RESUMEN
This case report is a chronic calcified pleural empyema in a patient who suffered a closed chest trauma 30 years ago. The first goal is to demonstrate how the closed chest trauma caused a bronchopleural fistula of the calcified pleural empyema, since the patient began to report continued purulent sputum after his trauma with weight loss and the appearance of an air-fluid level in the chest CT scan (no pleurocutaneous fistula in the clinical examination). The second goal is to reveal the rule and the interest of an open window thoracostomy in the management of chronic calcified pleural empyema, since a decortication remains difficult to perform in cases like this one.
RESUMEN
INTRODUCTION: Our purpose is to evaluate our results of surgery for tracheobronchial carcinoid tumour as well as the long-term survival. METHODS: This is a retrospective and descriptive study performed in the department of thoracic surgery of CHU Hassan II (Marocco) over a period of 9 years. It concerns all patients with a tracheal or bronchial carcinoid tumour who underwent surgery. RESULTS: Twenty-three patients with a mean age of 39 years were operated on for 24 carcinoid tumours. The sex ratio was 0.29. The diagnostic delay ranged from 3 months to 8 years and the main symptom was haemoptysis in 74% of cases (n=17). The tumour was localized in the right bronchial tree in 70% of cases (n=16). The procedures performed were tracheal resection and end-to-end anastomosis in 1 case, lobectomy in 12 cases including 3 sleeve lobectomies, bilobectomy of middle and lower lobes in 7 cases and pneumonectomy in 4 cases. The prognosis was favourable in 91% after an average follow-up of 29 months. CONCLUSIONS: Surgery remains the only curative therapeutic option for tracheobronchial carcinoid tumours with acceptable morbidity and mortality.
Asunto(s)
Neoplasias de los Bronquios/cirugía , Tumor Carcinoide/cirugía , Neumonectomía , Neoplasias de la Tráquea/cirugía , Adolescente , Adulto , Neoplasias de los Bronquios/diagnóstico , Neoplasias de los Bronquios/epidemiología , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/epidemiología , Diagnóstico Tardío , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Neumonectomía/efectos adversos , Neumonectomía/métodos , Neumonectomía/estadística & datos numéricos , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Procedimientos Quirúrgicos Torácicos/efectos adversos , Procedimientos Quirúrgicos Torácicos/métodos , Procedimientos Quirúrgicos Torácicos/estadística & datos numéricos , Neoplasias de la Tráquea/diagnóstico , Neoplasias de la Tráquea/epidemiología , Resultado del Tratamiento , Adulto JovenRESUMEN
Posttraumatic diaphragmatic hernias have long been known, but the variety of their clinical expression can lead to diagnostic delay and difficulties in treatment. An intrathoracic hernia of hollow abdominal viscera with subsequent necrosis and perforation is an uncommon late complication with poor prognosis. Surgical treatment is mandatory. Laparotomy is an excellent approach, making it possible to achieve therapeutic objectives for the abdomen and thorax with a short operative time and minimal complications in these patients whose hemodynamic status is often precarious. We report 2 cases of posttraumatic left diaphragmatic hernias with intrathoracic necrosis of the digestive tract, treated by laparotomy.
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Colon/cirugía , Hernia Diafragmática Traumática/cirugía , Laparotomía , Necrosis/cirugía , Adulto , Colon/patología , Colostomía , Hernia Diafragmática Traumática/complicaciones , Humanos , Masculino , Necrosis/etiologíaRESUMEN
Cervicothoracic cellulitis is a very serious, potentially life-threatening infection of the cervical and thoracic soft tissue. It is a genuine medical and surgical emergency with substantial mortality, and its surgical therapy has not yet been standardized. It spreads through the layers of the cervical fascia and can then disseminate to the mediastinum and the pleural cavities, requiring specific management that includes the thoracic surgeon. We present reports of 3 patients with cervicothoracic cellulitis, all complicated by mediastinitis, with pericardial effusion in 1 case and unilateral or bilateral pyothorax in 2 cases. Combining these cases with a review of the literature enables us to describe the management of these complicated cases as seen by a thoracic surgeon.
