9 results on '"RESPIRATORY organ surgery"'
Search Results
2. The Role of Open-Lung Biopsy in ARDS.
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Patel, Sanjay R., Karmpaliotis, Dimitri, Ayas, Najib T., Mark, Eugene J., Wai, John, Thompson, B. Taylor, and Malhotra, Atul
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LUNG biopsy , *ADULT respiratory distress syndrome , *BIOPSY , *DIAGNOSIS , *DISEASE management ,RESPIRATORY organ surgery - Abstract
Study objectives: The role of open-lung biopsy in ARDS has been questioned due to potentially high morbidity and low diagnostic yield. The goals of this study were to better define the frequency of unexpected diagnoses made by open-lung biopsy, the frequency biopsy results lead to a change in clinical management, and the frequency of procedural complications. Design: Case series. Setting: A large tertiary referral center. Patients: All individuals with available records undergoing open-lung biopsy between 1989 and 2000 for evaluation of ARDS based on the American-European Consensus Conference definition. Interventions: None. Measurements and results: The mean age in this cohort of 57 patients was 53 years (SD, 18 years) with Pa[sub O[sub 2]]/fraction of inspired oxygen ratio of 145 mm Hg (SD, 61 mm Hg) at the time of biopsy. A pathologic diagnosis other than diffuse alveolar damage or fibroproliferation was found in 60% of patients. The most common alternative diagnoses were infection (n = 8), alveolar hemorrhage (n = 5), and bronchiolitis obliterans organizing pneumonia (n = 5). Alternative diagnoses were as frequent in immunocompetent as immunosuppressed hosts (60% vs 59%, respectively). Biopsy results led to a change in management in the majority of patients, with addition of specific therapy in 60% and withdrawal of unneeded therapy in 37%. Although the overall complication rate was 39%, major complications occurred in only 7% of cases. No deaths were attributable to the procedure. Conclusions: In selected patients with clinical ARDS, open-lung biopsy can be performed safely, often reveals an unsuspected diagnosis, and frequently leads to alterations in therapy. Key words: ARDS; open-lung biopsy; pulmonary surgical procedures. [ABSTRACT FROM AUTHOR]
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- 2004
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3. Functional Analysis in Single-Lung Transplant Recipients.
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Zaporozhan, Julia, Ley, Sebastian, Gas, Klaus Kurt, Schmiedeskamp, Jörg, Biedermann, Alexander, Eberle, Balthasar, and Kauczor, Hans-Ulrich
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LUNG transplantation , *PULMONARY function tests , *RESPIRATION , *MAGNETIC resonance imaging , *RESPIRATORY diseases , *CYSTIC fibrosis ,RESPIRATORY organ surgery - Abstract
Objective: To develop and evaluate a postprocessing tool to quantify ventilated split-lung volumes on the basis of ³He-MRI and to apply it in patients after single-lung transplantation (SLTX). High-resolution CT (HRCT) was employed as a reference modality providing split air-filled lung volumes. Lung volumes derived from pulmonary function test results served as clinical parameters and were used as the "gold standard." Material and methods: Eight patients (mean age, 54 years) with emphysema and six patients (mean age, 58 years) with idiopathic pulmonary fibrosis. All patients were evaluated following SLTX. HRCT was performed during inspiration (slice thickness, 1 mm; increment, 10 mm). For correlation with ³He-MRI, HRCT images were reconstructed in coronal orientation to match the same anatomic levels. Aerated lung was determined by threshold-based segmentation of CT. ³He-MRI was performed on a 1.5-T scanner using a two-dimensional, fast low-angle shot sequence in coronal orientation covering the whole lung after inhalation of a 300-mL bolus of hyperpolarized are gas followed by normal room air for the rest of the tidal volume. Lung segmentation on ³He-MRI was done using different thresholds. Results: In emphysematous patients, ³He-MRI showed excellent correlation (r = 0.9) with vital capacity, while CT correlated (r = 0.8) with total lung capacity, ³He-MRI correlated well with CT (r > 0.8) for grafts and native fibrotic lungs. In emphysematous lungs, MRI showed a good correlation (r = 0.7) with the nonemphysematous lung volume from CT. Increasing thresholds in ³He-MRI reveal differences between aerated and ventilated lung areas with a different distribution in emphysema and fibrosis. Conclusions: ³He-MRI is superior to CT in emphysema to demonstrate ventilated lung areas that participate in gas exchange. In fibrosis, ³He-MRI and CT have a similar impact. The decrease pattern and the intraindividual ratio between ventilation of native and transplanted lungs will have to be investigated as a new surrogate for the ventilatory follow-up in patients undergoing SLTX. Key words: CT; hyperpolarized ³He; MRI; single-lung transplantation; split-lung function. [ABSTRACT FROM AUTHOR]
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- 2004
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4. Resection of the Right Middle Lobe and Lingula in Children for Middle Lobe/Lingula Syndrome.
