[Value of hemodynamics in the surgical indications of emphysema]. / Intérêt de l'exploration hémodynamique dans les indications chirurgicales des emphysèmes.

The authors present the results of a preliminary study designed to define the surgical indications in diffuse pulmonary emphysema based on the data of haemodynamic investigations. This series consists of 10 patients identified for disabling dyspnoea, diffuse emphysema and dynamic expiratory compression documented by the data of right micro-catheterisation by a DEP/DIP ratio greater than 2. The surgical operation consisted of reduction in the lung volume, the results of which were defined by pre- and postoperative examinations. In this way, it is possible to distinguish 3 groups of patients: one group was markedly improved, another was moderately improved and the third group continued to deteriorate analysis of the results suggests the determinant role of dynamic factors, in particular haemodynamic factors. The role of the diaphragm is demonstrated by modifications in its radius or curvature.

[Long-term survival of surgically treated lympho-epithelial thymomas]. / Survie éloignée des thymomes lympho-épithéliaux opérés.

The authors report the results of a multi-centre trial on 500 cases of lymph-epithelial thymoma (TLE) treated by 14 surgical teams. Most typically a tumour of the adult in the fifth decade, occurring most commonly in women (60%), one in every two cases of TLE occurs in auto-immune disease: usually myasthenia. Most often (3 times out of 4) the disease is latent and occupies the middle (40%) or superior mediastinum (30%). In 15% of cases the pulmonary radiograph is normal. Radical surgery is possible in 75% of cases, otherwise it is incomplete or even reduced to a simple biopsy. The 15 year prognosis obtained using actuarial survival curves is based on the surgical-anatomical classification of the study group of thymic tumours (GETT) giving: for stage I: a survival of 80% for stage II to IVA of 40% and for stages III to IVB of around 10%. Finally it should be noted that existence of a recurrence after a complete surgical excision (stage I) poses the problem of post-operative radiotherapy and the associated total thymectomy. Also, the identical prognosis after biopsy or incomplete surgery (IIIA and IIIB) with an increased morbidity for incomplete surgery. Finally the confirmation that pleural involvement (IVA) is not as adverse a factor as one would have supposed.

[Tracheal resection for tracheal tumors (excluding cancer)]. / Les résections trachéales pour tumeurs de la trachée (en dehors des cancers).

Tracheal resection was performed in 10 patients with non-malignant tracheal tumors. Clinical, histological, and technical features are discussed, particular emphasis being given to long-term results. These tumors, mostly cylindromas (7 out of 10 cases in this series) are amenable to very wide surgical resection of the resection-anastomosis type. Suggested treatment for cylindromas should include systematic postoperative irradiation, as this considerably improves long-term (10 and 15 years) results.