1
|
García-Laorden MI, Hernández-Brito E, Muñoz-Almagro C, Pavlovic-Nesic S, Rúa-Figueroa I, Briones ML, Rajas O, Borderías L, Payeras A, Lorente L, Freixinet J, Ferreres J, Obando I, González-Quevedo N, Rodríguez de Castro F, Solé-Violán J, Rodríguez-Gallego C. Should MASP-2 Deficiency Be Considered a Primary Immunodeficiency? Relevance of the Lectin Pathway. J Clin Immunol 2020; 40:203-210. [PMID: 31828694 PMCID: PMC7223972 DOI: 10.1007/s10875-019-00714-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/29/2019] [Indexed: 01/19/2023]
Abstract
Mannose-binding lectin (MBL)-associated serine protease-2 (MASP-2) is an indispensable enzyme for the activation of the lectin pathway of complement. Its deficiency is classified as a primary immunodeficiency associated to pyogenic bacterial infections, inflammatory lung disease, and autoimmunity. In Europeans, MASP-2 deficiency, due to homozygosity for c.359A > G (p.D120G), occurs in 7 to 14/10,000 individuals. We analyzed the presence of the p.D120G mutation in adults (increasing the sample size of our previous studies) and children. Different groups of patients (1495 adults hospitalized with community-acquired pneumonia, 186 adults with systemic lupus erythematosus, 103 pediatric patients with invasive pneumococcal disease) and control individuals (1119 healthy adult volunteers, 520 adult patients without history of relevant infectious diseases, and a pediatric control group of 311 individuals) were studied. Besides our previously reported MASP-2-deficient healthy adults, we found a new p.D120G homozygous individual from the pediatric control group. We also reviewed p.D120G homozygous individuals reported so far: a total of eleven patients with a highly heterogeneous range of disorders and nine healthy controls (including our four MASP-2-deficient individuals) have been identified by chance in association studies. Individuals with complete deficiencies of several pattern recognition molecules of the lectin pathway (MBL, collectin-10 and collectin-11, and ficolin-3) as well as of MASP-1 and MASP-3 have also been reviewed. Cumulative evidence suggests that MASP-2, and even other components of the LP, are largely redundant in human defenses and that individuals with MASP-2 deficiency do not seem to be particularly prone to infectious or autoimmune diseases.
Collapse
Affiliation(s)
- M Isabel García-Laorden
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Elisa Hernández-Brito
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Department of Medical and Surgical Sciences, School of Medicine, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Carmen Muñoz-Almagro
- Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Svetlana Pavlovic-Nesic
- Department of Pediatrics, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Iñigo Rúa-Figueroa
- Rheumatology Service, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - M Luisa Briones
- Department of Respiratory Diseases, Hospital Clínico y Universitario de Valencia, Valencia, Spain
| | - Olga Rajas
- Department of Respiratory Diseases, Hospital Universitario de la Princesa, Madrid, Spain
| | - Luis Borderías
- Department of Respiratory Diseases, Hospital San Jorge, Huesca, Spain
| | - Antoni Payeras
- Department of Internal Medicine, Hospital Son Llatzer, Palma de Mallorca, Spain
| | - Leonardo Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Spain
| | - Jordi Freixinet
- Department of Thoracic Surgery, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose Ferreres
- Intensive Care Unit, Hospital Clínico y Universitario de Valencia, Valencia, Spain
| | - Ignacio Obando
- Department of Pediatrics, Hospital Virgen del Rocío, Sevilla, Spain
| | - Nereida González-Quevedo
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Felipe Rodríguez de Castro
- Department of Medical and Surgical Sciences, School of Medicine, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Department of Respiratory Diseases, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Jordi Solé-Violán
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Intensive Care Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Carlos Rodríguez-Gallego
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
- University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
| |
Collapse
|
2
|
Rodriguez-Fuster A, Belda-Sanchis J, Aguilo R, Embun R, Mojal S, Call S, Molins L, Rivas de Andres JJ, Zafra JR, Navarrete CP, de la Cruz Lozano J, Rivas de Andres JJ, Flor RE, Freixinet J, Carbajo MC, Rombola CA, Heras F, Molins L, Mier Odriozola JM, Doyague FR, Rodriguez-Fuster A, Arrayas EC, Garay MR, Call S, Araujo EF, Barajas SG, Prim JMG, Gonzalez D, Ramos MB, Sarceda JRJ, Pascual RP, Molina GM, Fernandez MCM, Olaiz BD, Tristan AA, Franco CG, Wins R, Arnau A, Padilla JMC, Carriquiry G, Rosenberg M, Smith D. Morbidity and mortality in a large series of surgical patients with pulmonary metastases of colorectal carcinoma: a prospective multicentre Spanish study (GECMP-CCR-SEPAR). Eur J Cardiothorac Surg 2013; 45:671-6. [DOI: 10.1093/ejcts/ezt459] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
|
3
|
López-Encuentra A, López-Ríos F, Conde E, García-Luján R, Suárez-Gauthier A, Mañes N, Renedo G, Duque-Medina JL, García-Lagarto E, Rami-Porta R, González-Pont G, Astudillo-Pombo J, Maté-Sanz JL, Freixinet J, Romero-Saavedra T, Sánchez-Céspedes M, Gómez de la Camara A. Composite anatomical-clinical-molecular prognostic model in non-small cell lung cancer. Eur Respir J 2010; 37:136-42. [PMID: 20817702 DOI: 10.1183/09031936.00028610] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of the present study was to elaborate a survival model that integrates anatomic factors, according to the 2010 seventh edition of the tumour, node and metastasis (TNM) staging system, with clinical and molecular factors. Pathologic TNM descriptors (group A), clinical variables (group B), laboratory parameters (group C) and molecular markers (tissue microarrays; group D) were collected from 512 early-stage nonsmall cell lung cancer (NSCLC) patients with complete resection. A multivariate analysis stepped supervised learning classification algorithm was used. The prognostic performance by groups was: areas under the receiver operating characteristic curve (C-index): 0.67 (group A), 0.65 (Group B), 0.57 (group C) and 0.65 (group D). Considering all variables together selected for each of the four groups (integrated group) the C-index was 0.74 (95% CI 0.70-0.79), with statistically significant differences compared with each isolated group (from p = 0.006 to p < 0.001). Variables with the greatest prognostic discrimination were the presence of another ipsilobar nodule and tumour size > 3 cm, followed by other anatomical and clinical factors, and molecular expressions of phosphorylated mammalian target of rapamycin (phospho-mTOR), Ki67cell proliferation index and phosphorylated acetyl-coenzyme A carboxylase. This study on early-stage NSCLC shows the benefit from integrating pathological TNM, clinical and molecular factors into a composite prognostic model. The model of the integrated group classified patients with significantly higher accuracy compared to the TNM 2010 staging.
