Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.499
Filtrar
1.
J Cardiothorac Surg ; 17(1): 92, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35505352

RESUMO

BACKGROUND: Solitary fibrous tumors of the pleura are rare diseases of the thoracic cavity. They frequently grow unnoticed until they exert compressive effects on adjacent organs. Treatment of solitary fibrous tumors of the pleura is surgical resection. Post-operative surveillance is recommended to identify early recurrent disease. CASE PRESENTATION: We present a rare case of a 76-year-old female patient with no previous pulmonary history who presented with progressive dyspnea, fatigue, and involuntary weight loss. On chest X-ray and computed chest tomography scan, she was found to have a 16.7 cm × 12.8 cm × 10.1 cm bulky mass occupying the left hemithorax with associated compressive atelectasis of the lung. She underwent a computed tomography guided biopsy that revealed the mass to be a solitary fibrous tumor. The patient underwent left muscle sparing lateral thoracotomy with complete resection of the tumor. Post procedure, the left lung fully expanded. 18 months post-resection, she developed a 3.3 cm × 1.7 cm tumor along the left internal thoracic artery lymph node chain which was histologically identical to the resected tumor. The patient is currently being treated with bevacizumab and temozolomide. CONCLUSION: Solitary fibrous tumors are very rare pleural tumors. Surgical resection is the treatment of choice followed by close post-operative surveillance.


Assuntos
Fibrossarcoma , Neoplasias Pleurais , Tumor Fibroso Solitário Pleural , Cavidade Torácica , Idoso , Feminino , Fibrossarcoma/complicações , Humanos , Pleura/patologia , Pleura/cirurgia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/cirurgia , Tumor Fibroso Solitário Pleural/diagnóstico por imagem , Tumor Fibroso Solitário Pleural/cirurgia , Cavidade Torácica/patologia
2.
Thorac Cancer ; 13(9): 1423-1426, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35315237

RESUMO

Malignant melanoma is the most aggressive skin cancer that originates from melanocytes. Primary or metastatic pleural melanoma shares clinical and imaging characteristics with primary pleural tumors, such as pleural mesothelioma. Identification of the primary site can be challenging to distinguish between primary and secondary melanomas. We report a case of a 46-year-old woman with metastatic, rapidly progressing pleural melanoma mimicking primary pleural tumor. The metastatic pleural tumor from a primary cutaneous melanoma was diagnosed by reevaluating a previous surgical specimen. When evaluating patients with pleural melanoma, the primary site should be reevaluated to distinguish between primary and secondary melanomas.


Assuntos
Melanoma , Segunda Neoplasia Primária , Neoplasias Pleurais , Neoplasias Cutâneas , Feminino , Humanos , Melanoma/diagnóstico , Melanoma/patologia , Pessoa de Meia-Idade , Pleura/patologia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/cirurgia , Neoplasias Cutâneas/diagnóstico
4.
Interact Cardiovasc Thorac Surg ; 34(3): 485-487, 2022 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-34586396

RESUMO

Localized malignant mesothelioma is rare. It has a histological pattern identical to diffuse malignant mesothelioma but without diffuse serosal spread. Localized malignant mesothelioma typically originates from the pleura, peritoneum or pericardium, but can occasionally develop from organs. Our cases represent what might be the largest mediastinal localized malignant mesothelioma described and the first presentation of the epithelioid type in the stomach of an adult.


