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Surgical emphysema

Joseph Em van Agteren, Kristin V Carson, Leong Ung Tiong, Brian J Smith
BACKGROUND: Lung volume reduction surgery (LVRS) performed to treat patients with severe diffuse emphysema was reintroduced in the nineties. Lung volume reduction surgery aims to resect damaged emphysematous lung tissue, thereby increasing elastic properties of the lung. This treatment is hypothesised to improve long-term daily functioning and quality of life, although it may be costly and may be associated with risks of morbidity and mortality. Ten years have passed since the last version of this review was prepared, prompting us to perform an update...
October 14, 2016: Cochrane Database of Systematic Reviews
Franziska C Trudzinski, Philipp M Lepper, Daniela Leppert, Frank Langer, Christian Lensch, Monika Flaig, Robert Bals, Heinrike Wilkens, Peter Minko, Sebastian Fähndrich
Reducing hyperinflated areas in chronic obstructive pulmonary disease, either surgically or endoscopically, leads to improvement of functional parameters. It is unclear if bilateral treatment with endobronchial valves (EBV) aiming at total lobar occlusion is beneficial. The aim of this study was to assess the results after staged bilateral endoscopic treatment with EBV. This is a retrospective analysis of patients with severe airflow obstruction, who were treated bilaterally with EBV in two stages, aiming at subsequent atelectasis...
October 5, 2016: Respiration; International Review of Thoracic Diseases
Pallav L Shah, Felix J Herth, Wouter H van Geffen, Gaetan Deslee, Dirk-Jan Slebos
Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction...
September 29, 2016: Lancet Respiratory Medicine
Astrid Balança
OBJECTIVE: We report an emphysematous cystitis in a diabetic patient complicated by peritonitis. OBSERVATIONS: A 66-year-old male presented to the emergency with septic shock. Patient's history: poorly controlled diabetes and prostate adenoma. Clinical examination revealed a surgical abdomen and signs of shock. Blood sugar was 6g/L. CRP 274mg/L. The abdomino-pelvic CT scan showed a perforated bladder with emphysema of the bladder wall and endoluminal air bubbles...
September 2016: Annals of Physical and Rehabilitation Medicine
Xin-Li Mao, Li-Ping Ye, Hai-Hong Zheng, Xian-Bin Zhou, Lin-Hong Zhu, Yu Zhang
Submucosal tunneling endoscopic resection (STER) of subepithelial tumors (SETs) originating from the muscularis propria (MP) layer in the cardia is rarely performed due to the difficulty of creating a submucosal tunnel for resection. The aim of this study was to evaluate the feasibility of STER using methylene-blue guidance for SETs originating from the MP layer in the cardia. From January 2012 to December 2014, 56 patients with SETs originating from the MP layer in the cardia were treated with STER using methylene-blue guidance...
September 26, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Andre S Madsen, George Oosthuizen, Grant L Laing, John L Bruce, Damian Luiz Clarke
BACKGROUND: The purpose of this study was to audit our experience with computed tomography angiography (CTA) for the detection of aerodigestive tract injury (ADTI) following penetrating neck injury (PNI) and to assess the significance of deep surgical emphysema on CTA. METHODS: A prospectively maintained trauma registry at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa was retrospectively interrogated. The data of all patients with PNI investigated with CTA over a 4-y period were reviewed...
October 2016: Journal of Surgical Research
Nithin Jayan, Jaya Susan Jacob, Mohan Mathew, Roy Joy Mukkada
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is a safe and minimally invasive modality regarded as the first-line management of all types of achalasia. POEM is performed under general anesthesia with endotracheal intubation using an orally inserted flexible fiberscope. The aim of this study is to describe the anesthetic management of POEM for achalasia. MATERIAL AND METHODS: A chart review of 21 patients who underwent POEM for achalasia at our center from March 2013 to June 2015 was performed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Flore Vărcuş, Ciprian Duţă, Amadeus Dobrescu, Fuger Lazăr, Marius Papurica, Cristi Tarta
AIM: The purpose of the study was to compare the results of laparoscopic inguinal hernia repair using two different methods: transabdominal preperitoneal (TAPP) repair and the technique of totally extraperitoneal repair (TEP). METHODS: In this retrospective study were included 90 cases of inguinal hernia that underwent for laparoscopic approach of inguinal hernia repair at the Emergency County Hospital Timisoara at the 2nd Surgical Clinic between 2012 and 2013. The primary outcome was recurrence of the hernia at two years follow-up...
