Search results for "cardiothoracic surgery"
showing 10 items of 146 documents
Permanent stenting in “unextractable” common bile duct stones in high risk patients. A prospective randomized study comparing two different stents
2007
BACKGROUND: Endoscopic sphincterotomy (ES) and stone extraction is the treatment of choice for bile duct stones. Therefore, if ES and conventional stone extraction fail, further treatment is mandatory. Insertion of a biliary endoprosthesis is an effective option. MATERIALS AND METHODS: We treated 30 high-risk patients (17 women and 13 men, mean age 82 years) affected by difficult common bile duct stones. The patients were randomly assigned preoperatively using closed envelopes (blind randomization) into two groups to receive insertion of polyethylene or hydrophilic hydromer-coated polyurethane stent, respectively. Follow-up was achieved by contacting referring physicians and patient's relat…
Surgical treatment of pancreatic cancer
1984
From 1964 to 1982, there were 782 patients treated for carcinoma of the pancreas. In 174 patients pancreaticoduodenal resection was possible (22%). Until 1977 we performed Whipple procedures, while from 1978 to 1982 total pancreatectomy was preferred. Comparing the results of both methods, we did not find any advantages of total pancreatectomy. Operative mortality did not decrease, survival time did not extend, and the higher resection rates (up to 26%) for more advanced tumor stages were accompanied by greater morbidity. With respect to the patients with inoperable cancer of the pancreas, we found over the last 5 years that the rate of those not undergoing surgery has climbed from 8% to 25…
Periscope endograft technique to revascularize the left subclavian artery during thoracic endovascular aortic repair.
2013
To present early and midterm results of the periscope endograft (PG) technique to maintain left subclavian artery (LSA) blood flow in thoracic endovascular aortic repairs (TEVAR) involving zone 3.From April 2010 to January 2013, 14 consecutive high-risk patients (11 men; mean age 70±8 years, range 56-87) underwent TEVAR with the PG technique for 10 thoracic aortic aneurysms (TAA), 2 traumatic aortic ruptures, and 2 aortic dissections without a suitable landing zone (2 cm distal to the LSA). Five procedures were performed emergently for rupture (3 TAAs and the 2 trauma cases). Two patients had a periscope deployed in an aberrant right subclavian artery. The periscope endografts were sized 1 …
Patency of renal and visceral vessels after open thoracoabdominal aortic replacement.
2015
Objective In thoracoabdominal aortic aneurysms (TAAAs), a paradigm shift is observed from open surgery toward total endovascular aortic repair using fenestrated and branched endografts. Whereas outcome after open replacement in terms of mortality and paraplegia has been evaluated extensively, no studies exist addressing long-term patency of visceral and renal vessels. To enable comparison of target vessel patency between open and endovascular treatment, we analyzed our series of open TAAA replacements. Methods Our vascular surgery database was screened for patients who received open TAAA replacement between 1998 and 2012, and patient records were analyzed retrospectively. All available imag…
Isolated Lung Perfusion as an Adjuvant Treatment of Colorectal Cancer Lung Metastases: A Preclinical Study in a Pig Model
2012
BackgroundThe lung is a frequent site of colorectal cancer (CRC) metastases. After surgical resection, lung metastases recurrences have been related to the presence of micrometastases, potentially accessible to a high dose chemotherapy administered via adjuvant isolated lung perfusion (ILP). We sought to determine in vitro the most efficient drug when administered to CRC cell lines during a short exposure and in vivo its immediate and delayed tolerance when administered via ILP.MethodsFirst, efficacy of various cytotoxic molecules against a panel of human CRC cell lines was tested in vitro using cytotoxic assay after a 30-minute exposure. Then, early (operative) and delayed (1 month) tolera…
New evidence in one-lung ventilation
2017
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also includes routine use of PEEP and alveolar recr…
Bilateral thoracoscopic thymectomy using a novel positioning system.
2013
Several techniques of bilateral video-assisted thoracoscopic extended thymectomy have been proposed, and each has its own proponents. We summarize our experience in 20 patients who underwent bilateral video-assisted thoracoscopic extended thymectomy, using a new patient positioning that amplifies the thoracoscopic view of the cardiophrenic regions which are often difficult to visualize with standard techniques. In all cases, en-bloc thymectomy with complete dissection of the mediastinal fatty tissue was achieved without sternal retractors or additional incisions.
The use of video-assisted thoracic surgery in the management of Pancoast tumours
2010
We describe our experience using video-assisted thoracic surgery (VATS) as an adjunct to the surgical management of Pancoast tumors. Between March 2004 and November 2009, 13 patients with Pancoast tumors were included in this study. Surgery was performed by positioning the patient to allow either an anterior or a posterior thoracotomy. VATS was employed to explore the pleural cavity, to optimize the surgical access and as an assistance during surgical resection. Three patients with pleural carcinosis at thoracoscopy did not undergo further surgery. Seven lobectomies and three wedge resections were performed with an en bloc chest-wall resection and mediastinal lymphadenectomy. The surgical a…
Implantation of Gore-Tex chordae on aortic valve leaflet to treat prolapse using "the chordae technique": surgical aspects and clinical results.
2008
Background Repair of prolapsed aortic valve leaflets has been considered a challenging technique for cardiac surgeons. In this paper we describe our surgical approach, "the chordae technique." It consists of the correction of aortic cusp prolapse by shortening the free margin length and of an adjustment of the leaflets coaptation height by anchoring the prolapsing cusp to the aortic wall at the sinotubular junction level. Methods Between February 2003 and December 2006, 26 patients with one or more prolapsed aortic leaflets underwent surgical repair using the new approach. The mean age of patients was 55 ± 10 years. There were 10 (38.5%) patients with grade II aortic valve regurgitation, 4 …
Revaskularisation mit der A. gastroepiploica dextra — Bewertung der Indikation und des perioperativen Risikos
1997
Bei 35 Patienten (mittleres Alter 64,0 Jahre (±10,4 Jahre) wurde bei fehlender oder unbrauchbarer V. saphena magna neben der einoder beidseitigen A. thoracica interna (ITA) die rechte A. gastroepiploica (GEA) zur Revaskularisation der rechten Koronararterie (RCA) verwendet. Ausgeschlossen wurden Patienten mit erheblicher Adipositas (Broca-Index >20%) sowie Patienten mit abdominellen Voroperationen. In einem Fall konnte die GEA wegen Plaquebildung nicht verwendet werden. Bei 23 Patienten wurde die GEA mit dem R. interventricularis posterior (RIVP), bei 11 Patienten mit der RCA vor bzw. in Hohe der Crux anastomosiert.