Assuntos
Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Adulto , Humanos , Mediastino/patologia , Mesotelioma/diagnóstico por imagem , Mesotelioma/cirurgia , Pleura/patologia , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/cirurgia , Estômago
5.
Gen Thorac Cardiovasc Surg ; 70(2): 193-196, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34676483

RESUMO

A 69-year-old man with occupational exposure to asbestos was referred to our hospital with right diffuse malignant pleural mesothelioma. He underwent extrapleural pneumonectomy with reconstruction of the pericardium and diaphragm using elongated polytetrafluoroethylene patches, followed by postoperative chemotherapy and chest wall irradiation. One year later, he was hospitalized because of a right empyema caused by Escherichia coli infection. As chest drainage and systemic antibiotics did not eliminate the abscess around the artificial patches, a Clagett window was created. To avoid mediastinal and liver overshift into the right thoracic cavity, we only performed partial resection of the diaphragm patch and incision of the artificial pericardium. After 19 days of irrigation and dressing change, the artificial patches were completely removed. Two months later, the patient provided a culture-negative sample and had an improved nutritional status; we therefore performed closure of the Clagett window with thoracoplasty. He did not experience recurrence of empyema.


Assuntos
Empiema Pleural , Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Idoso , Empiema Pleural/etiologia , Empiema Pleural/cirurgia , Humanos , Masculino , Mesotelioma/cirurgia , Neoplasias Pleurais/cirurgia , Pneumonectomia/efeitos adversos
6.
Ann Surg Oncol ; 29(3): 1829-1837, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34657225

RESUMO

BACKGROUND: Thymoma patients with pleural dissemination are difficult to manage, and their treatment strategy remains undefined. This study aimed to investigate the clinicopathologic features of these patients, focusing on the association between the depth of pleural invasion and prognosis. METHODS: Between 2003 and 2019, the study identified 120 disseminated lesions in 20 thymoma patients. Seven patients had de novo stage IVa thymoma and 13 were recurrent cases. Extrapleural pneumonectomy was performed for 8 patients and debulking surgery for 12 patients. Invasion depth of pleural tumors was classified into two groups: when the disseminated tumors invaded the pleura beneath the elastic layer, the tumor was diagnosed as Da, and when the disseminated tumors invaded the pleura beyond the elastic layer, the tumor was diagnosed as Db. RESULTS: Of 120 nodules, 31 (26%), found in eight patients with recurrent malignancies, were classified as Db. The pathologic status of the surgical margin (PSM) was positive in eight patients, seven of whom had Db nodules. The 5-year overall survival (OS) rate was 100% in the Da group and 75% in the Db group (P = 0.02). The 5-year progression-free survival (PFS) rate was 66.7% in the Da group and 25% in the Db group (P = 0.02). Cox univariate analysis showed that PFS was significantly influenced by the depth of invasion (P = 0.04) and PSM (P = 0.03). CONCLUSION: Depth of pleural invasion may influence survival outcomes for thymoma patients with pleural dissemination. The patients in this study with Da-disseminated nodules had an increased probability of a longer OS and PFS and tended to achieve negative PSM compared with the patients with Db.


Assuntos
Neoplasias Pleurais , Timoma , Neoplasias do Timo , Humanos , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Pleura/patologia , Pleura/cirurgia , Neoplasias Pleurais/patologia , Neoplasias Pleurais/cirurgia , Estudos Retrospectivos , Timoma/patologia , Timoma/cirurgia , Neoplasias do Timo/patologia , Neoplasias do Timo/cirurgia , Resultado do Tratamento
7.
Thorac Cancer ; 13(1): 126-128, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34799989

RESUMO

A 70-year-old man diagnosed with right-sided malignant epithelial pleural mesothelioma, underwent pleurectomy/decortication after three courses of neoadjuvant chemotherapy. He had a history of mitral valve replacement and maze procedure with median sternotomy, and the procedures resulted in strong adhesion from the apex to the mediastinal side. In particular, the peeling of the area where the tumor invaded the pericardium required the most attention; however, the involved pericardium could be partially resected without damaging the right atrium. Finally, en bloc macroscopic complete resection with the entire pleura was successfully performed without conversion to extrapleural pneumonectomy.


