[Surgical treatment of myasthenia by thymectomy. A report on 248 cases (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Le Brigand.
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We have resumed the files concerning the twenty patients treated these last eight years at Medico-Surgical center of Villiers Saint Denis for empyema with bronchial fistula after pneumonectomy, out of more than five hundred patients treatment for empyema of all origins. On that occasion, we explained the principals and the technique of double drainage which enabled us to cure 10 patients, the other ten died of a progressive resumption of cancer in the process of being treated. The direct treatment of fistula through endoscope has completed the action of pleural baths seven times. We also needed to resort to a complementary thorachoplasty seven times, in order to collapse a pouch already very reduced and disinfected by double draining, which had enabled us to block the fistula as well.
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From 96 surgical interventions in the child, the authors studied the repartition of tumours according to their histological nature, their benignity or malignancy. For each kind of tumour they gave its frequency and clinical, radiological and biological data. Above all they studied the distant results of these interventions with an important set back. The results are excellent for benign tumours and promising for malignant ones and enable the deduction of therapeutical indications.
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The authors seek to draw statistical conclusions on the basis of 742 surgically treated mediastinal tumours. Tumours of the thymus were the most common (20%). They were followed by tumours of the thyroid, neurogenic tumours, haematosarcomas and mediastinal cysts - all with an occurrence rate of around 12 to 15%. From a histological standpoint, 34.5% of the tumours were malignant or "potentially malignant". After a topographical study of these tumours, the authors discuss the possibilities of surgical treatment, the latter being great even in the case of malignant lesions.
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A distinction is drawn between first category includes peduncolates, giant seslocal and diffuse primary tumours of the pleura on anatomopathological grounds. The first category includes peduncolated, giant sessile, and "deceptive" forms; the latter those in which the lung is surrounded by a "pleural" and "serous" mantle. Treatment is discussed and the soundness of surgical management is stressed.