RESUMO
The article discusses the diagnosis of thoracoabdominal wound (TAW) in 190 patients and the results of their operative treatment, information given in a questionnaire by 70 patients and out-patient examination of 19 of them in the late-term period. The clinical abdominal symptomatology is encountered 7 times more frequently in TAW than in and in combination with the X-ray signs allowing the diagnosis to be made in 21.58% of cases with TAW. Contrast study of the wound canal, thoracoscopy, and diagnostic pneumoperitoneum make it possible to establish or reject the diagnosis of TAW in all patients examined. Thoracotomy in the 7th intercostal space or at a lower level with transdiaphragmatic laparotomy allows for correction of the injuries in the chest and abdomen in 92.30% of patients. The mortality rate was 2.63%.
Assuntos
Traumatismos Abdominais/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Traumatismos Torácicos/cirurgia , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Adolescente , Adulto , Idoso , Diafragma/lesões , Diafragma/cirurgia , Drenagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Técnicas de Sutura , Traumatismos Torácicos/complicações , Traumatismos Torácicos/diagnósticoRESUMO
An analysis of 48 patients with traumatic hernias of the diaphragm is given. The authors consider in detail their errors in diagnosis in acute period of trauma and later. Recommendations are given for the prevention of late erroneous diagnosis of diaphragm hernias.
Assuntos
Hérnia Diafragmática Traumática/diagnóstico , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Adulto , Erros de Diagnóstico , Hérnia Diafragmática Traumática/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ruptura , Fatores de TempoAssuntos
Choque Traumático/diagnóstico , Traumatismos Torácicos/diagnóstico , Emergências , Hemorragia/diagnóstico , Hemorragia/mortalidade , Hemorragia/terapia , Humanos , Choque Hemorrágico/diagnóstico , Choque Hemorrágico/mortalidade , Choque Hemorrágico/terapia , Choque Traumático/mortalidade , Choque Traumático/terapia , Traumatismos Torácicos/mortalidade , Traumatismos Torácicos/terapiaRESUMO
On the basis of their experiences with the treatment of 1306 children the authors discuss problems of diagnostics and treatment of different congenital and acquired diseases of the lungs and esophagus.
Assuntos
Doenças Torácicas/cirurgia , Adolescente , Brônquios/anormalidades , Brônquios/cirurgia , Criança , Pré-Escolar , Humanos , Pulmão/anormalidades , Pulmão/cirurgia , Traumatismos Torácicos/cirurgia , UcrâniaRESUMO
On the basis of an experience with 24 reoperations on the lungs in children at late terms, indications have been developed for such operations and for their volume. A rational complex of treatment in the period of preoperative management was determined. Technical and tactical errors occupied the main place in the structure of causes resulting in reoperations. Recovery was achieved in all the 24 patients.
Assuntos
Pneumopatias/cirurgia , Complicações Pós-Operatórias , Atelectasia Pulmonar/etiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , ReoperaçãoAssuntos
Complicações Pós-Operatórias/cirurgia , Doenças da Traqueia/cirurgia , Traqueotomia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Recidiva , ReoperaçãoRESUMO
The experience of treatment of 253 cases of benign tumors and cysts of the mediastinum is summarized. Complex X-ray and endoscopic examination was used for diagnosis. Due to application of thoracoscopy, topical and morphologic diagnosis was improved. Surgery was the main method of treatment. Radical operations were carried out in 98.9% and in 6.3% they involved resection of the rib, lung, pericardium, the membranous part of the trachea and bronchus, esophageal diverticulum or removal of diaphragmatic hernia. The complicated and life-threatening nature of the procedure is mirrored in the postoperative lethality rate (1.57%) and pattern of complications and requires a strict observance of the suggested principles of surgery.
Assuntos
Cisto Mediastínico/diagnóstico , Neoplasias do Mediastino/diagnóstico , Diagnóstico Diferencial , Humanos , Cisto Mediastínico/cirurgia , Neoplasias do Mediastino/cirurgia , ToracoscopiaRESUMO
The method described was used in 70 patients with acquired esophago-respiratory fistulas. All the patients were treated by radical operations. The etiology, localization, complications of the fistulas and previous operations determined the character of surgery: there were isolated (in 8 patients), associated (in 43 patients) and reconstructive-restorative (in 19 patients) operations. Postoperative lethality was 4,28% (three patients died).
Assuntos
Brônquios/cirurgia , Fístula Brônquica/cirurgia , Esofagoplastia/métodos , Traqueia/cirurgia , Fístula Traqueoesofágica/cirurgia , Adulto , Fístula Brônquica/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos/transplante , Retalhos Cirúrgicos , Técnicas de Sutura , Fístula Traqueoesofágica/etiologiaAssuntos
Síndrome do Lobo Médio/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Lobo Médio/cirurgiaAssuntos
Anti-Infecciosos Locais/administração & dosagem , Bronquiectasia/tratamento farmacológico , Bronquite/tratamento farmacológico , Pneumonia/tratamento farmacológico , Traqueotomia/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Irrigação TerapêuticaAssuntos
Neoplasias Laríngeas/cirurgia , Neoplasias da Traqueia/cirurgia , Adulto , Criança , Feminino , Humanos , Neoplasias Laríngeas/complicações , Laringoestenose/complicações , Laringoestenose/cirurgia , Masculino , Neoplasias da Traqueia/complicações , Estenose Traqueal/complicações , Estenose Traqueal/cirurgiaAssuntos
Fístula Brônquica/cirurgia , Fístula Esofágica/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The method of occlusion of the draining bronchus in combination with a one-step percutaneous drainage of the purulent cavity by the Monaldi principle was used in 12 children for the treatment of giant pulmonary abscesses. It was shown that the proposed method unlike traditional procedures allows effective sanitation to be performed. It relieves symptoms of intrathoracic strain and thereby allows avoiding operations at the height of purulent intoxication. No complications and lethality followed the treatment.