Collapse
|
4
|
Freixinet J, Caballero-Hidalgo A, López-Valcárcel BG, García Fernández JL, Royo Crespo Í, Salvatierra Velázquez Á, Canalís Arrayás E, Sánchez García M, Torres Lanzas J, Varela Simó G, Muguruza Trueba I, Mariñán Gorospe M, Cantó Armengod A. Fe de errores de “Análisis de la situación actual y previsión de futuro de la especialidad de cirugía torácica”. Arch Bronconeumol 2009. [DOI: 10.1016/j.arbres.2009.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
5
|
Freixinet J, Caballero-Hidalgo A, González López-Valcárcel B, García Fernández JL, Crespo Royo Í, Salvatierra Velázquez Á, Canalís Arrayás E, Sánchez García M, Torres Lanzas J, Varela Simó G, Muguruza Trueba I, Mariñán Gorospe M, Cantó Armengod A. Análisis de la situación actual y previsión de futuro de la especialidad de cirugía torácica. Arch Bronconeumol 2009; 45:107-10. [DOI: 10.1016/j.arbres.2008.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Accepted: 03/29/2008] [Indexed: 10/21/2022]
|
6
|
Freixinet J, Beltrán J, Miguel Rodríguez P, Juliá G, Hussein M, Gil R, Herrero J. Indicadores de gravedad en los traumatismos torácicos. Arch Bronconeumol 2008. [DOI: 10.1157/13119941] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
7
|
Freixinet J, Beltrán J, Rodríguez PM, Juliá G, Hussein M, Gil R, Herrero J. [Indicators of severity in chest trauma]. Arch Bronconeumol 2008; 44:257-262. [PMID: 18448017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE We undertook a review of patients with chest trauma attended between January 1992 and June 2005 in order to establish severity criteria in these cases. PATIENTS AND METHODS During the study period, 1,772 cases (1,346 [76%] males) were treated, with ages ranging from 7 to 98 years (mean, 46.4 years). The Revised Trauma Score (RTS) was calculated and the following variables were also studied as potential indicators of severity: age, extent of the injury, number of rib fractures, presence of lung contusion, hemothorax, cardiorespiratory repercussions, and need for mechanical ventilation. RESULTS At the time of admission, 84.4% of patients presented only symptoms related to the injury, with no general repercussions, and 66.7% had an RTS of 12. The number of rib fractures was a reliable indicator of severity, as was the presence of multiple injuries, lung contusion, need for mechanical ventilation, and cardiorespiratory repercussions. Neither age nor presence of hemothorax was found to be an indicator of severity. Pleural drainage was performed in 756 cases and was effective in 670 (88.6%). CONCLUSIONS There are a number of indicators of severity in chest trauma, related more closely to the type and repercussions of the trauma than to the age of the patient. There is a high incidence of fluid or gas accumulation in the pleural space, though this can be easily managed by pleural drainage, which constitutes the main therapeutic procedure in chest trauma.
