Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 58
Mais filtros

Filtros aplicados

Base de dados
Tipo de estudo
Intervalo de ano de publicação
Lik Sprava ; (1-2): 77-80, 2015.
Artigo em Ucraniano | MEDLINE | ID: mdl-26118032


The authors are analyzing the epidemic situation in Ukraine and the epidemiology of chronic tuberculous pleuritis (CTP). They are suggesting 206 pleurectomy results of operated patiens. Restrictive type of venting disorders before surgery occurred are in 26.4% cases, 36.2% and 100%, respectively at 1; 2 and 3 stages of CTP. Reducing the number of patients with this type of violations occurred if 6.9 times, 11.7 times and 3.3 times respectively to operated in case of 1, 2 and 3 stages of CTP. Improvements and other positive functional parameters are submitted. The authors conclusion: pleurectomy is the method of functional rehabilitation at CTP cases.

Pleura/cirurgia , Cavidade Pleural/cirurgia , Pneumonólise/métodos , Tuberculose Pleural/cirurgia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Cavidade Pleural/patologia , Recuperação de Função Fisiológica , Tuberculose Pleural/patologia , Tuberculose Pleural/reabilitação , Ucrânia
Klin Khir ; (8): 48-53, 2013 Aug.
Artigo em Ucraniano | MEDLINE | ID: mdl-24171290


During 2006-2012 years different types of parietal pleurectomy (PE) with lung decortication (LD) were performed for 135 patients. Among them: 42 (31.1%)--had standart PE with LD (with performing usual thoracotomy); 34 (25.2%)--had video-assisted thoracic surgery (VATS) PE with LD; 36 (26.7%)--videothoracoscopy (VTS) PE with LD; 23 (17.0%)--standart PE with LD combined with lung resection. Common effectiveness of surgical treatment was 96.3%, mortality level--1.5%, postoperative complication level--8.9%. On the early stage of pleural diseases VATS PE with LD and VTS PE with LD are more preferable. To unclear and difficult cases for performing standart PE with LD we consider that operation should begin by VTS pleural space investigation. In some cases minithoracotomy is possible with performing VATS PE with LD or standart PE with LD (performing usual thoracotomy).

Pulmão/cirurgia , Pleura/cirurgia , Pleurisia/cirurgia , Cirurgia Torácica Vídeoassistida , Tuberculose Pleural/cirurgia , Humanos , Pulmão/patologia , Pleura/patologia , Pleurisia/mortalidade , Pleurisia/patologia , Pneumonólise , Complicações Pós-Operatórias/prevenção & controle , Análise de Sobrevida , Toracotomia , Tuberculose Pleural/mortalidade , Tuberculose Pleural/patologia
Arch Bronconeumol ; 49(2): 63-9, 2013 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22749682


Unexpandable lung is a mechanical complication by which the lung does not expand to the chest wall, impeding a normal apposition between the two pleural layers. The main mechanism involved is the restriction of the visceral pleura due to the formation of a fibrous layer along this pleural membrane. This happens because of the presence of an active pleural disease (lung entrapment), which can be resolved if proper therapeutic measures are taken, or a remote disease (trapped lung), in which an irreversible fibrous pleural layer has been formed. The clinical suspicion arises with the presence of post-thoracocentesis hydropneumothorax or a pleural effusion that cannot be drained due to the appearance of thoracic pain. The diagnosis is based on the analysis of the pleural liquid, the determination of pleural pressures as we drain the effusion and on air-contrast chest CT. As both represent the continuity of one same process, the results will depend on the time at which these procedures are done. If, when given a lung that is becoming entrapped, the necessary therapeutic measures are not taken, the final result will be a trapped lung. In this instance, most patients are asymptomatic or have mild exertional dyspnea and therefore they do not require treatment. Nevertheless, in cases of incapacitating dyspnea, it may be necessary to use pleural decortication in order to resolve the symptoms.

