[Torpid infection on a polycystic lung].
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Humans↗
Biomedical subjects
A Morcillo
Publications and source records attributed to A Morcillo.
[Resection of bronchogenic carcinoma invading the diaphragm].
The prognosis for survival when small cell non-anaplastic bronchogenic carcinoma (SCN-ABC) invades the diaphragm has not been clearly established because the diagnosis is rare. We report a series of eight patients who underwent full resection of SCN-ABC with diaphragm invasion. One died during the postoperative period. Mean survival was eight months for the remaining seven and no patient lived five years. All died as a result of remote metastasis. Given these results, we question whether surgery is the most appropriate treatment for these patients.
Aged↗
[Application of selection criteria in sequential double lung transplantation].
Since the first sequential double lung transplant was performed in 1986, such procedures have been increasing in number and the criteria used as indications for this type of surgery have broadened. Our aim was to reflect on the application of selection criteria and to describe the anesthetic and surgical techniques and postoperative follow-up of 72 patients who underwent this type of transplant surgery between March 1993 and December 1998. Actuarial survival five years after surgery was 74.4%. Among patients requiring transplantation after septic disease, actuarial survival was 90.8% for cystic fibrosis and 88.2% for bronchiectasis. Of the preoperative risk factors analyzed (prior surgery, pachypleuritis, multiresistant germs, poor nutrition, mechanical ventilation and corticoid therapy), only prior treatment with high doses of corticoids proved significant. Eleven patients have been diagnosed of bronchiolitis obliterans, four have died and only two continue to experience difficulties in daily living. The high survival rate and the restriction-free life after recovery lead us to consider sequential double lung transplantation to be the treatment of choice for all pulmonary diseases.
Adult↗
Antifungal prophylaxis during the early postoperative period of lung transplantation. Valencia Lung Transplant Group.
INTRODUCTION: Fungal infections occur frequently in lung transplant patients, with the highest risk being in the early postoperative period (the initial hospitalization after lung transplantation). Aspergillus is responsible for more than half of all fungal infections, and Aspergillus has even been considered a contraindication for lung transplantation because of its difficult therapy and frequently fatal outcome. The aim of this article is to evaluate the success of an antifungal prophylaxis protocol to prevent fungal infection in the immediate postoperative period in lung transplant recipients. MATERIAL AND METHODS: From March 1994 to March 1997, we performed 52 lung transplants in 31 men and 21 women who received antifungal prophylaxis with fluconazole, 400 mg/d, and aerosolized amphotericin B, 0.6 mg/kg/d, during the postoperative period. RESULTS: The mean (+/- SD) postoperative period duration was 49 +/- 27.5 days. No fungal infections were observed during this period, and all patients provided negative cultures. We also found no toxicity related to antifungal drugs. The dose of cyclosporine was easily adjusted in every recipient according to blood levels so that effective immunosuppression was not compromised. DISCUSSION: In our study, the removal of the lungs and antifungal prophylaxis with fluconazole and aerosolized amphotericin B prevented fungal infection in the postoperative period in all 52 lung transplant recipients.
Adolescent↗
[Recurrent mediastinal liposarcoma].
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Adult↗
Surgical results and prognostic factors in early non-small cell lung cancer.
BACKGROUND: We attempted to clarify the prognostic value of tumor size (maximum, 3 cm), the evidence of invasion proximal to a lobar bronchus at least 2 cm distal to the carina, and the absence or presence of visceral pleura invasion in patients with completely resected non-small cell lung carcinoma without lymph node invasion or satellite lesions (T1 N0 M0, T2 N0 M0). METHODS: The study included 158 patients. Four patients were excluded due to postoperative mortality (2.5%). The variables selected for the survival study were sex, age, symptoms presence or absence, bronchial invasion level (evidence or not of invasion proximal to a lobar bronchus at least 2 cm distal to the carina), pulmonary location, pneumonectomy or lesser resection, cell type, squamous or nonsquamous, tumor size, invasion or not of the visceral pleura, and T1 or T2 status. RESULTS: The overall survival rate in this series was 74% at 5 years and 60% at 10 years. Only the tumor size had a significant influence on survival (p = 0.0092). Patients with a tumor less than 2 cm in diameter did better (p = 0.0023). CONCLUSIONS: These observations suggest that it will be necessary to further research in clarifying the prognostic value of the bronchial invasion level and of the degree of the visceral pleura invasion and its implications when classifying a tumor as T1 or T2.
Adult↗