Collapse
Affiliation(s)
- Jordi Freixinet
- Servicio de Cirugía Torácica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España
| | | | | | | | | | | | | |
Collapse
|
8
|
Rodríguez P, Romero T, Rodríguez de Castro F, Hussein M, Freixinet J. Bronchogenic carcinoma associated with rheumatoid arthritis: role of FDG-PET scans. Rheumatology (Oxford) 2006; 45:359-60. [PMID: 16436491 DOI: 10.1093/rheumatology/kel006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
9
|
Freixinet J, Rodríguez P, Hussein M. [Spontaneous pneumothorax due to a ruptured pulmonary artery aneurysm in Rendu-Osler-Weber disease]. Arch Bronconeumol 2005; 41:641-2. [PMID: 16324605 DOI: 10.1016/s1579-2129(06)60302-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Freixinet J, Rodríguez P, Hussein M. Hemotórax espontáneo por rotura de aneurisma de arteria pulmonar en la enfermedad de Rendu-Osler-Weber. Arch Bronconeumol 2005. [DOI: 10.1157/13081257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
11
|
Rami-Porta R, Mateu-Navarro M, Freixinet J, de la Torre M, Torres-García AJ, Pun YW, Armengod AC. Type of resection and prognosis in lung cancer. Experience of a multicentre study. Eur J Cardiothorac Surg 2005; 28:622-8. [PMID: 16126400 DOI: 10.1016/j.ejcts.2005.06.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Revised: 06/18/2005] [Accepted: 06/21/2005] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Analysis of prognosis of the different types of resections for lung cancer defined by the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S). METHODS From October 1993 to September 1997, 2994 patients with bronchogenic carcinoma who underwent thoracotomy were prospectively recruited by the GCCB-S. Prior to recruitment, the GCCB-S had defined two types of non-resectional operations (diagnostic and exploratory thoracotomies) and three types of resections (complete-CR-: free resection margins, mediastinal nodal dissection, no extracapsular nodal involvement, no involvement of most distant removed nodes; relatively incomplete-RIR-: free resection margins, no mediastinal nodal dissection, unremoved nodes, involvement of most distant removed nodes, positive pleural effusion with no pleural implants; and incomplete-IR-: positive resection margins, extracapsular nodal involvement, unremoved positive nodes, positive pleural effusion with pleural implants). For survival analyses, patients with small cell carcinoma, induction therapy, postoperative mortality, unclassified operation, or lost to follow-up were excluded. The total number of evaluable patients was 2543. RESULTS In 1047 (97%) patients, RIR was defined because they had undergone a lesser nodal evaluation than mediastinal nodal dissection. Five-year survival and 95% confidence interval were: diagnostic thoracotomy 11% (0-30%), exploratory thoracotomy 5% (1-9%), IR 20% (14-26%), RIR 43% (39-47%), and CR 45% (41-49%). Differences between IR and CR or RIR were statistically significant (P<0.0001), but those between CR and RIR were not (P=0.18). CONCLUSIONS CR and RIR should be combined in a single category as complete resection, because they do not discriminate prognostic differences.
Collapse
Affiliation(s)
- Ramón Rami-Porta
- Thoracic Surgery Service, Hospital Mutua de Terrassa, University of Barcelona, Plaza Dr. Robert, 5. 08221 Terrassa (Barcelona), Spain.
| | | | | | | | | | | | | |
Collapse
|
12
|
Abstract
Thymolipoma is an uncommon benign tumor (accounting for 2% to 9% of thymus tumors). We present the case of a 26-year-old man who sought medical attention for left-sided pleural pain of 3 months duration. Computed tomography showed a mass in the left side of the chest occupying both the anterior mediastinum and the left pleural cavity. This mass caused lung collapse and mediastinal shift. Magnetic resonance imaging revealed a large fatty tumor and transthoracic biopsy with radiological guidance confirmed the diagnosis. The tumor was resected through a left thoracotomy. No postsurgical complications occurred and the histopathological diagnosis was thymolipoma.
Collapse
Affiliation(s)
- C Roque
- Servicio de Cirugía Torácica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
| | | | | | | | | | | |
Collapse
|
13
|
|
14
|
Freixinet J, Rodríguez P. [Changes in the surgical treatment of bronchogenic cancer]. Arch Bronconeumol 2005; 41:177-9. [PMID: 15826525 DOI: 10.1016/s1579-2129(06)60421-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Freixinet
- Unidad de Cirugía Torácica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España.
| | | |
Collapse
|
15
|
Freixinet J, Rodríguez P. ¿Se ha modificado el abordaje quirúrgico del cáncer broncogénico? Arch Bronconeumol 2005. [DOI: 10.1157/13073165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
16
|
Rodríguez P, Santana N, Gámez P, Rodríguez de Castro F, Varela de Ugarte A, Freixinet J. La mediastinoscopia para el diagnóstico de la enfermedad mediastínica: análisis de 181 exploraciones. Arch Bronconeumol 2003. [DOI: 10.1157/13042416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
17
|
Rodríguez P, Santana N, Gámez P, Rodríguez de Castro F, Varela de Ugarte A, Freixinet J. [Mediastinoscopy in the diagnosis of mediastinal disease. An analysis of 181 explorations]. Arch Bronconeumol 2003; 39:29-34. [PMID: 12550017 DOI: 10.1016/s0300-2896(03)75311-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To validate our experience with standard cervical mediastinoscopy (SCM) and extended cervical mediastinoscopy (ECM) to diagnose mediastinal nodes and masses, we studied 181 patients between January 1992 and February 2001. SCM and ECM were indicated for diagnostic staging of nodes related to bronchogenic carcinoma (Group I) or of mediastinal masses (Group II). An SCM was performed in all cases to explore the paratracheal region (2R, 2L, 4R, 4L, 7, 10R and 10L); in 21 additional cases, an ECM was performed to explore the aortopulmonary window or the subaortic region (area 5) and the para-aortic region (area 6). In Group I, the sensitivity of SCM was 93.6% and specificity was 100%; the positive predictive value (PPV) was 100%, the negative predictive value (NPV) was 82.8%, and the diagnostic yield was 95.1%. The sensitivity of ECM was 91% and specificity was 100%; PPV was 100%, NPV 93.3% and yield was 96%. In Group II, the sensitivity was 93.3%, specificity 100%, PPV 100%, NPV 81.2% and diagnostic yield 94.8%. The sensitivity of ECM in this group was 80%, specificity was 100%, PPV 100%, NPV 66.7% and yield 85.7%. A 2.7% complication rate was observed, with one case of bleeding after injury to the superior vena cava, one tracheal lesion, one recurring paralysis and two cases of surgical wound infection. The mean postoperative stay was 36 hours and mortality was zero. We conclude that SCM is highly specific for the evaluation of mediastinal node involvement in bronchogenic carcinoma and it is the approach of choice when a diagnosis of lesions located in the mid-mediastinal region has not been reached. ECM is a valid, safe alternative to anterior mediastinotomy for staging nodes and masses occupying para-aortic zones or the aortopulmonary window, with good diagnostic yield, low morbidity and absence of mortality.