Assuntos
Mesotelioma Maligno/cirurgia , Neoplasias Pleurais/cirurgia , Procedimentos Cirúrgicos Torácicos/métodos , Idoso , Humanos , Masculino , Mesotelioma Maligno/tratamento farmacológico , Terapia Neoadjuvante/métodos , Neoplasias Pleurais/tratamento farmacológico , Esternotomia/métodos
8.
Interact Cardiovasc Thorac Surg ; 34(4): 700-702, 2022 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-34792143

RESUMO

We report a case of localized malignant pleural mesothelioma (LMPM) of the interlobar fissure mimicking lung cancer. A 74-year-old woman presented with dyspnoea and a left pleural effusion. Chest computed tomography revealed a bulky mass, arising from the left lower lobe with intense uptake at the 18F-FDG PET. A left lower lobectomy was performed after thoracoscopic pleural biopsies. The final histology revealed an LMPM epithelioid like. We describe the diagnostic and curative path of the disease, speculating on the differential diagnosis and treatment of LMPM.


Assuntos
Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Idoso , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Mesotelioma/diagnóstico por imagem , Mesotelioma/cirurgia , Pleura/patologia , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/cirurgia
9.
Ann Thorac Surg ; 113(1): 200-208, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33971174

RESUMO

BACKGROUND: Whether extrapleural pneumonectomy (EPP) or extended pleurectomy/decortication (P/D) is the optimal resection for malignant pleural mesothelioma remains controversial. We therefore compared perioperative outcomes and long-term survival of patients who underwent EPP versus P/D. METHODS: Patients with the diagnosis of malignant pleural mesothelioma who underwent either EPP or P/D from 2000 to 2019 were identified from our departmental database. Propensity score matching was performed to minimize potential confounders for EPP or P/D. Survival analysis was performed by the Kaplan-Meier method and Cox multivariable analysis. RESULTS: Of 282 patients, 187 (66%) underwent EPP and 95 (34%) P/D. Even with propensity score matching, perioperative mortality was significantly higher for EPP than for P/D (11% vs 0%; P = .031); when adjusted for perioperative mortality, median overall survival between EPP and P/D was 15 versus 22 months, respectively (P = .276). Cox multivariable analysis for the matched cohort identified epithelioid histology (hazard ratio [HR], 0.56; P = .029), macroscopic complete resection (HR, 0.41; P = .004), adjuvant radiation therapy (HR, 0.57; P = .019), and more recent operative years (HR, 0.93; P = .011)-but not P/D-to be associated with better survival. Asbestos exposure (HR, 2.35; P = .003) and pathologic nodal disease (HR, 1.61; P = .048) were associated with worse survival. CONCLUSIONS: In a multimodality treatment setting, P/D and EPP had comparable long-term oncologic outcomes, although P/D had much lower perioperative mortality. The goal of surgical cytoreduction should be macroscopic complete resection achieved by the safest operation a patient can tolerate.


Assuntos
Mesotelioma Maligno/cirurgia , Pleura/cirurgia , Neoplasias Pleurais/cirurgia , Pneumonectomia/métodos , Idoso , Feminino , Humanos , Masculino , Mesotelioma Maligno/mortalidade , Pessoa de Meia-Idade , Neoplasias Pleurais/mortalidade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo
10.
Tumori ; 108(1): 26-32, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33719756

RESUMO

BACKGROUND: Definition of histologic subtype of malignant pleural mesothelioma (MPM) is important for management of patients, because surgical treatment improves prognosis for patients with epithelioid but not biphasic or sarcomatoid MPM. In a series of necropsies performed in a hospital specialized for MPM diagnosis, we retrospectively investigated the accuracy of histologic diagnosis performed on pathologic specimens collected through pleural biopsies obtained at video-assisted thoracoscopic surgery (VATS) or surgery. METHODS: We reviewed histologic records of an unselected series of autopsies performed in patients with MPM employed in the Monfalcone shipyards (Northeast Italy) or living with shipyard workers from 1999 through 2017. Using necropsy results as a gold standard, we calculated sensitivity, specificity, and positive and negative predictive values of histology from VATS or surgery after combining nonepithelioid subtypes. RESULTS: We retrieved necropsy records for 134 patients: 62 (46.3%) with epithelioid, 51 (38.1%) with biphasic, and 21 (15.7%) with sarcomatoid MPM. We observed good sensitivity of VATS (0.94) and surgery (0.89) in diagnosing epithelioid MPM. Conversely, specificity was low (VATS: 0.46; surgery: 0.32). Therefore, positive predictive values were also low (VATS: 0.58; surgery: 0.60). Misclassification was particularly high for biphasic MPM (three-fourths of biphasic MPM at necropsy had been classified as epithelioid at VATS or surgery). CONCLUSIONS: We observed a substantial degree of misclassification between epithelioid and biphasic MPM for pleural biopsies performed during VATS. Our results suggest caution should be taken in using histologic subtype obtained from VATS in selecting patients with MPM for surgical treatment. We also observed substantial misclassification of biospecimens collected during MPM surgery.


