Thoracic endometriosis-related non-catamenial pneumothorax with peculiar histological findings.

Thoracic endometriosis-related non-catamenial pneumothorax is a rare entity whose pathogenesis is still less unclear than catamenial pneumothorax one. Hormonal therapy and/or talc pleurodesis are not sufficient for successful management. Surgical videothoracoscopic resection has a central role in the treatment.

Diffuse alveolar hemorrhage due to valproic acid: Case report and review of the literature.

Valproic acid (VPA) is one of the most frequently used antiepileptic drugs for the treatment of focal and generalized epilepsies, absence seizures, and Lennox-Gastaut syndrome (LGS). VPA has been demonstrated to have a negative effect on both the intrinsic and extrinsic coagulation systems and controversy exists about the clinical relevance of such hematological abnormalities. We describe a case of reversible lung hemorrage due to VPA.

Tuberculosis a disease that created and shaped thoracic surgery.

Today it is incredible to think that an infectious disease, Tuberculosis (TB) as the disease that shaped Thoracic Surgery. The history of TB has so far evolved similarities with that of the mythological Phoenix, where the resurgence of this never completely eradicated "Insidious Disease" has now re-emerged and brought new challenges to modern medicine that of multi drug resistance. The probability of success, in treating complicated multi-drug resistant (MDR) TB pushing us back to the pre-antibiotic era, now depends on several factors: (I) optimal antibiotic management; (II) patient compliance; (III) multi-disciplinary teamwork; (IV) experience in carrying out "not-routine" surgical procedures; and finally (V) ability to offer long term patient hospitalization, frequently months, without bureaucratic and economical problems.

Videomediastinoscopy: a ten year experience on lung cancer stadiation and non-diagnosed mediastinal lymphoadenopathy.

Cervical Mediastinoscopy (CM) is a surgical procedure in it's own right requiring an operating room and general anesthesia and, in the recent past, the absence of minimally invasive techniques had created the myth of mediastinoscopy as the "gold standard" for the pathological staging of the mediastinum. Nowadays, investigating the mediastinum is different and this calls for a review of the role of the "gold standard" CM. Between January 1999 and December 2012 a total of 303 CM were performed; 167 for pre-operative lung cancer stadiation and 136 for non-diagnosed enlargement of mediastinal nodes.

"Roman Sandal" modified method for securing the chest drain to the skin.

Chest drain insertion is a simple procedure with very low morbidity and mortality. The correct procedure provides for a good fixation of the drainage to the skin. An alternative "Roman Sandal technique" for securing the chest drain to the skin is proposed compared to the classical methods.

Pulmonary aspergilloma: clinical aspects and surgical treatment outcome.

Aspergillomas are fungal balls within lung cavities. The natural history is variable. Hemoptysis is a dangerous sequela.

Open window thoracostomy for pleural empyema complicating partial lung resection.

Background: Although an open-window thoracostomy (OWT) represents the ideal method for drainage of postpneumonectomy empyema, several controversies exist concerning its application to pleural empyema complicating pulmonary resections less than pneumonectomy.

Methods: Between January 1993 and December 2003, 19 patients (16 male and 3 female) were treated for a pleural empyema complicating partial lung resection. The median age was 62 years (range, 17 to 79).

Surgical pleurodesis for Vanderschueren's stage III primary spontaneous pneumothorax.

The aim of the present study was to determine the impact of various pleurodesis procedures on post-operative morbidity and late recurrence rate after surgical treatment of Vanderschueren's stage III primary spontaneous pneumothorax. Between January 2001 and June 2004, 208 consecutive patients (169 male and 39 female; mean (range) age 25 (12-39) yrs) were submitted to 220 video-assisted thoracoscopic surgical procedures for primary spontaneous pneumothorax. All patients underwent apical lung resection; 112 were assigned at random to mechanical pleural abrasion (group A) and 108 to apical pleurectomy (group B).

Predictors of successful closure of open window thoracostomy for postpneumonectomy empyema.

Background: Although the open window thoracostomy (OWT) represents the ideal method for drainage of postpneumonectomy empyema (PPE), several controversies exist concerning its closure.

Methods: Between January 1993 and December 2003, an OWT was created in 31 patients (29 male and 2 female) with PPE. The median age was 61 years (range, 32 to 76).

