[Bronchiolo-alveolar cell carcinoma]. / Das Bronchioloalveolarzellkarzinom.

15 cases of bronchiolo-alveolar cell carcinoma were observed at the Dept. of Surgery of the University Hospital of Zurich from 1961 to 1976. The mean age of these patients was 56 years. The sex distribution was 13 males and 2 females. Five cases were discovered accidentally; the symptoms of the remaining 10 were uncharacteristic. Cytology, bronchoscopy and mediastinoscopy were negative at early stages. Diagnosis was made by histologic examination of the specimens only. Needle biopsy, performed routinely over recent years, proved helpful in 4 cases. In 12 out of 14 patients, lobectomy was considered 'radical'; nevertheless, only 2 survived more than 5 years. The disseminated form of the bronchiolo-alveolar cell carcinoma is characterized by a particularly poor prognosis. According to our experience and to the literature, only the solitary, nodular type shows a more favourable outlook.

[Therapy of pleural empyema after pneumonectomy with open-window drainage and continuous rinsing]. / Die Therapie des Pleuraempyems nach Pneumonektomie durch Thoraxfensterung bzw. kontinuierliche Spülung.

From 1961 to 1977 24 thoracic empyemas (=4,75%) after 507 pneumonectomies were observed at the Surgical Clinic A of the Zurich University Hospital. Two methods for the management of this condition are discussed: open-window drainage (CLAGETT) and continuous rinsing of the pleural cavity (LUIZY). The first mentioned method proved to be a palliative one in our patients: no thoracostomy could be re-closed operatively. Two thoracic windows healed up spontaneously without recurrence of an empyema; one patient died shortly after the operation from respiratory insufficiency. Of the five patients treated by continuous rinsing, four were cured as for their empyema, but one of the latter died from renal insufficiency. In one case an open-window drainage finally had to be accomplished.

[Of what kind of material should bile duct T-tubing be made?]. / Aus welchem Material sollen Gallenwegs-T-Drains bestehen?

T-drainage tubings consisting of siliconized latex, silicone rubber, siliconized latex with additional silicone treatment of the surface of the short legs, or silicone rubber with PVC covering of the long branch were tested in experiments with dogs. Fibrous encapsulation, incrustation, and behaviour of the material were checked after 1, 2, 4, and 12 weeks. Siliconized latex proved to be the most suitable material.

[Breast wound reconstruction with plastic mesh]. / Brustwandrekonstruktion mit der Doppelnetzplastik.

A combined network plasty is presented which allows covering of thoracic wall defects without difficulties. The technique consists in closing the defect with a nylon netting in order to reestablish stability, and in air-tight covering of this netting with the greater omentum. This wound is covered after 10 to 14 days with split skin grafts. The method was applied to 7 patients with local recurrences of a breast cancer, two of them infected. The follow-up after 4 to 13 months reveals well-healed wounds in every case. The stomach is not altered, neither clinicallly nor in X-ray controls.