Assuntos
Mesotelioma Maligno/diagnóstico , Neoplasias Pleurais/diagnóstico , Sarcoma/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Biópsia , Feminino , Humanos , Itália/epidemiologia , Masculino , Mesotelioma Maligno/classificação , Mesotelioma Maligno/patologia , Mesotelioma Maligno/cirurgia , Pessoa de Meia-Idade , Pleura/diagnóstico por imagem , Pleura/patologia , Neoplasias Pleurais/classificação , Neoplasias Pleurais/patologia , Neoplasias Pleurais/cirurgia , Prognóstico , Estudos Retrospectivos , Sarcoma/classificação , Sarcoma/patologia , Sarcoma/cirurgia , Cirurgia Torácica Vídeoassistida
11.
Kyobu Geka ; 74(13): 1122-1125, 2021 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-34876545

RESUMO

A 71-year-old woman with chest pain and exertional dyspnea was referred to our hospital. Computed tomography revealed a huge intrathoracic tumor with left parietal pleural dissemination. Transthoracic echocardiography showed the left ventricular dysfunction due to external compression by the tumor. After excision of the tumor, marked improvement of the left ventricular dysfunction was obtained for eight years. But the patient died due to cardiac invasion of the tumor 9th year after surgery.


Assuntos
Neoplasias Pleurais , Tumor Fibroso Solitário Pleural , Idoso , Dor no Peito , Feminino , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Pleura , Neoplasias Pleurais/complicações , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/cirurgia , Tumor Fibroso Solitário Pleural/complicações , Tumor Fibroso Solitário Pleural/diagnóstico por imagem , Tumor Fibroso Solitário Pleural/cirurgia , Tomografia Computadorizada por Raios X
12.
Cir Cir ; 89(S1): 102-105, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34762616

RESUMO

We present a clinical case of a solitary fibrous pleural tumor (TFSP) with abnormal behavior due to its high aggressiveness and poor short-term prognosis, where an ALK translocation was identified. TFSP is an infrequent tumor, with an estimated incidence of around 8 per 100,000 inhabitants and with few cases reported in the literature. The most common is that it is a neoplasm of benign behavior, with debut as a localized mass and whose The treatment of choice is surgical resection. All the data in the literature contrast with our experience, which we report below.


Presentamos un caso clínico de un tumor fibroso solitario pleural (TFSP) de comportamiento anómalo por su alta agresividad y mal pronóstico a corto plazo, en el que se identificó una translocación de ALK. El TFSP es un tumor infrecuente, con una incidencia estimada en torno a 8 casos por 100,000 habitantes y con pocos reportes en la literatura. Lo más habitual es que se trate de una neoplasia de comportamiento benigno, con debut como una masa localizada y cuyo tratamiento de elección es la resección quirúrgica. Todos los datos de la literatura contrastan con nuestra experiencia, que presentamos a continuación.


