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[PMID]:29489689
[Au] Autor:Jiang L; Tao T; Zheng J; Jia Z; Xu H; Ni Y
[Ad] Endereço:Department of Cardiothoracic Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China.
[Ti] Título:Case report of refractory pericardial effusion associated with lymphatic fistula due to surgical injury during sternotomy.
[So] Source:Medicine (Baltimore);97(9):e9892, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: A 35-year old Chinese female was admitted to hospital with refractory pericardial effusions 10 days post mitral valve replacement via median sternotomy. We performed an exploratory resternotomy and found lymphatic leakage on the surface of the diaphragm which was continuously emitting a light yellow fluid. PATIENT CONCERNS: The patient complained of no obvious discomfort except for the concern of massive pericardial effusion drainage. DIAGNOSES: Exploratory resternotomy and biochemical testing lead to a supradiaphragmatic lymphatic fistula being diagnosed as the cause of the refractory pericardial effusion. INTERVENTIONS: The fistula was closed with a continuous suture and no other fistulas were found after a thorough exploration. OUTCOMES: The patient was discharged home on postoperative day 5 and recovery was uneventful. LESSONS: In this case a timely exploratory resternotomy proved effective in seeking the cause of and treating pericardial effusion following cardiac surgery.
[Mh] Termos MeSH primário: Complicações Intraoperatórias/etiologia
Doenças Linfáticas/complicações
Derrame Pericárdico/etiologia
Fístula do Sistema Respiratório/complicações
Esternotomia/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Diafragma/patologia
Diafragma/cirurgia
Drenagem
Feminino
Seres Humanos
Complicações Intraoperatórias/patologia
Doenças Linfáticas/patologia
Derrame Pericárdico/cirurgia
Fístula do Sistema Respiratório/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009892


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[PMID]:29262461
[Au] Autor:Li WP; Xu HM; Zhao LM; Li XY
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University; Shanghai 200062, China.
[Ti] Título:[Advances in endoscopic treatment of congenital pyriform sinus fistula in children].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;52(12):952-955, 2017 Dec 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Pyriform sinus fistula is a rare clinical disease, often with recurrent acute suppurative thyroiditis or neck infection in children.The traditional method treatment is complete resection of the fistula with or without hemithyroidectomy in external cervical surgical approach, but in recent years, minimally invasive endoscopic occlusion of the internal opening for the treatment of pyriform sinus fistula is performed in many hospitals, including electrocautery, chemocautery, laser cauterization, biocauterization, and suture closure. Literatures about endoscopic management of pyriform sinus fistula in children are reviewed and various surgical methods, complications and success rate are evaluated.
[Mh] Termos MeSH primário: Endoscopia/métodos
Doenças Faríngeas/terapia
Seio Piriforme
Fístula do Sistema Respiratório/terapia
[Mh] Termos MeSH secundário: Cauterização
Criança
Eletrocoagulação
Feminino
Seres Humanos
Terapia a Laser
Masculino
Pescoço/cirurgia
Doenças Faríngeas/congênito
Recidiva
Fístula do Sistema Respiratório/congênito
Estudos Retrospectivos
Tireoidectomia
Tireoidite Supurativa/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2017.12.019


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[PMID]:28858113
[Au] Autor:Kiuchi MG; Lobato GM; Chen S
[Ad] Endereço:aArtificial Cardiac Stimulation Division bAnesthesiology Division, Department of Medicine, Hospital e Clínica São Gonçalo, São Gonçalo, RJ, Brazil cDepartment of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Título:Extraction of a dual-chamber pacemaker and inserting of a new automatic implantable cardioverter defibrillator: The easy procedure almost became catastrophic: a case report.
[So] Source:Medicine (Baltimore);96(35):e7919, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The cardiovascular illnesses are in the middle of the foremost reasons of death around the world. Deaths in Europe, from sudden cardiac death (SCD), reach nearby 700,000 individuals every year. In the United States, statistics point to the existence of nearly 1 million yearly deaths from cardiovascular sickness, of which 330,000 are the consequence of abrupt. The significance of automatic implantable cardioverter-defibrillator (ICD) has been proven in subjects with preceding myocardial infarction and stark systolic left ventricular dysfunction (secondary prevention). CASE PRESENTATION: In this case, we describe a female patient, 94 years old, with a dual-chamber pacemaker since 2014, normal functioning, and controlled hypertension. The patient was in use of bisoprolol 10 mg daily, hydrochlorothiazide 25 mg daily, and candesartan cilexetil 16 mg daily. She presented 2 episodes of syncope associated with the high ventricular rate (HVR), which characterizes sustained ventricular tachycardia (SVT) due to its instability, besides 1 episode of cardiorespiratory arrest. During an attempt to position the active monocoil shock lead in the right ventricle, there was perforation of the upper posterolateral wall of the right atrium, transfixing the pericardium and constituting a pericardial-pleural fistula with hemothorax formation in the right hemithorax. We chose to remove the electrodes and suture the left pocket. There was no cardiac tamponade or pericardial effusion, verified by a pericardial puncture. Thoracic drainage was introduced into the right hemithorax, and 3 L of blood were drained acutely with volume replacement and hemotransfusion. We maintained thoracic drainage in water seal. The ICD was implanted on the right side. CONCLUSION: So, in this case, we reported a rare complication during pacemakers or ICD implantation that is the pericardial-pleural fistula with hemothorax formation in the contralateral hemithorax. Despite the patient's advanced age, we had the dexterity and luck to save her life.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Procedimentos Cirúrgicos Cardíacos/métodos
Hemotórax/etiologia
Fístula do Sistema Respiratório/etiologia
Taquicardia Ventricular/cirurgia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Desfibriladores Implantáveis
Feminino
Seres Humanos
Marca-Passo Artificial
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007919


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[PMID]:28766955
[Au] Autor:Mei J; Huang Z; Wu K; Zhao Y; Yang J; Liu Y
[Ad] Endereço:1 Department of Otorhinolaryngology, Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
[Ti] Título:Risk Factors of Stomal Recurrence After Laryngectomy: A Systematic Review and Meta-analysis.
[So] Source:Ann Otol Rhinol Laryngol;126(9):654-668, 2017 Sep.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We wished to investigate the risk factors for stoma recurrence following laryngectomy. METHODS: PubMed, Cochrane Library, and Embase were searched to identify primary research studies published between January 1, 1967, and October 31, 2016. We only included observational epidemiological studies and used risk ratios (RRs) and 95% confidence intervals (CI) to summarize the primary risk factors associated with recurrence following laryngectomy. RESULTS: A total of 44 articles, including 11 928 patients, were included in the current meta-analysis. The pooled estimates of the stomal recurrence rate and the local recurrence rate following laryngectomy were 6.60% (95% CI, 5.40-7.90) and 19.40% (95% CI, 14.00%-24.80%), respectively. For stomal recurrence, we confirmed a series of earlier identified factors, including tumor site, prior tracheotomy, tracheotomy timing, T-classification, lymph node metastases, postoperative pharyngoperistomal fistula, and a positive surgical margin. For local recurrence, postoperative radiotherapy, overexpression of p53, and overexpression of p21 were significant, while preoperative tracheostomy and postoperative pharyngoperistomal fistula had an unexpectedly low impact on risk. CONCLUSION: This study has confirmed a series of earlier identified factors for stomal recurrence and local recurrence following laryngectomy. Our results will provide important insights for clinical practice.