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Ayed, Adel K.
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LUNG surgery , *RESPIRATORY diseases , *PEDIATRIC surgery , *BRONCHIECTASIS , *ATELECTASIS , *SURGERY ,RESPIRATORY organ surgery - Abstract
Study objectives: To review our experience with specific characteristics, indications, and results of pulmonary resection in children with middle lobe/lingula syndrome. Design: Retrospective cohort study. Setting: Thoracic Surgery Department, Chest Diseases Hospital, Kuwait. Patients and intervention: Thirteen children with middle lobe, lingula, or both syndromes were treated with pulmonary resection from January 1995 to December 1999. Results: The mean age was 7.5 years (range, 5 to 10 years). Eight patients were girls, and five were boys. All patients underwent high-resolution CT and bronchoscopy. Bronchiectasis and atelectasis of right middle lobe, lingula, or both was noted in nine patients. Bronchial stenosis and inflammation of the bronchus was found endoscopically in four patients. The indications for surgery were recurrent respiratory tract infection with persistent atelectasis and bronchiectasis in nine patients, and recurrent respiratory tract infection with bronchiectasis in four patients. A right middle lobectomy was done on seven patients and a lingulectomy on four patients. Two patients underwent staged thoracotomies (right middle lobectomy and lingulectomy). There were no operative deaths. Only two patients had postoperative complications: atelectasis (n = 1), and pneumothorax (n = 1). Mean follow-up was 3.5 years (range, 3 to 5 years) for all patients. Nine patients were asymptomatic, and four patients had improved. Conclusion: Right middle lobe or lingula syndrome with the presence of bronchiectasis, bronchial stenosis, or failure of lung to re-expand are indications for early pulmonary resection. Key words: atelectasis; bronchiectasis; pulmonary resection; right middle lobe. [ABSTRACT FROM AUTHOR]
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- 2004
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5. Effects of Additional Minocycline Pleurodesis After Thoracoscopic Procedures for Primary Spontaneous Pneumothorax.
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Jin-Shing Chen, Hsao-Hsun Hsu, Shuenn-Wen Kuo, Christianne, Pi-Ru Tsai, Chen, Robert J., Jang-Ming Lee, and Yung-Chie Lee
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PNEUMOTHORAX , *CHEST endoscopic surgery , *LUNG surgery , *POSTOPERATIVE care , *SURGERY , *THERAPEUTICS ,RESPIRATORY organ surgery - Abstract
Study objectives: To evaluate the safety and efficacy of additional minocycline pleurodesis after thoracoscopic treatment of primary spontaneous pneumothorax. Design: Retrospective comparative study with a historical control. Setting: Thoracic surgical division of a university-affiliated tertiary medical center. Patients and methods: Between April 1994 and April 2001, 313 consecutive patients (minocycline group) with primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. After operation, minocycline hydrochloride, 7 mg/kg, was instilled into the pleural space through a thoracostomy tube. The control group consisted of 51 consecutive patients who underwent the same thoracoscopic procedures alone for primary spontaneous pneumothorax between January 1992 and April 1994. Results: There was no significant difference between the two groups in terms of demographic data, operative findings, and operation time. Chest pain was a common complaint after minocycline pleurodesis, but the total doses of requested analgesics were comparable in both groups. The rate of prolonged air leaks was significantly lower in the minocycline group (7.0% vs 17.6%, p = 0.025). Patients treated with minocycline had shorter periods of postoperative chest drainage and hospitalization. The ipsilateral recurrence rate was also significantly lower in these patients (2.9% vs 9.8%, p = 0.033). Conclusions: Minocycline pleurodesis is a safe and convenient procedure that may improve the outcome and reduce the rate of recurrence after thoracoscopic treatment for primary spontaneous pneumothorax. A randomized control study may be needed to confirm the findings. Key words: minocycline; pleurodesis; primary spontaneous pneumothorax; thoracoscopy. [ABSTRACT FROM AUTHOR]
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- 2004
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6. Bilateral video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax.
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Ayed, Adel K.
