Biomedical subjects

P Froeschle

Publications and source records attributed to P Froeschle.

4 recordsLinked to original sources

PubMed2005

Video-thoracoscopy and staged management of preoperative empyema in lung cancer.

The incidence of pleural empyema as a primary finding in lung cancer patients is low (0.1 to 0.3 %) and the management of those patients deemed operable consists of either infection control prior to resection, or thoracotomy and resection before infection control. We successfully resolved (in one patient) and alleviated (in a second patient) empyema-related systemic infection by video-assisted thoracic surgery (VATS), and were thus able to resect their lung tumours 14 and 21 days later, respectively.

Aged↗

PubMed2003

[Remission rate of mediastinal lymph nodes after multimodal therapy of lung cancer--is it a prognostic factor?].

OBJECTIVE: General acceptance in the oncologic community has been gained for combined modality treatment of non-small cell lung (NSCLC) cancer in locally advanced stage IIIA and IIIB disease. However, no optimal regimen has been established. This study (chemotherapy and radiochemotherapy followed by operation) assesses feasibility, response, resectability, and survival in patients with stage IIIA and IIIB lung cancer. Currently, only little data is available about the prognostic significance of tumor clearance of mediastinal nodes. Thus, an important aim of our study was to evaluate the prognostic significance of the extent of tumor reduction in mediastinal nodes by a neoadjuvant multimodality protocol. PATIENTS: In a phase II protocol, 26 patients underwent neoadjuvant radiochemotherapy. Subsequently, a radical lymphadenectomy was performed during surgery. The extent of tumor regression was determined according to the methodology initially described by Salzer-Kuntschik for osteosarcoma: Grade I: no vital tumor cells, grade II: some tumor cells, grade III: less than 10 % vital tumor cells, grade IV: 10-50 % vital tumor cells, grade V: more than 50 % vital tumor cells, grade VI: no effect of chemotherapy. RESULTS: Complete pathologic response was seen in 30.7 % of primary tumors, in 38.5 % of mediastinal lymph nodes, and in 23 % of corresponding specimens simultaneously. Median survival was 34.7 months for those patients with grade I, 12.6 months with grade II, and 8.9 months for patients showing a grade III/IV regression in mediastinal nodes. Response rate to neoadjuvant chemotherapy in mediastinal nodes proved to be the only statistically significant parameter for long-term survival: In cases with no vital tumor cells in the operation specimen, median survival was 34.7 months in comparison to those with vital cells showing a median survival of only 11.4 months (P = 0.01). CONCLUSION: Patients with locally advanced NSCLCs can enjoy long-term survival after multimodal therapy. However, the complications related to therapy are considerably. Especially, clearance of tumor cells from mediastinal lymph nodes is an important independent prognostic factor.

Adult↗

PubMed1996

[Thoracic surgery in advanced age].

From 1990 through 1992, 70 patients 70 years of age or older (mean 72.8 years) underwent surgery for lung cancer at our hospital (47 males/23 females). 68 patients took part in a follow-up. Operative treatment consisted of standard lung resections in 42 cases. 17 patients underwent enlarged resections. In the postoperative period, complications occurred in 32 cases (47%). The overall operative mortality rate of 13% was mainly due to concomitant cardiovascular diseases and enlarged lung resections. Critical preoperative evaluation of the patients' functional status and selection of the proper operative procedure promise a successful treatment of lung cancer in the elderly.

Aged↗

PubMed1986

[Microscopic analysis of saphenous veins used for aortocoronary bypass].

The Authors describe a study performed on a sample of 88 saphenous veins used as aorto-coronary bypass grafts. The patients underwent surgery in the Department of Cardiovascular Surgery of Ancona from Jan. 1981 to Dec. 1984. The morphological analysis (light and electron microscope) was conducted with a comparative method between two surgical techniques (ST). The first refers (Group I) to 1981-82, the second (Group II) to 1983-84. In Group I the veins were taken with a conventional surgical technique. In Group II the ST was performed using an atraumatic procedure, topic vasodilators, distension of the vein with autologous blood and driving pressure less than 150 mmHg, and storage of the vein in blood at room temperature. The results show that in Group II there is better preservation of the endothelial venous layer. The distending pressure of the venous graft (less than 150 mmHg) and prevention of venous spasm were statistically relevant (p less than 0.05). The AA. conclude that vein graft damage during surgery can be avoided by means of the following procedures: dissection of the vein with atraumatic technique; prevention of venous spasm with topic vasodilators; distension of the vein at pressure less than 150 mmHg.

Coronary Artery Bypass↗