Collapse
Affiliation(s)
- P Rodríguez
- Servicio de Cirugía Torácica, Hospital de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | | | | | | | | | | |
Collapse
|
18
|
Mateu M, Freixinet J, Rami R, Rivas J. Cirugía videotoracoscópica: problemas perioperatorios y complicaciones postoperatorias inmediatas. Análisis de 1.573 casos registrados por el Grupo Cooperativo de Cirugía Videotoracoscópica SEPAR (GCCVTSEPAR). Cir Esp 2002. [DOI: 10.1016/s0009-739x(02)71919-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Freixinet J, Rodríguez P, Santana N. [Askin tumor of the chest wall]. Arch Bronconeumol 2002; 38:55. [PMID: 11809140 DOI: 10.1016/s0300-2896(02)75148-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
20
|
Rodríguez P, Santana N, Rodríguez de Castro F, Redondo E, Hussein M, Freixinet J. [Recurring invasive thymoma of the diaphragm]. Arch Bronconeumol 1999; 35:140-2. [PMID: 10216747 DOI: 10.1016/s0300-2896(15)30293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diaphragmatic recurrence of a thymoma is rare. We report the case of a 70-year-old woman who underwent transternal thymectomy and adjuvant radiation therapy, and who was admitted four years later with recurrence of the thymoma in the left hemidiaphragm with infiltration of the inferior ipsilateral pulmonary lobe. The thymoma was excised along with the left hemidiaphragm, chest wall and three ribs and an atypical segmentectomy of the left lower lobe was performed. The hemidiaphragm was reconstructed and the chest wall was repaired with synthetic mesh. Surgery was complemented with radiotherapy.
Collapse
Affiliation(s)
- P Rodríguez
- Unidad de Cirugía Torácica, Hospital Universitario Nuestra Señora del Pino, Las Palmas de Gran Canaria
| | | | | | | | | | | |
Collapse
|
21
|
|
22
|
Abstract
Thoracotomy is used to approach and treat anterior spinal lesions arising from various causes. Between 1990 and 1997, we treated 56 patients (40 men and 16 women) between 14 and 67 years old (mean 38.4). All had spinal lesions that were impossible or difficult to reach by a posterior approach. Thirty-one (55.3%) had suffered spinal damage, 8 (14.3%) had spinal deformities, 7 (12.5%) had metastatic tumors, 5 (8.9%) had herniated discs, 4 (7.1%) had Pott's disease and 1 (1.8%) had osteolysis at D6. Thoracotomy was left-sided in 35 cases (62.5%) and right-sided in 19 (33.9%). Video-assisted thoracoscopy was used twice (3.6%). The level of incision was based on the site of the lesion, and the pleural cavity was opened in all cases except one. The posterolateral pleuro-diaphragmatic fold was dissected and the diaphragm opened for retroperitoneal access in 37 cases (66.1%) of thoracolumbar disease. Orthopedic treatment consisted of autologous bone grafts in all cases and placement of a Kaneda splint in 32 cases (57.1%). One patient had to undergo surgery a second time due to inappropriate placement of the vertebral splint. Pneumothorax occurred in one patient after removal of pleural drains. The incision became infected in one patient, and one case of ileal paralysis was observed. Overall, morbidity was 7.1%. We conclude that thoracotomy offers a good alternative approach to spinal lesions. Results are good and morbidity low.
Collapse
Affiliation(s)
- J Freixinet
- Unidad de Cirugía Torácica, Hospital Universitario Ntra. Stra. del Pino, Las Palmas de Gran Canaria
| | | | | | | | | | | |
Collapse
|
23
|
|
24
|
Abstract
Surgery for pulmonary tuberculosis (PTB) has passed through various stages throughout history, having been the treatment of choice in the past. It has now been relegated to second place for treatment of this disease. One of the most strongly debated surgical indications has been clinical picture of multidrug resistance with the focus of pulmonary tuberculous activity located in a segment, lobe, or lung. In these cases some authors have described good results with surgical excision. Another important indication is the complications of PTB, among which bronchiectases (provoking pictures of suppuration, superinfections, or hemoptysis) are found, along with known destructive pulmonary sequelae such as destroyed lung, massive hemoptysis, and the presence of a bronchopleural fistula that cannot be resolved with pleural drainage. The presence of a neoplasm in a patient affected by PTB is a surgical indication if the lesion is resectable. The existence of an unidentifiable pulmonary mass or node is a surgical criterion because it might signal bronchogenic carcinoma. A frequent indication for surgery is pulmonary aspergilloma, which in a large percentage of cases is a destructive PTB sequela and generates serious complications, hemoptysis being the most frequent. Mediastinal tuberculous lymphadenitis that produces compressive symptoms and pulmonary complications, especially in children, is another surgical indication for decompressing the bronchial tree. The surgery in these cases consists in excision and curettage of adenopathies. Surgery therefore now constitutes a valid option for the treatment of certain clinical pictures of PTB that do not respond to medical treatment, are serious, and are potentially fatal.
