Treatment outlines for the management of primary leiomyosarcoma of the inferior vena cava.

Primary venous Leiomyosarcoma (LMSs) are extremely rare tumours with poor survival rates. Surgery is currently the only potentially curative therapy in non-metastatic disease, but it consists in challenging interventions. The authors report the experience of one single centre in the treatment of LMS and a literature overview focusing on the diverse methods of vessels repair.

Sigmoid diverticulitis. Longitudinal analysis of 222 patients with a minimal follow up of 5 years.

Objective: The surgical treatment of severe attacks of sigmoid diverticulitis and the indications for prophylactic surgery are currently matters of debate. We have analysed our experience in a university hospital, bringing new information into the discussion.

Method: All patients admitted to our department between 1995 and 2002 for an attack of sigmoid diverticulitis were reviewed.

Laparoscopic versus open right hepatectomy: a comparative study.

Background: The safety of laparoscopic major liver resections is still uncertain. The aim of this study was to compare our results for laparoscopic right hepatectomy (LRH) with those for open right hepatectomy (ORH).

Methods: Patients undergoing LRH were compared with retrospectively selected patients from our ORH database.

Surgical treatment of rectal cancer: results of a strategy for selective preoperative radiotherapy.

Aim: The indications for preoperative adjuvant therapy in rectal cancer are still a subject of debate. The objective of this study was to analyze the results of surgical resection and selective radiotherapy in a group of high-risk patients (Dukes B and C) taken from a series of 148 consecutive patients with rectal cancer.

Methods: All patients with rectal cancer considered for resection during the period 1994-2004 were prospectively included.

[Thoracoplasty: the current role].

The Authors report a retrospective analysis of 29 patients who underwent thoracoplasty between 1990 and 1999. The mean follow-up period was 30 months. The median age was 55 years.

Surgical repair of an aneurysm of the innominate artery with fistulization into the trachea.

This report describes a 43-year-old patient presenting with an aneurysm located at the junction between the innominate artery and aorta, with spontaneous fistulization into the trachea. Emergency treatment of this unusually located lesion was undertaken to prevent intratracheal rupture. After ligation of the innominate artery, right common carotid artery, and right subclavian artery due to the risk of infection, the tracheal fistula was treated by direct closure and exclusion using an autologous pericardial flap.

[Thymectomy in myasthenia gravis. A series of 68 patients].

Since January 1988 to December 1998, by the Department of Thoracic Surgery, Haut-Lévêque Hospital, University of Bordeaux, 68 consecutive patients were operated for myasthenia gravis. The aim of our study was to evaluate the results obtained in a group of patients who underwent a thymectomy for myasthenia gravis, in order to contribute for the determination of the prognostic factors which can influence the post-operative course. This series consists on 68 patients.

[Esophageal perforation during transesophageal echocardiography].

Known for its reliability, transoesophageal echocardiography is an investigation which is increasingly used in cardiology, cardiac surgery and intensive care units. It is a semi-invasive investigation of which oesophageal perforation is a very rare but serious complication. Two cases of oesophageal perforation after transoesophageal echocardiography are reported out of a series of 87 oesophageal perforations treated between January 1981 and February 1999.

Determination of moxifloxacin (BAY 12-8039) in plasma and lung tissue by high-performance liquid chromatography with ultraviolet detection using a fully automated extraction method with a new polymeric cartridge.

The aim of this study was to develop a high-performance liquid chromatographic (HPLC) assay for the determination of moxifloxacin in human plasma and lung tissue. The assay was based on HPLC with a Supelcosil ABZ+ column and ultraviolet detection set at a wavelength of 296 nm. The extraction procedure was characterized by a fully automated liquid-solid extraction using an OASIS column for the solid phase.

CT-guided transthoracic needle biopsy of pulmonary nodules smaller than 20 mm: results with an automated 20-gauge coaxial cutting needle.

Aims: To evaluate the efficacy and the complication rate of CT-guided percutaneous lung biopsy of pulmonary nodules smaller than 20 mm in diameter using a 20-gauge coaxial automated biopsy device.