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Celulitis (Flemón)/terapia , Drenaje , Empiema Pleural/terapia , Mediastinitis/terapia , Derrame Pleural/terapia , Toracotomía , Celulitis (Flemón)/diagnóstico por imagen , Empiema Pleural/diagnóstico por imagen , Humanos , Masculino , Mediastinitis/diagnóstico por imagen , Derrame Pleural/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
INTRODUCTION: Primary tumours of the trachea are very rare and may develop from the tracheal salivary glands. CASE REPORTS: We describe four patients operated on in our service between 2010 and 2017 of whom two had an adenocystic carcinoma, one a mucoepidermoid carcinoma and one a pleomorphic adenoma of the trachea. All were treated by resection and tracheal anastomosis with clear margins in three cases. The malignant cases received adjuvant treatment consisting of radiotherapy in one case and radiochemotherapy in the second. Immediate postoperative recovery was uncomplicated in all patients. One death followed the developement of post irradiation tracheal stenosis two years after surgery in a patient with an adenocystic carcinoma where the resection margins were invaded by tumour. CONCLUSIONS: Resection and anastomosis of the trachea remains the best therapeutic option with a better prognosis when the resection is complete.
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Adenoma Pleomórfico/cirugía , Carcinoma Adenoide Quístico/cirugía , Carcinoma Mucoepidermoide/cirugía , Neoplasias de las Glándulas Salivales/cirugía , Neoplasias de la Tráquea/cirugía , Adenoma Pleomórfico/patología , Adulto , Carcinoma Adenoide Quístico/patología , Carcinoma Mucoepidermoide/patología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales/patología , Glándulas Salivales/cirugía , Tráquea/patología , Tráquea/cirugía , Neoplasias de la Tráquea/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
Sporadic lymphangioleiomyomatosis is an orphan disease of the young woman. Its clinical manifestations are mainly respiratory, including spontaneous pneumothorax. The management is multidisciplinary. We report the case of a young patient with bilateral spontaneous pneumothorax revealing sporadic lymphangioleiomyomatosis.
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Neoplasias Pulmonares/complicaciones , Linfangioleiomiomatosis/complicaciones , Neumotórax/etiología , Adulto , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirugía , Linfangioleiomiomatosis/diagnóstico , Linfangioleiomiomatosis/cirugía , Neumotórax/diagnóstico , Neumotórax/cirugía , Radiografía Torácica , Cirugía Torácica Asistida por VideoRESUMEN
INTRODUCTION: Our purpose is to report our experience in the management of pulmonary hydatid cysts ruptured in the pleura. Materiel and methods: We collected all records of patients with a ruptured hydatid cyst of the lung in the pleura who underwent surgery for this in the department of thoracic surgery of the CHU Hassan II of Fes during the 6-year period that started in 2010. RESULTS: The study included 20 men and 14 women with an average age of 30.44 ± 18.4 years. Radiological findings showed a hydropneumothorax in 21 cases, hydrothorax in 10, pachypleuritis in 29, and a floating membrane in 13 cases. In all cases, pleuropulmonary decortication was associated with pericystectomy in 20 cases and parenchymal resection in 3 cases. A hydatid membrane bathing in the pleural cavity was found in 32 cases. The postoperative course was uneventful in 28 cases. CONCLUSION: Long-term follow-up should be established to detect possible recurrences or pleural dissemination, which appear to be prevented by long-term use of anthelmintic agents.
