Results of upfront surgery in a mixed stage population of patients with esophageal carcinoma: early outcome and long term survival.

Purpose: To evaluate early outcome and long term survival in a mixed stage population of patients undergoing upfront esophagectomy for esophageal cancer.

Methods: Retrospective analysis of the data of 92 patients who underwent esophagectomy (thoracoabdominal: 76, Ivor-lewis: 16) between 1998 and 2017. Tumors were located in gastro-esophageal junction (52), lower third (31) and middle third (9) of the esophagus.

Simultaneous Bilateral Spontaneous Pneumothorax in an Adult Patient With Pulmonary Langerhans Cell Histiocytosis: A Case Report.

We report a case of a young female with known history of pulmonary Langerhans cell histiocytosis who was initially presented in the emergency department of a university hospital with respiratory distress. Clinical assessment and diagnostic workup revealed left hemithorax subcutaneous emphysema, bilateral pneumothorax, and atelectasis in both lower lung lobes. The patient was treated with bilateral staged thoracoscopic bullectomy and mechanical abrasion of the parietal pleura combined with chemical pleurodesis with talc.

Save or sacrifice the internal mammary pedicle during anterior mediastinotomy?

Ligation and dissection of internal mammary vessels is the most under-estimated complication of anterior mediastinotomy. However, patients requiring anterior mediastinotomy may experience long survival that makes the development of ischemic heart disease throughout their life possible. Therefore, the un-judicial sacrifice of the internal mammary pedicle may deprive them from the benefit to have their internal mammary artery used as a graft in order to successfully bypass severe left anterior descending artery stenoses.

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment.

Airway injuries are life threatening conditions. A very little number of patients suffering air injuries are transferred live at the hospital. The diagnosis requires a high index of suspicion based on the presence of non-specific for these injuries symptoms and signs and a thorough knowledge of the mechanisms of injury.

Right upper lobe partial anomalous pulmonary venous connection.

Partial anomalous pulmonary venous return (PAPVR) is a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium. We report a case of a 45-year-old male with PAPVR to superior vena cava which was incidentally discovered during a right lower bilobectomy for lung cancer.

Pancoast tumors: characteristics and preoperative assessment.

Superior sulcus tumors (SSTs), or as otherwise known Pancoast tumors, make up a clinically unique and challenging subset of non-small cell carcinoma of the lung (NSCLC). Although the outcome of patients with this disease has traditionally been poor, recent developments have contributed to a significant improvement in prognosis of SST patients. The combination of severe and unrelenting shoulder and arm pain along the distribution of the eighth cervical and first and second thoracic nerve trunks, Horner's syndrome (ptosis, miosis, and anhidrosis) and atrophy of the intrinsic hand muscles comprises a clinical entity named as "Pancoast-Tobias syndrome".

Hemodynamic effects of combination therapy with inhaled nitric oxide and iloprost in patients with pulmonary hypertension and right ventricular dysfunction after high-risk cardiac surgery.

Objective: The purpose of this study was to evaluate the hemodynamic effects of inhaled nitric oxide (NO) plus aerosolized iloprost in patients with pulmonary hypertension/right ventricular dysfunction after cardiac surgery.

Design: A retrospective study.

Setting: A single center.

Inhaled nitric oxide plus iloprost in the setting of post-left assist device right heart dysfunction.

Background: Pulmonary hypertension and right ventricular (RV) dysfunction may complicate the implantation of a left ventricular assist device (LVAD). We examined whether inhaled vasodilators can sufficiently reduce RV afterload, avoiding the need for temporary RV mechanical support.

Methods: The study includes 7 patients with RV dysfunction after LVAD insertion.

Prognostic factors of atrial fibrillation following elective coronary artery bypass grafting: the impact of quantified intraoperative myocardial ischemia.

Background: Atrial fibrillation (AF) occurs in 28-33% of the patients undergoing coronary artery revascularization (CABG). This study focuses on both pre- and peri-operative factors that may affect the occurrence of AF. The aim is to identify those patients at higher risk to develop AF after CABG.

Transternal repair of a giant Morgagni hernia causing cardiac tamponade in a patient with coexisting severe aortic valve stenosis.

Background: Foramen of Morgagni hernias have traditionally been repaired by laparotomy, laparoscopy or even thoracoscopy. However, the trans-sternal approach should be used when these rare hernias coexist with other cardiac surgical diseases.

Case Presentation: We present the case of a 74 year-old symptomatic male with severe aortic valve stenosis and global respiratory failure due to a giant Morgagni hernia causing additionally cardiac tamponade.

