False aneurysm of the left common carotid artery 52 years after penetrating injury of the chest.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J F Azorin.
Explore the source record for details and available documents.
Disruption of a mainstream bronchus is a rare but dreaded complication of pneumonectomy. When the bronchial tump measures at least 15 mm, the conventional therapeutic strategy is to drain the pleural cavity followed by closure of the fistula via trans-mediastinal sternotomy. After an experimental study on cadavers to test the technical feasibility of main bronchus closure via a cervical approach using a video-mediastinoscope, we used video-assisted mediastinal surgery successfully in a patient with a left main bronchus fistula.
Disruption of a mainstem bronchus is a rare but dreaded complication of pneumonectomy. After an anatomic study on cadavers, we successfully used a video mediastinoscope to close a postpneumonectomy main bronchus fistula via a cervical incision.
The objective of this prospective study was to evaluate the mortality and morbidity of sarcoma pulmonary metastasis resection with continuous chemotherapy. Ifosfamide was administered at the daily dose of 1200 mg/m2/24 h. Twenty-six resections of pulmonary sarcoma were performed from December 1990 to April 1992. The primary lesion was already resected in all patients. Peri-operatory chemotherapy was started 30 minutes before surgery and continued for 6 days. Chemotherapy was associated with an uroprotector, antiemetic drugs and adequate hydration. Patients had a mean age of 30.6 years. The delay between initial and thoracic surgery was 81 months. The following was performed: tumorectomy (32), wedge (18), lobectomy (7), diaphragm resection (1), left pneumectomy (1). All patients had the 6-days chemotherapy course. None of the patients died. Respiratory failure following superinfection, but not necessitating assisted ventilation, was observed in one case. The following adverse events were noted: nausea (34.6%), uncomplicated cystitis (15.4%), leucopenia (7.6%), fever (3.8%). Mean duration of hospitalization was 11.8 days. Chemotherapy adverse effects did not result in significant morbidity. Bronchial fistula was not observed. Following the results of this pilot study, we feel that perioperatory chemotherapy can be added to sarcoma pulmonary metastasis resection surgery without increasing patient morbidity and mortality.
A French multicentre, open, randomized trial was conducted in lung cancer surgery in order to test the optimal dosage regimen: Fraxiparine 3075 IU AXa (fixed dosage) and Fraxiparine 4100 or 6150 IU AXa (dosage adjusted for body weight only), over a period of 8 days. 75 patients were allocated to each group. Efficacy (Doppler ultrasonography at D0 and D8, controlled by bilateral ascending phlebography when positive) and safety, i.e. perioperative blood loss and postoperative bleeding complications were the main assessment criteria. The efficacy of the two treatment regimens was confirmed = no deep vein thrombosis and/or pulmonary embolism. No significant difference of safety was observed between the two groups: nevertheless fewer patients developed major bleeding complications in the Fraxiparine fixed dosage group (2 patients) than in the Fraxiparine adjusted dosage group (6 patients). Blood loss was comparable in the 2 groups; a statistical difference (p = 0.09) was showed between D0 and D2 in favour of Fraxiparine fixed dosage group. The results of this trial indicate that Fraxiparine administered at fixed dosage represents an effective and safe prophylaxis against fatal thromboembolism in patients undergoing oncologic thoracic surgery.