Pulmonary resection for lung cancer in HIV-positive patients with low (<200 lymphocytes/mm(3)) CD4(+) count.

The clinical improvement obtained with combination treatment has modified the therapeutic approach of lung cancer in HIV-positive patients. Aggressive surgical treatment has become a viable option for those patients in whom the CD4(+) cell count was greater than 200 lymphocytes/mm(3). We recently extended our surgical indications to include two HIV-positive patients with lung cancer (stage IIIA and IIB) and low (<200 lymphocytes/mm(3)) CD4(+) count.

Lobectomy for destroyed lung in quadriplegic patients.

Background: Sixty-seven percent of quadriplegic patients after spinal cord injury (SCI) develop respiratory complications, which leads to death in one third. Preventive measures may fail to avoid parenchymal destruction and possible septic complications.

Methods: Three quadriplegic patients (C3-C6 level), with destroyed lower lobes and incontrollable septic symptoms, were subjected to lobectomy.

Prognostic factors after surgical treatment of lung cancer invading the diaphragm.

Background: Diaphragmatic invasion from lung cancer (T3-diaphragm) is a rare occurrence reported to portend a poor prognosis.

Methods: Fifteen patients with T3-diaphragm (14 males, 1 female; median age, 64 years) were surgically treated over a twenty-year period by en bloc resection (14 patients). One patient was only explored.

Modern morbidity following pulmonary resection for postprimary tuberculosis.

Between January 1991 and March 1996, a total of 28 patients with postprimary tuberculosis underwent resection for disease progression (n = 8), multidrug resistance or noncompliance to the medical treatment (n = 11), parenchymal sequelae (n = 3), suspected cancer (n = 5), and for the correction of postpneumonectomy bronchopleural fistula and empyema (n = 1). On admission, eight patients presented with sputum positivity (28.6%).

Effectiveness of leukocyte filters in reducing tumor cell contamination after intraoperative blood salvage in lung cancer patients.

Objectives: In an effort to reduce allogeneic blood transfusions in patients undergoing elective surgery for lung cancer, we investigated the effectiveness of a method of processing shed blood with an automated device for intra operative blood salvage (IOBS) and filtration with a 3rd-generation polyester filter to remove tumor cells.

Methods: Sixteen patients were operated on for different types of lung cancer. We searched for malignant cells in pre- and postprocessed shed blood employing density gradient centrifugation, staining of cytospins with hematoxylin-eosin, and antibodies to human cytokeratins.

Pulmonary actinomycosis: surgical considerations.

Pulmonary actinomycosis is a rare disease. Of 2,247 patients presenting with a radiological pulmonary opacity, 13 (0.6%) were identified with pulmonary actinomycosis in a 13 year period.

Results of surgical management of tuberculosis: experience in 206 patients undergoing operation.

Between January 1978 and December 1990, 206 operations for pulmonary tuberculosis were performed at our institution, a former sanatorium located in northern Italy. Patients with tuberculoma and pleural tuberculous disease were excluded from this series. Cavitary sequelae, bronchiectases, and hemoptysis were the most common indications for resection.

Impact of autologous blood transfusion on blood support in general thoracic surgery: analysis of 969 patients over a 5-year period.

Autologous blood transfusion (ABT) is increasingly used in order to avoid transfusion-related risks. The effectiveness of this simple and feasible procedure depends on several factors, such as the timing of surgery, the patient's overall condition and, last but not least, the pre-disposition of the medical team towards the routine use of ABT. We report our experience in blood support with ABT for general thoracic surgical patients, indicating an overall partially satisfactory outcome due to a limited use of the procedure.

Lobar hypoplasia.

Lung tissue developmental abnormalities are seldom reported. According to the classification of Schneider (1900), which was amended by Boyden (1955), they include pulmonary agenesis, aplasia and hypoplasia. Due to the early onset of symptoms, lung agenesis and aplasia are usually detected soon after birth.

Lung cancer with a single brain metastasis: therapeutic options.

Between January 1983 and December 1988 67 patients presenting with solitary cerebral recurrence from lung cancer were observed in our Institution. Resection was possible in 21 cases (31%). The surgical treatment included craniotomy with radical thoracotomy in 10 patients, craniotomy alone (with thoracotomy not including radical lung resection) in 5 patients and craniotomy performed within months of the initial elective thoracic surgery in 6 patients.