RESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Hiperidrose/complicações , Hiperidrose/terapia , Simpatectomia/métodos , Instrumentos Cirúrgicos/tendências , Estudos Prospectivos , Frequência Cardíaca , Hemodinâmica , Hiperidrose/fisiopatologiaRESUMO
BACKGROUND: Uncontrollable chest wall bleeding secondary to thoracic trauma has been a challenging problem faced by surgeons. Thoracic packing has been described as a good alternative although most thoracic surgeons avoid it because of the potential deleterious effects on cardiopulmonary function. METHODS: We describe a selective gauze packing technique of the thoracic wall preserving cardiopulmonary function in 3 patients with uncontrollable bleeding, where gauze packs were placed on bleeding areas holding them in a "sandwich-like" arrangement between the skin and the pleura and tightly fixed with coated wire stitches using internal and external-thoracic Ventrofil® devices. RESULTS: Successful hemostasis and cardio-respiratory stability were achieved in all cases after selective packing. X-ray showed acceptable lung expansion and no heart compression. CONCLUSIONS: This selective packing technique is simple, feasible and highly effective in managing uncontrollable post-traumatic or even post-operative chest wall hemorrhages when the life of patients is in danger.
Assuntos
Bandagens , Hemorragia/etiologia , Hemorragia/terapia , Técnicas Hemostáticas , Traumatismos Torácicos/complicações , Parede Torácica/lesões , Coração/fisiologia , Hemostasia , Humanos , Pulmão/fisiologia , Índice de Gravidade de Doença , Traumatismos Torácicos/cirurgiaRESUMO
T4 lung cancer invading the full thickness of the aortic arch was completely removed in a 78-year-old lady using a non-fenestrated endograft closing the left subclavian artery origin without performing surgical revascularization. Left thoracotomy and upper lobectomy with resection of superior segment of the lower lobe and full thickness of the infiltrated aorta was performed without covering the aortic defect. The margins of the specimen were free of tumor. The patient survived 32 months. J. Surg. Oncol. 2016;114:412-415. © 2016 Wiley Periodicals, Inc.