Inalação/fisiologia , Pleura/patologia , Doenças Pleurais/diagnóstico , Mecânica Respiratória , Drenagem , Dispneia/etiologia , Exsudatos e Transudatos/química , Exsudatos e Transudatos/citologia , Fibrose , Humanos , Hidropneumotórax/etiologia , Capacidade Inspiratória/fisiologia , Complacência Pulmonar/fisiologia , Pneumopatias Obstrutivas/complicações , Manometria , Pleura/diagnóstico por imagem , Doenças Pleurais/patologia , Doenças Pleurais/cirurgia , Derrame Pleural/etiologia , Derrame Pleural/cirurgia , Pneumonólise , Atelectasia Pulmonar/complicações , Tomografia Computadorizada por Raios X
Wien Med Wochenschr ; 161(7-8): 217-21, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21533928


The endemic spread of tuberculosis after World War II and the deficiency of appropriate antituberculous drugs had led to a renaissance of the surgical tuberculosis therapy until the early 1950s. Late complications of plombage performed decades before are rare and are mainly related to infection and/or migration of the inserted foreign material and are scarcely recognized today. We report on a 73-year-old male patient, who was admitted to the emergency room of our hospital with acute massive haemoptysis for four days. On physical examination the patient presented with decreased breath sounds over the left lung and an old left-sided thoracotomy scar. Radiological findings and bronchoscopy revealed an empyema and a fistula as late complications 53 years after collapse therapy with insertion of a plombage for the treatment of pulmonary tuberculosis. The endobronchial nylon threads in the left bronchial tree and the fistula ending in the left lower bronchus confirmed our diagnosis. The patient was successfully treated by resection of the affected lower lobe. The present casuistic demonstrates a rare cause of spontaneous haemoptysis: late complications after extrapleural pneumolysis and plombage for cavitary tuberculosis over 50 years after the initial operation.

Hemoptise/etiologia , Pneumonólise/efeitos adversos , Complicações Pós-Operatórias/etiologia , Tuberculose Pulmonar/cirurgia , Idoso , Broncopatias/diagnóstico , Broncopatias/etiologia , Broncopatias/cirurgia , Broncoscopia , Colapsoterapia , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Empiema Tuberculoso/diagnóstico , Empiema Tuberculoso/etiologia , Empiema Tuberculoso/cirurgia , Fístula/diagnóstico , Fístula/etiologia , Fístula/cirurgia , Humanos , Masculino , Doenças Pleurais/diagnóstico , Doenças Pleurais/etiologia , Doenças Pleurais/cirurgia , Pneumonectomia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Reoperação , Toracotomia , Tomografia Computadorizada por Raios X
Chirurg ; 68(9): 921-7; discussion 928, 1997 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-9410683


The epidemic spread of tuberculosis after World War II and the deficiency of appropriate antituberculotic drugs led to a renaissance of surgical procedure such as plombage thoracoplasty, initiated in 1891 by Tuffier. Especially in Germany the insertion of paraffin and polyethylene was used in order to achieve an extrapleural pneumothorax in order to collapse the tuberculous cavities in the upper lobes. Due to a high rate of early complications and the assumed cancerogenicity, in a considerable number of cases the material was removed soon after its deployment. In some cases with the filling remaining in place, 30-40 years later infections and/or neoplasms occurred. From 1985 to 1996 in two centers of thoracic surgery 13 patients underwent procedures for removal of filling material. The patients suffered from infections (n = 11), malignant lymphoma associated with infection of the plombage (n = 1) and bronchial carcinoma (n = 1). Technically, we performed the thoracoplasty described by Schede (n = 9). Schede's thoracoplasty in combination with a muscle flap repair (n = 1) or partial resection of the thoracic wall (n = 1), an empyemectomy (n = 1), and an en-bloc pleuropneumonectomy (n = 1). All patients suffered from multiple underlying diseases (COPD, coronary heart disease, diabetes mellitus). However, apart from beside two procedure related deaths (pulmonary embolism n = 1, pneumonia complicated by multi-organ failure n = 1) no other major complications were observed. The plombage material in the case of malignant lymphoma is probably carcinogenic in relation to the time of exposure and should be removed in all cases.

Pneumonólise/efeitos adversos , Pneumotórax Artificial/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Tuberculose Pulmonar/cirurgia , Adulto , Idoso , Carcinoma Broncogênico/mortalidade , Carcinoma Broncogênico/cirurgia , Causas de Morte , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Linfoma/mortalidade , Linfoma/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/mortalidade , Reoperação , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/mortalidade , Infecção da Ferida Cirúrgica/cirurgia , Toracoplastia , Tuberculose Pulmonar/mortalidade
Ann Thorac Surg ; 64(1): 220-4; discussion 224-5, 1997 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9236365


