Biomedical subjects
Publications and source records attributed to B K Nigam.
A carcionoma at the orifice of the left main bronchus is generally considered inoperable. Since 1963, in six patients, we have mobilised the transverse aortic arch and, working above the aortic arch, cut the left main bronchus off the trachea and closed the stump. The operation is completed as a pneumonectomy; it is referred to as a supra-aortic pneumonectomy. The indications, technique, and results are described.
Ffity-five patients suffering from second primary lung carcinoma, 10 synchronous and 45 after resection for lung carcinoma (metachronous), have been observed from 1400 resections. The first manifestation of a second carcinoma in this series has always been the appearance of a new shadow in the follow-up radiograph. In our experience, second primary lung carcinoma is a disease affecting only heavy cigarette smokers. Heavy cigarette smokers suffering from squamous-cell carcinoma are at special risk. The results of re-operation, the significance of the time interval between the original operation and the appearance of the second primary carcinoma, and the slow growth rate of some second primaries are briefly discussed. No clear-cut methods exist for distinguishing a second primary from a metastasis from the original carcinoma.
Three cases which presented with clinical and radiological features consistent with a diagnosis of lung neoplasm and eventually turned out to be due to a foreign body are described. Their management and outcome was different in each case. The value of making a firm histological diagnosis in bronchoscopically visible lesions prior to thoracotomy is emphasised. Multiple bronchoscopic examinations and biopsies may be needed to achieve a histological diagnosis.