[Mh] Termos MeSH primário: Neoplasias Laríngeas/cirurgia
Laringectomia
Recidiva Local de Neoplasia/epidemiologia
Estomas Cirúrgicos/patologia
Traqueostomia
[Mh] Termos MeSH secundário: Inibidor de Quinase Dependente de Ciclina p21/metabolismo
Seres Humanos
Neoplasias Laríngeas/metabolismo
Neoplasias Laríngeas/patologia
Linfonodos/patologia
Margens de Excisão
Recidiva Local de Neoplasia/patologia
Estadiamento de Neoplasias
Doenças Faríngeas/epidemiologia
Radioterapia Adjuvante
Fístula do Sistema Respiratório/epidemiologia
Fatores de Risco
Traqueostomia/estatística & dados numéricos
Traqueotomia/estatística & dados numéricos
Proteína Supressora de Tumor p53/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (CDKN1A protein, human); 0 (Cyclin-Dependent Kinase Inhibitor p21); 0 (TP53 protein, human); 0 (Tumor Suppressor Protein p53)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417720221


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[PMID]:28296740
[Au] Autor:Ren H; Duan L; Zhao B; Wu X; Zhang H; Liu C
[Ad] Endereço:Department of Pediatric Surgery, Children's Hospital of Shanxi Province, Shanxi, China.
[Ti] Título:Diagnosis and treatment of communicating bronchopulmonary foregut malformation: Report of two cases and review of the literature.
[So] Source:Medicine (Baltimore);96(11):e6307, 2017 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Communicating bronchopulmonary foregut malformation (CBPFM) is a rare congenital malformation involving both the digestive and respiratory systems. To our best knowledge, most cases of CBPFM reported in the literature were in infancy or adulthood and CBPFM in infantile is even rarer with a high case-fatality rate partly due to misdiagnosis. PATIENT CONCERNS: We presented 2 cases of neonatal CBPFM. A 11-hour male newborn was admitted because of moaning for 7 hours, and a 1-day male newborn was referred to us with profuse foams, choking on breast-milk feeding and facial cyanosis. DIAGNOSES: With the assistance of upper gastrointestinal tract imaging and contrast-enhanced chest computed tomography (CT), the diagnosis was established according to the most recent diagnostic criteria. INTERVENTIONS: The case one recieved a lower left pneumonectomy and surgical repair of esophageal fistula. The case two was performed with a surgical repair of esophageal atresia and esophageal tracheal fistula firstly, and then also received a repair of communicating bronchopulmonary foregut malformation two weeks after the first operation. OUTCOMES: The case one was cured and discharged 2 weeks after admission. Unfortunately the case two died from respiratory failure. LESSONS: Pediatric surgeons should therefore be aware that type I CBPMF is rare and preoperative diagnosis is usually difficult. Maldiagnosis is uncommon because clinicians often focus their attention on esophageal atresia and neglect pulmonary abnormalities. Other than upper gastrointestinal tract radiography and CT scan, bronchoscopy should be considered in pediatric patients with esophageal atresia complicated with pulmonary abnormalities, knowing that bronchoscopy may help confirm the diagnosis and select surgical strategies.
[Mh] Termos MeSH primário: Anormalidades Múltiplas/diagnóstico por imagem
Anormalidades Múltiplas/cirurgia
[Mh] Termos MeSH secundário: Obstrução das Vias Respiratórias
Anormalidades do Sistema Digestório/diagnóstico por imagem
Anormalidades do Sistema Digestório/cirurgia
Endoscopia do Sistema Digestório
Atresia Esofágica/cirurgia
Seres Humanos
Recém-Nascido
Masculino
Anormalidades do Sistema Respiratório/diagnóstico por imagem
Anormalidades do Sistema Respiratório/cirurgia
Fístula do Sistema Respiratório/diagnóstico por imagem
Fístula do Sistema Respiratório/cirurgia
Tomografia Computadorizada por Raios X
Traqueia/diagnóstico por imagem
Traqueia/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170403
[Lr] Data última revisão:
170403
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006307


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[PMID]:28267436
[Au] Autor:Dugan KC; Laxmanan B; Murgu S; Hogarth DK
[Ad] Endereço:Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, IL.
[Ti] Título:Management of Persistent Air Leaks.
