , Hemangiossarcoma/diagnóstico por imagem , Humanos , Masculino , Radiografia , Costelas/diagnóstico por imagem , Neoplasias Torácicas/diagnóstico por imagem
13.
Ann Thorac Surg ; 71(4): 1094-9, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11308142

RESUMO

BACKGROUND: The study was performed to assess prognostic factors in patients with lung cancer invading the chest wall treated by surgery. METHODS: We reviewed retrospectively clinical records of all patients operated on for lung cancer invading chest wall structures between 1984 and 1998. RESULTS: Two hundred one patients were operated on in this 14-year period. One hundred thirty-seven lobectomies, 55 pneumonectomies, and 9 wedge resections were performed. Extrapleural resection (when invasion was limited to the parietal pleura) and chest wall resection (in the case of invasion of deeper structures) were combined with pulmonary resection in 79 (39%) and 122 (61%) cases, respectively. Pathologic TNM stages were T3N0 in 116 (57.5%) cases, T3N1 in 52 (26%), T3N2 in 27 (13.5%), and T4N0-N1 in 6 (3%). A complete resection was achieved in 167 (83%) cases. Fourteen postoperative deaths (7%) occurred. One hundred thirty-nine patients (74%) underwent postoperative radiotherapy. Actuarial 5-year survival was 24% and 13% after complete and incomplete resection, respectively (p < 0.05). Actuarial 5-year survival after complete resection was 25% in T3N0 patients, 20% in T3N1, and 21% in T3N2. In completely resected patients, univariate and multivariate analyses identified three independent prognostic factors: nodal involvement, depth of parietal invasion, and age. Radiation therapy did not improve survival if a complete resection was possible. CONCLUSIONS: Completeness of resection, nodal involvement, depth of invasion, and age affect survival of patients with lung cancer invading the chest wall. N2 disease should not be considered a contraindication to surgery.


Assuntos
Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Neoplasias Ósseas/secundário , Neoplasias Ósseas/cirurgia , Carcinoma de Células Grandes/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Pulmonares/cirurgia , Adenocarcinoma/mortalidade , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/epidemiologia , Neoplasias Ósseas/mortalidade , Carcinoma de Células Grandes/mortalidade , Carcinoma de Células Grandes/secundário , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/secundário , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Pneumonectomia/métodos , Pneumonectomia/mortalidade , Probabilidade , Prognóstico , Estudos Retrospectivos , Distribuição por Sexo , Análise de Sobrevida , Tórax , Resultado do Tratamento
14.
Minerva Chir ; 52(7-8): 913-7, 1997.
Artigo em Italiano | MEDLINE | ID: mdl-9411292

RESUMO

Pneumomediastinum (spontaneous, iatrogenic and traumatic) is a relatively uncommon infrequently reported entity. The most common cause is the rupture of marginal pulmonary alveoli, allowing bubbles of air to dissect along the vascular sheaths and connective tissue planes to the mediastinum. Rupture of the trachea or thoracic traumas are other causes of pneumomediastinum. The most common presenting complaint was retrosternal pain, dyspnea, dysphagia, weakness and neck pain. Physical finding revealed: subcutaneous emphysema extended to face, chest or neck, and Hamman's sign. Chest X-ray was made in all cases and diagnosis was completed with chest CT scan and tracheoscopy. We present our series of 34 PM between January 1.1993 to July 31.1995 and discuss about etiology, diagnosis and treatment of this entity.


Assuntos
Enfisema Mediastínico/etiologia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Broncodilatadores/uso terapêutico , Diagnóstico Diferencial , Drenagem , Feminino , Humanos , Doença Iatrogênica , Masculino , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/terapia , Pessoa de Meia-Idade , Alvéolos Pulmonares/lesões , Radiografia Torácica , Traumatismos Torácicos/complicações , Tomografia Computadorizada por Raios X , Traqueia/lesões
15.
J Thorac Cardiovasc Surg ; 113(1): 55-63, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9011702

RESUMO

OBJECTIVE AND METHODS: This study reports clinicopathologic features, treatment, and outcome of 30 recurrent thymomas out of 266 totally resected thymomas. RESULTS: The mean disease-free interval to recurrence was 86 months. Recurrence occurred less frequently and after a longer disease-free interval after resection of encapsulated versus invasive thymomas. The presence of associated myasthenia gravis did not affect recurrence proportion, disease-free interval, or survival after recurrence. A local recurrence occurred in 11 patients, 17 patients had a distant recurrence, and the extent of the recurrence could not be determined in 2 cases. Surgical treatment of the recurrent tumor was attempted in 16 cases, and a total resection was possible in 10 cases; exclusive radiotherapy was done in 11 cases. Overall 5- and 10-year survivals were 48% and 24%, respectively. In a univariate analysis, survival was significantly better in the presence of a local recurrence and in case of a total resection of the recurrent tumor. The use of adjuvant therapy after the resection of the initial thymoma had no effect on reducing the incidence of recurrence, in prolonging the disease-free interval, or in improving survival after the development of the recurrence. In a multivariate survival analysis, significant prognostic factors were the presence of a local recurrence and total resection of the recurrent tumor. CONCLUSIONS: Surgical resection is recommended in patients with recurrent thymoma. Local recurrence and total resection of the recurrent tumor are associated with excellent prognosis. A poor prognosis may be anticipated in the presence of distant recurrence and when radical surgical treatment is not done.


