Pleural lavage after pulmonary resection for bronchogenic carcinoma.

A cytologic examination of pleural fluid was performed on a pleural lavage specimen collected at the completion of operation after pulmonary resection in 135 of 599 patients undergoing curative pulmonary resection for a non-small cell carcinoma of the lung between 1977 and 1982. The cytologic results of lavage was positive for malignant cells in 12 of the 135 patients (8.9%).

Postsurgical stage I bronchogenic carcinoma: morbid implications of recurrent disease.

Three hundred forty-six patients with post-surgical non-small cell Stage I bronchogenic carcinoma were followed from 5.0 to 10.8 years (median, 7.

Changing incidence of abdominal aortic aneurysms: a population-based study.

The apparent incidence of abdominal aortic aneurysms among Rochester, Minnesota residents increased seven-fold between 1951 and 1980, while the incidence of thoracic aortic aneurysms declined somewhat. Rates for abdominal aneurysms rose with age and were greater among men. The overall incidence in 1971-1980 was 36.

Management of recalcitrant median sternotomy wounds.

During a 7 year period, 38 consecutive patients (31 male and seven female) had repair of an infected sternotomy wound. Their mean age was 56 years (range 13 to 78 years). Sternotomy was performed for cardiac disease in 34 patients.

Carcinosarcoma of the lung: Mayo Clinic experience and response to chemotherapy.

The clinical presentation, clinical course, and results of various treatment modalities of 17 patients with carcinosarcoma of the lung were reviewed. This group of patients was 0.2% of all Mayo Clinic patients with lung cancer who had been treated between 1971 and 1982.

Roentgenographically occult lung cancer: pathologic findings and frequency of multicentricity during a 10-year period.

During the first 10 years of the Mayo Lung Project, 68 roentgenographically inapparent ("occult") lung cancers were localized and apparently completely resected. A pathologic classification was developed based on depth of tumor infiltration. The five categories were (1) in situ carcinoma confined to surface epithelium or ducts of mucous glands or acini (23 cancers), (2) intramucosal invasion not greater than 0.

Chest wall reconstruction. Experience with 100 consecutive patients.

Experience with 100 consecutive chest wall reconstructions during the past 7 years was reviewed. There were 52 female and 48 male patients with ages ranging from 13 to 78 years (average 53). Of the 100 patients, 42 had tumors of the chest wall, 19 had radiation necrosis, 24 had infected median sternotomies , and 15 had combinations of the three.

Superior mesenteric artery embolus.

We have presented a case of SMA embolization with early diagnosis and successful embolectomy. A high index of suspicion is necessary, since the relative paucity of early signs and symptoms often belies the gravity of the situation. Prompt angiography can corroborate the diagnosis and allow expeditious laparotomy.

Lower limb ischemia in young adults: prognostic implications.

Fifty patients (41 men and nine women) less than 36 years of age were evaluated for lower limb ischemia. Claudication was the presenting symptom in 30 patients (60%) and distal ulceration in 20 (40%). The mean age was 28.

Abdominal aortic aneurysm repair combined with a second surgical procedure--morbidity and mortality.

Some patients who undergo repair of an abdominal aortic aneurysm require a concomitant procedure. This study compares the morbidity and mortality rates of patients who undergo combined procedures with those who undergo aneurysmorrhaphy alone. Five hundred sixty-three elective aneurysmorrhaphies were performed in the years 1971, 1976, and 1980.

En bloc (non-chest wall) resection for bronchogenic carcinoma with parietal fixation. Factors affecting survival.

Seventy-three patients (57 men and 16 women) underwent en bloc resection of lung and attached parietes between 1970 and 1982. All patients had documented malignant pleural invasion. Chest wall parietal pleura was invaded in 33 patients, pericardium in 14, phrenic or vagus nerve in nine, left atrium in five, superior vena cava in four, esophagus in two, diaphragm in one, and multiple structures in five.

Late survival after abdominal aortic aneurysm repair: influence of coronary artery disease.

To evaluate long-term survival in relation to preoperative risk factors, we reviewed 1112 patients undergoing abdominal aortic aneurysm (AAA) repair from 1970 to 1975. A 6-to 12-year follow-up was obtained on 1087 patients (97.7%) by chart review, death certificates, autopsy reports, and questionnaires returned by patients and referring physicians.

The serratus anterior muscle: intrathoracic and extrathoracic utilization.