Collapse
Affiliation(s)
- J Freixinet
- Thoracic Surgery Service, University Hospital Ntra. Sra. del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain
| |
Collapse
|
25
|
Canalis E, Castella J, Díaz P, Freixinet J, Rivas J, Zalacaín R, Pac J. [Minimal requirements for a respiratory endoscopy unit. Area of Diagnostic and Therapeutic Techniques of the Spanish Society of Pneumology and Thoracic Surgery]. Arch Bronconeumol 1997; 33:92-8. [PMID: 9091121 DOI: 10.1016/s0300-2896(15)30661-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- E Canalis
- Hospital Clínic i Provincial, Barcelona
| | | | | | | | | | | | | |
Collapse
|
26
|
Freixinet J, Canalis E, Rivas JJ, Rodriguez de Castro F, Torres J, Gimferrer JM, Sanchez-Lloret J. Surgical treatment of primary spontaneous pneumothorax with video-assisted thoracic surgery. Eur Respir J 1997; 10:409-11. [PMID: 9042641 DOI: 10.1183/09031936.97.10020409] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report the results of our experience using video-assisted thoracoscopic surgery (VATS) to treat primary spontaneous pneumothorax (PSP) from January 1992 until December 1994 in a multicentered co-operative study. A total of 132 patients (110 males and 22 females, aged 13-38 yrs, mean age 26 yrs) were treated by VATS to deal with the PSP that they presented with. A standard VATS technique was used. Apical bullae were always removed, and mechanical pleural abrasion was performed, leaving a pleural drainage tube. In two cases (1.5%), a switch to thoracotomy was necessary. In eight cases (6%), air leakage persisted for 5 days after surgery, which resolved with pleural drainage. There were eight postoperative relapses (6%), which were treated with pleural drainage (n = 4), VATS (n = 3) or axillar thoracotomy (n = 1). The average postoperative stay was 5.6 days (range 2-15 days). We conclude that video-assisted thoracoscopic surgery is a viable alternative for the treatment of primary spontaneous pneumothorax. There is, however, a high relapse rate, and in a number of cases air leakage persists in the postoperative period.
Collapse
Affiliation(s)
- J Freixinet
- Thoracic Surgery Service, University Hospital Ntra. Sra. del Pino, Canary Island, Spain
| | | | | | | | | | | | | |
Collapse
|
27
|
|
28
|
Freixinet J, Caminero J, Rodríguez de Castro F. [Pulmonary tuberculosis with diaphragm involvement]. Arch Bronconeumol 1996; 32:432-3. [PMID: 8983576 DOI: 10.1016/s0300-2896(15)30732-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
29
|
Solé-Violán J, Rodríguez de Castro F, Rey A, Freixinet J, Aranda A, Caminero J, Bolaños J. Comparison of bronchoscopic diagnostic techniques with histological findings in brain dead organ donors without suspected pneumonia. Thorax 1996; 51:929-31. [PMID: 8984705 PMCID: PMC472617 DOI: 10.1136/thx.51.9.929] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The techniques for recognising pneumonia in mechanically ventilated patients were evaluated as no "gold standard" is available to establish the diagnosis in these patients. METHODS A prospective study was performed on nine brain dead organ donors not suspected of having pneumonia to assess the specificity of bacteriological results from different samples by comparing them with the histological findings from an open pulmonary biopsy specimen taken immediately after death through a mini-thoracotomy. RESULTS Seven of the nine organ donors without clinical evidence of pulmonary infection and not on antibiotic therapy showed histological features of bronchopneumonia. There was no association between the histological findings and quantitative cultures of the lung biopsy specimen. CONCLUSIONS Histological evidence of pneumonia was common in this group of ventilated patients who had no clinical signs of the disease.
Collapse
Affiliation(s)
- J Solé-Violán
- Servicio de Medicina Intensiva, Universidad de Las Palmas de Gran Canaria (ULPGC), Spain
| | | | | | | | | | | | | |
Collapse
|
30
|
Affiliation(s)
- J Freixinet
- Respiratory Service, Ntra. Sra. Del Pino University Hospital, Canary Islands, Spain
| | | | | | | | | |
Collapse
|
31
|
Julià-Serdà G, Freixinet J, Abad C, Rodriguez de Castro F, López L, Caminero J, Cabrera P. Massive hemoptysis as a manifestation of fistulized thoracic aortic aneurysms into the bronchial tree. J Cardiovasc Surg (Torino) 1996; 37:417-9. [PMID: 8698790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Aortobronchial fistulas are an uncommon and serious cause of hemoptysis. We present three cases of aortobronchial fistulas that were diagnosed and treated at our hospital. They were presented as massive hemoptysis. The clinical suspicion of a leaking thoracic aortic aneurysm into the bronchial tree should prompt the correct diagnostic procedures since early surgery is the only way to manage this condition.