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Equinococosis Pulmonar , Cavidad Pleural , Adulto , Equinococosis Pulmonar/diagnóstico por imagen , Equinococosis Pulmonar/cirugía , Femenino , Humanos , Masculino , Cavidad Pleural/parasitología , Estudios Retrospectivos , Rotura EspontáneaRESUMEN
INTRODUCTION: The biliobronchial fistula of hydatic origin is a rare complication and the left localization is exceptional. OBSERVATION: We report the case of a 26-year-old patient from the rural area who was referred to us for treatment of biliptysis. The thoracic and abdominal computed tomography diagnosed a left biliobronchial fistula was. Management consisted of primary endoscopic sphincterotomy, followed by left exclusive thoracotomy surgery to treat pulmonary, hepatic and diaphragmatic repair. The evolution was favorable with disappearance of the biliptysie. CONCLUSION: The diagnosis of left biliobronchial fistula requires a precise assessment not only by the imagery but also the bronchial fibroscopy allowing the acurate localisation of the lesion before any surgical enterprise.
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Fístula Biliar/etiología , Fístula Bronquial/etiología , Equinococosis Hepática/complicaciones , Adulto , Fístula Biliar/diagnóstico , Fístula Bronquial/diagnóstico , Equinococosis Hepática/diagnóstico , Humanos , Masculino , Radiografía TorácicaRESUMEN
Aspergillus is a mycelial fungus formed of filaments that penetrate the airways when its spores are inhaled. It is rarely located in the pleura. We report two cases of patients, one aged 67 years and the other 37 years, with pleural aspergillosis. The first underwent a thoracostomy, followed later by a myoplasty for closure. Pleuropulmonary decortication was performed in the second patient. The pathology examination confirmed an intrapleural aspergilloma in both patients. Antifungal treatment was not performed. The postoperative course was simple and no recurrence was noted. Based on these two cases over a 7-year period and a review of the literature, we detail the issues in this management and emphasize the interest of surgery.
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Empiema Pleural/cirugía , Aspergilosis Pulmonar/cirugía , Adulto , Anciano , Empiema Pleural/microbiología , Humanos , Masculino , Aspergilosis Pulmonar/complicacionesRESUMEN
INTRODUCTION: The aim of our study was to assess the interest of cervical mediastinoscopy in the management of benign mediastinal lymphadenopathy. METHOD: We performed a single-center retrospective descriptive study over a period of 5 years (2013-2017) in the department of thoracic surgery of university hospital Hassan II of Fez. RESULTS: During this period, a total of 137 cervical mediastinoscopies were performed among which 68 for a benign disease. This represents a frequency of 49.63 %. There were 22 men and 46 women with a mean age of 43.76 years±17.08. Chest CT showed isolated mediastinal lymphadenopathy in 52 %, associated with pulmonary images in 35 %. Cervical mediastinoscopy led to pathological diagnosis in 94 %. The pathological results showed a sarcoidosis in 51.5 %, tuberculosis in 41.2 % and a lymph node echinococcosis in 1 case. CONCLUSION: Cervical mediastinoscopy remains a low risk modality in expert hands, which allows pathological diagnosis with excellent sensitivity, acceptable morbidity and no mortality in our experience.
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Enfermedades del Mediastino/diagnóstico , Enfermedades del Mediastino/cirugía , Mediastinoscopía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Ganglios Linfáticos/patología , Masculino , Enfermedades del Mediastino/epidemiología , Enfermedades del Mediastino/patología , Mediastinoscopía/métodos , Persona de Mediana Edad , Estudios Retrospectivos , Sarcoidosis/diagnóstico , Sarcoidosis/epidemiología , Sarcoidosis/patología , Sarcoidosis/cirugía , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Tuberculosis/patología , Tuberculosis/cirugía , Adulto JovenRESUMEN
INTRODUCTION: Tuberculous pyothorax or empyema is one of the serious forms of tuberculosis and still poses public health problems. Through a series of patients who undergone pleuropulmonary decortication, we propose our model of management and determine the main factors prognostic. METHOD: We retrospectively retrieved for 8 years 93 cases of patients with pleuropulmonary decortication for tuberculous pyothorax confirmed by histological examination pre- or postoperatively. RESULTS: There were 33 women and 60 men with an average age of 28.4 years±10.35. In all cases, the radiological findings showed a pachypleuritis associated with an enclosed pyothorax in 79.6% of cases (n=74), a free cavity pyothorax in 8.6% of cases (n=8) and a passive atelectasis in all these cases. Chest tube was performed before surgery in 91.4% of cases (n=85) until the effusion was completely drained. The univariate analysis of the results of the surgery allowed to determine 4 factors of good prognosis: preoperative preparation (including chest tube with total drying of the empyema, respiratory physiotherapy and weight gain) P=0.04, complete peroperative pulmonary re-expansion P=0.03, the lowest stay in intensive care unit P=0.02 and the follow-up P=0.01. CONCLUSION: Pleuropulmonary decortication is a safe therapeutic alternative in the late stages of tuberculous empyema with acceptable morbimortality.
