Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists.

Background: Stage III N2 non-small cell lung cancer (NSCLC) is a very heterogeneous disease associated with a poor prognosis. A number of therapeutic options are available for patients with Stage III N2 NSCLC, including surgery [with neoadjuvant or adjuvant chemotherapy (CTx)/neoadjuvant chemoradiotherapy (CRT)] or CRT potentially followed by adjuvant immunotherapy. We have no clear evidence demonstrating a significant survival benefit for either of these approaches, the selection between treatments is not always straightforward and can come down to physician and patient preference.

Spiral wire localization of lung nodules: procedure effectiveness and oncological usefulness.

Background: In the last years, a large number of techniques and devices for localizing small pulmonary nodules prior to resection have been developed with the aim of facilitating minimally invasive surgery (VATS). However, each device presents pros and cons and there is no unanimous consensus. We report our experience with an uncommon wire system with spiral shape for percutaneous marking.

Prognostic factors of oligometastatic non-small-cell lung cancer following radical therapy: a multicentre analysis.

Objectives: Patients with oligometastatic non-small-cell lung cancer (NSCLC) may benefit from therapy with curative intent. Our goal was to identify prognostic factors related to better prognosis in a multicentre analysis of patients who underwent surgery of primary tumours in combination with radical treatment of all metastatic sites.

Methods: We retrospectively reviewed the records of oligometastatic patients who underwent resection of primary tumours at 4 centres (August 2001-February 2018).

Management of residual pleural space after lung resection: fully controllable paralysis of the diaphragm through continuous phrenic nerve block.

Background: Residual pleural space after lung resection associated with air leak is a challenging issue, potentially causing serious complications. We report a new, postoperative technique to reduce the pleural space, inducing a controlled and reversible paralysis of the diaphragm.

Methods: Ten patients were enrolled (7 lobectomies, 2 bilobectomy, 1 wedge resection).

Chylothorax after endoscopic ultrasound with fine-needle aspiration causing migrating appearance of a solitary fibrous tumor of the pleura.

Trans-esophageal endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is widely used to assess mediastinal masses. Common complications are self-limiting bleeding or pain, but occasionally, more serious accidents have been reported. A 54-year-old woman with a huge mass located in the left middle mediastinum presented 2 days after an EUS-FNA with dyspnea and chest pain.

Lung Ultrasound to Detect Residual Pneumothorax After Chest Drain Removal in Lung Resections.

Background: Indication for postdrain removal imaging after lung resection is debated. Chest roentgenogram (CR) is widely used to confirm lung expansion but not evidence based. We propose to introduce lung ultrasound (LUS) as alternative to exclude significant pneumothorax (PTx) in this setting.

Balloon sclerotherapy: a new method for the treatment of truncal varicose veins.

Background: Truncal varicose veins may be treated by conventional surgery or endovenous therapy. Endovenous ablation, such as laser or radiofrequency treatment, is less invasive but technically demanding, not cheap and has still the possibility of important side-effects. Moreover the treatment requires in the best case tumescent anesthesia.

The long-term mobility and mortality of patients with peripheral arterial disease following bilateral amputation.

Objectives: To study the postoperative course, mobility, housing conditions and the mortality following bilateral amputations in patients with peripheral arterial occlusive disease (PAD).

Design: Part retrospective, part prospective open study.

Setting: Vascular unit of a university hospital.

Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome?

Objective: Long-term evaluation of efficacy and quality of life after radical surgical approach for myasthenia gravis (MG). Comparison between short-term follow-up and long-term outcome.

Methods: All patients (n=26, 16 men and 10 women, mean age: 40.

Randomized controlled trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice repair.

Background: There is a scarcity of data on long-term results after laparoscopic hernia repair. Herein we report on the outcome of a group of patients who were followed up for 5 years in a multicenter study on hernia repair.

Methods: A total of 100 patients with 127 hernias were randomized to undergo either transabdominal preperitoneal (TAPP) or Shouldice hernia repair.

[Palliative surgery for primary and secondary thoracic malignancies].

Palliative thoracic surgical interventions aim to assure or to improve quality of life. They encompass surgical correction of vital complications, treatment of symptoms that limit daily activities, and prophylactic interventions to reduce symptoms and improve prognosis. Interventions are based on statistically proved results as well as on profound clinical experience in oncologic surgery.

