RESUMO
A nearly nation-wide team-work of six chest hospitals was made with 4284 patients to analyse all performed diagnostic procedures up to the present. Its frequency and diagnostic importance in relation to the radiographic stages of the disease were examined. Especially the procedure of bronchologic examination, having been partly underrated with the morphological ascertainment of sarcoidosis, are now purposefully analysed. This showed that also with perbronchic punction-biopsy and bronchoscopic excision morphologically confirming of the diagnosis was possible at a high percentage. On the other side the right diagnosis was made clinically before bioptic procedures in the majority of the patients. The overall conclusion is that, according to the experiences made in our hospitals, the relatively harmless bronchologic procedures are in general sufficient to obtain bioptic verfication of the diagnosis "sarcoidosis". Other bioptic operations like mediastinoscopy or lung biopsy can be restricted to cases with reasonable doube of the diagnosis.
Assuntos
Sarcoidose/patologia , Doenças Torácicas/patologia , Biópsia por Agulha , Broncopatias/diagnóstico , Broncopatias/patologia , Alemanha Oriental , Humanos , Pneumopatias/diagnóstico , Pneumopatias/patologia , Mediastinoscopia , Sarcoidose/diagnósticoRESUMO
177 lung cancer patients over 70 years old treated during the period from 1961 to 1975 were analyzed and evaluated for surgical resection. 109 cases were lobectomies, 39 nontypical resections and 29 were pneumonectomies. The postoperative mortality was 6.2%. Our concept of surgical treatment for patients with lung cancer over 70 years of age is as follows: Avoid pneumonectomy, prefer lobectomy or non-typical resection. The five years survival rate among 77 elderly patients amounted to 35%.
Assuntos
Pneumonectomia , Cuidados Pós-Operatórios , Idoso , Brônquios/metabolismo , Drenagem/métodos , Humanos , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/prevenção & controle , Embolia Pulmonar/prevenção & controleRESUMO
To examine the value of an intensive preoperative irradiation on the bronchial carcinoma, 196 operable patients with tumors being histologically confirmed were divided into two groups by drawing the lot: 99 patients for preoperative irradiation, 97 for primary operation. The correspondence of the following criteria was tested and confirmed: age, sex, no symptons, histological tumor type. The preoperative irradiation dose amounted to 5,500 RHD (CO-60). Out of both groups the same number of patients was resected (83 and 85 respectively); within the preoperative irradiated group, however, 11 patients were omitted before the operation (information on reasons), while within the not irradiated group the number of thoracotomized but not resected cases was adequately greater (13). There is no statistically significant difference within the annual survival rate, although the mortality of the primarily operated patients is a bit more favourable. Quite the same is valid for postoperative mortality and complications. The local recurrences (in all cases of necropsy), however, are statistically significant reduced after preoperative irradiation. Since there is no influence on the rate of surviving, the conclusion is drawn that the majority of the operable cases has already developed small distant metastatic formations, being decisive for the prognosis before any therapy was performed. That is why a new prospective series with a low irradiation dose is started, where an increase of complications is not to be expected, but the possibility exists to influence local micrometastatic formations, that means an influence only to those cases with the probability of a low degree of remote metastatic formations.