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Drenaje/métodos , Empiema Tuberculoso/cirugía , Pleura/cirugía , Toracotomía/métodos , Adolescente , Adulto , Antituberculosos/uso terapéutico , Tubos Torácicos/efectos adversos , Niño , Femenino , Humanos , Pulmón/patología , Pulmón/cirugía , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Pleura/patología , Pronóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
Carcinoid tumors are well differentiated neuroendocrine tumors of low grade malignancy or attenuated malignancy. Atypical bilateral bronchial forms are rarely reported. They pose a real problem of therapeutic strategy. We report a case of a 36-year-old woman with two large bilateral atypical carcinoid tumors. She received delayed bilateral parenchymal resection with postoperative uneventful course. Through a review of the literature, we discuss the therapeutic strategy. This observation remains special for several reasons. Not only by the rarity of the bilateral and atypical forms but also for the bilateral tumor sizes which led to a difficult intraoperative anesthetic management.
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Neoplasias de los Bronquios/patología , Tumor Carcinoide/patología , Adulto , Neoplasias de los Bronquios/cirugía , Tumor Carcinoide/cirugía , Femenino , Humanos , Pulmón/patología , Pulmón/cirugía , Neumonectomía/métodos , Toracotomía/métodos , Tomografía Computarizada por Rayos XRESUMEN
INTRODUCTION: The bronchial biliary fistula surgery is a major one, always going with a higher rate of complication especially in case of bile duct obstruction. The aim of this study is to find out the contribution of endoscopic sphincterotomy while reporting the results of surgical treatment of bronchial biliary fistulae by exclusive thoracotomy. METHODS: This was a retrospective study, which took place in the Department of Thoracic Surgery, University Hospital Hassan II, from January 2009 to March 2016. The parameters studied in connection with the bronchial biliary fistula of hydatid origin were: age, sex, origin, history of surgery especially for hepatic hydatid cyst, term of bilyptysie, imaging results, preoperative cholangiography indications, surgical treatment modalities and patients trends. RESULTS: A sample of 12 patients was included (6 men and 6 women) with an average age of 44 years old, with a gap spanning between 17 and 81 years. Seven patients had at least a history of hepatic hydatid surgery. The biliptysie was the main symptom in 8 patients. A biological cholestasis syndrome was found in 6 patients. The thoracoabdominal CT scan performed on all patients comes out with results in 100% of cases. Four patients received endoscopic retrograde cholangiography that allowed them to release the bile duct completely by sphincterotomy with extraction of hydatid membrane in one patient and with development of a biliary stent in another patient. The incision was a low posterolateral thoracotomy in 10 patients that went under surgery. It has allowed to deal in one-time liver and lung injuries combined with diaphragmatic breach repair. Inside the group of patients that went under surgery, the postoperative results were simple in 8 cases. We have noted an overall mortality rate of 18.2%. CONCLUSION: Bronchial biliary fistula surgery complications remains considerable despite the progress of diagnostic imaging. Preoperative endoscopic sphincterotomy is a milestone in the handling of this surgery. It may even be suggested as exclusive therapy in inoperable patients with significant biliptisy.
