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Biomedical subjects

K Khargi

Publications and source records attributed to K Khargi.

7 recordsLinked to original sources
PubMed1996

Pulmonary function and postoperative complications after wedge and flap reconstructions of the main bronchus.

Between 1980 and 1989, 8 wedge and 17 flap main bronchoplasties were done in 24 patients (4 carcinoid tumors, 4 benign lesions, 17 carcinomas). Bronchial anastomotic stenoses, pulmonary function, and survival were evaluated. Preoperative ventilation/perfusion scans with preoperative and postoperative spirometry were done in all patients except two who underwent a wedge bronchoplasty. Postoperative bronchoscopy was done in all patients. Follow-up was complete for the patients with carcinoma (N = 17). In the wedge group bronchial anastomotic stenoses occurred in three (38%) of eight patients. All three patients had serious postoperative complications (persistent atelectasis in one, prolonged ventilatory support in two); one patient died and the other two had impaired postoperative pulmonary function. Complete function recovery occurred in only three (38%) of eight patients who underwent wedge bronchoplasty. In the flap group, bronchostenosis occurred in 3 (18%) of 17 patients. The associated complications (mucus retention, minor atelectasis, partial lobar torsion) were mild. Complete pulmonary function recovery occurred in 13 (76%) of 17 patients who had flap bronchoplasty. Actuarial survival, for the patients with carcinoma, was 88%, 47%, and 41% after 1, 3, and 5 years, respectively. The local recurrence rate was 25% (4/16). In our series, flap main bronchoplasties were effective for the resection of bronchial tumors with local involvement of the adjacent main bronchus. Wedge main bronchoplasties, however, were associated with substantial postoperative complications.

Adult↗
PubMed1996

Lung function and perfusion after bronchial and pulmonary arterial sleeve resection.

Between January 1985 and December 1991, six patients underwent arterial and bronchial sleeve resections of the left upper lobe. Preoperative and postoperative spirometry, preoperative split pulmonary radionuclide ventilation/perfusion (V/Q) scans and postoperative bronchoscopy were obtained in four patients. Postoperative serial digital vascular images (DVI) of the pulmonary artery were obtained in three patients and one patient had a postoperative V/Q scan. For each patient the preoperative and postoperative forced expiratory volume in is (FEV1) were determined to assess the postoperative ventilatory recovery. At bronchoscopy all patients had a patent bronchial anastomosis. At postoperative DVI, in three patients, vascularization of the residual left lung was delayed and less intense compared with the non-operated right lung. Postoperative V/Q scan, in one patient, showed reduced ventilation and perfusion of the residual lung. Preoperative and postoperative FEV1 of the four patients were 2688/1998 ml, 2154/1752 ml, 2618/2100 ml and 2277/2015 ml. Operative mortality was zero. One patient had a postoperative atelectasis of the left lower lobe. In our series, ventilation and vascularization of the reimplanted and revascularized left lower lobe were reduced. But, in our opinion, the preserved residual lung parenchyma was still a relevant advantage.

Aged↗
PubMed1994

Pulmonary function after sleeve lobectomy.

Preoperative and postoperative pulmonary function of 109 sleeve lobectomy patients (90 right upper lobe, 10 left upper lobe, and 9 left lower lobe) were evaluated over a period of 30 years. Ninety-eight men and 11 women, with a mean age of 60 years, were reviewed. The diagnosis was lung cancer in 97 patients and carcinoid tumors in 12 patients. Indications for operation were anatomic suitability in 103 patients, and impaired pulmonary function (forced expiratory volume in 1 second (FEV1) less than 1,200 mL) in 6 patients. The predicted postoperative FEV1 was calculated and compared with the measured postoperative FEV1. Preoperative spirometry and split pulmonary radionuclide ventilation/perfusion scans were used to calculate the predicted postoperative FEV1. Postoperative spirometry had been performed 125 days after operation (range, 25 to 342 days). Our results showed a gradual improvement in postoperative pulmonary function. A complete and stable condition was reached 4 months after operation. Correlation between the predicted (mean, 2,097 mL) and measured FEV1 (mean, 2,067 mL) was good (linear regression and correlation test; r = 0.72). These values did not differ significantly (Wilcoxon signed rank test; p = 0.81). Our findings indicated a complete recovery of the reimplanted lung lobes after sleeve lobectomy.

Female↗
PubMed1993

Hemorrhage due to inflammatory erosion of the pulmonary artery stump in postpneumonectomy bronchopleural fistula.

Bleeding from the pulmonary artery in patients with a bronchopleural fistula after pneumonectomy is a rare but devastating complication. The incidence is unknown, but our data suggest an incidence of 4% in all postpneumonectomy bronchopleural fistulas. Two case histories are presented in which the anterior transpericardial approach was used to stop the pulmonary bleeding by direct suturing. Nevertheless, 1 patient died 5 days later because of irreversible brain damage; the other patient recovered well after a protracted convalescence.

Aged↗
PubMed1991

Aortocaval fistulas.

The only effective treatment of an aortocaval fistula is the surgical closure of the fistula opening with insertion of an aortic prosthesis to restore the arterial continuity. The diagnosis of this distinct but infrequent clinical entity is often missed because of lack of suspicion. Proper preoperative evaluation facilitates the choice of surgical approach and reduces the morbidity. Three patients are presented with an aortocaval fistula: two with spontaneous rupture of an atherosclerotic abdominal aneurysm into the inferior vena cava and one with a traumatic fistula following intervertebral disk surgery 33 years before. All three patients suffered from pain in the abdomen and back, a palpable pulsatile abdominal mass and an audible continuous harsh bruit. Cardiac failure was present in two of them. Successful surgical closure could be accomplished in two patients although the perioperative course was complicated by ventricular arrhythmia, profuse blood loss and an inferior vena cava syndrome. One patient with a spontaneous aortocaval fistula passed away due to intraoperative exsanguination.

Aged↗
PubMed1990

Mesenteric venous thrombosis caused by deficiency of physiologic anti-coagulants: report of a case.

Mesenteric venous thrombosis is a clinical entity, which is rarely recognized on admission. The patients are admitted with vague abdominal complaints and, eventually, abdominal sepsis might occur requiring laparotomy. Nowadays, underlying hypercoagulable states such as antithrombin-III, protein-C and protein-S deficiencies are recognized more frequently as a distinct cause of mesenteric venous thrombosis. In this paper, a case of mesenteric venous thrombosis due to protein-C deficiency is presented. The patients generally have a history of thromboembolism of the deep veins of the legs at young age. The combination of vague abdominal complaints and a history of thrombosis of the deep veins of the legs should arouse the suspicion of mesenteric venous thrombosis. In these cases, contrast-enhanced computerized tomography is a non-invasive diagnostic means which may provide the diagnosis. If infarction of the gut is present, resection is mandatory and a second-look operation should be performed. After surgery, heparinization is essential. This must be followed by administration of oral anticoagulants for an indefinite period in case of an underlying antithrombin III, protein-C or protein-S deficiency.

Adult↗