Biomedical subjects
Publications and source records attributed to L H Lampl.
One of the rare cases in which metastases of a carcinoid tumor infiltrate the aortic wall is reported. Cross-clamping the descending aorta and en-bloc resection of the tumor and the descending aorta were possible. The postoperative course was uneventful.
In a retrospective study of 302 patients, who were operated on in our centre between 12/85 and 9/87, 25 patients required a chest wall resection. The most frequent indication (11 times) was an infiltration of the thoracic wall by bronchial carcinoma. 8 times we resected a primary rib tumour, in rarer cases a thoracic wall resection was required for mesothelioma, echinococcus alveolaris and tuberculoma. In 10 patients the defect was too small to require a patch. Initially we applied Marlex-mesh and Vicryl-mesh to cover the defects. In our last 10 cases GORE-TEX-2 mm-patch was used. The technical ease of the method, the mechanical stability and durability, the tightness for air and fluid and the positive tissue response speaks for the continued application of this material. Additional methods such as myocutaneous flaps are not necessary and should only be used in complex defects.
Intrathoracic displacement of the proximal humerus following axillary luxation is a rare injury; but with ipsilateral serial costal fracture and/or single costal fracture with contused lung it has to be included in the considerations concerning differential diagnosis and the tactics of surgical approach. The primary measures are determined by the extent of pulmonary damage; the further course is marked by aseptic necrosis of the head of the humerus. On the basis of our study case we are describing a typical course, and discussing its problems taking into consideration the individual publications available so far.