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Fístula Biliar/cirugía , Fístula Bronquial/cirugía , Equinococosis/complicaciones , Esfinterotomía Endoscópica/métodos , Toracotomía/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Fístula Biliar/complicaciones , Fístula Bronquial/complicaciones , Colangiografía/métodos , Equinococosis/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Desatendidas , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Esfinterotomía Endoscópica/efectos adversos , Cirujanos , Tasa de Supervivencia , Cirugía Torácica , Toracotomía/efectos adversos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: The rib fractures and instability of the chest wall are the main lesions of closed chest trauma. These lesions can be a source of chronic, often disabling with daily discomfort resulting limitation of some activities. The objective of this study was to assess the prevalence of this phenomenon in order to improve the quality of early care. METHODOLOGY: Through an observational retrospective cohort study on a number of 41 patients supported and monitored for traumatic rib fractures at the Military Hospital of Meknes during the period from October 2010 to March 2016. RESULTS: The circumstances of the accident were dominated by accidents of public roads (86%) and concerned the young adult male. Radiographs have enumerated 165 fracture lines with an average of 4 rib fractures per patient. These were unilateral fractures in 88% of cases, and concerned the means arc in 46% of cases. The rib fracture was undisplaced fracture in 39% of patients, whereas in 2 patients, a flail chest was present. Post-traumatic hemothorax (63% of cases) were the thoracic lesions most commonly associated with rib fractures. The initial management consisted in the use of analgesics systemically in all patients. The retrospective evaluation of pain by the verbal scale was possible in 30 patients. The persistent pain was noted in 60% of cases. This pain was triggered by a simple effort to moderate in 55% of cases, and hard effort in 28% of cases. In 17% of patients, even at rest, the pain occurred intermittently. The impact in terms of disability was mild to moderate in 28% of cases and important in 17%. The neuropathic pain was found in 3 patients. Therapeutically, the first and second levels of analgesics were sufficient to relieve pain. The neuroleptics were required for 2 patients. CONCLUSION: Our study confirms the persistence of chronic painful, sometimes lasting several years after the initial chest trauma. This pain is responsible of disability triggered most often after exercise.
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Dolor en el Pecho/epidemiología , Dolor Crónico/epidemiología , Fracturas de las Costillas/complicaciones , Traumatismos Torácicos/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Analgésicos/administración & dosificación , Dolor en el Pecho/tratamiento farmacológico , Dolor en el Pecho/etiología , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/etiología , Estudios de Cohortes , Evaluación de la Discapacidad , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Prevalencia , Estudios RetrospectivosRESUMEN
Primary or secondary diaphragmatic echinococcosis is rare, accounting for 1% of the thoracic locations. They may be operative discovery or by their complication, hence a variable symptomatology making this localization a particular entity. The thoracic and abdominal CT allows a complete assessment. Surgery remains the only therapeutic approach. In complicated forms an additional surgery is required for complete care. The prognosis is generally good apart from the risk of recurrence. Through a series of 4 operated patients, we focus on the clinical and therapeutic features of this pathology and its complications.
