Biomedical subjects

M Casillas

Publications and source records attributed to M Casillas.

At least 19 recordsLinked to original sources

PubMed1990

Management of non-tumoral tracheal stenosis in 112 patients.

From January 1973 to August 1989, 112 patients with non-tumoral tracheal strictures were treated in our unit. In 102 patients, the stenosis followed respiratory support. Eighty-one patients were treated surgically; the rest required only endoscopic therapy. In 28 patients, surgical treatment followed failure of endoscopic management. Of the patients submitted to surgery an isolated tracheal stenosis was present in 54 cases while a laryngotracheal stricture was the lesion in the other 27. Tracheal resection and end-to-end anastomosis was performed in the former group. Rethi, Pearson and Couraud procedures, respectively, were carried out in the latter. We emphasize the difference in the results achieved in the first 5 years and those obtained in the last 10 years. In the former period, 7 reoperations were needed. On the other hand, although the overall mortality of both series was 9%, it decreased to 2% during the last 10 years. Excellent or good ultimate results were achieved in 92% of survivors. Finally, we stress the differences in the proportion of reinterventions and definitive failures in the surgical treatment of isolated tracheal stenosis compared to laryngotracheal strictures.

Adolescent↗

PubMed1989

Surgical treatment of lung carcinoma involving the chest wall.

From 1969 to 1986, 97 patients with chest wall invasion by lung carcinoma (excluding superior sulcus tumours) underwent surgical resection in two hospitals, La Paz (Madrid) and La Fé (Valencia). The same surgical policy was used in both thoracic surgical units: extrapleural pulmonary resection when tumour involved only the parietal pleura (N = 36), and en bloc chest wall resection when the carcinoma extended into the ribs and intercostal muscles (N = 61). The tumour histology was classified according the WHO criteria. Lobectomy or bilobectomy was carried out in 72%, pneumonectomy in 18% and segmentectomy or wedge resection in 10% of the patients. The perioperative mortality was higher in the en bloc resection group 9/61 (15%) versus 2/36 (6%) for extrapleural dissection. The node staging was NO in 58/97 (60%), N1 in 16/97 (16%) and N2 in 23/97 (24%). The probability of survival was calculated by the Kaplan-Meier method collecting data from the perioperative survivors only. The overall 5-year survival was 23% with no significant differences between the en bloc resection and the extrapleural lung resection groups. The most important predictor of survival was the node stage. The 5-year survival for N1 and N2 were 8% and 6%, respectively. These percentages increased to 34% when N0 patients were considered. Other predictors of survival were not significant. The authors conclude that either extrapleural or en bloc chest wall resection are both valid procedures which may be used depending on the depth of local invasion.

Adenocarcinoma↗

PubMed1988

Mediastinal hemangiomas.

Explore the source record for details and available documents.

Hemangioma↗

PubMed1979

The surgical treatment of cancer of the esophagus. Summary of replies to a questionnaire.

In an attempt to assess the different methods of treatment of tumors of the esophagus we contacted 170 surgeons (in 1975-1976). Seventy-six (45%) answered a questionnaire concerning the surgical management of esophageal tumors, the reasons for non operability and non resectability, the place of radiotherapy, the validity of palliative procedures, the exposure and type of resection for tumors at various levels in the esophagus, the technical details of the operations, the resectability and mortality rate, the anastomotic leak rate and its treatment, and the five-year survival rate after operation. The replies to the questionnaire are summarized.

Esophageal Neoplasms↗

PubMed1978

[Morgagni's hernia. Surgical treatment by subsiphoining route].

Explore the source record for details and available documents.

Adolescent↗

PubMed1977

Thoracoscopy in the diagnosis of pleural effusion.

The technique, indications, and complications of diagnostic thoracoscopy are described. Two hundred and eight explorations have been performed in our service in the last seven years. From 137 pleural malignancies we have obtained an unequivocal positive biopsy in 129 (94%) with a minimum number of complications and no mortality. From our experience we conclude that thoracoscopy, when porperly performed, is diagnostic in most pleural conditions.

Biopsy↗

PubMed1977

[Carena-shaped thorax following surgical correction of a sternal fissure (author's transl)].

Explore the source record for details and available documents.

Bone Diseases, Developmental↗

PubMed1975

Mediastinoscopy in the surgical management of lung carcinoma.

Up to December 1973, we had performed 100 mediastinoscopies for lung carcinoma. Fifty-two were positive and 48 negative. In 80 cases there was clinical or radiological suspicion of mediastinal invasion. With radiological evidence of mediastinal node involvement exploration was positive in 32 out of 35 cases, when chest radiography findings were equivocal in 19 out of 45, and when radiology of the mediastinum was normal in only one of 20 cases. Mediastinoscopy was more frequently positive when the carcinoma was oat-cell or anaplastic. Of 48 patients with negative biopsies, 41 were explored. In 26 the carcinoma extended beyond the lung. In 1973 we circularized 83 thoracic surgeons concerning (1) the use of mediastinoscopy for patients with lung carcinoma assessed for surgery, (2) the significance of mediastinal node involvement, (3) the results of radiotherapy alone in patients rejected for surgery, and (4) the survival rate in patients with positive mediastinal nodes treated with surgery alone or together with radiotherapy. The replies to the questionnaire are summarized. The authors emphasize the usefulness of mediastinoscopy but state that care must be taken when deciding to withhold operation for a possible cure.

Biopsy↗

PubMed1975

Surgical stabilization of traumatic flail chest.

Since 1970 we have stabilized the ribs to correct paradoxical movement of the chest wall in chest injuries, using an original technique, in order to avoid as far as possible the need for long-term chest wall stabilization by intermittent positive pressure respiration (IPPR). The technical details of surgical stabilization are described, and the different types of stainless steel struts are shown. Type I was originally used either as an intramedullary nail or as an external brace. Types II and III were designed for external fixation of the strut to the rib. Treatment of 29 patients with severe flail chest, classified into four groups is shown: group I was treated by IPPR, group II by IPPR plus surgical stabilization, group III by surgical stabilization only, and group IV by surgical stabilization after exploratory thoracotomy. The clinical results are discussed. We conclude that surgical stabilization of the paradoxial movement of the chest wall can avoid the use of the respirator or at least reduce the interval of IPPR to a short period during the initial recovery from trauma. Using type III struts, we have obtained stabilization of the flail chest in all cases even in patients with severe anterior paradoxical movement. The patients' tolerance of surgical stainless steel struts was good.

Humans↗

PubMed1973