Material And Methods: A prospective study was undertaken of 200 patients who underwent 202 consecutive biopsies of pulmonary nodules, performed with a single type of automated biopsy device. Sixty-seven biopsies of nodules smaller than 20 mm in diameter were performed in 66 patients (group A).

Conservative treatment for postintubation tracheobronchial rupture.

Background: Postintubation tracheobronchial rupture is usually responsible for unstable intraoperative or postoperative conditions, and its management is discussed. We insist on conservative treatment as a viable alternative after late diagnosis of postintubation tracheobronchial rupture.

Methods: We conducted a retrospective study including 14 consecutive patients treated between April 1981 and July 1998.

[Clear cell adenoma of the parathyroid gland: a rare and misleading lesion].

Parathyroid adenomas are common lesions and are considered to be the cause of most of the primary hyperparathyroidism cases. We report the case of a 73 year-old man who presented with a primary hyperparathyroidism. Clinical and histological explorations revealed the presence of an isolated parathyroid tumor containing exclusively clear cells and devoid of malignancy.

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.

Intermediate-term results after en bloc double-lung transplantation with bronchial arterial revascularization. Bordeaux Lung and Heart-Lung Transplant Group.

Objective: Between May 1990 and January 1994, 18 patients underwent en bloc double-lung transplantation with tracheal anastomosis and bronchial arterial revascularization. Because at that time it was already suggested that chronic ischemia could be a contributing factor in occurrence of obliterative bronchiolitis, the purpose of this study was to evaluate, with a follow-up ranging from 22 to 69 months, the midterm effects of bronchial arterial revascularization on development of obliterative bronchiolitis.

Results: Results were assessed according to tracheal healing, functional results, rejection, infection, and incidence of obliterative bronchiolitis.

Superior vena cava gunshot wound: successful management.

Superior vena cava gunshot wounds are rare and usually associated with high mortality before patients reach the hospital. We present an exceptional case with a 16 hour preoperative delay and a final recovery.

[Value of video-assisted thoracic surgery in internal medicine. Apropos of 7 cases].

Since a few years, the medical thoracoscopy has already been used specially for the diagnostic and therapeutic taking up of the pleural pathology. Behind it, the video-assisted thoracic surgery has been improved since 1990. As a surgical technology, it proved its interest refering to the classical thoracotomy by lessening operative morbidity and mortality.

The bronchial arteries: anatomic study and application to lung transplantation.

The bronchial arterial system (BAS) and its territory was studied in dissections of 40 fresh adult cadavers. The arterial distribution was assessed by catheterisation of the ostia and injection of contrast medium. The number of bronchial aa.

[Left single-lung allotransplantation with or without bronchial artery revascularization in pigs. Development of a model with a five-week survival].

After lung transplantation, immunological mechanisms are easier to understand if the pathologist can examine larger pieces of tissues than those obtained by endoscopic biopsies. The purpose of this study was to test the experimental left-lung transplantation in the pig, performed with or without bronchial arterial revascularization and with a survival of 5 weeks. Three animals were only thoracotomised (sham-operated), ten were allotransplanted without and nine with- bronchial arterial revascularization.

[War wounds of the upper vena cava. Recovery after management from Sarajevo to Paris].

Penetrating chest injuries involving the superior veina cava are a seldom observed entity to our knowledge. Most often they cause death before the patient can reach a surgical facility; because of the exsanguination and a difficult surgical approach. The authors report a war-case of superior veina cava injury and have reviewed and analysed the literature concerning the issue of immediate intensive care and surgical approach of such life threatening injuries; especially in war conditions.

Bronchial revascularization in double-lung transplantation: a series of 8 patients. Bordeaux Lung and Heart-Lung Transplant Group.

Donor airway ischemia is the main cause for defective tracheal or bronchial healing after double-lung transplantation. Anatomical studies and bronchial arteriograms have shown that the right intercostal bronchial artery is constant (95% of instances) and provides an important blood supply to the distal trachea, the carina, and the right bronchial tree as well as to the left side through a subcarinal and periadventitial anastomostic network. To maintain this important bilateral bronchial circulation, it is of capital importance not to mobilize the arteries individually and to avoid large dissections around the carina.