3,724 research outputs found
Commentary. coronavirus disease 2019 (COVID-19) and the airway. how can surgery help?
No full texta large number of cases of benign tracheal stenosis is eventually expected because of the prolonged intubation and/or tracheostomy performed to
manage the severe respiratory impairment occurring in many patients with COVID-19. The authors reported the presence of a process of coagulative necrosis in the tissue of the resected airway (documented at the pathologic examination), thus confirming the recently published literature
that points out the systemic effect of the COVID-19 that sometimes leads to multiorgan involvement
Pulmonary artery reconstruction with pulmonary vein conduit for lung cancer: medium-term results
No full text“Thoracoscopic volume reduction of the native lung after single lung transplantation for emphisema”
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The influence of propofol, remifentanil and lidocaine on the tone of human bronchial smooth muscle
No full textPleurodesis with an autologous blood patch to prevent persistent air leaks after lobectomy
No full textJ Thorac Cardiovasc Surg. 2007 Mar;133(3):759-62. Pleurodesis with an autologous blood patch to prevent persistent air leaks after lobectomy. Andreetti C, Venuta F, Anile M, De Giacomo T, Diso D, Di Stasio M, Rendina EA, Coloni GF. SourceUniversity of Rome La Sapienza, Department of Thoracic Surgery, Rome, Italy. Abstract OBJECTIVE: Air leakage after pulmonary lobectomy is a well-known problem often contributing to extended hospitalization. Many techniques have been proposed to prevent and treat air leakage, but none have been proved incontrovertibly effective. We evaluated the role of an autologous blood patch after pulmonary lobectomy. METHODS: Twenty-five patients with air leaks on the sixth postoperative day after lobectomy were enrolled in this study. They were randomly assigned to 2 groups: group A (12 patients), with 50 mL of autologous blood infused in the pleural cavity; and group B (13 patients), with 100 mL of blood infused. These 2 groups were retrospectively compared with the last 15 patients showing the presence of air leaks for at least 6 days (group C) (in this group the duration of leakage after the sixth postoperative day was compared). We recorded the duration of posttreatment air leaks and hospitalization. RESULTS: Air leaks stopped 2.3 +/- 0.6 days after the procedure in group A, 1.5 +/- 0.6 days after the procedure in group B, and after 6.3 +/- 3.7 days in group C. The air leakage disappeared within 72 hours in all patients in groups A and B. There was a statistically significant difference in the duration of drainage between groups A and B (P = .005), groups A and C (P = .0009), and groups B and C (P = .0001), showing the effectiveness of an autologous blood patch, particularly with 100 mL of blood. CONCLUSIONS: Management of air leaks after lobectomy with an autologous blood patch is easy, safe, and effective, and does not add costs. It may become the gold standard treatment early in the postoperative course. PMID:17320580[PubMed - indexed for MEDLINE] Publication Types, MeSH TermsPublication TypesComparative StudyRandomized Controlled TrialMeSH TermsAgedAir*Blood Transfusion, Autologous*Carcinoma, Non-Small-Cell Lung/pathologyCarcinoma, Non-Small-Cell Lung/surgeryFemaleFollow-Up StudiesHumansLung Neoplasms/pathologyLung Neoplasms/surgeryMaleMiddle AgedPleurodesis/methods*Pneumonectomy/adverse effects*Pneumonectomy/methodsPostoperative CarePostoperative Complications/prevention & control*ProbabilityRisk AssessmentTreatment Outcome LinkOut - more resource
Relevance of Pharmacogenomics and Multidisciplinary Management in a Young-Elderly Patient WithKRASMutant Colorectal Cancer Treated With First-Line Aflibercept-Containing Chemotherapy
No full textIntroduction:Intensive oncological treatment integrated with resection of metastases raised the clinical outcome of metastatic colorectal cancer (MCRC). In clinical practice, complex evaluation of clinical (age, performance status, comorbidities), and biological (tumoral genotype, pharmacogenomic) parameters addresses tailored, personalized multidisciplinary treatment strategies. Patients with MCRC unsuitable for first-line intensive medical treatments are prevalent and showed worse clinical outcome. After progression to oxaliplatin-based chemotherapy, aflibercept/FOLFIRI significantly improved clinical outcome, even if no survival benefit was reported in adjuvant fast relapsers by aflibercept addition. The case reported a young-elderly (yE) patient withKRASmutant colorectal cancer rapidly progressing to adjuvant chemotherapy, unfit owing to comorbidities, with multiple pharmacogenomic alterations, who gained long-term survival in clinical practice by multidisciplinary treatment strategy consisting of first-line and re-introduction of aflibercept-containing chemotherapy and two-stage lung metastasectomies. Case presentation:A 71-years-old yE patient, unfit for intensive oncological treatments owing to Cumulative Illness Rating Scale (CIRS) stage secondary, affected byKRASc.35 G>T mutant colorectal cancer, rapidly progressing with lung metastases after adjuvant XelOx chemotherapy, reached long-term survival 66 months with no evidence of disease after first-line and re-introduction of tailored, modulated aflibercept (4 mg/kg) d1,15-irinotecan (120 mg/m(2)) d1,15-5-fluorouracil (750 mg/m(2)/day) dd1-4, 15-18; and secondary radical bilateral two-stage lung metastasectomies. Safety profile was characterized by limiting toxicity syndrome at multiple sites (LTS-ms), requiring 5-fluorouracil discontinuation and aflibercept reduction (2 mg/kg), because of G2 hand-foot syndrome (HFS) for >2 weeks, and G3 hypertension. Pharmacogenomic analyses revealed multiple alterations of fluoropyrimidine and irinotecan metabolism: severe deficiency of fluorouracil degradation rate (FUDR), single nucleotide polymorphisms ofUGT1A1*28 variable number of tandem repeats (VNTR) 7R/7R homozygote,ABCB1c.C3435T, c.C1236T,MTHFRc.C667T homozygote,DPYDc.A166G,TSER28bp VNTR 2R/3R heterozygote. Conclusions:In clinical practice, a complex management evaluating clinical parameters andRAS/BRAFgenotype characterizing an individual patient with MCRC, particularly elderly and/or unfit owing to comorbidities, is required to properly address tailored, multidisciplinary medical and surgical treatment strategies, integrated with careful monitoring of superimposing toxicity syndromes, also related to pharmacogenomic alterations, to gain optimal activity, and long-term efficacy
“Thoracoscopic treatment of recurrent controlateral pneumothorax after single lung transplantation.“
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