[So] Source:Chest;152(2):417-423, 2017 Aug.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Alveolar-pleural fistulas causing persistent air leaks (PALs) are associated with prolonged hospital stays and high morbidity. Prior guidelines recommend surgical repair as the gold standard for treatment, albeit it is a solution with limited success. In patients who have recently undergone thoracic surgery or in whom surgery would be contraindicated based on the severity of illness, there has been a lack of treatment options. This review describes a brief history of treatment guidelines for PALs. In the past 20 years, newer and less invasive treatment options have been developed. Aside from supportive care, the literature includes anecdotal successful reports using fibrin sealants, ethanol injection, metal coils, and Watanabe spigots. More recently, larger studies have demonstrated success with chemical pleurodesis, autologous blood patch pleurodesis, and endobronchial valves. This manuscript describes these treatment options in detail, including postprocedural adverse events. Further research, including randomized controlled trials with comparison of these options, are needed, as is long-term follow-up for these interventions.
[Mh] Termos MeSH primário: Pneumopatias/terapia
Doenças Pleurais/terapia
Fístula do Sistema Respiratório/terapia
[Mh] Termos MeSH secundário: Ar
Tubos Torácicos
Doença Crônica
Feminino
Seres Humanos
Pneumopatias/complicações
Masculino
Doenças Pleurais/complicações
Pleurodese/instrumentação
Pleurodese/métodos
Pneumotórax/etiologia
Guias de Prática Clínica como Assunto
Fístula do Sistema Respiratório/complicações
Fatores de Risco
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE


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ASSAD, Renato Samy
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[PMID]:28082466
[Au] Autor:Scordamaglio PR; Tedde ML; Minamoto H; Assad RS; Fernandes PMP
[Ad] Endereço:Division of Respiratory Endoscopy, Heart Institute (InCor) University of Sao Paulo School of Medicine, São Paulo, SP, Brazil.
[Ti] Título:Can total bronchopleural fistulas from complete stump dehiscence be endoscopically treated?
[So] Source:Eur J Cardiothorac Surg;51(4):702-708, 2017 04 01.
[Is] ISSN:1873-734X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Objectives: Bronchopleural fistula (BPF) is an uncommon complication following a lung resection to address various conditions. BPFs are associated with high morbidity and mortality rates. This study evaluated the endoscopic treatment of 'total' BPFs using the Occlutech-Fígulla® cardiac device at a single centre. Methods: We selected nine patients with chronic and complete BPFs. Under direct bronchoscopic visualization, the BPFs were treated using the Occlutech-Fígulla device. The patients were followed up for 12 months to determine the treatment level and complications. Results: The procedure had a favourable outcome in three patients, resulting in complete fistula closure. Two patients had partial closure and showed improvements in their clinical conditions. In two other cases, closure of the bronchial stump was unsuccessful using this method. Two patients died from causes unrelated to the procedure or the device. During the follow-up period, no complications related to infection or device-related injuries were reported. Conclusions: In patients without clinical conditions that require surgical treatment, the Occlutech-Fígulla cardiac device can be a safe and effective method for the endoscopic treatment of large BPFs resulting from complete dehiscence of a bronchial stump. No severe events were reported.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Fístula do Sistema Respiratório/etiologia
Fístula do Sistema Respiratório/cirurgia
Deiscência da Ferida Operatória/complicações
[Mh] Termos MeSH secundário: Adulto
Idoso
Fístula Brônquica/etiologia
Fístula Brônquica/cirurgia
Broncoscopia/efeitos adversos
Doença Crônica
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Doenças Pleurais/etiologia
Doenças Pleurais/cirurgia
Pneumonectomia/efeitos adversos
Estudos Prospectivos
Dispositivo para Oclusão Septal/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170114
[St] Status:MEDLINE
[do] DOI:10.1093/ejcts/ezw377


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[PMID]:27519594
[Au] Autor:Han X; Li L; Zhao Y; Liu C; Jiao D; Ren K; Wu G
[Ad] Endereço:Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
[Ti] Título:Individualized airway-covered stent implantation therapy for thoracogastric airway fistula after esophagectomy.
