1,721,028 research outputs found
Self-expanding stents in the treatment of tracheobronchial obstruction
No full textThe self-expandable stainless steel stents (Gianturco, William Cook, Bjaeverskov, Denmark) used extensively in biliary ducts and the vascular system have recently been modified for use in the tracheobronchial tree. Between March 1991 and September 1992, six patients with unresectable tracheobronchial and mediastinal diseases were treated with the placement of one or more self-expanding stents under direct vision with a fiberoptic bronchoscope. All patients had been intubated for severe respiratory insufficiency. In all cases, immediate relief of respiratory symptoms was achieved and all patients were extubated 1 or 2 days after stent placement. Tolerance of the stents was excellent. No patient complained of pain, discomfort, or foreign body sensation. No infection or obstruction of the stents was observed. The chest roentgenogram and the bronchoscopies performed during follow-up have shown no change in the position of the stents. Our results seem promising since these devices provide effective palliation of airway obstructions and are well tolerated
Lower esophageal sphincter hypersensitivity to opioid receptor stimulation in patients with idiopathic acalasia
No full text
Thoracic Endometriosis Syndrome: Association With Pelvic Endometriosis and Fertility Status
No full textStudy Objective To evaluate associations among catamenial pneumothorax, pelvic endometriosis, and fertility status. Design Retrospective study (Canadian Task Force classification II-2). Setting Departments of Thoracic Surgery and Obstetrics and Gynecology, San Raffaele Hospital, Milan, Italy. Patients Sixteen females referred to the Department of Thoracic Surgery for treatment of spontaneous pneumothorax between January 2001 and January 2014 and referred to the outpatient clinic for gynecologic follow-up. Interventions Thoracoscopy for catamenial pneumothorax and laparoscopy for pelvic endometriosis. Measurements and Main Results Characteristics of the patients, the presence of endometriosis, and their fertility status were statistically analyzed. Pelvic endometriosis was diagnosed in 9 patients (56.3%), but 6 patients did not undergo a laparoscopic procedure to confirm or exclude the disease. Seven of the affected patients (77.8%) had stage III-IV endometriosis. Two-thirds of the patients with pelvic endometriosis who attempted conception conceived spontaneously, as did all of the patients without histopathological confirmation of endometriosis. Conclusion Thoracic endometriosis syndrome, characterized mainly by catamenial pneumothorax, is a relevant condition in patients affected by endometriosis. However, few previous studies have analyzed this condition from a gynecologic standpoint, in terms of characteristics of endometriosis and fertility status of affected women. Our findings support the presence of a strong association between catamenial pneumothorax and pelvic endometriosis, as well as a minimal effect of catamenial pneumothorax on fertility status, even in the presence of pelvic endometriosis
Results of surgical treatment after neoadjuvant chemotherapy for stage III non-small cell lung cancer
No full textThe potential benefits of an approach combining neoadjuvant chemotherapy and surgery in stage IIIA and IIIB NSCLC have to be weighed against a potential increase in postoperative complications. We evaluated the results in terms of postoperative complications and survival in patients with stage III NSCLC who underwent complete surgical treatment after neoadjuvant chemotherapy with two regimens: mitomycin, vinblastine, and cisplatin (MPV) versus gemcitabine and cisplatin (GC). From March 1991 to September 2005, 110 patients with stage III NSCLC (86 stage IIIA and 24 stage IIIB) underwent complete surgical treatment after neoadjuvant chemotherapy. Ninety-two patients were men and 18 were women, with a mean age of 59 (range, 39-80) years. The neoadjuvant chemotherapy regimen was MPV in 72 patients and GC in 38. The overall response (> 50%) to chemotherapy was 84%. Postoperative mortality and morbidity were 1.8% and 20%, respectively. Overall 5-year survival was 46%. Minor response to neoadjuvant chemotherapy (< 50%) and residual nodal N2 involvement in stage IIIA had an adverse impact on survival (p < 0.05). Favorable long-term survival was observed after neoadjuvant chemotherapy with MPV and GC regimens in stage IIIA and IIIB NSCLC, with relatively low postoperative mortality and morbidity. Caution should be taken when offering surgical treatment to patients with minor response to induction chemotherapy and residual N2 disease in view of the significantly reduced survival. RI ciriaco, paola/H-5716-2012Background The potential benefits of an approach combiningneoadjuvant chemotherapy and surgery in stage IIIAand IIIB NSCLC have to be weighed against a potentialincrease in postoperative complications. We evaluated theresults in terms of postoperative complications and survivalin patients with stage III NSCLC who underwent completesurgical treatment after neoadjuvant chemotherapy withtwo regimens: mitomycin, vinblastine, and cisplatin (MPV)versus gemcitabine and cisplatin (GC).Methods From March 1991 to September 2005, 110patients with stage III NSCLC (86 stage IIIA and 24 stageIIIB) underwent complete surgical treatment after neoadjuvantchemotherapy. Ninety-two patients were men and18 were women, with a mean age of 59 (range, 39–80)years. The neoadjuvant chemotherapy regimen was MPVin 72 patients and GC in 38.Results The overall response ([50%) to chemotherapywas 84%. Postoperative mortality and morbidity were 1.8%and 20%, respectively. Overall 5-year survival was 46%.Minor response to neoadjuvant chemotherapy (\50%) andresidual nodal N2 involvement in stage IIIA had an adverseimpact on survival (p\0.05).Conclusions Favorable long-term survival was observedafter neoadjuvant chemotherapy with MPV and GCregimens in stage IIIA and IIIB NSCLC, with relativelylow postoperative mortality and morbidity. Caution shouldbe taken when offering surgical treatment to patients withminor response to induction chemotherapy and residual N2disease in view of the significantly reduced survival
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