Burden between Undersupply and Overtreatment in the Care of Primary Spontaneous Pneumothorax.

Background: The optimal treatment of primary spontaneous pneumothorax (PSP) is still controversial. The purpose of this study was to analyze the incidence of recurrence, the recurrence-free time, and to identify risk factors for recurrence after PSP.

Methods: We performed a retrospective analysis of 135 patients with PSP who were treated either conservatively with a chest tube ( = 87) or surgically with video-assisted thoracoscopic surgery (VATS;  = 48) from January 2008 through December 2012.

Superior vasodilation of human pulmonary vessels by vardenafil compared with tadalafil and sildenafil: additive effects of bosentan.

Objectives: Pulmonary arterial hypertension is characterized by pulmonary vascular proliferation and remodelling, leading to a progressive increase in pulmonary arterial resistance. Vasodilator properties of 3 different phosphodiesterase (PDE)-5 inhibitors alone and in combination with an endothelin (ET) receptor antagonist were compared in an ex vivo model.

Methods: Segments of human pulmonary arteries (PAs) and pulmonary veins (PVs) were harvested from lobectomy specimens.

Short-term and long-term outcomes of intrathoracic vacuum therapy of empyema in debilitated patients.

Background: This retrospective study analyzed the effectiveness of intrathoracic negative pressure therapy for debilitated patients with empyema and compared the short-term and long-term outcomes of three different intrapleural vacuum-assisted closure (VAC) techniques.

Methods: We investigated 43 consecutive (pre)septic patients with poor general condition (Karnofsky index ≤ 50 %) and multimorbidity (≥ 3 organ diseases) or immunosuppression, who had been treated for primary, postoperative, or recurrent pleural empyema with VAC in combination with open window thoracostomy (OWT-VAC) with minimally invasive technique (Mini-VAC), and instillation (Mini-VAC-Instill).

Results: The overall duration of intrathoracic vacuum therapy was 14 days (5-48 days).

Mini-open vacuum-assisted closure therapy with instillation for debilitated and septic patients with pleural empyema.

Objectives: This prospective study is an evaluation of the mini-open vacuum-assisted closure with instillation (Mini-VAC-Instill) therapy for the treatment of complicated pleural empyema.

Methods: We investigated septic patients in poor general physical condition (Karnofsky index ≤50%) with multimorbidity and/or immunosuppression who were treated by minimally invasive intrathoracic VAC-Instill therapy without the insertion of an open-window thoracostomy (OWT) between December 2012 and November 2014. All patients underwent mini-thoracotomy with position of a tissue retractor, surgical debridement and local decortication.

Prospective, comparative study of the On-Q® PainBuster® postoperative pain relief system and thoracic epidural analgesia after thoracic surgery.

Objective: Pain after thoracotomy is associated with intense discomfort leading to impaired pulmonary function.

Design: Prospective, non-randomized trial from April 2009 to September 2011.

Setting: Department of Thoracic Surgery, single-center.

Minimally Invasive Vacuum-Assisted Closure Therapy With Instillation (Mini-VAC-Instill) for Pleural Empyema.

Enthusiasm for minimally invasive thoracic surgery is increasing. Thoracoscopy plays a significant therapeutic role in the fibrinopurulent stage (stage II) of empyema, in which loculated fluid cannot often be adequately drained by chest tube alone. For some debilitated and septic patients, further procedures such as open-window thoracostomy (OWT) with daily wound care or vacuum-assisted closure (VAC) therapy are necessary.

Combination of sildenafil and bosentan for pulmonary hypertension in a human ex vivo model.

Purpose: Both sildenafil and bosentan have been used clinically to treat pulmonary arterial hypertension. As these substances target different pathways to modulate vasoconstriction, we investigated the combined effects of both drug classes in isolated human pulmonary vessels.

Methods: Segments of pulmonary arteries (PA) and veins (PV) were harvested from 51 patients undergoing lobectomy.

Radiotherapy in the treatment of postoperative chylothorax.

Background: Chylothorax is characterized by the presence of chyle in the pleural cavity. The healing rate of non-operative treatment varies enormously; the maximum success rate in series is 70%. We investigate the efficacy and outcomes of radiotherapy for postoperative chylothorax.

Minimally invasive vacuum-assisted closure therapy in the management of complex pleural empyema.

Objectives: The pool of potential candidates for pleural empyema is expanding. In a previous technical report, we tested the feasibility of the minimally invasive insertion of a vacuum-assisted closure (Mini-VAC) system without the insertion of an open-window thoracostomy (OWT). In this study, we describe a consecutive case series of complex pleural empyemas that were managed by this Mini-VAC therapy.

Vacuum-assisted closure of pleural empyema without classic open-window thoracostomy.

A 64-year-old man was diagnosed with complex empyema after a second course of palliative chemotherapy for metastatic lung cancer. Because of the poor general condition of the patient, the decision was made to proceed with vacuum-assisted closure (VAC) therapy of the empyema without Eloesser or Clagett open-window thoracostomy (OWT). Installation and changing of the VAC sponge were performed using the ALEXIS Wound Protector/Retractor (Applied Medical, Rancho Santa Margarita, CA), a flexible polymer membrane tube.

Complex pleural empyema can be safely treated with vacuum-assisted closure.

Objective: For patients with postoperative pleural empyema, open window thoracostomy (OWT) is often necessary to prevent sepsis. Vacuum-assisted closure (VAC) is a well-known therapeutic option in wound treatment. The efficacy and safety of intrathoracal VAC therapy, especially in patients with pleural empyema with bronchial stump insufficiency or remain lung, has not yet been investigated.

Is the mediastinal lymphadenectomy during pulmonary metastasectomy of colorectal cancer necessary?