[So] Source:Surg Endosc;31(4):1713-1718, 2017 Apr.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Thoracogastric airway fistula (TGAF) is a rare and dangerous complication of esophagectomy performed for esophageal and cardiac carcinomas. Herein, we aimed to explore the feasibility and efficacy of individualized airway stent implantation for the treatment of TGAF after esophagectomy. METHODS: Based on different TGAF types and relevant data on chest computed tomography, customized airway-covered stents were positioned so as to cover the entrance to the fistula by an interventional radiologist using fluoroscopic guidance. RESULTS: Of the 63 patients with TGAF, 12 had thoracogastric-tracheal fistulas, 14 had thoracogastric-carinal fistulas, 21 had thoracogastric-left main bronchial fistulas, 15 had thoracogastric-right main bronchial fistulas, and 1 had a thoracogastric-right intermediate bronchial fistula. The following different stent types were placed: 7 straight self-expandable covered metallic stents, 2 hinged self-expandable covered metallic stents, 41 Y-shaped self-expandable covered metallic stents, and 13 large Y and small Y paired self-expandable covered metallic stents. In all 59 cases (93.65 %), the implantation was successful at the first attempt, with the procedure times ranging from 5 to 10 min. Esophagograms with water-soluble iodinated contrast showed that the fistulae were completely covered with no contrast flowing into the airways and lungs, and with the stents fully expanded. We recorded four cases (6.35 %) of incomplete or recurrent fistula closure. CONCLUSION: Customized airway-covered stents may be an appropriate palliative therapy for patients with thoracogastric airway fistula who are unfit for surgery or have a high postoperative risk.
[Mh] Termos MeSH primário: Esofagectomia
Fístula Gástrica/terapia
Complicações Pós-Operatórias/terapia
Fístula do Sistema Respiratório/terapia
Stents
[Mh] Termos MeSH secundário: Adulto
Idoso
Fístula Brônquica/etiologia
Fístula Brônquica/terapia
Estudos de Viabilidade
Feminino
Seguimentos
Fístula Gástrica/etiologia
Seres Humanos
Masculino
Meia-Idade
Fístula do Sistema Respiratório/etiologia
Estudos Retrospectivos
Doenças da Traqueia/etiologia
Doenças da Traqueia/terapia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160814
[St] Status:MEDLINE
[do] DOI:10.1007/s00464-016-5162-9


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[PMID]:27177264
[Au] Autor:Li Y; Hu X; Jiang G; Chen C
[Ad] Endereço:Department of General Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
[Ti] Título:Pneumonectomy for Treatment of Destroyed Lung: A Retrospective Study of 137 Patients.
[So] Source:Thorac Cardiovasc Surg;65(7):528-534, 2017 Oct.
[Is] ISSN:1439-1902
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Whether pneumonectomy is needed for the treatment of destroyed lungs is still controversial and unresolved in the clinic. Pneumonectomy is destructive and is associated with a significant incidence of postoperative complications. The purpose of this study is to analyze the operative techniques, postoperative morbidity, mortality, and long-term outcomes of patients with destroyed lungs who underwent pneumonectomy. We retrospectively analyzed 137 patients with destroyed lungs who underwent pneumonectomy. The data were queried for the details of operative technique, development of perioperative complications, mortality, and long-term survival. Univariate and multivariate analyses were performed to investigate the risk factors of pneumonectomy among the patients. A total of 77 male and 60 female patients were reviewed. The youngest patient was 18 years, and the oldest was 75 years, with a mean age of 40.1 years. Postoperative complications were observed in 25 patients (18.2%). The rate of bronchopleural fistula (BPF) was 5.1% (7/137). Two perioperative deaths (1.5%) were noted. Univariate and multivariate analyses indicated the blood loss (hazard ratio [HR], 5.32; 95% confidence interval [CI], 1.27-18.50; = 0.021) was the independent risk factor of postoperative complications, and the type of the disease (HR, 4.50; 95% CI, 1.19-9.69; = 0.034) was the independent risk factor of the BPF, for the patients with destroyed lung after pneumonectomy. Pneumonectomy for destroyed lung is a high risk for postoperative complications. Our findings suggested that pneumonectomy in destroyed lung was satisfactory with strict surgical indications, adequate preoperative preparation, and careful operative technique, and the long-term outcomes can be especially satisfactory. Pneumonectomy for destroyed lung is still a treatment option.