Assuntos
Timoma/cirurgia , Neoplasias do Timo/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Radiografia , Timoma/diagnóstico por imagem , Timoma/mortalidade , Timoma/radioterapia , Neoplasias do Timo/diagnóstico por imagem , Neoplasias do Timo/mortalidade , Neoplasias do Timo/radioterapia
16.
J Cardiovasc Surg (Torino) ; 36(6): 607-9, 1995 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8632036

RESUMO

A case report of a patient with pleural empyema resulting from esophagopleural fistula following perforation of squamous cell carcinoma of the esophagus is presented. The patient had previously received a right pneumonectomy for bronchogenic carcinoma with the adjunct of postoperative radiotherapy. Description of the case, differential diagnosis and therapy of esophagopleural fistulas (EPF) as well as a review of the Literature is described and discussed.


Assuntos
Carcinoma de Células Escamosas/complicações , Empiema Subdural/etiologia , Fístula Esofágica/etiologia , Neoplasias Esofágicas/complicações , Fístula/etiologia , Doenças Pleurais/etiologia , Pneumonectomia , Complicações Pós-Operatórias , Carcinoma Broncogênico/cirurgia , Fístula Esofágica/complicações , Fístula/complicações , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/complicações
17.
J Cardiovasc Surg (Torino) ; 36(5): 511-4, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8522574

RESUMO

Bronchial carcinoid is the most frequent cause of Cushing's syndrome due to ectopic ACTH production. The authors report a case of bronchial carcinoid which diagnosis was difficult because of the presence of pulmonary mycosis, that determined a hypercorticosuprarenalism. Medical treatment with octreotide, ketoconazolo and mitotane was useless, and bilateral suprarenalectomy was performed. A scintigraphy with raced somatostatin revealed a left lung area capting radiation. A CT scan of the thorax revealed a lesion of the lingula and the patient underwent an atypical lung resection with complete solution of the symptom. The problems of diagnosis and treatment of neuroendocrine tumors of the lung are discussed and the importance of SSA in the diagnostic procedure is pointed out.


Assuntos
Neoplasias Brônquicas/complicações , Tumor Carcinoide/complicações , Síndrome de Cushing/etiologia , Síndrome de ACTH Ectópico , Hormônio Adrenocorticotrópico/metabolismo , Adulto , Neoplasias Brônquicas/diagnóstico , Neoplasias Brônquicas/metabolismo , Neoplasias Brônquicas/terapia , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/metabolismo , Tumor Carcinoide/terapia , Síndrome de Cushing/diagnóstico , Hormônios Ectópicos/metabolismo , Humanos , Hidrocortisona/metabolismo , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/diagnóstico , Masculino
18.
Minerva Chir ; 50(9): 789-91, 1995 Sep.
Artigo em Italiano | MEDLINE | ID: mdl-8587714

RESUMO

Castleman's disease(CD) is an uncommon lymph node syndrome, generally located in mediastinum side, rarely systemic. Two histhologic types are described: the more common, termed the hyaline-vascular type, generally asymptomatic, and the second termed plasma cell type, with systemic manifestations of the disease, like fever, anemia and weight loss. The authors present a case of a young man with Castleman's disease, treated by prednisone without reduction of the adenopathy, and thus successfully operated, and discuss about aetiopathogenic theories and treatment of this disease.


Assuntos
Hiperplasia do Linfonodo Gigante , Adulto , Hiperplasia do Linfonodo Gigante/terapia , Humanos , Masculino , Mediastino
19.
J Cardiovasc Surg (Torino) ; 36(1): 97-8, 1995 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7721933

RESUMO

A case of hemangioma of the left twelfth rib is presented. clinical presentation, radiologic appearance and differential diagnosis with other vascular tumors of the bone are discussed, along with a review of the literature.


Assuntos
Neoplasias Ósseas/patologia , Hemangioma/patologia , Costelas/patologia , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/cirurgia , Diagnóstico Diferencial , Hemangioma/metabolismo , Hemangioma/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Costelas/metabolismo , Costelas/cirurgia
20.
Minerva Chir ; 49(12): 1311-6, 1994 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-7746454

RESUMO

The authors report 4 cases of patients with benign fibrous mesothelioma of the pleura, an extremely rare pathology (not more than 500 cases reported to date in the literature), and discuss biological behaviour, diagnosis and surgical treatment. Benign fibrous mesothelioma is generally diagnosed by chance during chest x-ray given that it is paucisymptomatic; diagnostic procedures include thoracic CT (which may be supplemented by transthoracic needle biopsy) and bronchoscopy. Treatment is surgical and consists of exeresis of the neoplasia; prognosis is excellent and cases are reported in the literature of 24-year follow-up without recurrence. Lastly, the authors underline the importance of modern immunohistochemical techniques which help the surgeon to formulate a precise diagnosis and to differentiate benign fibrous mesothelioma.


Assuntos
Mesotelioma/diagnóstico , Neoplasias Pleurais/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Mesotelioma/patologia , Mesotelioma/cirurgia , Pleura/patologia , Pleura/cirurgia , Neoplasias Pleurais/patologia , Neoplasias Pleurais/cirurgia , Toracotomia
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