Assuntos
Neoplasias Pleurais , Tumor Fibroso Solitário Pleural , Humanos , Neoplasias Pleurais/genética , Neoplasias Pleurais/cirurgia , Receptores Proteína Tirosina Quinases , Síndrome
13.
Integr Cancer Ther ; 20: 15347354211043508, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34472358

RESUMO

PURPOSE: Health utility, which is a measure of patient-reported outcome (PRO), has recently been used in health-related quality of life for patients with various cancers. However, the relationship between health utility and the physical function and of patients undergoing pleurectomy/decortication (P/D) as surgical treatment for malignant pleural mesothelioma (MPM) has not been reported in the perioperative and convalescent phases. This study aimed to evaluate the perioperative and postoperative health utility of patients undergoing P/D for MPM at one year postoperatively and to examine the relationship with physical function. METHODS: We included patients underwent P/D. Grip strength, knee extension strength, 6-minute walk distance (6MWD), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) were measured to assess physical function, and the Short-Form Six-Dimension (SF-6D) was completed to assess health utility. These assessments were performed preoperatively, postoperatively, and one year postoperatively. Statistical analysis was performed using one-way analysis of variance for comparison of pre and postoperative and one year mean values. RESULTS: There were 24 subjects (23 males, 65.5±8.3 year). SF-6D, 6MWD, FVC, and FEV1 values one year operatively improved significantly compared with postoperative. Additionally, SF-6D was correlated with 6MWD. CONCLUSION: Health utility were also correlated with exercise capacity.


Assuntos
Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Mesotelioma/cirurgia , Neoplasias Pleurais/cirurgia , Pneumonectomia , Qualidade de Vida , Resultado do Tratamento
16.
BMJ Case Rep ; 14(6)2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34083185

RESUMO

Pleural lipomas are rarely encountered in the thoracic cavity. Sometimes, they infiltrate the intercostal space to have a component on either side of the intercostal space forming a hourglass configuration. They are generally solitary, small and asymptomatic. We present the case of a 49-year-old man with two giant pleural lipomas, both originating from the right parietal pleura, and one of which was passing through the intercostal space giving rise to a hourglass-shaped configuration. When they occur, although benign, considering the evolutionary potential, excision is recommended.


Assuntos
Lipoma , Neoplasias Pleurais , Parede Torácica , Humanos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Pleura , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/cirurgia
17.
In Vivo ; 35(4): 2457-2463, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34182531

RESUMO

BACKGROUND/AIM: Leiomyoma is a rare benign tumor originating from smooth muscle fibres. In the respiratory tract, these tumors are rare and in the pleura, cases are exceptional, with only a few reported so far. This is the main reason we decided to present this case of primary leiomyoma of the visceral pleura. CASE REPORT: We present a case of a 51-year-old asymptomatic patient who, during a routine medical examination using standard chest radiography, presented with a 3 by 2 cm homogenous mass in the right superior pulmonary area, tangent to the chest wall (same level with the 3rd rib). Further investigation using computed tomography (CT) in the chest confirmed the presence of a 31/18 mm solid mass in the right upper lobe, in contact with the parietal pleura. Surgery was performed for two reasons: i) removal of the tumoral mass and ii) establishing a histopathological diagnosis. Intraoperatively, a well-defined, homogenous, ivory white non-infiltrating mass was discovered in the right upper lobe on the visceral pleura and in close proximity to the minor fissure. The mass was removed with negative surgical margins and was left with healthy tissue. Histopathological examination and immunohistochemistry came as a surprise, establishing our diagnosis of leiomyoma. CONCLUSION: Primitive pleural leiomyoma must remain a possibility when considering the differential diagnosis of pleural tumors. The main course of treatment is complete surgical resection. In our case, long-term follow up did not present any local recurrence.


Assuntos
Leiomioma , Neoplasias Pleurais , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Pleura/diagnóstico por imagem , Pleura/cirurgia , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/cirurgia , Tomografia Computadorizada por Raios X
18.
Thorac Cancer ; 12(16): 2271-2274, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34173725

RESUMO

Calcifying fibrous tumor of the pleura (CFTP) is a rare benign tumor of the thoracic cavity. Due to the low incidence of CFPT, it is prone to be misdiagnosed because intraoperative analysis of frozen section is a challenge for pathologists. At present, it is difficult to distinguish this tumor from other benign thoracic tumors based on radiographic features. Therefore, surgical resection is the best method for definite diagnosis and treatment.


