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Complex pectus excavatum in adults: which is the best solution? Reply to Actis Dato et al
No full textComment on:
Complex pectus excavatum in adults: which is the best solution? [Eur J Cardiothorac Surg. 2013]
External longitudinal titanium support for the repair of complex pectus excavatum in adults. [Eur J Cardiothorac Surg. 2012
Biomechanical behaviour of native and sutured bronchi. An in-vitro study
No full textBACKGROUND: Biomechanical behaviour evaluation of a suture is an important information for the surgeon to choose the best technique to perform. OBJECTIVE: To assess the biomechanical behavior of the native and mechanically sutured bronchi. METHODS: Ten bronchi were harvested from slaughtered pigs and then randomly separated in two groups, a control intact group and a sutured group where specimens were cut in half and sutured, to evaluate mechanical properties during a tensile test using a loading frame machine. In addition optoelectric motion tracking system was used to evaluate suture profile motion during the test. RESULTS: Significant differences (p < 0.05) were found between the two groups for the parameters investigated. The control group showed a higher maximal stress resistance and stiffness than the suture group, while elongation at rupture was increased in the sutured group. All the sutures broke in symmetric manner, as the mean of the side difference of the sutured specimens was 0.93 ± 0.80 mm at rupture. CONCLUSIONS: Biomechanical behaviour of native and sutured bronchi was evaluated, giving highly reproducible parameters regarding mechanical properties that may help clinicians and bioengineers to rationalize the choice for a particular suture material or suture technique, increasing surgical outcomes
Pneumoperitoneum as a valuable option in the treatment of post lower lobectomy bronchopleural fistula
No full textAlthough the incidence of post-lobectomy bronchopleural fistula has decreased over years, it remains a threatening complication in lung surgery. Once the fistula is diagnosed, treatment options are several. Conservative versus operative treatment is currently a matter of debate generally regarding timing, patient's condition and fistula's size. Although prompt resurgery is strongly suggested for early onset large fistulas, the clinical scenario may suggest a cautious conduct and conservative treatment could be advocated and repeated. Endoscopic management is now widely employed for limited, small bronchial dehiscence while pneumoperitoneum has surprisingly never been reported for this purpose, despite its potential. We report a case of a complete right lower lobe bronchial stump reopening, successfully treated by pneumoperitoneum
Diagnosis and endovascular treatment of an internal mammary artery injury
No full textInternal mammary artery (IMA) disruption after blunt chest trauma is rare. In some instances, it may occur after
mild chest trauma with minor external physical findings. However, prompt diagnosis and treatment are necessary,
as it can be associated with vascular and parenchymal injuries.
We report a case of blunt chest trauma resulting in a sternal fracture associated with an IMA injury, active
anterior mediastinal bleeding, bilateral lung contusions, and a left hemothorax. It was successfully treated by selective
embolization to the left IMA branch and chest tube placement
Thoracotomy versus VATS: short term outcomes from a large randomized controlled trial
No full textThoracotomy versus VATS: short term outcomes from a large randomized controlled tria
Multiple pleuropericardial implants of thymoma after videothoracoscopic resection
No full textThe case of a 49-year-old man with multiple pleuropericardial implants of B2 thymoma is reported. Two years earlier, the patient had undergone left videothoracoscopic (VATS) resection of a 6-cm thymoma in another hospital. The operative report describes a technically correct procedure with morcellation of the lesion within a retrieval thoracoscopic bag. Through a standard thoracotomy, 11 implants were resected with macroscopically complete tumor removal. The origin of cell spillage was ascribed to manipulation of the thymoma during VATS resectio
Totally Cervical Thymoma from the Orthotopic Thymus
No full textTotally cervical thymoma is extremely rare and usually arises from ectopic thymic tissue. We report a case of a B1 thymoma localized in the neck, misdiagnosed for a decade as a thyroid nodule. Fine needle aspiration biopsy led to a preoperative suspicion of the correct diagnosis. The tumor was resected intact through a cervical collar incision, along with the upper thymic horn from which it originated. A pathogenetic hypothesis was formulated
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