Surgical and Functional Problems in Pulmonary Resection for Lung Cancer

Thirty-four cases of pulmonary cancer have been studied by the methds of spirametry and temporary unilateral pulmonary occlusion with and temporary unilateral pulmonary occlusion with and without exercise. The prognostic significance of cardiopulmonary function for resectional treatment was re-evaluated by thesemans, and the functional indication values, which had been reported previously, were proved valuable. The postoperative pulmonary failure developed in patients with the RV : TLC ratio over 45%. It was emphasized that the relationships among pulmonary arterial presure, diastolic right heart pressure, and cardiac output, were the most important factors in judging how the borderline cases will tolerate surgical intervention. HARVEY\u27S conception was discussed in this regard

The Experimental Study on Lung Transplantation

Previous studies in the laboratory have been shown that homografts of the lung in canine can survive extended period of time, if methotrexate is given to the recipient animal, Several homografts survive more than a month. A series of fifty unrelated mongrel pairs have been subjected to, homotransplantation of the left lung. In each case the donor lung was stored in vitro 2 to 12 hours before placement in the recipient animal. The lung was perfusated with 5% dextrose, 3.6% PVP and plasma at 4°C by infusion pump and was ventilated with room air by respirator. It has been eluciated by histologic and electromicroscopic study including autopsy and survival rate that the safety storage period had been within 4 to 6 hours to prevent a fine change on donor lung due to storages

Resuscitation from Cardiac Arrest, Occuring During Cardiac Catheterisation : A

This is the report of a case of successful cardiac resuscitation following cardiac arrest during cardiac catheterisation, treated with brain cooling, 12 minutes having elapsed between the arrest and initiation of cardiac massage

Clinical Evaluation with Referrence to Operative Specificity on Tracheal and Bronchial Reconstruction

The clinical specificity were evaluated in those 11 cases who underwent tracheal recon - structive surgery and in those 25 cases who underwent bronchial reconstructive surgery respectively. Its prognosis after tracheal reconstruction at the level of intrathoracic region was extremely poor. The operative specificity with regard to tracheal surgery consist of being a poor genera- condition preoperativelly and of having an urgent demand of removal of tracheal stenotic lesion to alleviate respiratory distress . The prognosis after tracheal surgery was commonly poor and was similar to that after emergency operation as a general accep - tance for the reason of unfavorable general condtion . The present study was to define clinical problems in which the salvage after tracheal surgery was entirely difficult. The improvement of the prognosis following tracheal surgery should be found in maximum endeavor for prevention of postoperative complication related to operative death intimately. However, terminal tracheostomy employed for lesions of cervical trachea was one o

An Evaluation of Surgical Problems for Carcinoma of Esophagus in view of Autopsy Findings

By comparison of the findings in operation and those in autopsy, 9 cases of death within 30 days after esophagectomy and dissection of the lymph node for thoracic esophageal cancer were examined mainly on the influence of dissection of the lymph node. In autopsy, remained metastatic lymph node was observed in 4 of them (44,4%). Remained metastatic thoracic lymph node was to the tracheobronchial lymph node group. Metastatic abdominal lymph node was observed in many cases at the operation, but in autopsy remained cancer in this area was not observed. It is proved that remained metastatic lymph node in the abdomen at autopsy is in paraaortic lymph node in high rate. It was examined by the experiment with the dogs that frequency of pulmonary complication will be higher if extended radical mediastinal lymph node dissection is performed. In the experiment, decrease of lung surfactant, rise in pulmonary wedge pressure, trouble in perfusion of pulmonary lymph flow in the experiment by dye solution, and interstitial edema and alveolar edema in the lung in histological examination were observed. As described above, since direct operative death after esophagectomy is related to respiratory complications, treatments for this complications may be able to be improved, if the cause is made clear and pathological treatments are carried out. In order to improve surgical treatments for metastasis to the lymph node of esophageal cancer, these points should be given attention to

The Effect of Surgical Repair for Pectum Excavatum on Cardiopulmonary Function

In five patients with corrective surgery for pectus Excavatum, the effectiveness of surgical repair were evaluated from the results of pulmonary function test as well as the finding on ECG according to follow-up study postoperativelly. Of five patient undergone the corrective surgery which sternoturnover with costalplasty employed in 4, and sternoplasty alone in I, all of them were male and the average age except 3 years of age was 14.8 years ranging from 10 to 21 years. There are no manifestation of clinical syndrome in all 5 cases. However, the fair mental growth demands psychologically the early corrective surgery in young chidren. By follow-up study after surgical correction for pectus excavatum during a period from 3 months to 3 years and 3 months, the finding on EKG of right ventricular overload revealed the improvement within 2 months after surgical correction in contrast the results of pulmonary function test disclosed no marked changes until 2 months following surgery. From the view of cosmetic efficacy of corrective surgery, sternoturnover with or without costalplasty are one of the adovocating operative procedures

The Clinical Evaluation of Radical Lobectomy with Sleeve Resection of both the Bronchus and the Pulmonary Artery for Lung Cancer

Operative procedures of lobectomy with sleeve anastomosis of both the bronchus and pulmonary artery were evaluated in 5 patients undergone surgery. 1) The indications of this operation exist in patients with hillar type of lung cancer with cancerous invasion into the wall of the pulmonary artery segmentally. The lesions in left side were not infrequently indicated rather than that in right side. 2) Three patients were followed for three months to 2 years and 3 months. Two of them are alive from 3 months to 2 years and 3 months without recurrence respectively. The remaining one died in one year and half postoperatively of local recurrence and distant metastasis. 3) We encountered in 2 cases of hospital death unrelated operative techiniques. From one experience of autopsy on postoperative 12th day, the ischemic lesion of the lung was detected following the cessation of pulmonary flow by torsion in the anastomotic site. It was emphasized that pulmonary blood flow is necessary to nourish the lung under interruption of bronchial flow by bronchoplastic procedure. The cause of the remaining one was hemorrhagic diathesis owing to hyperfibrinolytic activity