The serratus anterior muscle has the potential of being used alone, with skin, or with skin and bone for transposition or for transplantation. Its use either inside or outside of the chest is essentially limited only the skill and experience of the surgeon. The serratus anterior muscle is a robust and reliable muscle unit.

Abdominal aortic aneurysms: the changing natural history.

The records of all patients with abdominal aortic aneurysms (AAAs) in a Midwest city with a stable population over a 30-year period were reviewed. There were 296 patients (196 men and 100 women) for an incidence of 21.1 aneurysms/100,000 person-years.

Intrathoracic transposition of extrathoracic skeletal muscle.

During the past 6 years, 31 patients (20 males and 11 females) underwent 45 intrathoracic muscle transpositions of extrathoracic skeletal muscle. Eleven patients had postpneumonectomy empyema, 11 had bronchopleural fistula, four had infection of the heart and great vessels, three had reinforcement of tracheal anastomoses, and two had perforation of the gastrointestinal tract. Life-threatening infection was present in 28 patients.

Pulmonary resection of metastatic renal cell carcinoma.

Over a ten-year period, 44 patients with known primary renal cell cancer underwent thoracotomy for pulmonary metastases. The median postthoracotomy survival for all patients was 33 months. The five-year survival was 27 percent.

Roentgenographically occult lung cancer. A ten-year experience.

During the past 10 years, 54 patients, all men, were found to have roentgenographically occult lung cancer. The mean age was 61 years (range 45 to 76 years). All patients had abnormal findings on sputum cytologic study (carcinoma in 41 patients and squamous cell atypia in 13).

Uncommon visceral artery aneurysms.

Aneurysms of the hepatic, celiac, and superior mesenteric arteries are uncommon visceral artery aneurysms. They are often difficult to diagnose, and symptoms of expansion or rupture may easily be misinterpreted as suggestive of primary gastrointestinal disease. These aneurysms appear to have a significant propensity toward rupture.

Arteriomegaly: classification and morbid implications of diffuse aneurysmal disease.

Ninety-one patients with arteriomegaly and diffuse aneurysmal disease below the level of the renal arteries have been classified according to the extent and location of aneurysmal change. There exists a high incidence of thrombotic and embolic complications, and treatment entails increased rates of morbidity and mortality when compared to surgical treatment of simple abdominal aneurysms of peripheral artery aneurysms. Complete revascularization at the initial operation would appear to give the best result, but this approach must be tempered by the individual patient risk factors and the urgency of the mode of presentation of the patient.

Isolated iliac artery aneurysms.

The records of 50 patients with isolated iliac artery aneurysms seen between January 1970 and January 1982 were reviewed. Forty-seven were men and three were women. Their ages ranged from 41 to 92 years (mean 69.

In vivo quantitation of platelet deposition on human peripheral arterial bypass grafts using indium-111-labeled platelets. Effect of dipyridamole and aspirin.

Indium-111-labeled autologous platelets, injected 48 hours after operation, were used to evaluate the thrombogenicity of prosthetic material and the effect of platelet inhibitor therapy in vivo. Dacron double-velour (Microvel) aortofemoral artery bifurcation grafts were placed in 16 patients and unilateral polytetrafluoroethylene femoropopliteal grafts were placed in 10 patients. Half the patients in each group received platelet inhibitors before operation (dipyridamole, 100 mg 4 times a day) and after operation (dipyridamole, 75 mg, and acetylsalicylic acid, 325 mg 3 times a day); the rest of the patients served as control subjects.

Bronchogenic carcinoma with chest wall invasion: factors affecting survival following en bloc resection.

Sixty-six patients (54 men and 12 women) with primary bronchogenic carcinoma and documented chest wall invasion underwent en bloc chest wall and pulmonary resection at the Mayo Clinic between January 1, 1960, and January 1, 1980. Ages ranged from 36 to 85 years, with a mean of 62.2.

Thoracic aortic aneurysms: a population-based study.

Thoracic aortic aneurysms were detected in 72 residents (44 women and 28 men) in a stable midwestern community over a 30-year period, for an age- and sex-adjusted incidence of 5.9 new aneurysms per 100,000 person-years. The incidence was equal in both sexes and decreased slightly over the 30 years.

Unexplained diaphragmatic paralysis: a harbinger of malignant disease?

The records of 103 male and 39 female patients with unexplained diaphragmatic paralysis were reviewed. A probable cause of the paralysis was not revealed by the initial history, physical examination, or review of plain chest roentgenograms. Paralysis occurred on the left in 82 patients (58%), on the right in 58 (41%), and bilaterally in two (1%).