BACKGROUND: As soon as complications due to migration of extraperiosteal plombage material had been documented, early removal became the rule. Some patients who have escaped this rule may still present with long-term complications. METHODS: Since 1980, 14 patients aged 54 +/- 10 years were admitted 28 +/- 11 years after collapse therapy. Eight presented with signs of infection, 4 with hemoptysis, and 2 with periscapular pain. Vascular erosion, suspected in 3 patients, was demonstrated with angiograms in 1. RESULTS: Ablation of the material was combined with excision of the devitalized ribs in 13 patients. Femorofemoral bypass was used in 2 patients for repair of an aortic erosion. Single ablation of subcutaneously migrated material was performed in a poor-risk patient. Operative bleeding was moderate except in 2 patients; 1 of them died intraoperatively during repair of an aortic erosion. A second patient died postoperatively with a massive pulmonary embolus on day 11. Infection was diagnosed in 8 patients (Mycobacterium tuberculosis, 4; and pyogens, 4). Operative outcome was satisfactory in all 12 operative survivors. A single patient presented with an infected apical space at 1 year and underwent complementary resection of the first rib. CONCLUSIONS: We recommend routine ablation of any residual plombage material whenever operative risk is acceptable because of the high incidence of spontaneous complications.

Migração de Corpo Estranho/etiologia , Metilmetacrilatos , Pneumonólise/efeitos adversos , Próteses e Implantes/efeitos adversos , Adulto , Idoso , Feminino , Migração de Corpo Estranho/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
Chest ; 108(4): 1163-4, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7555133


An infected axillary sinus tract discharged balls made of an acrylic resin consisting essentially of polymerized methyl methacrylate (Lucite) 45 years following performance of an extraperiosteal pneumonolysis and Lucite ball plombage for collapse therapy of right upper lobe cavitary tuberculosis. Surgical extraction of the balls was performed, followed by a partial decortication of the lung and intrathoracic transposition of a pectoralis major muscle flap to fill the residual pleural space. Primary healing was attained, and the patient is well 1 1/2 years after surgery.

Fístula Cutânea/cirurgia , Doenças Pleurais/cirurgia , Pneumonólise/efeitos adversos , Tuberculose Pulmonar/complicações , Axila , Doença Crônica , Terapia Combinada , Fístula Cutânea/etiologia , Feminino , Humanos , Linfoma Folicular/patologia , Linfoma Folicular/terapia , Metilmetacrilato , Metilmetacrilatos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Músculos Peitorais/transplante , Doenças Pleurais/etiologia , Pneumonólise/métodos , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/cirurgia , Fatores de Tempo , Tuberculose Pulmonar/cirurgia
Ann Chir ; 46(6): 530-4, 1992.
Artigo em Francês | MEDLINE | ID: mdl-1444155


Two cases of catamenial pneumothorax are reported, a rare condition characterized by its sudden occurrence in a female patient between the ages of 30 and 40 years, always at the onset of the menstrual cycle. Its exact origin is unknown, but the frequent co-existence of endometriosis and a defect in the diaphragm suggests that endometriosis may be important in the etiology both of the pneumothorax and the diaphragmatic lesion. Pelvic endometriosis was present in both our patients, one of whom also had diaphragmatic endometriosis. The treatment of the pneumothorax in both our cases consisted of pleural decortication with excellent results so far.

Coristoma/diagnóstico , Endometriose/complicações , Hérnia Diafragmática/complicações , Ciclo Menstrual , Pneumotórax/etiologia , Adulto , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Pneumonólise , Pneumotórax/diagnóstico por imagem , Pneumotórax/terapia , Radiografia
Ann Fr Anesth Reanim ; 11(4): 464-6, 1992.
Artigo em Francês | MEDLINE | ID: mdl-1416282


A case of re-expansion pulmonary oedema is reported. A 7-year-old girl, after having been operated on for a lung tumour, had a postoperative haemothorax combined with atelectasis of the left upper lobe. After she had recovered from the first dose of chemotherapy, the thoracotomy wound was reopened to remove the partially organised and lysed haemothorax, as well as the very thickened pleura. The patient developed clinical signs of pulmonary oedema very shortly after the end of the anaesthetic (tachypnoea, cyanosis, a decrease in oxygen saturation when FIO2 < 1, pink frothy secretions in the endotracheal tube). End-inspiratory crepitations became audible in the left lung field only. The chest film showed left-sided diffuse nodular alveolar opacities. The girl was again ventilated, with + 5 cmH2O positive end-expiratory pressure. She was extubated 36 h later, and discharged a few days later without any sequela. This case was the first to be described in a child after pleural surgery. The death rate, estimated from a literature survey, is about 20%.

Pneumonólise/efeitos adversos , Complicações Pós-Operatórias/etiologia , Edema Pulmonar/etiologia , Criança , Feminino , Hemotórax/complicações , Humanos , Neoplasias Pulmonares/cirurgia , Respiração com Pressão Positiva , Edema Pulmonar/terapia