26 research outputs found
The use of the LigaSure device and the Stapler in closure of the small bowel: a comparative ex vivo study
Purpose To evaluate the feasibility and effectiveness of
the LigaSure device in closing divisions of the small bowel
in an ex vivo porcine model.
Methods Two types of closure were performed: stumps
created by ‘‘muco-mucosa’’ fusion and stumps created by
‘‘sero-serosa’’ fusion. For each type of closure, different
power levels of the LigaSure system were tested in com-bination with different numbers of applications and then
compared with the Stapler group.
Results With both types of intestinal closure, the highest
value of burst pressure was obtained with the application of
a power level of three bars and one frequency application.
The high burst pressure of the muco-mucosa stump group
was significantly lower than that of the Stapler group
(41.8 ±5.9 vs. 75.8±5.9, respectively, p\0.01). No
differences were found between the high burst pressure of
the sero-serosa stump group and the Stapler group
(74.1 ±5.5 vs. 75.8±5.9, respectively,p=0.2).
Conclusions Our preliminary results showed that the
LigaSure is an efficient tool for closing the intestines when
sero-serosa stumps are created. The second step of our
work will be to evaluate the feasibility of this tool in cre-ating intestinal anastomos
Small cell lung cancer associated with solitary fibrous tumors of the pleura: A case study and literature review
AbstractIntroductionSmall cell lung cancer (SCLC) is the most aggressive type of lung cancer. The surgical treatment is possible only in a few and defined occasions. The association between SCLC and a solitary fibrous tumor of pleura (SFTP) is extremely rare.Case presentationA 56 year-old man had a lung lesion (size 16Â mm) FDG-avid (SUV 7.9) within upper lobe of right lung. No lymph adenopathy or other distant lesion were found. The pathological results of FNAB showed the presence of malignant cells inconclusive for a definitive diagnosis. Following thoracotomy, the exploration of pleural cavity showed an unexpected lesion (size. 3Â cm) originating from parietal pleura and not radiologically seen. The intraoperative diagnosis was solitary fibrous tumor of the pleura. Then, an upper right lobectomy was achieved. The histological findings of the lung tumor diagnosed to be a SCLC (p-stage: T1N0M0). An adjuvant treatment was started. At 20 months after the procedure, no recurrence was found.ConclusionSurgery as part of multimodality treatment may be indicated in the treatment of SCLC in the early stage (T1N0M0). However, before proceeding to attend tumor resection an exploration of pleural cavity is mandatory in order to exclude any pleural involvement
Post-pneumonectomy broncho-pleural fistula successfully closed by open-window thoracostomy associated with V.A.C. therapy
AbstractBroncho-pleural fistula (BPF), is a dramatic complication that may occur after lung resection. The treatment is challenging due to its high rate of morbidity and mortality. Herein, a case of BPF associated with empyema, occurred in an elderly patient who had undergone to left pneumonectomy for non-small cell lung cancer (NSCLC), is reported. After various treatments including chest drainage and endoscopic procedures, BPF was successfully closed by open-window thoracotomy associated with vacuum assisted closure (V.A.C.) device therapy. The authors conclude that V.A.C. is a convenient and safe measure in the management of empyema with BPF. Moreover, in similar clinical contexts, V.A.C. may be the only option available that may assure the survival of the patient and the avoiding any later-phases of residual cavity
Pulmonary arterovenous malformation causing hemothorax in a pregnant woman without Osler- Weber-Rendu syndrome
Pulmonary arteriovenous malformations
(PAVMs), although most commonly congenital, are
usually detected later in life. Case report: We present a
case of a 19-year-old woman with no previous history
of AVM or telangiectasia, who presented dyspnea and
hypoxia by massive left hemothorax in the 34th week of
gestation. After emergent cesarean delivery, a chest computed
tomography (CT) with i.v. contrast showed a likely
3 cm area of active contrast in left lower lung. Chest tube
placement revealed about 2 liters of blood. The patient was
subsequently found to have pulmonary AVM. A successful
embolisation of AVM followed by lung atipic resection
involving AVM and decortication for lung re-expansion
were the treatments provided. Conclusions: Women with
known pulmonary AVM should be maximally treated prior
to becoming pregnant, and the physician should be alert
to complications of pulmonary AVM during pregnancy
Pulmonary arterovenous malformation causing hemothorax in a pregnant woman without Osler-Weber-Rendu syndrome
Pulmonary arteriovenous malformations (PAVMs), although most commonly congenital, are usually detected later in life. Case report: We present a case of a 19-year-old woman with no previous history of AVM or telangiectasia, who presented dyspnea and hypoxia by massive left hemothorax in the 34th week of gestation. After emergent cesarean delivery, a chest computed tomography (CT) with i.v. contrast showed a likely 3 cm area of active contrast in left lower lung. Chest tube placement revealed about 2 liters of blood. The patient was subsequently found to have pulmonary AVM. A successful embolisation of AVM followed by lung atipic resection involving AVM and decortication for lung re-expansion were the treatments provided. Conclusions: Women with known pulmonary AVM should be maximally treated prior to becoming pregnant, and the physician should be alert to complications of pulmonary AVM during pregnancy
Extrathoracic recurrence of type A thymoma
INTRODUCTION:
Neoplasms of the thymus gland are the most common tumors in the anterior mediastinum, and differentiation between benign and malignant forms is rather difficult. Extrathoracic invasions or metastases are extremely rare, and only a few cases have been reported previously.
CASE PRESENTATION:
We report herein the case of a patient in whom a thymoma type A recurred at skeletal muscle 2-years after surgery. The metastases were completely resected. Adjuvant treatment was started. Actually, no signs of recurrence were seen.
CONCLUSION:
Our case shows that also thymoma type A, generally defined as a low malignancy, may recur. Thus, a strict follow-up is required. If metastases are present, surgical resection with curative intent associated with adjuvant therapy should be attended