Acta chirurgica Hungarica
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Acta chirurgica Hungarica · Jan 1999
Case ReportsTwo cases of benign tracheo-gastric fistula following esophagectomy for cancer.
Two successfully managed cases of esophageal replacement for cancer complicated by neoesophagotracheal fistula are described. In both cases radical esophagectomy with a gastric pull-up was performed. In the postoperative period different complications necessitated prolonged ventilatory support and tracheostomy. ⋯ The defect on the membranous trachea was patched with autologous fascia lata graft. A left pectoralis major muscle flap was interposed between the trachea and the pulled up stomach in both cases to prevent recurrence of the fistula. Treatment of this potentially life-threatening and rare condition yielded excellent results.
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Acta chirurgica Hungarica · Jan 1999
Video-assisted thoracoscopic pleurodesis for malignant pleural effusions.
The objective was to analyse the efficiency, and safety of thoracoscopic pleurodesis (TP). A retrospective study was made of an initial series of 75 patients undergoing lifetime follow-up who received TP in our department for the treatment of malignant pleural effusions (MPE). ⋯ Videothoracoscopic pleurodesis (talc poudrage) as a simple and efficient procedure seems to be the best alternative treatment regimen for the management of MPE in a group of selected patients.
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Bronchopleural fistula (BPF) is a life-threatening complication of pneumonectomy. Its treatment still challenges the thoracic surgeon. We present our 10-year experience in the management of this entity. ⋯ BPF after pneumonectomy continues to be a problem without definite solution at present. Prevention has not been achieved with the use of staples for bronchial stump closure. Small leaks may be scaled endoscopically with fibrin glue. Otherwise, early surgical closure is mandatory, especially when empyema thoracis coexists.
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Acta chirurgica Hungarica · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol-fentanyl or midazolam-fentanyl intravenous anaesthesia for carotid endarterectomy.
Carotid endarterectomy has become a standard surgical operation in the therapy of cerebrovascular insufficiency. The cardiovascular status of the patients needs special attention, since the long-term prognosis is predominantly influenced by concomitant coronary artery disease. General anesthesia techniques are raising the challenge of maintaining cardiovascular stability and establishing adequate cerebral monitoring. ⋯ Fifteen patients were anaesthetised with propofol-fentanyl or midazolam-fentanyl combined with N2O-O2. Haemodynamic parameters (mean arterial pressure, heart rate) showed not significant changes during anaesthesia. Recovery profil proved to be significantly better after propofol-fentanyl compared to midazolam-fentanyl anaesthesia.