ABSTRACT
INTRODUCTION: Penetrating cardiac injuries is still a diagnostic problem at this time. Their management requires immediate surgical intervention and excellent surgical critical care postoperatively. PRESENTATION OF CASES: A 15-year old male patient was stabbed with a knife to the right chest. The chest radiograph showed an haemothorax and the angiography showed an intercostals artery and a right auricle injury. After an emergency operation the patient was released home in good condition after the toracotomy had healed. A 19-year old male patient was stabbed with a knife to the chest more than once. By a left toracotomy we sutured the lesion of the left ventricle with multiple single stitch in non-absorbable suture, we covered the suture with a sealant. The patient released home in 24 days. DISCUSSION: Penetrating cardiac injuries is one of the leading cause of death from urban violence. To evaluate a thoracic trauma with cardiac injury it's clear the use of thorax X-ray and multislice angio-Tc scan. Echocardiography has clearly emerged for the diagnosis in patients haemodynamically stable. When the patient is haemodynamically unstable the emergency thoracotomy is mandatory. CONCLUSION: Despite the high mortality of penetrating cardiac injuries new surgical and radiological tecniques may help surgeon to save this patients.
Subject(s)
Heart Injuries/surgery , Wounds, Penetrating/surgery , Adolescent , Humans , Male , Young AdultABSTRACT
BACKGROUND: The aim of this study was to define any benefits in terms of early outcome for laparoscopic colectomy in patients over 75 years old (OP) compared with the outcomes of a younger populations (YP). METHODS: Forty elderly patients undergoing laparoscopic colectomy for colorectal cancer between 2007-2011 were studied, the patients are divided for gender, age, year of surgery, site of cancer, and comorbidity on admission and compared with 40 younger patients. RESULTS AND DISCUSSION: Mean (standard deviation) age was 81.3 in OP and 68.3 YP Conversion rate was the same between the two groups. There was no difference in operative mean time . The overall mortality rate was 0% percent. The surgical morbidity rate was the same but there was an increased in cardiologic e bronchopneumonia complications in older population. Patients treated with laparoscopic approach had a faster recovery of bowel function and a significant reduction of the mean length of hospital stay not age related. Laparoscopy allowed a better preservation of postoperative independence status. CONCLUSIONS: Laparoscopic colectomy for cancer in elderly patients is safe and beneficial including preservation of postoperative independence and a reduction of length of hospital stay.