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Diafragma/parasitología , Equinococosis/cirugía , Enfermedades Torácicas/cirugía , Adulto , Diafragma/diagnóstico por imagen , Diafragma/patología , Equinococosis/complicaciones , Equinococosis/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Enfermedades Torácicas/complicaciones , Enfermedades Torácicas/diagnóstico , Procedimientos Quirúrgicos Torácicos , Tomografía Computarizada por Rayos XRESUMEN
INTRODUCTION: Bronchiectasis is a serious and disabling disease. Surgical treatment is an interesting alternative to be proposed early to patients in case of complications or deterioration of quality of life, despite an optimal medical treatment. Through this retrospective study and literature review, we analyze surgical results for bronchiectasis. PATIENTS AND METHOD: We conducted a monocentric, retrospective, descriptive and analytical study in the Department of thoracic surgery of CHU Hassan II Fès, about 64 patients operated for bronchiectasis during the period from January 2009 to December 2016. RESULTS: There were 30 men and 34 women with an average age of 32years. Twenty six percent (26 %) had a history of recurrent lung infection, and 17.18 % would have been treated for pulmonary tuberculosis and declared cured. Productive cough (93 %), morning chronic bronchorrhea (92 %) and repeatedly hemoptysis (62.5 %) were the main symptoms. On CT scanning, the bronchiectasis was unilateral and localized in 49 cases. The right lung was involved in 27 cases and the location was bilateral in 15 cases. It was 38 cystic bronchiectasis, 16 cylindrical bronchiectasis, and 10 mixed lesions predominantly cylindrical. The flexible bronchoscopy carried out in 34 cases, had shown a carcinoid tumor in 1 case, a bronchiolithiasis in 1 case and a intrabronchial foreign body in 1 case. The incision was a conservative posterolateral thoracotomy in all cases. The performed surgical procedure was lobectomy in 53 % of patients. The morbidity rate was 32.80 % and dominated by septic complications. After a mean follow-up of 20.52months, 2 cases of recurrence minimal hemoptysis and 1 case of renewed bronchorrhea are noted. For all other patients the outcome was favorable and no deaths have been noted to date. CONCLUSION: The surgery of bronchiectasis requires a perfect collaboration between the pulmonologist, the thoracic surgeon, the anesthesiologist, the biologist and particularly the physiotherapist for an optimal care of patients.
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Bronquiectasia/cirugía , Procedimientos Quirúrgicos Torácicos/métodos , Adulto , Anciano , Bronquiectasia/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Procedimientos Quirúrgicos Torácicos/efectos adversos , Resultado del TratamientoRESUMEN
INTRODUCTION: Tako-tsubo syndrome, or "left ventricular transitory apical balloon syndrome", is an acute coronary syndrome with normal coronary arteries. OBSERVATION: We report the case of a 50-year-old patient operated for a post-tuberculous destroyed lung, for which she had a left pneumonectomy. Six months later, she presented with chest pain complicated by cardiorespiratory arrest. The Tako-tsubo syndrome was retained after eliminating the other causes. CONCLUSION: The diagnosis of Tako-tsubo syndrome should be considered before the sudden occurrence of an acute coronary syndrome in the aftermath of stress or emotional shock.
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Neumonectomía/efectos adversos , Cardiomiopatía de Takotsubo/diagnóstico , Dolor en el Pecho/etiología , Angiografía Coronaria/métodos , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Cardiomiopatía de Takotsubo/etiología , Tomografía Computarizada por Rayos XRESUMEN
INTRODUCTION: Tumors of the mediastinum are a heterogeneous group of dysembryoplatic and neoplastic diseases essentially with different prognoses and therapeutic. These tumors develop slowly and remain long asymptomatic in 40-50% of cases. The purpose of our work is to bring the result of surgical management in diagnostic and therapeutic of principal mediastinum tumors framework. PATIENTS AND METHOD: We reviewed retrospectively the records of 68 patients in our training, between January 2009 and December 2013, for tumor of the mediastinum in the diagnostic framework and or therapy. RESULTS: There were 37 men and 31 women with a mean age of 37 years with extremes ranging from 11 to 73 years and 77.94% had an age between 11 and 50. In 39 patients, surgery had a diagnostic purpose (2 benign tumors and 37 malignancies including 27 cases of lymphomas). Curative surgery was performed in 34 patients, dominated by the tumors of thymic origin in 15 cases. Conventional surgery had involved 32 patients. The surgical approach was a total vertical sternotomy in 14 patients, in 17 patients was posterolateral thoracotomy and a left anterior thoracotomy in 1 patient. Video assisted thoracic surgery had been done in 3 patients under resection of a pleuropericardique cyst. Overall mortality was 4.41 percent. It is a death at D17 of the postoperative (thymoma with myasthenia) following a myasthenic crisis requiring a tracheotomy. A patient operated on for invasive thymoma developed myopathy and died at D44 of the postoperative following a difficulty of weaning. Another patient had a thymoma B3 benefited from 6 courses of neoadjuvant chemotherapy and then a thymectomy had presented a respiratory distress with bilateral pleural effusion, death at D10 of the postoperative by septic shock following a nosocomial infection. CONCLUSION: Tumors of the mediastinum are infrequent, discovered more often by chance. The main prognostic factor is the completeness of tumor resection without taking the break. Conventional surgery always keeps a place in our context, despite the advent of minimally invasive surgery.
