Postoperative pulmonary torsion: report of a case and survey of the literature including spontaneous and posttraumatic torsion.

A case of postoperative torsion of the left upper lobe following thoracotomy for removal of a large mediastinal tumor is presented. Diagnosis was made on the sixth postoperative day by axial computerized tomography. At rethoracotomy the upper lobe, well delimited against the lower lobe by deep fissure, was found to be twisted by 180 degrees in clock-wise direction.

[Surgical treatment of metapneumonic pleural empyema].

During a period of 13 years 54 patients have been treated for metapneumonic pleural empyema, namely 3 children (all boys), 31 men and 20 women. One patient was admitted in extremis heavily intoxicated after unsuccessful attempt at closed drainage. He died during thoracotomy for open drainage.

[Results of resection treatment of locally limited bronchial carcinoma (Stages I and II)].

Of 238 patients operated upon for bronchogenic carcinoma between 1977 and 1985 the tumor was locally limited in 108, of whom, according to the new international staging system, 66 patients were in stage I (T1N0 + T2N0) and 42 in stage II (T1N1 + T2N1). 89 were male and 19 (18%) female. The mean age was 61.

[Results of the surgical treatment of locally-advanced bronchus carcinoma (stage III)].

117 patients with stage III bronchogenic carcinoma (AJC) underwent thoracotomy after careful staging between 1977 and 1985. 13 patients were found to be inoperable, while in 104 resection was performed. Operative mortality was 8.

[Cavernous bronchus carcinoma].

In thoracic surgery patients the etiology of cavities has drastically changed in the last 20 years. While at present only very few patients need surgery for cavernous tuberculosis, cavities of cancerous origin are becoming more and more frequent. During the period from 1977 to 1985 24 out of 225 bronchogenic carcinomas treated by resection were found to be cavernous (10.

[The value of mediastinoscopy in the diagnosis of hilar and mediastinal lymph node enlargement].

Of 116 mediastinoscopies performed over a period of 5 years without serious complications, 36 were for diagnosis of obvious or suspected mediastinal and hilar lymphadenopathy. In 34 of these 36 procedures large samples of paratracheal lymph nodes were excised for histological and partially also for bacteriological examination. In 24 patients a definite diagnosis was obtained (mediastinoscopy positive).

[Endobronchial metastases of extrathoracic malignancies].

The importance of endobronchial metastases originating from extrathoracic malignant tumors is emphasized and illustrated with 11 personally observed cases and with 87 cases from the literature. The primary tumors most frequently found are carcinoma of the breast, hypernephroma, and carcinoma of colon and rectum. 7 of the authors' own 11 patients are still alive at the time of publication, including two women 24 and 12 months respectively after pulmonary resection for endobronchial metastasis from carcinoma of the rectum.

[Massive lung necrosis in klebsiella pneumonia (so-called massive lung gangrene)].

In the literature only 13 cases of voluminous necrosis of lung tissue, generally referred to as massive pulmonary gangrene, could be found. This disease constitutes an unusual, very severe complication of lobar pneumonia, mostly due to Klebsiella. This type of pneumonia generally affects old or otherwise debilitated persons, quite often chronic alcoholics.

[Postoperative complications following pulmonary surgery (author's transl)].

Postoperative complications occurring in a series of 177 patients undergoing lung surgery are discussed in detail according to their pathogenesis. In all, 68 serious complications were observed in 54 patients (30.5 per cent).