Biomedical subjects
Publications and source records attributed to H Plate.
It is told about twenty penetrating wounds of thorax in the last ten years. They deal with twelve stab wounds, five gunshot wounds and three impalement wounds. The organic lesions are dominated by wounds of lung. Drainage of thorax is chosen as therapy in uncomplicated cases. Thoracotomy was necessary in 6 cases, 5 of them were urgent.
From 1969 to 1988 on the Department of Thoracic Surgery "Vogelsang" of the District Hospital Magdeburg were performed 128 thoracotomies on 114 patients because of metastases from extrapulmonary tumours. In most of the cases the primary tumours were carcinomas of kidney, of testes, colorectal carcinomas and breast cancer. By resection we employed all important methods of lung surgery, 5 times as median sternotomy. The survival time of 3 years run to 40% and that of 5 years to 24%. By patients with different lung metastases we found an aggravation of prognosis.
Reported are 48 cases of aspergilloma underwent surgical treatment. Cardinal symptom was hemoptysis in 26 patients. Because of massive bleeding one patient had to treat by thoracotomy without delay. Specific metabolic properties of the fungus, the situation of the wall and the content of the cavum as well as the genesis of the development of the cavum are discussed in connection with the tendency to hemoptysis.
In the last 30 years five patients with foreign bodies from tracheobronchial tree were treated. In four cases the foreign body was not discovered. In all patients was necessary to carry out a lobectomy.
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Between 1977-1988 89 patients had an operation on tuberculosis in our thoracic surgical department. It were 11 preoperatively diagnosed and 76 undiagnosed cases of tuberculosis and 2 infections with nontuberculosis mycobacteria. In cases, where tuberculosis was diagnosed, surgical therapy was only used because of uneffective antituberculotic therapy. Surgical operations are always applied as secondary late measures. We have manly employed limited resections saving parenchyma. The frequency of postoperative complications was 11.2%. An adequate postoperative chemotherapy is obligatory.
Ten outdated traumatic ruptures of the diaphragm are reported in this paper. The accidents had been up to 34 year back. Symptoms were rarely characteristic. Long intervals with no complaint were found to be possible. X-ray techniques were helpful in diagnosis in seven cases. All ten patients underwent thoracotomy.
Experience obtained from surgical treatment of 107 cases of spontaneous pneumothorax is reported in this paper. Surgical approaches depended on primary disease, rate of recurrence, and localisation. Chemical pleurodesis was performed in addition to cautious pulmonary resection on 44 patients, while partial or sub-total pleurectomy was performed on 41 patients for prophylaxis against recurrence. Additional interventions, including decortication, were necessary in many cases. Three patients were sternotomised for bilateral processes.
Between 1973 and 1985, 107 thoracotomies were performed in cases of spontaneous pneumothorax in 100 patients. Only in 3 patients we found a primary pneumothorax. In relation to the basic illness, the gravity of accompanying diseases and the frequency of relapses, we employed an graduated concept of treatment: Pleurocentesis, thoracodrainage, thoracotomy. The indication for primary operation was established in 10 patients and for sternotomy in 3 cases of simultaneous bilateral pneumothorax. There was a low frequency of relapses (1 patient) in comparison with conservative treatment. The frequency of complications in total was judged to be low.
40 patients underwent surgery for aspergilloma at the authors' ward of thoracic surgery. Pulmonary defects or cavities were recorded from 95 per cent of them (13 cases of bronchiectasis, eight with tuberculous caverns, and six cysts). Serological methods, 100 per cent in accuracy, were superior to all other diagnostic approaches. Lobectomy was the most common therapeutic approach, followed by segment resection and atypical resection. Surgery has proved to be the optional therapeutic approach to aspergilloma, though a high rate of postoperative complications has to be expected.