Postintubation Tracheal Ruptures - A case report -

Tracheobronchial ruptures (TBR) rarely complicate surgical procedures under general anesthesia. Seemingly uneventful intubations can result in injury to the trachea, which often manifests as hemoptysis and subcutaneous emphysema. We present 2 patients with postintubation TBR who were treated surgically and discuss considerations in the management of this potentially lethal injury

Tracheal rupture after endotracheal intubation - A report of three cases -

Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50 years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change

Prediction of outcome after abdominal aortic aneurysm rupture

BackgroundMost vascular surgeons practice a selective policy of operative intervention for patients with ruptured abdominal aortic aneurysm (AAA). The evidence on which to justify operative selection remains uncertain. This review examines the prediction of outcome after attempted open repair of ruptured AAA.MethodsThe Medline and EMBASE databases and Cochrane Database of Systematic Reviews were searched for clinical studies relating to the prediction of outcome after ruptured AAA. Reference lists of relevant articles were also reviewed.ResultsThe last 20 years has seen >60 publications considering variables predictive of outcome after AAA rupture. Four predictive scoring systems are reported: Hardman Index, Glasgow Aneurysm Score, Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM), and the Vancouver Scoring System. No scoring system has been shown to have consistent or absolute validity. Of the remaining data, there are no individual or combination of variables that can accurately and consistently predict outcome.ConclusionsLittle robust evidence is available on which to base preoperative outcome prediction in patients with ruptured AAA. Experienced clinical judgement will remain of foremost importance in the selection of patients for ruptured AAA repair

Chirurgie mini-invasive de l'aorte sous-rénale (à propos de 20 cas)

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Pontage fémoro-poplité supra-articulaire (résultats à long terme à propos de 135 cas)

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Chirurgie aortique et fonction rénale

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUP (751062107) / SudocMONTPELLIER-BU Médecine (341722104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Chirurgie après traitement d'induction du carcinome bronchique non à petites cellules au stade IIIA N (résultats à long terme et facteurs pronostiques)

Le traitement des carcinomes bronchiques non à petites cellules (CBNPC) au stadeIIIA N2 est un sujet de controverse pour lequel la siratégie thérapeutique optimale reste à définir. L'association d'un traitement néo-adjuvant par chimiothérapie, plus ou moins radiothérapie, associée â une chirurgie seconde est l'option thérapeutique choisie par notre service depuis les années 1990. L'objectif de notre étude rétrospective est de présenter notre expérience avec les résultats de survie à long tenue obtenus chez 123 patients présentant un CBNPC au stade IlIA N2 opérés apres traitement d'induction. La survie globale et sans récidive de notre série est respectivement de 44.7 (IC95%: 30-106) et de27 mois (IC95%: 17-80). La survie à 3 et 5 ans est respectivement de 45,5 et 32,5% et la survie à 5 ans sans récidive de 26.8%. La mortalité post opératoire globale est de 7.3%. En analyse univariée, les facteurs pronostiques influents sont: le downstaging (ypN0) avec une survie globale de 117 mois, IDle réponse histologique complète, une résection de type R0 et la lobectomie. Chez des patients sélectionnés une stratégie bi ou trimodale apparaît comme une option thérapeutique favorable.MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Les syndromes de la traversée thoraco-brachiale (résultats du traitement chirurgical à propos de 72 cas)

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF