The Case for Pulmonary Metastasectomy-Clinical Practice Narrative Review and Commentary.

Pulmonary metastasectomy has become a well-established procedure for patients with certain types of solid tumors. Patients are usually scheduled for staged lung metastasectomy in case of primary tumor control, the absence of distant non-lung metastases, and when complete resection is achievable. Nodules are removed with precision resection in order to ensure radical resection with minimal margins; this technique permits good oncological results, preserving the surrounding pulmonary parenchyma and causing minimal distortion compared to staplers.

Diffuse alveolar hemorrhage due to valproic acid: Case report and review of the literature.

Valproic acid (VPA) is one of the most frequently used antiepileptic drugs for the treatment of focal and generalized epilepsies, absence seizures, and Lennox-Gastaut syndrome (LGS). VPA has been demonstrated to have a negative effect on both the intrinsic and extrinsic coagulation systems and controversy exists about the clinical relevance of such hematological abnormalities. We describe a case of reversible lung hemorrage due to VPA.

Tuberculosis a disease that created and shaped thoracic surgery.

Today it is incredible to think that an infectious disease, Tuberculosis (TB) as the disease that shaped Thoracic Surgery. The history of TB has so far evolved similarities with that of the mythological Phoenix, where the resurgence of this never completely eradicated "Insidious Disease" has now re-emerged and brought new challenges to modern medicine that of multi drug resistance. The probability of success, in treating complicated multi-drug resistant (MDR) TB pushing us back to the pre-antibiotic era, now depends on several factors: (I) optimal antibiotic management; (II) patient compliance; (III) multi-disciplinary teamwork; (IV) experience in carrying out "not-routine" surgical procedures; and finally (V) ability to offer long term patient hospitalization, frequently months, without bureaucratic and economical problems.

Nerve-sparing schwannoma removal from two infrequent origins.

Schwannomas of nerve sheath origin (Schwann cell) are the most common neurogenic thoracic tumors and they usually originate from an intercostal nerve, especially in the paravertebral region. Tumors that originate from other nerves such as the phrenic nerve, vagus, or sympathetic nerves are uncommon. We report two cases of schwannomas in rare locations.

"Roman Sandal" modified method for securing the chest drain to the skin.

Chest drain insertion is a simple procedure with very low morbidity and mortality. The correct procedure provides for a good fixation of the drainage to the skin. An alternative "Roman Sandal technique" for securing the chest drain to the skin is proposed compared to the classical methods.

Hepatic metastases from breast cancer.

The prognosis of patients with hepatic metastasis from breast cancer treated with systemic or regional chemotherapy is disappointing. When technically feasible, liver resection offers the best results. Eighteen patients out of 22 submitted to laparotomy underwent radical liver resection.

[Nasogastric tubes: a lot of bother].

The insertion of the nasogastric tube is one of the procedure that produces the most discomfort for the patients and practitioners. The AA, with the make use of their clinical experience and the data of the literature, report some personal reflections about the management of the nasogastric tube. The AA also analyse some variables (choice of the tube, approach to the patient, insertion of the tube, examination of the position, fixation and removal) that can influence on discomfort of the patient.

[Amyand's hernia. Case report].

The authors report a case of Amyand's hernia and describe the pathophysiology, the diagnosis and the therapy in occurrence of this surgical condition.

[A rare case of intestinal carcinoid tumour. Clinical considerations and therapeutic approach].

The AA report on a case of intestinal carcinoid tumour. The characters of these tumours to permit a specific clinical and therapeutic approach.