Intrathoracic application of vacuum wound therapy following thoracic surgery.

Objective: The VAC system (vacuum-assisted wound closure) is an established noninvasive active therapy to promote the healing of difficult wounds that fail to heal with conventional treatment after cardiac surgery. We report our initial experience of the intrathoracic application of the VAC system after extended thoracic surgery.

Methods: Thirteen patients (11 men, 2 women) with a median age of 60 years (range 41 to 82 years) with deep wound infections after thoracotomy (empyema = 3; lobectomy = 5; Pancoast = 1; pneumonectomy = 4) were treated primarily with the VAC system after initial surgical debridement.

[Thoracic surgery in children--common diseases and their therapy].

In the day life in a thoracic surgery department interventions in childage are more or less seldom. The skill of the surgical and anesthesiological team is strictly related to the outcome of the patient. Beneath benign tumors of the lung and mediastinum are inflammatory diseases first of all pleuraempyema in the focus of interest.

[Malformation of a bronchial artery with shunt into the pulmonary vascular bed - a rare cause of massive haemoptysis].

We present the case of an otherwise healthy 41-year-old woman, who was admitted after having expectorated bright red blood. While the chest roentgenogram was found to be normal, fiberoptic bronchoscopy revealed mild active bleeding originating from the apicoposterior segmental bronchus of the left upper lobe, which exacerbated during the examination. The bleeding was contained through blockade of the upper lobe bronchus by means of a double-lumen endotracheal tube.

[Surgical therapy of pleural empyema with tauroline].

Empyema continues to be a significant problem in spite of improved surgical techniques and the use of new, more potent antimicrobial agents. This report describes our experience in the treatment of empyema at the Clemens Hospital in Münster, Germany, from 1990 to 1996. Basic to conservative treatment are closed drainage with intensive irrigation and instillation of Taurolin, a chemotherapeutic agent against bacterias, yeasts and mycetes.

[Treatment of small cell bronchial carcinoma with reference to stage classification].

There are controversial views and discussions on surgical treatment of small cell lung cancer. A retrospective study covering the period from 1959 through 1983 has been conducted by the authors to analyse resective approaches to lung cancer. A total of 2,039 resections for lung cancer included operations on 354 small cell carcinomas according to the WHO nomenclature.