Assuntos
Neoplasias de Tecido Fibroso/patologia , Neoplasias de Tecido Fibroso/cirurgia , Neoplasias Pleurais/patologia , Neoplasias Pleurais/cirurgia , Adulto , Calcinose/patologia , Calcinose/cirurgia , Humanos , Masculino
19.
Interact Cardiovasc Thorac Surg ; 33(5): 827-828, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34160042

RESUMO

Meningiomas are the most common intracranial tumours in adults and they are infrequently associated with a metastasis clinical course. Pleural metastases are extremely rare and no guidelines on a specific treatment have been established. When localized, surgical resection is the mainstay of treatment, but there is a high risk of pleural recurrence. We aimed to describe a novel surgical approach in pleural metastasis of meningiomas. We report the case of a 41-year-old man with the medical history of surgically resected intracranial atypical meningioma. Nine years after diagnosis of atypical meningioma, a CT scan of the chest disclosed 10 pleural implants gathered in the fissure, in the paramediastinal pleura and at the base of the left hemithorax. Surgical resection was decided. Parietal and mediastinal pleura resection with visceral pleural lesions removal were performed. Cytoreductive surgery was associated with intrathoracic hyperthermic chemotherapy. Postoperative course was uneventful and no adjuvant therapy was undertaken. The patient is free of pleural recurrence 12 months post operatively. The present case report suggests that cytoreductive surgery with intrathoracic hyperthermic chemotherapy is feasible and safe in pleural metastasis from meningioma. Prolonged follow-up and prospective studies are mandatory to assess its oncological benefit.


Assuntos
Hipertermia Induzida , Neoplasias Meníngeas , Meningioma , Neoplasias Pleurais , Adulto , Humanos , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Pleura , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/tratamento farmacológico , Neoplasias Pleurais/cirurgia , Estudos Prospectivos
20.
Gen Thorac Cardiovasc Surg ; 69(9): 1320-1325, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34028663

RESUMO

OBJECTIVE: Pleurectomy/decortication has been preferably employed as a curative-intent surgery for malignant pleural mesothelioma. However, visceral pleurectomy during pleurectomy/decortication provides technical challenges. For visceral pleurectomy, pleural incisions are commonly made to create a dissection plane between the visceral pleura and the lung parenchyma, which may cause tumor dissemination and may not allow en bloc complete resection of the entire pleura. To overcome such potential disadvantages, we have developed a novel surgical technique without any pleural incision (non-incisional pleurectomy/decortication) to achieve en bloc removal of the entire pleura. METHODS: A total of 36 consecutive patients who underwent non-incisional pleurectomy/decortication for malignant pleural mesothelioma from January 2017 through December 2020 in our institute were retrospectively reviewed to assess the feasibility. RESULTS: Macroscopic complete resection was achieved in 31 patients (86.1%) with non-incisional pleurectomy/decortication. In the majority of patients (n = 29), en bloc complete resection of the entire pleura was achieved (without pleural laceration in 10 and with some pleural laceration in 19 patients). The total operation time and the duration of visceral pleurectomy were significantly shorter as compared with those for conventional pleurectomy/decortication (median, 350 versus 506 min [P = 0.011], and 43 versus 97 min [P < 0.001], respectively). Among 36 patients who underwent non-incisional pleurectomy/decortication, postoperative complications developed in 13 patients (36.1%), and one patient died on the postoperative day 95 caused by aggressive tumor progression of residual tumor. CONCLUSIONS: Non-incisional pleurectomy/decortication is a fast and feasible technique to achieve en bloc macroscopic complete resection for malignant pleural mesothelioma.


Assuntos
Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Mesotelioma/diagnóstico por imagem , Mesotelioma/cirurgia , Pleura/cirurgia , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...