July 2016: Chirurgia
Franziska C Trudzinski, Anna J Höink, Daniela Leppert, Sebastian Fähndrich, Heinrike Wilkens, Thomas P Graeter, Frank Langer, Robert Bals, Peter Minko, Philipp M Lepper
BACKGROUND: Patients with a forced expiratory volume in 1 s (FEV1) below 20% of the predicted normal values (pred.) and either homogeneous emphysema or low diffusing capacity for carbon monoxide (DLCO) have a high risk for adverse events including death when undergoing surgical lung volume reduction. OBJECTIVES: We hypothesized that selected patients can benefit from endoscopic lung volume reduction (eLVR) despite a very low FEV1. METHODS: This study is a retrospective analysis of consecutive patients with severe airflow obstruction, an FEV1 ≤20% of pred...
2016: Respiration; International Review of Thoracic Diseases
Hajime Otsuka, Keishi Sugino, Yoshinobu Hata, Takashi Makino, Satoshi Koezuka, Kazutoshi Isobe, Naobumi Tochigi, Kazutoshi Shibuya, Sakae Homma, Akira Iyoda
The syndrome of combined pulmonary fibrosis and emphysema (CPFE) has been characterized by severely impaired gas exchange and poor survival. However, the clinical features of patients with lung cancer plus CPFE have remained elusive. The present study performed a retrospective analysis to examine the clinical characteristics and outcome of surgically resected patients with lung cancer plus CPFE. Among 831 patients with primary lung cancer who underwent surgical resection, 23 patients (2.8%) were diagnosed with CPFE and 9 patients (1...
September 2016: Molecular and Clinical Oncology
Yu Yoshino, Kimihiko Funahashi, Rei Okada, Yasuyuki Miura, Takayuki Suzuki, Takamaru Koda, Kimihiko Yoshida, Junichi Koike, Hiroyuki Shiokawa, Mitsunori Ushigome, Tomoaki Kaneko, Yasuo Nagashima, Mayu Goto, Akiharu Kurihara, Hironori Kaneko
BACKGROUND: Fournier's gangrene in the setting of rectal cancer is rare. Treatment for Fournier's gangrene associated with rectal cancer is more complex than other cases of Fournier's gangrene. We report on a patient with severe Fournier's gangrene in the setting of locally advanced rectal cancer who was treated with a combined modality therapy. CASE PRESENTATION: A 65-year-old man presented with general fatigue and anal pain. The medical and surgical histories were unremarkable...
2016: World Journal of Surgical Oncology
George Manchi, Mathias M Brunnberg, Muhammad Shahid, Ahmad Al Aiyan, Leo Brunnberg, Silke Stein
An 8-year-old male Jack Russell crossbreed dog was admitted to our hospital with dyspnea and shock following a dog-bite injury on the ventral neck. Radiographs revealed subcutaneous emphysema and bilateral thyrohyoid bone fractures. Intraoperatively, rupture of both sternohyoid muscles, both hyoepiglotticus muscles, both thyrohyoid muscles, and a partial cranial rupture of the superficial sphincter colli muscle were detected. Part of the epiglottis was detached from the thyroid cartilage. The patient's severed muscles and torn epiglottis were reattached using a simple interrupted suture pattern...
2016: Frontiers in Veterinary Science
Yasuo Kohashi, Toru Arai, Chikatoshi Sugimoto, Kazunobu Tachibana, Masanori Akira, Masanori Kitaichi, Seiji Hayashi, Yoshikazu Inoue
BACKGROUND: The prognosis of combined cases of pulmonary fibrosis and emphysema is unresolved partially because radiological differentiation between usual interstitial pneumonia and nonspecific interstitial pneumonia is difficult in coexisting emphysema cases. OBJECTIVE: The purpose of this study was to clarify the clinical impact of emphysema on the survival of patients with idiopathic pulmonary fibrosis (IPF). METHODS: One hundred and seven patients with interstitial lung diseases were diagnosed by surgical lung biopsies between 2006 and 2012, and 47 patients were diagnosed with IPF through multidisciplinary discussion...
2016: Respiration; International Review of Thoracic Diseases
L V Duggan, B Ballantyne Scott, J A Law, I R Morris, M F Murphy, D E Griesdale
BACKGROUND: Transtracheal jet ventilation (TTJV) is recommended in several airway guidelines as a potentially life-saving procedure during the 'Can't Intubate Can't Oxygenate' (CICO) emergency. Some studies have questioned its effectiveness. METHODS: Our goal was to determine the complication rates of TTJV in the CICO emergency compared with the emergency setting where CICO is not described (non-CICO emergency) or elective surgical setting. Several databases of published and unpublished literature were searched systematically for studies describing TTJV in human subjects...