[Mh] Termos MeSH primário: Pneumopatias/cirurgia
Pulmão/cirurgia
Pneumonectomia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Fístula Brônquica/etiologia
Feminino
Seres Humanos
Modelos Logísticos
Pulmão/diagnóstico por imagem
Pulmão/patologia
Pneumopatias/diagnóstico por imagem
Pneumopatias/patologia
Masculino
Meia-Idade
Análise Multivariada
Doenças Pleurais/etiologia
Pneumonectomia/efeitos adversos
Pneumonectomia/mortalidade
Fístula do Sistema Respiratório/etiologia
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160514
[St] Status:MEDLINE
[do] DOI:10.1055/s-0036-1583524


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[PMID]:26269390
[Au] Autor:Hirano T; Iwasaki T; Fujita K; Takeno S; Suzuki M
[Ad] Endereço:Department of Otolaryngology, Faculty of Medicine, Oita University, Oita, Japan.
[Ti] Título:Repair of a large pharyngocutaneous fistula with a free jejunal patch flap after salvage laryngectomy: A case report.
[So] Source:Microsurgery;37(1):61-65, 2017 Jan.
[Is] ISSN:1098-2752
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Preoperative chemoradiation therapy increases the risk of pharyngocutaneous fistula (PCF) after laryngectomy. In this report, we describe the use of a free jejunal patch flap and a deltopectoral flap for surgical treatment of a large PCF. A 52-year-old man underwent salvage laryngectomy and right neck dissection after concurrent radiotherapy for laryngeal carcinoma. On postoperative day 5, a pharyngeal fistula and neck abscess occurred with the right internal jugular vein thrombosis. We sutured the pharyngeal mucosa to the cervical skin to avoid carotid artery exposure, and we also ligated the right internal jugular vein. The PCF developed afterwards. The patient was being fed through a nasogastric tube and the fistula had increased in size. At the time of surgery, the external orifice became 5 cm × 5 cm in size. We performed the repair with a free jejunal patch flap and a deltopectoral flap. The harvested jejunum was opened along its antimesenteric border to design a sufficient free jejunal flap to cover the large PCF. A deltopectoral pedicled flap was used to reconstruct the neck skin defect to resurface the free jejunal patch flap. Both flaps survived. The patient could resume an oral diet 2 weeks after surgery. At 1 month after surgery, the skin pedicle of the deltopectoral flap was divided. There was no contracture or stricture 3 years after surgery and he maintained a regular diet. Reconstruction with a free jejunal patch flap and a deltopectoral flap may be a suitable method for repair of a large PCF. © 2014 Wiley Periodicals, Inc. Microsurgery 37:61-65, 2017.
[Mh] Termos MeSH primário: Fístula Cutânea/cirurgia
Retalhos de Tecido Biológico/transplante
Jejuno/transplante
Doenças Faríngeas/cirurgia
Complicações Pós-Operatórias/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Fístula do Sistema Respiratório/cirurgia
[Mh] Termos MeSH secundário: Fístula Cutânea/etiologia
Seres Humanos
Laringectomia
Masculino
Meia-Idade
Doenças Faríngeas/etiologia
Fístula do Sistema Respiratório/etiologia
Terapia de Salvação
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150814
[St] Status:MEDLINE
[do] DOI:10.1002/micr.22464



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