Surgical decision making in tracheobronchial injuries on the basis of clinical evidences and the injury's anatomical setting: a retrospective analysis.

Background: Airway trauma is a life threatening condition requiring prompt diagnosis and management. We present our experience focusing on the diagnosis, airway management and treatment.

Material And Methods: This is a retrospective analysis of 25 patients treated for tracheal or bronchial injury within a 12 year period.

Superior vena cava syndrome in a patient with previous cardiac surgery: what else should we suspect?

Background: Although mediastinal tumors compressing or invading the superior vena cava represent the major causes of the superior vena cava syndrome, benign processes may also be involved in the pathogenesis of this medical emergency. One of the rarest benign causes is a pseudoaneurysm developing in patients previously having heart surgery.

Case Report: We present the case of a large pseudoaneurysm of the ascending aorta, five years after primary surgery, with a significant compression of the right mediastinal venous system causing superior vena cava syndrome, detected at chest CT angiography.

Primary aortoesophageal fistula due to thoracic aortic aneurysm: successful surgical treatment.

Aortoesophageal fistula is a rare emergency that presents a real challenge for cardiothoracic surgeons. There have been few reports of survivors. We present the case of a 70-year-old man with aortoesophageal fistula, mediastinal abscess, and severe septicemia consequent to esophageal erosion and rupture of a chronic degenerative descending thoracic aortic aneurysm.

Cardiac surgery in a patient with retroperitoneal fibrosis and heart valvulopathy, both due to pergolide medication for Parkinson's disease.

Retroperitoneal fibrosis is best described as a chronic inflammatory process which may be idiopathic, but can rarely be brought about by medications, such as pergolide, used for treating Parkinson's disease. Pergolide can produce a fibrotic process in heart valves, resulting in valve insufficiency in up to 25% of cases. Herein we describe the case of a 68-year-old man who received pergolide for 2 years for Parkinson's disease.

Modified maximal thymectomy for myasthenia gravis: effect of maximal resection on late neurologic outcome and predictors of disease remission.

Background: Although thymectomy is a standard practice of care in patients with myasthenia gravis, the best approach to thymic resection remains controversial. This study was conducted to assess the effect of maximal resection on neurologic outcome and identify predictors of disease remission.

Methods: Data of 78 myasthenic patients who underwent modified maximal thymectomy during a 17-year period were retrospectively analyzed.

Low incidence of bronchopleural fistula after pneumonectomy for lung cancer.

Bronchopleural fistula (BPF) after pneumonectomy for NSCLC remains a highly morbid complication. We examined possible factors including the surgical techniques associated with BPF development. From 221 pneumonectomies for NSCLC, bronchial stump closure was mechanically performed in 192 patients and manually in the remaining 29.

Current role of surgery in small cell lung carcinoma.

Small cell lung carcinoma represents 15-20% of lung cancer. Is is characterized by rapid growth and early disseminated disease with poor outcome. For many years surgery was considered a contraindication in Small Cell Lung Cancer (SCLC) since radiotherapy and chemoradiotherapy were found to be more efficient in the management of these patients.

Modified maximal thymectomy for thymic epithelial tumors: predictors of survival and neurological outcome in patients with thymomatous myasthenia gravis.

Background: Thymic epithelial tumors are characterized by slow growth and variable malignant behavior. We present our experience on the surgical management of these tumors.

Materials And Methods: We conducted a retrospective analysis of patients with thymomas undergoing modified maximal thymectomy over a period of 16 years.

Routine suction of intercostal drains is not necessary after lobectomy: a prospective randomized trial.

Background: The decision to proceed to simple underwater seal drainage or apply active suction to the underwater seal after lung resection is mostly based on surgeon preference. The purpose of this study was to test whether routine application of active suction is necessary after lobectomy.

Patients And Methods: This was a prospective randomized controlled trial conducted in the Patras University Hospital.

Asymptomatic pseudo-aneurysm of the aortic arch in a patient with aberrant right subclavian artery. A complication of Kommerell's diverticulum?

Kommerell's diverticulum is an aortic arch deformity associated with an aberrant subclavian artery. Symptoms related to compression of adjacent structures, dilatation of the aortic diverticulum or accelerated atherosclerosis leading to increased risks of dissection and rupture represent the indications for surgical treatment. Several surgical strategies have been used for the management of this congenital abnormality.

Solitary fibrous tumor of the lung.

Solitary fibrous tumors are mesenchymal entities integrated in a mixed group of hemangiopericytoma-like neoplasms. Although classically presented as a pleura-based mass, there are extrapleural sites including the lung. We present the clinical, imaging, and histological features of a solitary fibrous tumor of the lung.