Collapse
Affiliation(s)
- G Julià-Serdà
- Department of Cardiovascular Surgery, Hospital N.S. Pino, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | |
Collapse
|
32
|
Freixinet J, Rodríguez de Castro F, Quevedo S, López L, Hussein M, Roca MJ. [Traumatic hemothorax treated by video-assisted thoracoscopic surgery]. Arch Bronconeumol 1995; 31:424-5. [PMID: 7582438 DOI: 10.1016/s0300-2896(15)30887-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The introduction of video-assisted thoracic surgery (VTS) has significantly furthered the use of the thoracoscope in surgery. In the case we describe, a 79-years-old man at high risk for surgery came to our hospital with hemothorax due to trauma. The necessary procedure was performed successfully with VTS, which allowed for the repair of an acute condition that would otherwise have been treated conventionally by way of posterolateral thoracotomy. We conclude that VTS may play an important role in the diagnosis and treatment of certain thoracic injuries, so that surgery involving more extensive bleeding is rendered unnecessary.
Collapse
Affiliation(s)
- J Freixinet
- Unidad de Cirugía Torácica, Hospital Universitario Nuestra Señora del Pino, Las Palmas de Gran Canaria
| | | | | | | | | | | |
Collapse
|
33
|
Abstract
Pulmonary sequestration is a term used to describe an area of embryonic lung tissue supplied by an anomalous systemic artery. Two forms are recognised-extralobar and intralobar-with different clinical presentations. A patient is reported with intralobar pulmonary sequestration in the left lung and colonisation with Aspergillus which was successfully treated by lower lobectomy.
Collapse
Affiliation(s)
- J Freixinet
- Thoracic Surgery Service, Hospital Universitario Ntra. Sra. del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain
| | | | | | | | | |
Collapse
|
34
|
Freixinet J, López L, Rodríguez de Castro F, Hussein M, Quevedo S, Hermosa MJ. [Primary spontaneous pneumothorax. A retrospective study of 495 cases]. Arch Bronconeumol 1995; 31:276-9. [PMID: 7627422 DOI: 10.1016/s0300-2896(15)30913-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We conducted a retrospective study of patients treated in our department for primary spontaneous pneumothorax (PSP) between 1986 and 1993. The 495 patients were between 12 and 81 years old (mean 28.2 years). Four hundred fifteen (83.8%) were men and 80 (16.2%) were women. PSP was in the right lung in 262 cases (52.9%) and in the left lung in 215 (43.5%). Both sides were affected in 18 cases (3.6%). The initial treatment was pleural drainage; small caliber drains were used in 85 and no associated complications were observed. On 185 occasions (37.3%), patients required surgical repair as a result of air leaks, recurrence or acute hemorrhage. There were postsurgical complications in 15 cases (8.1%) but no recurrences or deaths after surgery. We observed no significant differences in the number of recurrences after use of conventional drains or small caliber drains. Nor were there differences in mean time of hospital stay or complications after conventional surgery or video assisted surgery, a technique that has only recently been introduced. We conclude that PSP responds well to treatment with pleural drains and that small caliber catheters offer a good alternative for treating first episodes. Surgery is indicated when there is recurrence or when air leaks are persistent. At present, video assisted thoracoscopic surgery has successfully replaced axillary thoracotomy for most patients.
Collapse
Affiliation(s)
- J Freixinet
- Unidad de Cirugía Torácica, Hospital Universitario Nuestra Señora del Pino, Las Palmas de Gran Canaria
| | | | | | | | | | | |
Collapse
|
35
|
Roca MJ, Freixinet J, López L. [The large-cell neuroendocrine carcinoma]. Arch Bronconeumol 1995; 31:193. [PMID: 7743068 DOI: 10.1016/s0300-2896(15)30950-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
36
|
Abstract
Between 1985 and 1991, we treated 6 children, aged 2 months to 3 years, who required an invasive procedure for the management of complications caused by enlarged mediastinal lymph nodes secondary to tuberculosis. Radiologic and endoscopic studies revealed bronchial involvement by lymph nodes, with endobronchial granulomas and lobar or pulmonary obstruction in 4 patients and marked tracheal and esophageal stenosis produced by extrinsic compression in the remaining 2. Pathologic study of the lymph node or bronchial samples from the 6 patients disclosed granulomas with caseous necrosis and Langhans' giant cells. All the children were treated with a standard 6-month drug regimen consisting of isoniazid, rifampicin, and pyrazinamide. Five of the patients underwent thoracotomy for the purpose of nodal curettage or excision. In 1, upper right lobectomy and bronchoplasty were necessary. The sixth patient was treated by endoscopic resection of the granulomas. There was no postoperative morbidity, and radiologic and endoscopic evidence of resolution of the lesions was observed in all the patients. In our experience, surgical treatment, when performed as a coadjuvant treatment for tracheobronchial complications stemming from mediastinal tuberculous lymphadenitis, results in the resolution of the lesions and has no related morbidity.
