1,721,020 research outputs found
Stenosi del bronco intermedio: riconoscimento di una singolare complicanza post-trapianto e suo trattamento
No full textScopo del lavoro: Le complicanze legate all'ischemia sono la causa più importante di morbidità e mortalità in seguito a trapianto di polmone. L'Ischemia sofferta dai grossi rami bronchiuali durante il trasposto ed il trapianto del graft oltre che essere la possibile causa di deiscenza anastomotica o ulcerazioni della mucosa, è ritenuta la possibile noxa patogeneticadella stenosi tardiva dei grossi bronchi nel periodo post-operatorio. Appare emergere dalla letteratura che il pronco intermedio possa essere particolarmente prono alla sofferenza ischemica e stenotizzarsi tardivamente dopo il trapianto
Thoracoscopic versus conventional lobectomy : comparable short-term results associated to lower systemic impact
No full textVideotoracoscopy has emerged as an alternative to the conventional technique in thoracic surgery. We compared the outcomes after VTS and coventional lobectomies, in terms of postoperative pain, systemic inflammation and pulmonary function.From October 2010 and May 2011, 57 patients underwent pulmonary lobectomy. Among them, 15 patients received VTS lobectomy and 42 received open lobectomy. 15 patients were selected from the “open” group and used as controls.Operative times differed between the two groups (VTS 238.5 vs open 191.6 min, p 0.01), but we found no difference when we compared chest tube stay (POD 6.0 ± 2.83 vs 5.1 ± 2.94, NS). Perceived postoperative pain (NRS scale) was the same (POD1 3.1 vs 2.7, POD2 2.2 vs 2.2, POD3 1.5 vs 1.3, NS) and the total amount of analgesics per patient, expressed as mg of morphine/Kg, was also not statistically different (4 vs 4.8, NS). Furthermore, no statistical difference was observed in postoperative WBC and CRP between the two groups, although we believe this to be mainly due to the small population size. The average CRP was 7.6 vs. 11.6 on POD3 and 5.07 vs. 8.15 on POD5, in the VTS group and open group respectively. We didn’t have any major complications, but 4 patients who had undergone VTS lobectomy had a late pleural effusion requiring thoracentesis, despite the usual postoperative management. Moreover, a patient in the same group had postoperative pneumonia: we consider it to be related to an underlying HIV-related immunosuppression, rather than to the surgical technique itself. One patient in the “open” group experienced severe postoperative pain. One patient in each group had prolonged air-leaks and after that the “fissureless” technique was introduced when thoracoscopic lobectomies were performed.We believe VTS lobectomy to be a safe technique, associated to a lower systemic impact on the patient compared to the conventional technique
Stenosis of bronchus intermedius: an unusual complication after transplantation and its treatment
Full text linkComplications related to ischemia are the most important cause of morbidity and mortality after lung transplantation. Ischemia suffered by large bronchi during topical cooling and transplantation of the graft is considered the possible pathogenic noxa for late stenosis as well as a possible cause of anastomotic leak or ulceration of the mucosa. It seems to emerge from the literature that the bronchus intermedius may be particularly prone to ischemia and may undergo stenosis late after transplantation
Extracellular vescicles and lung transplantation: new prospective in the evaluation of injury and function of the graft
No full textlung transplantation (LuTX) is a consolidated surgical therapy of end-stage pulmonary failure when maximal medical therapy fails. To assess the quality of the graft of the donor, chest x-ray, arterial gas analysis and smoking history are currently used, but often these factors do not allow a proper evaluation of the real cellular damage. In the donor, aspiration of gastric content, brain-death, or initial intensive care infections affect transplant outcome especially in the first 72 hours. Furthermore, ischemia-reperfusion lung injury (IRI) has a key role in the development of primary grafts dysfunction (PGD)
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
Termoablazione con microonde versus lobectomia polmonare: studio con propensity match
No full textSebbene la chirurgia resti il trattamento di prima scelta nel tumore polmonare non a piccole cellule (NSCLC) in stadio iniziale, la terapia locale (radioterapia, termoablazione) ha acquistato un ruolo rilevante nei pazienti affetti da NSCLC localizzato che non possono essere sottoposti a chirurgia per età avanzata o per ridotta funzione cardio-respiratoria. Il presente studio è indirizzato alla valutazione della non inferiorità della termoablazione con microonde (MW) rispetto alla lobectomia polmonare nel trattamento di lesioni primitive in I stadio o secondarie del polmone
Can a trainee safely learn video-assisted thoracoscopic surgery (VATS) lobectomy without open lobectomy experience?
No full textPulmonary lobectomy is the gold standard for the treatment of localized lung cancer; its minimally invasive approach has gained full acceptance in terms of oncological adequacy. Learning video-assisted thoracic surgery (VATS) lobectomy is now fundamental for a trainee in thoracic surgery. The aim of this study is to investigate whether trainee without extensive experience in open lobectomy can safely perform VATS lobectomy for early stage lung cancer
Lo pneumotorace catameniale: nostra esperienza monocentrica e revisione della letteratura
No full textLo pneumotorace catameniale rappresenta una rara forma di pneumotorace spontaneo ricorrente che colpisce giovani donne in età fertile. La sua eziologia è associata alla presenza di endometriosi toracica ma la variabilità del decorso clinico, la difficoltà di riscontro istologico e la possibile assenza di lesioni diaframmatiche evidenti spesso impediscono una diagnosi di certezza. Quesito può rendere il successivo iter terapeutico soltanto empirico con alti tassi di recidive post-chirurgiche. Scopo di questo lavoro è descrivere l'indicazione chirurgica ed il successivo follow-up terapeutico eseguiti in caso di pneumotorace catameniale nella nostra esperienza monocentrica
Prognostic value of TILS (tumor infiltrates lymphocytes) and PET in pleural mesothelioma: retrospective analysis of monocentric experience
No full textMalignant pleural mesothelioma (MPM) is a relatively rare but aggressive cancer with poor prognosis. A therapeutic gold-standard doesn’t exist, so the treatment is nowadays object of randomized clinical trials. A high SUV (standard uptake value) at preoperative positron emission tomography (PET) is a prognostic value of worse prognosis. The histological analysis of tumorinfiltrating lymphocytes (TILs) has increased importance in different cancers, for prognostic value and for immunotherapies. In MPM it’s not known if SUV is higher in case of high lymphocytic concentration (TILs) in tumoral tissue. This kind of analysis was conducted in different studies with no clear evidence of a prognostic value of lymphocytes assessment. The aim of this study is to evaluate whether in MPM there is an association between SUV, histotype, TILs score and subtypes, and clinical outcomes
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