Inguinal mass as a late complication of hip arthroplasty. Differential diagnosis and treatment from a vascular surgical perspective.

We report on three patients with a symptomatic inguinal mass as a late complication of repetitive arthroplastic hip surgery. In one case, there was a false aneurysm and in two cases a so-called "synovial cyst". A synovial cyst is usually an enlarged iliopsoas bursa in communication with the capsule of the hip joint.

[Pericardial empyema as a rare complication of pneumococcal pneumonia].

The case histories of 3 patients hospitalised for severe pneumococcal pneumonia are reported. Electrocardiography showed generalized ST-segment elevations and echocardiography revealed pericardial effusion. Pericardiocentesis was performed and analysis of the punctate fluid was consistent with empyema.

[The indications for and results of video thoracoscopic sympathectomy].

Background And Objectives: Thoracoscopic sympathectomy, for years an effective way to treat mainly palmar and axilla hyperhidrosis, experienced a revival since the application of the principles of minimally invasive surgery. We report the personal experiences of three surgeons with this technique, as well as patients' view of the outcome.

Patients And Methods: Between January 1990 and November 1997, 73 procedures were performed in 43 patients (23 males, 20 females, mean age 38.

[Systematic scientific quality improvement in surgical specialties. The AQS mode].

Background: How can the new legal requirements (Law on Statistics 1992 with its corresponding regulations of 1993: minimum data record of the Federal Department of Statistics (BFS) with ICD codification and the law on medical insurance 1995 with its corresponding regulations of 1996: necessity of documenting quality and efficiency) be integrated into the daily hospital routine with reasonable expenditure of time and costs?

Method: The BFS minimum data record was combined with additional information on quality improvement on one single questionnaire. The surgical departments of the Hospital Limmattal in Schlieren and the Regional Hospital Bienne founded the Association for Quality Improvement in Surgery (AQC) in 1995 and have tested the AQC system for two years.

Results: Until the end of 1997 data from 15,115 surgical procedures were collected in our database.

[Septic pylephlebitis with detection of gas in the portal vein: a rare complication of sigmoid diverticulitis].

Pylephlebitis, septic thrombosis of the portal vein and its branches, is an infrequent complication of intra-abdominal inflammatory processes which may lead to thrombosis of the portal vein or to liver abscesses. Air in the protal venous system usually predicts a fatal outcome. The survival rate calculated in all reported cases is less than 25%.

[Rupture of a Baker cyst with compartment syndrome. A rare complication of knee arthroscopy].

We report a case of leakage of irrigation fluid into the extra-articular soft tissue, due to rupture of a Baker's cyst during arthroscopy of the knee joint. A four-quadrant fasciotomy of the calf musculature was performed to prevent the devasting ischemic complications of an imminent compartment syndrome. A survey of the literature reveals no consensus regarding the treatment of such complications.

[Does a shower put postoperative wound healing at risk?].

A prospective randomized study was designed to determine the effect of postoperative water contact on tissue healing. A total of 121 patients undergoing open hernia repair was divided into two groups. The first group was permitted to shower postoperatively, allowing the wound to come into direct contact with the water, the second group was instructed to keep the incision dry.

[Chronic cholestatic liver disease and grand mal seizures].

History And Clinical Findings: A 48-year-old woman was hospitalised because of grand-mal seizures. 3 years previously a malignant melanoma had been resected from the skin of the back. She was also known to have chronic cholestasis of unknown cause.

Controlled multicenter trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice herniorrhaphy. Early results.

Background: In February 1993 a prospective randomized multicenter trial was initiated to compare laparoscopic transabdominal preperitoneal hernioplasty to Shouldice herniorrhaphy as performed by surgeons of nonspecialized clinics.

Methods: Until January 1994, 87 patients with 108 hernias took part in the trial (43 Shouldice and 44 laparoscopic repairs).

Results: The laparoscopic procedure took significantly longer than did the open operation but caused less pain as measured by pain analogue score and consumption of paracetamol and narcotics.

Risk and hazards of video-thoracoscopic surgery: a collective review.

Objective: Since 1990, video-thoracoscopy has rapidly gained widespread acceptance. In contrast to conventional thoracoscopy no comprehensive studies of potential risks and hazards have been carried out. To date interest has centered on possible indications and thoracoscopic techniques.