Collapse
Affiliation(s)
- J Freixinet
- Thoracic Surgery Service, Nuestra Señora Del Pino Universitary Hospital, Las Palmas de Gran Canaria, Canary Islands, Spain
| | | | | | | | | | | |
Collapse
|
37
|
Freixinet J, Beltrán J, López Rivero L. [Thoracic injuries]. Arch Bronconeumol 1995; 31:43. [PMID: 7881719 DOI: 10.1016/s0300-2896(15)30989-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
38
|
Freixinet J, Sanchez-Palacios M, Guerrero D, Rodriguez de Castro F, Gonzalez D, Lopez L, Guerra M. Pulmonary arteriovenous fistula ruptured to pleural cavity in pregnancy. Scand J Thorac Cardiovasc Surg 1995; 29:39-41. [PMID: 7644908 DOI: 10.3109/14017439509107200] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Congenital pulmonary arteriovenous fistula is frequently associated with hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber disease). With the increased blood flow in pregnancy such fistulas enlarge, occasionally giving rise to haemothorax, which generally has a poor prognosis. A familial case is presented in which massive haemothorax required emergency thoracotomy in the 27th week of pregnancy.
Collapse
Affiliation(s)
- J Freixinet
- Department of Thoracic Surgery, Hospital Insular de Gran Canaria, Canary Islands, Spain
| | | | | | | | | | | | | |
Collapse
|
39
|
Lopez L, Varela A, Freixinet J, Quevedo S, Lopez Pujol J, Rodriguez de Castro F, Salvatierra A. Extended cervical mediastinoscopy: prospective study of fifty cases. Ann Thorac Surg 1994; 57:555-7; discussion 557-8. [PMID: 8147621 DOI: 10.1016/0003-4975(94)90544-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
To assess the usefulness of extended cervical mediastinoscopy (ECM) in the staging of bronchogenic carcinoma, an ECM was performed prospectively in 50 patients with bronchogenic carcinoma of the left lung. The ECM was used after evaluation of disease operability and computed tomographic findings, and was performed simultaneously with standard cervical mediastinoscopy. In ECM, using the same cervical incision as in a standard cervical mediastinoscopy, dissection is performed behind the anterior face of the sternum. The aortic arch is reached at the level of the origin of the innominate artery. The mediastinoscope is then passed by sliding it along the left anterolateral face of the aortic arch until it reaches the aortopulmonary window. Extended cervical mediastinoscopy was considered positive when a nodal biopsy result consistent with a neoformative process or direct invasion of the mediastinal structures was found. Four patients with positive standard cervical mediastinoscopy and negative ECM were excluded. A false negative ECM was defined as the presence of infiltrated adenopathies at the paraaortic level detected on postoperative histologic study. The ECM was positive in 5 patients in whom operation was contraindicated. Resectability in the remaining 41 patients was 97.6%. Postoperative pathologic study showed infiltrated adenopathy in 3 patients (2 subcarinal, 1 subaortic) accounting for 40 true negatives (the subcarinal group is inaccessible by ECM). This study suggests that ECM has outstanding specificity (100%), sensitivity of 83.3%, and a diagnostic accuracy of 97.8%. A positive predictive value of 100% and a negative predictive value of 97.5% were also identified by this study.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- L Lopez
- University Hospital Ntra. Sra. del Pino, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | |
Collapse
|
40
|
Freixinet J, López Rivero L, Rodríguez de Castro F. Fístula broncopleural tratada mediante adhesivo biológico a través de fibrobroncoscopia. Arch Bronconeumol 1993. [DOI: 10.1016/s0300-2896(15)31205-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
41
|
Abstract
We assessed omental revascularization of heterotopic tracheal implants in rats, and investigated the influence of factors that can enhance revascularization. The trachea of the donor animal was excised in two parts, and each tracheal allograft was implanted in the omentum of two recipients. The influence of mechanical factors was evaluated by applying traction at both ends of the graft with and without drainage of the tracheal lumen, and the influence of pharmacologic factors by giving cefonicid, hydrocortisone, cefonicid plus hydrocortisone, or cyclosporine and azathioprine during the postoperative period. Revascularization of the graft from the omentum with preservation of the tracheal structure was established. Graft viability showed significant differences between the tracheal implants to which no traction had been applied and those with traction at both ends. Tracheal allografts from animals receiving immunosuppressants were completely viable and no significant differences were found between the controls and animals in this group.