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Neoplasias del Mediastino/clasificación , Neoplasias del Mediastino/cirugía , Procedimientos Quirúrgicos Torácicos/clasificación , Procedimientos Quirúrgicos Torácicos/métodos , Adolescente , Adulto , Anciano , Niño , Femenino , Hospitales Universitarios , Humanos , Masculino , Neoplasias del Mediastino/epidemiología , Neoplasias del Mediastino/patología , Mediastino/patología , Mediastino/cirugía , Persona de Mediana Edad , Marruecos/epidemiología , Estudios Retrospectivos , Cirugía Torácica Asistida por Video/estadística & datos numéricos , Procedimientos Quirúrgicos Torácicos/estadística & datos numéricos , Toracotomía/estadística & datos numéricos , Timectomía/estadística & datos numéricos , Timoma/epidemiología , Timoma/cirugía , Neoplasias del Timo/epidemiología , Neoplasias del Timo/cirugía , Adulto JovenRESUMEN
INTRODUCTION: The aim of our study is to report our surgery results in bilateral sequelae bronchiectasis and to assess its impact on the life quality of our patients. METHOD: This is a retrospective descriptive study in thoracic surgery department of Teaching Hospital Hassan II of Fez in Morocco. It involved all patients with bilateral bronchiectasis which is predominant on a few lobes or segments (localized) and who underwent surgery during the period 2010-2015. The epidemiological, clinical and paraclinical data, the surgery results, the evolution and the impact on life quality were assessed. RESULTS: From a total of 47 patients with bilateral bronchiectasis, 13 were operated, thus a frequency of 27.6%. The average age was 32years, ranging from 15 to 54years. Women were in majority (61.5%) representing a sex ratio of 1.6. The association of chronic bronchorrhea and hemoptysis was the main reason of medical consultation in 46.16%, followed by isolated chronic bronchorrhea in 38.46%. Surgical resection involved the left side in 61.5% of cases. The left lower lobectomy was the most accomplished gesture. An improvement in symptoms was found in 11 patients (84.6%) as a decrease in bronchorrhea, hemoptysis episodes and decreasing use of antibiotics. CONCLUSION: Bilateral bronchiectasis surgery can be performed with acceptable morbidity and mortality in well-selected patients with an improvement in symptoms.
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Bronquiectasia/cirugía , Neumonectomía , Adolescente , Adulto , Bronquiectasia/epidemiología , Femenino , Hemoptisis/epidemiología , Hemoptisis/cirugía , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Neumonectomía/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/cirugía , Estudios Retrospectivos , Procedimientos Quirúrgicos Torácicos/métodos , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Dermatofibrosarcoma protuberans (Darrier-Ferrand sarcoma, DFSP) is an uncommon tumor. This sarcoma has a tendency to local recurrence, requiring a wide surgical resection. OBSERVATION: We report herein two cases of patients presenting with recurrent dermatofibrosarcoma protuberans after several surgical resections. A wide surgical resection with guided tissue regenaration has been performed in one case, whereas the second case required a skin graft. CONCLUSION: Despite a short follow-up, our aim was to highlight the local aggressiveness of the DFSP and point out its therapeutic challenge, usually requiring a wide and aggressive surgery.