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PNEUMOTHORAX , *THORACOSCOPY , *THERAPEUTICS , *THORACIC surgery , *INTERVIEWING , *LONGITUDINAL method , *REOPERATION , *RETROSPECTIVE studies ,RESPIRATORY organ surgery - Abstract
Objective: To review our experience with bilateral video-assisted thoracoscopic surgery (VATS) for the treatment of bilateral spontaneous pneumothorax (SP).Design: Retrospective study followed by a telephone interview for follow-up.Setting: Thoracic Surgery Department, Chest Diseases Hospital, Kuwait.Patients and Interventions: Fifteen patients undergoing bilateral VATS for bilateral SP from 1994 to 1999.Results: The mean age of the patients was 22.9 years (range, 17 to 34 years), and 14 were men. All patients were successfully treated using the bilateral video-assisted technique. Operative indications included simultaneous bilateral pneumothorax (n = 7) and contralateral recurrence of SP (n = 8). Twelve patients had primary SP. In the three remaining patients, simultaneous bilateral SP was secondary to sarcoidosis in two patients and histiocytosis X in one patient. Eleven patients had multiple blebs or bullae located in the upper lobes, and 4 patients had no blebs. All blebs or bullae were resected. All patients had gauze pleurodesis. The mean +/- SD operative time was 133.6 +/- 9.1 min. There were no perioperative complications and no deaths attributable to the procedure. Postoperative prolonged air leak occurred in three patients (20%). The mean drainage time was 3 days (range, 2 to 8 days). The mean postoperative hospital stay was 5 +/- 1.7 days. Mean follow-up was 3.3 years (range, 2 to 5 years) for all patients. Pneumothorax recurred in one patient with histiocytosis X after 1 month and required a reoperation on the right side.Conclusions: Bilateral VATS is a safe procedure in the treatment of simultaneous and nonsimultaneous bilateral SP. This avoids the need for subsequent operations. [ABSTRACT FROM AUTHOR]- Published
- 2002
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7. Quantitation of regional ventilation during the washout phase of lung scintigraphy: measurement in patients with severe COPD before and after bilateral lung volume reduction surgery.
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Travaline, John M., Maurer, Alan H., Charkes, David, Urbain, Jean Luc, Furukawa, Satoshi, J., Criner, Gerard, Travaline, J M, Maurer, A H, Charkes, N D, Urbain, J L, Furukawa, S, and Criner, G J
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LUNG surgery , *AIRWAY (Anatomy) , *RESPIRATION ,RESPIRATORY organ surgery - Abstract
Study Objectives: We sought to investigate the effect of lung volume reduction surgery (LVRS) on regional lung ventilation.Design: Retrospective analysis of routinely acquired data before and after LVRS.Setting: Large, urban, university medical center.Patients: Twenty-nine patients with severe emphysema.Intervention: Bilateral LVRS.Measurements and Results: (133)Xe washout curves during lung scintigraphy exhibit a biphasic pattern (the first component of the washout curve [m(r)] corresponds to an initial rapid phase in washout that reflects larger airways emptying, and the second component [m(s)] reflects a slower phase of washout that is attributed to gas elimination via smaller airways). We analyzed six standardized regions of the lung (upper, mid, and lower zones of the right and left lung), and calculated m(r) and m(s) for each lung region. The mean (+/- SE) baseline FEV(1) was 0.69+/-0.04 L, total lung capacity (TLC) was 139 +/-4% predicted, and the residual volume (RV)/TLC ratio was 65+/-2%. The mean improvement in FEV(1) 3 months post-LVRS was 38%. Post-LVRS, m(r) and m(s) increased in 79 and 74 lung regions, respectively, and there was no relationship with respect to lung regions that had or had not been operated on. The increase in m(s), however, significantly correlated with the increase in FEV(1) (r = 0.66; p<0.0001) and the decrease in RV/TLC (r = -0.67; p<0.0001). An increase in m(s) also correlated with a decrease in PaCO(2) (r = -0.39; p = 0.03), but m(r) showed no relationship with any parameter.Conclusions: Small airways ventilation in lung regions that had and had not been operated on is associated with a greater improvement in lung mechanics following LVRS. [ABSTRACT FROM AUTHOR]- Published
- 2000
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8. Aerosolized β-Adrenergic Agonist Therapy Reduces Pulmonary Edema Following Lung Surgery.
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Matthay, Michael A. and Calfee, Carolyn S.
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ADRENERGIC beta agonists , *PULMONARY edema , *LUNG surgery , *EDEMA , *THERAPEUTICS ,RESPIRATORY organ surgery - Abstract
The article comments on the experimental studies that have provided evidence that aerosolized beta-adrenergic agonist therapy reduces edema following lung surgery and accelerates the removal of alveolar edema fluid in both normal and injured lungs. The author believes that the researchers should be congratulated for performing a clinical study that advances the translation of basic science insights into potentially improved treatment for patients with pulmonary edema.
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- 2008
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9. Midterm Results of Minimally Invasive Diaphragm Plication for Diaphragm Paralysis.
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Odell, David, D'Cunha, Jonathan, Kast, Teri, Maddaus, Michael, and Andrade, Raphael
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DIAPHRAGM diseases ,RESPIRATORY organ surgery - Abstract
An abstract of the study "Midterm Results of Minimally Invasive Diaphragm Plication for Diaphragm Paralysis" by David Odell and colleagues is presented.
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- 2012
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