Collapse
Affiliation(s)
- L López-Rivero
- Department of Thoracic Surgery, Hospital Ntra. Sra. del Pino, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | |
Collapse
|
42
|
Rubio J, Rodríguez A, Varela A, López L, Freixinet J, García C, Rojas A. [Evaluation of 2 techniques for ventilation support during single-lung ventilation]. Rev Esp Anestesiol Reanim 1992; 39:14-8. [PMID: 1598444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In a group of 22 patients undergoing thoracotomy we compared two techniques of ventilatory assistance to the nondependent lung during single lung ventilation. We simultaneously administered a 0.5% FiO2 to the dependent lung. We used a CPAP system with continuous O2 flow limited by an underwater valve at a pressure of +5 cmH2O. We performed 33 ventilatory assistances: in 15 cases to the nondependent lung (CPAP group) and in 18 patients to the lower lobe of the nondependent lung (lobar CPAP group). Evaluation of both techniques was performed by means of arterial blood gas measurement and the mean values were compared using the student's t test. During single lung ventilation the PaO2 in CPAP group increased from 85.86 +/- 22.28 mmHg to 155.52 +/- 59.54 mmHg (p less than 0.001) and in the lobar CPAP series it increased from 88.75 +/- 24.34 mmHg to 122.36 +/- 43.21 mmHg (p less than 0.01). In 11 out of the 22 patients we firstly applied the lobar CPAP and thereafter the CPAP to the whole lung in order to compare the efficacy of both techniques in the same patient. The PaO2 during single lung ventilation was 86.9 +/- 22.7 mmHg and it increased to 111.1 +/- 37.9 mmHg after lobar CPAP (p less than 0.01) ant to 163.3 +/- 64 mmHg after total lung CPAP ventilation (p less than 0.001). Our results confirm the usefulness of both techniques and they indicate that CPAP to the whole nondependent lung is the most effective.
Collapse
Affiliation(s)
- J Rubio
- Servicio de Anestesiología y Reanimación, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria
| | | | | | | | | | | | | |
Collapse
|
43
|
López L, López Pujol J, Varela A, Baamonde C, Socas L, Salvatierra A, Freixinet J, Cerezo F. Surgical treatment of stage III non-small cell bronchogenic carcinoma involving the chest wall. Scand J Thorac Cardiovasc Surg 1992; 26:129-33. [PMID: 1439643 DOI: 10.3109/14017439209099067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Thirty-five patients who had undergone surgery for non-small cell bronchogenic carcinoma with isolated involvement of the chest wall were reviewed. The diagnosis was preoperatively suspected in 80% of cases. En-bloc resection of the invaded chest wall was performed in 25 cases and parietal pleurectomy in ten in which the pleura was easily dissectable from the costal plane. Of the eight patients with major complications in the early postoperative period, six, including the two who died perioperatively, had undergone en-block resection. The 5-year actuarial survival rate was 22% overall and 36% in the patients without lymph node involvement. No significant relationship between survival and type of operation or degree of chest wall invasion was found. Isolated involvement of the chest wall by non-small cell bronchogenic carcinoma does not necessarily contraindicate surgery with curative intent. Parietal pleurectomy is valid in selected cases. Long-term survival depends basically on node involvement.
Collapse
Affiliation(s)
- L López
- Department of Thoracic Surgery, Hospital Universitario NTRA. SRA. Del Pino, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
A case of tracheal agenesis diagnosed at birth is discussed in which surgical correction was attempted. Both main bronchi were divided and anastomosis of the main right bronchus to the larynx was attempted, after intrapericardial release of the right lung and severing of the lower pulmonary ligament: bronchoplastic reconstruction of the trachea was impossible. We think that tracheal agenesis, a rare cause of respiratory distress in the newborn, has no suitable therapy today. It is justified to attempt surgical correction if any promising device is at hand or if any doubt exists that an uncorrectable situation is present.
Collapse
Affiliation(s)
- L Lopez
- Thoracic Surgery Service, Hospital Ntra. Scra. del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain
| | | | | | | | | | | |
Collapse
|
45
|
|
46
|
Abstract
Persistence of congenital bronchoesophageal fistulae into adulthood is rare. Three patients, one male and two female, of 52, 27 and 63 years of age, respectively, are reported. All three presented with chronic respiratory symptoms and coughing spells associated with ingestion. The barium swallow confirmed diagnoses. Treatment was surgical and consisted of excision of the fistulous tract, suture of the oesophageal and bronchial orifices and the interposition of a parietal pleura flap in two cases, and of biological glue in one. All three patients recovered and are free of symptoms.
Collapse
Affiliation(s)
- J Freixinet
- Thoracic Surgery Service, Cardiothoracic Surgery Unit, Faculty of Medicine, University Clinic, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
47
|
Freixinet J, Catalán M, González J, Sanjuán M, Mateu M, Gimferrer J, Letang E, Callejas M, Sánchez-Lloret J. Análisis de 110 casos de nódulo pulmonar solitario tratados quirúrgicamente. Arch Bronconeumol 1990. [DOI: 10.1016/s0300-2896(15)31660-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
48
|
Abad C, Freixinet J, Solé M. [Ruptured mycotic aneurysm of the femoral artery]. Angiologia 1989; 41:213-6. [PMID: 2610398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
After several commentaries about mycotic aneurysms related to drug addicts, author exposes the case of a young man attached to heroin, presenting a ruptured femoral mycotic aneurysm, surgically treated. Surgery in these cases is commented on.
Collapse
|
49
|
Mestres C, Freixinet J, Cugat E, Mulet J, Montserrat J, Picado C. Pleuropericarditis eosinofílica como manifestación inicial de la enfermedad de Hodgkin. Arch Bronconeumol 1987. [DOI: 10.1016/s0300-2896(15)31935-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
50
|
Freixinet J, Callejas M, Palliso F, Marti M, Mateu M, Ramirez J, Llovera J, Sanchez-Lloret J. Carcinoma bronquioloalveolar originado en un quiste broncogenico. Arch Bronconeumol 1987. [DOI: 10.1016/s0300-2896(15)31927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|