Surgical outcome of combined pulmonary and atrial resection for lung cancer.

Objectives: The study was carried out to assess the short and long-term outcome of patients with non-small cell lung cancer infiltrating the left atrium treated by surgery.

Methods: We retrospectively collected the hospital files of twenty-three consecutive patients operated on between 1982 and 2001 in two units of Thoracic Surgery. Four patients received an induction regimen.

Spontaneous intercostal pulmonary hernia.

A case of spontaneous intercostal pulmonary hernia as a result of vigorous coughing is reported in a 67-year-old man. The great majority of acquired pulmonary hernias are post-traumatic; rare cases are spontaneous, resulting from prolonged and/or repeated increased intrathoracic pressure. This hernia was successfully repaired with a polyglactin absorbable mesh and approximation of the ribs with heavy stitches.

The modified "hemi-clamshell" approach for tumors of the cervicothoracic junction.

The anterior approaches proposed for treatment of the apical chest tumors (anterior transcervical, transmanubrial, and hemi-clamshell) have precise advantages and limits. To avoid these limits we have modified the hemi-clamshell with the resection of the first costal cartilage and the costoclavicular ligament. This allows a wider opening of the sternocostal flap, with safe control of the entire subclavian vessels as well as easier access to the T1 to T3 vertebral bodies and the posterior chest wall.

[The surgical treatment of nonpalpable breast carcinomas].

The wide-spreading use of mammography in clinical approach and in screening programmes contributed to a sensible modification in the population of patients affected by breast malignancies. A special increase has been recorded in non-palpable breast tumors. The Authors have analyzed a total of 135 patients with impalpable breast lesions during the period 1990-1997.