Pharmacokinetic population study to describe cefepime lung concentrations.

Pharmacokinetic parameters of cefepime in 2 g plasma and lung tissue bid over 3 days to achieve the steady-state was studied in 16 patients (15 male, one female) subjected to lung surgery for bronchial epithelioma. The aims of this study were firstly to quantify cefepime lung diffusion with cefepime lung concentrations in comparison with cefepime serum concentrations, and secondly to estimate population pharmacokinetic parameters of cefepime in lung tissue using NONMEM. The mean characteristics of patients were: age, 60 years (range, 51-69 years), weight, 73 kg (range, 62-87 kg) and creatinine clearance, 77 ml/min (range, 62-92 ml/min).

Lobar exclusion after transpericardial herniation in a heart-lung transplantation.

Lobar herniation is a rare complication of heart-lung transplantation (HLT). We describe a case of right lower lobe herniation through the pericardial window into the left pleural space diagnosed 54 days after operation. Extensive adhesions precluded a lobectomy through a right thoracotomy approach, therefore the lobe was simply excluded and left in situ.

Esophagectomy for cancer in the patient aged 70 years and older.

Background: Advanced age increases the risk of any major surgical intervention, particularly esophageal resection. High morbidity and increased mortality have been reported in operations for esophageal cancer in the elderly.

Methods: To determine outcome, risk factors, and the advisability of esophageal resection in the elderly, a single-institution retrospective review was performed of esophagectomy for cancer over a 14-year period.

Acquired tracheoesophageal fistula and its management.

Tracheoesophageal fistulae (TEF) are severe lesions leading to serious and eventually fatal pulmonary complications. Currently, TEF are mainly iatrogenic, occurring in the course of tracheal intubation for resuscitation or malignant after invasion of both esophageal and tracheal walls. Difficulty in treatment results from the need to manage both the consequences of esophagotracheal communication and those of the illness responsible for fistula.

[Treatment of abdominal aortic aneurysm: importance of the aorto-aortic tube?].

We compared retrospectively the immediate and mid-term outcome in 203 operations for AAA performed at the Saint-Michel Hospital in the vascular surgery department. Two groups of patients were treated either with a tube graft or with a Dacron bifurcated graft. In our experience, the tube was prefered when there were no haemodynamically significant stenosis or aneurysmal dilatations in the iliac arteries.