September 2016: British Journal of Anaesthesia
Liliana Costa, Ricardo Matos, Sara Júlio, Fernando Vales, Margarida Santos
BACKGROUND: Urgent airway management is one of the most important responsibilities of otolaryngologists, often requiring a multidisciplinary approach. Urgent surgical airway intervention is indicated when an acute airway obstruction occurs or there are intubation difficulties. In these situations, surgical tracheostomy becomes extremely important. METHODS: We retrospectively studied the patients who underwent surgical tracheostomy from 2011 to 2014 by an otolaryngologist team at the operating theater of the emergency department of a tertiary hospital...
2016: World Journal of Emergency Medicine
Joanne M Jenkins, Rizwan Q Attia, Anna Green, Paul Cane, John Pilling
Pulmonary placental transmogrification is a rare lung lesion that microscopically resembles placenta with cystic spaces filled with papillary structures. Considered a histological variant of bullous emphysema, only 30 reported cases have been published in the world's literature. We report a rare case of pulmonary placental transmogrification in a 72-year-old man, in whom the clinical presentation of the disease mimicked lung carcinoma. Histopathology of the surgically resected segment showed a complex bulla with squamous metaplasia and placental transmogrification...
July 28, 2016: Asian Cardiovascular & Thoracic Annals
Francesco Emanuele Praticò, Michele Corrado, Giovanni Della Casa, Raffaele Parziale, Giuseppe Russo, Silvia Eleonora Gazzani, Enrica Rossi, Daniele Borgia, Maurizio Mostardi, Emanuele Bacchini, Simone Cella, Massimo De Filippo
Congenital pulmonary malformations represent a broad spectrum of anomalies that may result in varied clinical and pathologic pictures, ranging from recurrent pulmonary infections and acute respiratory distress syndrome, which require timely drug therapy, up to large space-occupying lesions needing surgical treatment. This classification includes three distinct anatomical and pathological entities, represented by Congenital Cystic Adenomatoid Malformation, Bronchopulmonary Sequestration and Congenital Lobar Emphysema...
2016: Acta Bio-medica: Atenei Parmensis
Edward G Chekan, John F Cummings, Isaac Mabe, Shawn Hunter, Jeffrey W Clymer
BACKGROUND: Choosing the correct surgical staple height is dependent on knowledge of specific tissue thickness and compressibility. The purpose of this study was to measure the thickness of cadaveric human lung tissue. MATERIALS AND METHODS: Between December 2012 and February 2013, whole lungs were procured from 12 donors. Inclusion criteria included negative serology, no prior thoracic surgery, and completion of measurements within 72 hours of death. Tissue thickness was measured in the anterior-to-posterior direction using a tissue measuring device (TMD) at 41 lung locations...
July 29, 2016: Surgical Technology International
Yasuyuki Mizumori, Yasuharu Nakahara, Tetsuji Kawamura, Shin Sasaki, Hiroaki Tsukamoto, Yoshiro Mochiduki
BACKGROUND: Bronchial occlusion therapy using silicon spigots is effective for intractable pneumothorax. However, sometimes the pneumothorax is refractory to bronchial occlusion because of collateral ventilation. For such difficult pneumothoraces, we attempted an intrabronchial infusion of autologous blood plus thrombin to control collateral ventilation and stop air leaks. METHODS: We performed bronchial occlusions using silicon spigots in patients with spontaneous pneumothorax secondary to emphysema and refractory to chest drainage, but which was inoperable owing to each patient's poor surgical candidacy and poor overall health condition...
July 2016: Journal of Bronchology & Interventional Pulmonology
Rajeev Chaudhari, Shahil Rameshbhai Khant, Dipen Patel
BACKGROUND: Inguinal lymph node involvement is an important prognostic factor in penile cancer. Inguinal lymph node dissection allows staging and treatment of inguinal nodal disease. However, it causes morbidity and is associated with complications such as lymphocele, skin loss, and infection. AIMS: To report our institutional experience with video endoscopic inguinal lymphadenectomy (VEIL) for radical management of inguinal nodes in patients with penile squamous cell carcinoma...
July 2016: Urology Annals
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