[Coexistence of mediastinal adenopathies of different etiologies -- case report]. / Coexistenta de adenopatii mediastinale de etiologii diferite -- caz clinic.

The paper presents the case of a 52-year-old Caucasian female with several comorbidities (diabetes mellitus II, transitory ischemic stroke, sarcoma of uterus -operated, chemotherapy), which was addressed to the pneumology department for the diagnosis of sarcoidosis, established through mediastinoscopy followed by histopathological examination of lymph node biopsies. Further investigations performed in our department sustained the diagnosis of stage I sarcoidosis and expectative without systemic corticotherapy was the clinicians' decision. The follow-up during several months showed spontaneous remission of the mediastinal adenopathies except one, in the medium lobe, which was supposed to have other ethiology than sarcoidosis. Surgical excision of this tumor and several lymph-node biopsies was performed through right thoracotomy; the histopathological exam sustained the diagnosis of "ganglionar metastasis from endometrial sarcoma' but immunohistochemical tests showed that it was a "sclerosing hemangioma of the lung" - tumor with benign evolution. The coexistence of adenopathies of different and rare etiologies make this case interesting, the different evolution of these adenopathies suggested the different morphological pattern of them.

[Tracheal stenosis--diagnostic and therapeutic principles, results]. / Stenozele traheale--principii de diagnostic si tratament, rezultate.

Between November 2001-April 2010, 107 tracheal resections were performed in our department for different types of tracheal stenosis: iatrogenic or tumoral, benign or malignant. We present the diagnosis and treatment principles that we used, along with our results. We operated on 74 (69.15%) iatrogenic postintubation tracheal stenosis, 6 (5.6%) of them complicated with tracheo-esophageal fistula, 6 (5.6%) benign tumors, 11 (10.28%) primary malignant and 16 (14.97%) secondary malignant ones, with a 3.8% total mortality. Tracheal resection and reconstruction is the only curative treatment for all types of tracheal stenosis. Interventional endoscopy is of a major importance in the assessment and treatment of tracheal stenosis. We believe that each patient diagnosed with a tracheal stenosis should be referred to a tertiary center with multidisciplinary experience in the treatment of tracheal stenosis.

[Thoracoscopic sympathectomy for arterial ischemia of the upper extremities: a case report]. / Simpatectomia toracoscopica în tratamentul ischemiei arteriale a membrului superior: prezentare de caz.

INTRODUCTION: Thoracoscopic surgery reduce the morbidity of sympathectomy. Major indications of video-assisted sympathectomy (VAT) include hyperhidrosis, Raynaud's disease, causalgia, and reflex sympathetic dystrophy. Because little information is available in the national and international literature VAT sympathectomy in the treatment of upper extremities ischemia, we decided to present our first case. CLINIC CASE: The 38 years old patient was hospitalized for left upper-extremity ischemia (Raynaud's syndrome). Thoracoscopic sympathectomy was performed with resection of the main trunk proximally immediately after the stellate ganglion and distally at the level of T4 and identification and resection of 2 collateral branches of the sympathetic chain T2-T3. RESULTS: The postoperative evolution demonstrated evident clinical benefit. The thermography performed postoperative showed hyperthermia and hyper-vascularization in the left hemithorax with a difference of temperature of 2 degrees C between the two sides of the thorax. COMMENT: Before the advent of VAT, thoracic sympathectomy was performed only in highly selected patients because of its invasiveness. Now VAT sympathectomy is considered in most cases as the last resort to prevent extensive and successive amputation. Because the procedure is minimally invasive, safe, and associated with a low rate of complications, it should be considered earlier in the natural course of this disease.

[Left bronchial resection with bronchial anastomosis in a patient with posttraumatic bronchial stenosis]. / Rezectia bronsica stânga cu bronhoanastomoza la un pacient cu stenoza bronsica posttraumatica.

We present the case of a 25 year old patient, who suffered a car accident two month before he came to our hospital. At that moment, he had multiple costal fractures and left haemothorax, resolved by surgical means. At the actual presentation: dullness in the inferior half of left hemithorax, abolished breath sounds at this level. Radiologic--left lung atelectasis, bronchoscopic examination revealed--complete stenosis of the main left bronchus, while computer tomography has shown complete obstruction of the main left bronchus, at 1.7-2 cm from the carina. Fibrosis after posttraumatic bronchial disruption was the cause of the stenosis. Surgical treatment was the choice, with segmental resection of the main left bronchus and reanastomosis; the permeability was maintained on a month after the surgical intervention.