Adjuvant antifungal therapy after pulmonary surgery for aspergilloma: is it useful?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether adjuvant antifungal therapy is useful after pulmonary surgery for aspergilloma. One hundred and sixteen papers were identified using the search described below, of which 5 papers presented the best evidence to answer the clinical question.

Harvest technique for pedicled intrathoracic transposition of pectoralis major muscle.

Residual upper pleural spaces after subtotal pulmonary resection continues to pose great challenge for the thoracic surgeon. Although not all residual spaces deserve surgical attention, only in special situation (empyema with or without bronchopleural fistula). It increases morbidity, mortality, hospital stays, and costs.

Primary pulmonary myoepithelial carcinoma.

Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial carcinoma belongs to this group. Since it was first described in 1998, we have identified only seven actual cases reported in the literature so far.

Cardiopulmonary response following surgical repair of pectus excavatum in adult patients.

Objective: Severe pectus excavatum are common in adult patients, often causing psychological complaints and physiological impairments. Although lung function at rest may minimally deteriorate after surgical correction, it remains unclear if surgery improves exercise capacity. The objective of present study is to assess whether the surgical repair of pectus excavatum in adults would improve exercise tolerance.

Postoperative ischemic bronchitis after lymph node dissection and primary lung cancer resection.

Background: The purpose of this study was to determine the incidence and symptoms of postoperative ischemic bronchitis (POIB) after systematic lymph node dissection (LND) and evaluate the effect of hyperbaric oxygen therapy in patients with primary lung cancer.

Methods: From January 2004 to December 2009, 1,071 patients underwent a standard resection for non-small cell lung cancer and radical systematic lymph node dissection. Fiberoptic bronchoscopy was performed systematically between days 7 and 12.

Postpneumonectomy cavity herniation through an intercostal space.

Mediastinal shift is common after pneumonectomy and herniation of the remaining lung into the opposite hemithorax has consequently been reported. In this case, we present the herniation of the pneumonectomy cavity contained by the calcified pleura through an intercostal space, in a patient who has undergone a left pneumonectomy 47 years previously. We repaired the intercostal muscular defect using a Mersuture mesh.

Indications and results of anterior mediastinal tracheostomy for malignancies.

Background: This study was designed to assess the early and long-term results, and determine suitable indications of anterior mediastinal tracheostomy, after radical resection for cervicothoracic malignancies.

Methods: From 1985 to 2009, 13 patients ranging in age from 40 to 75 years underwent an anterior mediastinal tracheostomy for malignancy, 2 as an isolated procedure, 5 with concomitant laryngectomy, and 6 with concomitant laryngopharyngoesophagectomy. The patients had subglottic carcinoma, proximal tracheal carcinoma invading the subglottic larynx (n = 6), stomal recurrence following laryngectomy (n = 4), esophageal carcinoma invading the proximal trachea (n = 2), or tracheal recurrence after conventional resection (n = 1).

Results of systematic nodal dissection in typical and atypical carcinoid tumors of the lung.

Background: To determine the lymphatic spread frequency and location in patients, who underwent lung resection for carcinoid tumors, associated with systematic nodal dissection.

Methods: From January 1998 to June 2007, 54 patients underwent anatomic lung resection associated with systematic nodal dissection for tumors classified as typical (TC) or atypical carcinoid according to 1999 World Health Organization criteria. The number and location of the resected lymph nodes were specified.