Helvetica chirurgica acta
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Pulmonary aspergillomas usually arise from colonization of Aspergillus in preexisting lung cavities. Between 1972 and 1988, 18 patients underwent thoracotomy for treatment of pulmonary aspergilloma in our institution. Eight patients had simple aspergilloma and ten had complex aspergilloma. ⋯ Patients with simple aspergilloma tolerated surgery quite well and the outcome was satisfactory. By contrast operative mortality was 30% (3 deaths) in patients with complex aspergilloma and complications occurred in 8 patients (80%). Treatment of pulmonary aspergilloma must be individualized to take into account the patient's overall health and the risks attendant with each treatment modality.
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Myocardial contusion is the most common manifestation of cardiac trauma; the true heart rupture or posttraumatic aneurysms are rare. Pericardial rupture can lead to cardiac strangulation; haemorrhagic pericardial effusion following trauma requires surgical drainage. Constrictive pericarditis occurs rarely after pericardial injury. ⋯ In penetrating heart trauma a surgical revision is almost always necessary, to perform hemostasis and to decompress pericardial tamponade. Traumatic rupture of the descending thoracic aorta is amenable to immediate surgical treatment; end-to-end-anastomosis with simple aortic cross-clamping is the method of choice. Pump oxygenator is rarely necessary in treatment of cardiac trauma; emergency surgery--pericardial decompression, hemostasis and bilateral chest drainage--is performed in primary trauma center.
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Helvetica chirurgica acta · Apr 1990
[Thoracic wall and lung trauma. Diagnosis, clinical aspects, surgical indications and technic].
Diagnosis, pathophysiology, clinical course, indication for and technique of operative procedure are described for treatment of flail chest, pneumothorax, hematothorax, lung rupture and contusion, and for tracheobronchial injuries. A simple "finger-troicart" technique for thoracocentesis and chest tube is mentioned as well as the value of early and simultaneous fiberoptic exploration of the trachea, bronchi and esophagus.
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Helvetica chirurgica acta · Dec 1989
[Blood transfusions and prognosis following curative resection of colorectal cancer: is there an association?].
More recently a number of retrospective analyses in rather ill defined patient populations demonstrated an association between perioperative blood transfusion and recurrence after curative resection of colorectal cancer. In the randomized trial (SAKK 40/81) (adjuvant cytotoxic intraportal infusion versus no further treatment) we evaluated the transfusion status in a well defined, prospectively documented and controlled patient population. ⋯ After a median follow-up of 4 years, the transfused patients developed significantly more recurrences (38.2%) than patients without blood transfusions (23.1%), the death-rate being 33.7% versus 23.0%, respectively. Patients without transfusion but treated with adjuvant intraportal chemotherapy are strikingly doing better (10.5% recurrences) than patients with perioperative blood transfusion not having an adjuvant treatment (44.5% recurrences).
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Helvetica chirurgica acta · Dec 1989
[Magnetic resonance tomography in preoperative analysis of chronic post-traumatic osteomyelitis].
Chronic osteomyelitis in 8 patients was studied preoperatively by magnetic resonance (MR) imaging and in part of them also by computed tomography (CT). Morphologic information about extraosseous and intraosseous changes was important for surgical planning. In long bones CT generally is superior delineating bone structures (sequestra and fragments of devitalized bone in the intramedullary cavity) and MR may be used as an adjunct for localizing extraosseous and intraosseous abscesses. In trabecular bones as the os calcis MR seems to be equivalent to CT.