The aim of study was to investigate the pattern of mediastinal lymph node metastases in patients with colorectal cancer metastasis. Twenty-four pulmonary metastasectomies with mediastinal lymphadenectomies were performed on 19 patients (14 unilateral and five bilateral operations). The metastases were centrally localised in eight cases; the primary tumour was colon cancer in 15 patients and rectal cancer in nine cases.

[Lobectomy performed through a video-assisted mini thoracotomy, as a new technique in our clinical practice].

Unlabelled: In this retrospective study, we present our experiences and results with lobectomy performed through video-assisted mini thoracotomy (VAMT), a technique that we have been using since 2006.

Method And Patients: In the first half of 2006 10 video-assisted lobectomies were performed in our department. There were eight women and two men; the mean age was 61.

Lung cancer as a second primary malignant tumor: prognostic values after surgical resection.

Prognostic values of lung cancers as second primary malignant tumors (LC-as-SPTs) developed after a different type of first primary malignant tumor were analyzed. Forty-three patients underwent surgery for first primary malignant tumors and later for LC-as-SPTs. The most frequent first primary tumors were: 14 laryngo-pharyngeals; 7 lungs; and 5 colons.

Visceral pleural infiltration as a negative prognostic factor in lung metastasis.

The prognostic value of visceral pleural infiltration in lung metastasis was analysed. Fifty-two patients (32 males and 20 females) were operated on for lung metastases. The locations of the primary tumours were as follows: 19 colon, 10 kidneys, 8 melanomas, 3 breast, 3 bladder, 2 uterus, 2 osteosarcomas, 1 testis, and 1 parotid, 1 haemangiopericytoma, 1 thyroid gland and 1 larynx.

The role of microvascularization and growth/adhesion-regulatory lectins in the prognosis of non-small cell lung cancer in stage II.

Objective: To investigate the role of growth/adhesion-regulatory lectins in the prognosis of the stage II non-small cell lung carcinomas (NSCLCs) via quantitative lectinhistochemical examinations and measurement of microvascularization of the tumour.

Methods: In 94 radically operated lung cancer patients, stage II NSCLC was confirmed histologically (T1N1: 6, T2N1: 66, T3N0: 22). Immunohistochemical methods were applied to investigate the galectin-1, galectin-3, CL-16 and hyaluronic-acid-binding capacities of the tumours, and also the expression of galectin-1, -3 and heparin binding lectin.

[Video-assisted, extended thymectomy for the treatment of myasthenia gravis. Our early experiences].

Introduction: Extended thymectomy is the key-point of the surgical treatment of the myasthenia gravis (MG), when the thymus with the surrounding fatty tissue on the neck and in the mediastinum is removed. In this study we present a new surgical technique introduced into our practice in November 2004, and with that the thymectomy is performed with video-thoracoscopic method, without sternotomy.

Patients And Methods: Since November 2004, 6 patients (5 females and 1 male) were operated on for MG.

[Prognostic role of microvascularization in surgically treated lung cancer].

Objective: The aim of our study was the determination of microvascularization and its prognostic significance in lung cancer patients.

Methods: Histological sections were prepared from paraffin-embedded tissues removed from the peripheral part of the tumor of 450 radically operated non-small cell and small cell lung cancer patients. Immunohistochemical staining was performed with antibody against factor VIII-associated antigen.

Prognostic significance of endogenous adhesion/growth-regulatory lectins in lung cancer.

Objective: To determine the expression of endogenous adhesion/growth-regulatory lectins and their binding sites using labeled tissue lectins as well as the binding profile of hyaluronic acid as an approach to define new prognostic markers.

Methods: Sections of paraffin-embedded histological material of 481 lungs from lung tumor patients following radical lung excision processed by a routine immunohistochemical method (avidin-biotin labeling, DAB chromogen). Specific antibodies against galectins-1 and -3 and the heparin-binding lectin were tested.

Prognostic significance of microvascularization in cases of operated lung cancer.

Objective: Measurement of microvascularization and determination of its prognostic significance in cases of lung cancer.

Methods: Section prepared from histological material from 432 radically operated non-small cell lung cancer patients were stained with antibodies against factor VIII-associated antigen. During computer imaging, the absolute and relative parameters of the vascularization were determined, as was the density of tumour cells situated in the vicinity of the vessels.

[Results and alternatives in the surgical treatment of lung cancer].

Objective: The aim of our study was to analyse the results of surgical treatment in lung cancer cases.

Patients And Methods: Between 1990 and 1999, 860 patients were operated on for primary lung cancer. In 775 patients (90.

Lung cancer and its operable brain metastasis: survival rate and staging problems.

Background: We assessed the survival rates regarding different stages of operable lung cancers causing operable brain metastasis in patients with or without cancer-related symptoms. The correlation between survival rates and the disease-free interval between lung surgery and metastasectomy was studied.

Methods: Sixty-five patients were operated on for lung cancer and brain metastases.

Combined off-pump coronary artery by-pass and right upper lobectomy for lung cancer through median sternotomy.

Patients who smoke are at risk of both coronary artery disease and lung cancer, but concomitant lesions of the heart and lung are uncommon. Management of these concomitant lesions is controversial because of the systemic side-effects of a cardiopulmonary by-pass (CPB) and the difficult approach of the lung. An off-pump coronary artery by-pass (OPCAB) can be a successful procedure in the combined treatment of lung cancer and cardiac disease.

[Pancreas resection for lung cancer metastasis].

This case report describes the successful resection of a solitary pancreatic metastasis that developed 21 months following lobectomy of an early pulmonary adenocarcinoma (pT1N0M0). The metastasis caused no complaints. The resected pancreas contained a glucagonoma in addition to the metastasis.