1,721,012 research outputs found
Reconstruction of the pulmonary artery
Full text linkSleeve resection and prosthetic reconstruction of the pulmonary artery have progressively gained acceptance as an alternative to pneumonectomy in lung cancer surgery. Previous concern was mainly related to technical difficulties, intraoperative and postoperative complications, lack of long-term survival, and impact on cardiopulmonary function. For this reason it was not until very recently that lobectomy associated with resection and reconstruction of the pulmonary artery, associated or not to a sleeve resection of the bronchus, has been demonstrated to be an advantageous alternative. The concern about an increased complication rate has been proven to be excessive; in fact, pulmonary artery reconstruction can be performed safely and effectively with the correct indications and technique. We hereby report our experience, along with a review of the indications, the surgical technique, and outcome of pulmonary artery reconstruction
Editorial comment Interventional endoscopy in the management of benign tracheal stenoses: definitive treatment at long-term follow-up
No full textTreatment of recurrent thymic tumors
No full textSurgery is the cornerstone of therapy for recurrent thymic tumors. The pattern of recurrence is, however, less defined. Between 1966 and 1988, we operated on 83 patients with thymoma, 11 of whom underwent surgery for recurrence (group I). In 1989, we initiated a prospective multimodality protocol and have enrolled 128 patients with 9 (7%) recurrences since (group II). In group I, 1 patient was originally at stage I, 2 were at stage II, 5 at stage III, and 3 at stage IV. The patients underwent 1 (#10) or 2 (#1) reoperations and 5 showed histological progression of malignancy. One patient died postoperatively, 6 died of disease, and 3 are alive and disease free 18 to 22 years after the first operation. In group 2, no patient was originally at stage I, 1 was at stage II, 4 were at stage III, and 4 at stage IV. Reoperation (5 patients) was followed by chemotherapy and 2 showed histological progression of disease. One patient died after 2 years, and 4 patients are alive after 6 to 11 years. All recurrent tumors were thymomas with cortical differentiation. Early onset of recurrence was a negative prognostic factor. Thymomas can recur also at early stages. A multimodality approach is indicated also for early stage lesions based on histology. © 2005 Elsevier Inc. All rights reserved
The endoscopically harvested omental flap for deep sternal wound infection: the Leeuwarden experience
No full textThe Intercostal Space
No full textThis article provides a comprehensive account of the anatomy and physiology of the intercostal space, the knowledge of which is important for thoracic surgeons. A wide variety of clinical applications involve the intercostal space, ranging from simple inspection of a widened space in the emphysematous patient, to thoracentesis, to the surgical preparation of an intercostal musculopleural flap. Each of these procedures can be easier and safer if the intercostal anatomy is thoroughly understood. The precise knowledge of the relationships between the neuromuscular and osseous components within the intercostal space may help reduce pain and improve chest wall motility. © 2007 Elsevier Inc. All rights reserved
Ossification of the intercostal muscle around the bronchial anastomosis does not jeopardize airway patency
No full text[No abstract available
Thoracoscopic Water Pleurectomy for the Treatment of Recurrent Spontaneous Pneumothorax
No full textWe describe a new technique for thoracoscopic pleurectomy for the treatment of spontaneous pneumothorax. This is performed by percutaneous subpleural infiltration of 0.9% saline solution from the second to the seventh or eighth intercostal space, the so-called water pleurectomy. The extrapleural infiltration allows gentle separation of the parietal pleura by the division of its natural adherence to the endothoracic fascia. This technique reduces the trauma of the procedure and decreases bleeding. Technical details and preliminary results are reported
LUNG CONSERVATION TECHNIQUES: BRONCHIAL SLEEVE RESECTION AND RECONSTRUCTION OF THE PULMONARY ARTERY.
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