Prediction of cardiopulmonary morbidity after resection for lung cancer: stair climbing test complications after lung cancer surgery.

BACKGROUND: The objective of this study was to assess the role of a modified stair climbing test in predicting postoperative cardiopulmonary complications. METHODS: A consecutive series of 150 patients who had undergone pulmonary resection for lung carcinoma formed the prospective database of this study. All patients performed a preoperative modified stair climbing test. Univariate and multivariate analyses were performed to identify predictors of postoperative cardiopulmonary complications. RESULTS: With univariate analysis, the patients with complications had a lower pre-exercise and postexercise percentage of oxygen saturation. PaO (2) levels were found to be lower and a greater change in oxygen desaturation during exercise was noted. Logistic regression analysis showed that the percent of oxygen saturation pre-exercise and the change in percent of oxygen desaturation during exercise were independent and reliable predictors of cardiopulmonary morbidity. CONCLUSIONS: A modified stair climbing test is a safe, economical and simple test capable of predicting cardiopulmonary complications.

Treatment of a benign tracheoesophageal fistula in a ventilator dependent quadriplegic patient.

Management of an acquired benign tracheoesophageal fistula in a patient who is dependent on mechanical ventilation is controversial, since the usual procedure is weaning before repair. Here, we describe surgical treatment of a tracheoesophageal fistula in a quadriplegic patient with 28 months of follow-up, who has to remain permanently on mechanical ventilation with a tracheostomy cannula.

Resection of the tracheal carina in an eight-year-old child: a case report.

An 8-year-old girl, who had been mechanically ventilated for 2 days, was referred to our clinic with total atelectasis of the right lung. Bronchoscopic examination showed an endobronchial mass lesion which was located on the right side of the carina. Carinal resection was performed and the patient was discharged on postoperative day 7. We presented this case report because of the rarity of tracheal tumors in childhood and to discuss the recommended surgical technique for pediatric carinal resection.

How can we approach a left-sided stab wound in the neck, with isolated tracheal laceration?

Any penetrating trauma to the mediastinum may cause great vessel damage resulting in massive bleeding or even shock. Associated tracheal injury increases morbidity and mortality. We report a case of a penetrating mediastinal injury with isolated tracheal laceration. The stab entered in the left supraclavicular fossa. The patient presented with right-sided pneumothorax, pneumomediastinum and respiratory collapse. Bronchoscopy revealed two injuries in the trachea that were repaired by right thoracotomy and left cervicotomy. The patient was discharged on postoperative day 6. Isolated thoracic tracheal injury is very rare in mediastinal stab wounds and operative strategy may change according to bronchoscopic findings.