1,721,034 research outputs found
Dyspnea and Fatigue Following Video-assisted Thoracic Surgery for Pulmonary Lobectomy: Measuring Scales to Optimize the Allocation of Resources
No full textAnother Use for EUS: Removal of a Transesophageal-Migrated Mediastinal Foreign Body
No full textRemoval of foreign bodies from the upper gastrointestinal tract, though a common occurrence, can be technically challenging and risky. We report the case of a young man that, after eating a pizza cooked in a wood-burning oven, reported a sense of foreign body. Though the first evaluation by fiberoptic laryngoscopy found no foreign body, after a few weeks, the patient was readmitted from the ER for worsening symptoms and fever. A CT scan showed a metallic mediastinal foreign body inside a large fluid collection. After multidisciplinary evaluation, an endoscopic removal was attempted by accessing the mediastinal collection through EUS-guided positioning of a Hot AxiosTM stent. The cavity was drained by naso-esophageal suction. The foreign body was a fragment of the brush used to clean the oven. The patient is now doing well after 7 months
An alternative technique for anterior chest wall reconstruction: The sternal allograft transplantation
Full text linkOBJECTIVES:
Sternal resection is indicated for a variety of pathological conditions, mainly neoplastic or related to sternotomy complications. Resection of the sternum generally leaves a large chest-wall defect, and reconstruction is thus the most difficult part of the operation. Correct stabilization of the anterior chest wall is very important to avoid secondary complications and respiratory failure. In the last few years, different technical solutions have been used to reconstruct the sternum. We describe our technique using a sternal allograft to reconstruct the anterior chest wall after partial or complete sternal resection.
METHODS:
Between June 2010 and February 2012, four patients underwent sternectomy followed by anterior chest wall reconstruction using sternal allograft. The sternal allograft was harvested from a multitissue donor following Italian legislation for tissue donation. Three patients had neoplastic involvement of the sternum, and one had a complete sternal defect as a complication of a cardiac operation.
RESULTS:
We had no operative mortality. Three patients underwent partial sternal transplantation, and one underwent total sternal replacement. We had no postoperative respiratory insufficiency, infections or mechanical failure of the reconstructions. The respiratory function was preserved in all patients. The follow-up period was free from complications related to the sternal allograft implantation.
CONCLUSIONS:
The technique of sternal allograft transplantation is simple, reproducible and provides excellent functional and cosmetic results. Further studies including a larger number of patients are needed to understand the biology of the allograft and the long-term results of this technique
Synchronous Thymoma and Lung Adenocarcinoma Treated with a Single Mini-invasive Approach
No full textA 75 year-old man with a lesion in the middle lobe of the lung was discovered to also have, during the follow-up period, a mass in the mediastinum, diagnosed as a multi-thymic cyst. Both pathologies were successfully treated with a single surgical approach by video-assisted thoracoscopy. We performed a middle VATS lobectomy with complete lymphadenectomy followed by radical thymectomy without additional incision. The postoperative course was uneventful.
Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved
Safety and Effectiveness of Cadaveric Allograft Sternochondral Replacement After Sternectomy: A New Tool for the Reconstruction of Anterior Chest Wall
Full text linkSurgical excision with wide margins, prevention of respiratory impairment, and protection of surrounding organs are primary goals in resection and reconstruction of the chest wall. We describe our experience of the use of cadaveric cryopreserved sternal allograft
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Long-term metabolic assessment of cryopreserved sternal allograft: a case series
No full textBACKGROUND: Sternal resection and reconstruction with cryopreserved allografts provides a safe alternative to traditional methods of anterior chest wall reconstruction. Despite favorable results, successful integration of the graft sternum has never been demonstrated due to the invasiveness of bone biopsy. We describe our experience of using 18F-sodium fluoride PET/CT scans as a non-invasive method of evaluating graft integration.METHODS: Seven patients underwent surgery and radiological follow-up. Surgical indications were sternal metastases (n=5) and sternal dehiscence (n=2). Sternal reconstruction was performed using a cryopreserved cadaveric sternal allograft fixed in place with titanium plates and screws. Follow-up with 18F-NaF PET/CT scans was performed at 1 and 2 years after surgery.RESULTS: Three patients underwent total sternectomy; 2 partial upper sternectomy involving the manubrium, clavicle (only 1 patient) and upper sternal body; and 2 partial sternectomy of the sternal body and xiphoid process. Focal tracer accumulation occurred at the junctions between native bone and graft bone. The median SUVmax at 1 year was 16.8 (range: 11.2-37.9; P25-P75 13.6-19.4) while at 2 years it was 10.8 (range: 6.1-30.2; P25-P75 8.9-15.1). In 6 cases accumulation was lower at the second scan while in one patient the accumulation was higher at the second scan.CONCLUSIONS: Sternal reconstruction with cryopreserved allograft is safe and well-tolerated. 18F-NaF PET/CT scans are a useful and promising non-invasive method of demonstrating the metabolic activity of the graft and its incorporation into the host skeleton during follow-up
Uniportal video-assisted removal of a right paratracheal pericardial cyst: an unusual location
No full textCystic lesions of the pericardium are a rare entity. Generally, they are congenital and located in the cardiophrenic angle. The right paratracheal location is unusual and differential diagnosis in particular with bronchogenic cyst is difficult even when using magnetic resonance imaging (MRI). The surgical indication exists in case of symptomatic patients or huge mass with compression of nearby structures. Different surgical approaches have been reported in literature to treat mediastinal cysts. We report a case of uniportal thoracoscopic removal of an unusual located right paratracheal pericardial cyst
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