Technique for resection of intrathoracic pulsion diverticula of the esophagus.
Explore the source record for details and available documents.
Diverticulum, Esophageal↗
Biomedical subjects
P Gatzinsky
Publications and source records attributed to P Gatzinsky.
[Pulmonary hydatidosis--an unusual cause of recurrent hemoptysis].
Explore the source record for details and available documents.
Adolescent↗
Pneumothorax in pregnancy.
Since 1957, only 15 cases of isolated spontaneous pneumothorax in pregnancy have to our knowledge been reported in the English literature. The treatment of pneumothorax in pregnancy is more difficult than in non-pregnant patients. A case is reported and therapy discussed.
Adult↗
A case of carcinoma in intralobar pulmonary sequestration.
A case of intralobar pulmonary sequestration with the unusual origin of an abnormal artery from the ascending aorta and with cancer localised in the sequestrated lung tissue is presented. The preoperative investigation failed to diagnose the cancer.
Adenocarcinoma↗
Pathogenesis of shrinking pleuritis with atelectasis--"rounded atelectasis".
The pathogenesis of "shrinking pleuritis with atelectasis" or "rounded atelectasis" is discussed on the basis of 37 operated patients and on experiments on cadaver lungs. Peroperative dissections with microscopic examinations and the results of experiments with the cadaver lungs support the concept that the lesion is caused by an inflammatory reaction in the visceral layer of the pleura, caused by asbestos fibers. The inflammation occurs in stages, with deposition of connective tissue that shrinks and causes considerable atelectasis of the underlying pulmonary parenchyma. Compression of the lung due to fluid collecting in the pleural cavity involved was not noted.
Asbestos↗
Treatment of benign strictures and injuries of the oesophagus with a permanent oesophageal tube introduced through a cervical oesophagostomy. I. Method.
Permanent oesophageal tubes of various design have been used for treatment of severe benign oesophageal strictures and oesophageal injuries. A method in which the tube is introduced into the oesophagus through cervical oesophagostomy as proposed by Belinoff is presented and technical details are discussed.
Catheterization↗
Treatment of benign strictures and injuries of the oesophagus with a permanent oesophageal tube introduced through a cervical oesophagostomy. II. Clinical observations.
Eighty-four patients with severe benign oesophageal strictures and/or oesophageal perforation have been managed with a permanent oesophageal tube (POT) introduced through a cervical oesophagostomy. Sixty-eight patients had severe strictures of varying etiology. In these patients, the conservative treatment by bouginage could not be continued due to a stricture unyielding for dilatation or early recurrence of the stricture after a number of dilatations. Eleven of these patients had iatrogen oesophageal perforation at the time the treatment with POT was started. In 16 patients indication for treatment with POT was a severe injury of the oesophagus and in 15 of them it was transmural. The results of the treatment are considered to be satisfactory. The mortality rate, the final results and the factors determining poor results of the treatment are discussed. The treatment with POT introduced through a cervical oesophagostomy is considered to be a valuable method which can be used in cases with stricture and injuries of the oesophagus in which conventional conservative treatment is futile or impossible and resection of the oesophagus undesirable.
Adolescent↗
Long term results of operation for shrinking pleuritis with atelectasis.
During 14 years 34 patients were operated on for shrinking pleuritis with atelectasis. They were followed up after one to 14 years (mean 6.0) by interview, chest radiography, and spirometry. Most were in good condition, but a reduction in vital capacity had occurred in eight and in FEV1 in 15 patients. Radiographs were normal in 28 patients except for small pleural or parenchymal fibrotic changes. One patient had a suspected recurrence of shrinking pleuritis with atelectasis after nine years, suggesting continuation of the disease process despite operation.
Adult↗
Resectional operations and long-term results in carcinoma of the esophagus.
The 5 year survival rate after resectional operations for carcinoma of the esophagus is still very low. Many factors have been identified as contributing to these poor long-term results. The main factor found in this study, comprising 102 patients undergoing resection out of 125 patients operated upon during a 10 year period, was nonradical resection. The main cause of nonradical resection was invasion of the tumor into the mediastinum, which was observed in 80% of the patients. In 43 of the 102 patients undergoing resection, the penetration of the carcinoma into the tissue surrounding the esophagus was observed only histologically. Thirty-three of the 38 hospital survivors in this group died within 2 years of the operation of recurrence of carcinoma. Fourteen of 17 survivors after resectional operations in whom the tumor growth was still limited to the esophagus were alive from 2 to 9 years (mean 6 years) after the operation, without evidence of recurrence.
Adult↗
Surgical treatment of symptomatic gastroesophageal reflux recurring after hiatal hernia repair.
Experience of 30 cases with reoperation for recurrent symptoms after hiatal hernia repair is reported. The primary operation had been transabdominal in 21 cases (11 simple cruroplasty, 7 Nissen, 3 Hill) and transthoracic in 9 (5 Husfeldt, 4 simple cruroplasty). Stenosis and/or esophageal shortening were present in at least 8 patients at the primary operation. Symptoms recurred within a year in 26 of the 30 patients. A transthoracic approach was used for all reoperations. At the time of reoperation, 14 patients had no reflux complications or had esophagitis only. At follow-up (2-12 years) 13 were symptom-free and 1 was improved: X-ray showed hernia in one case and 3 had positive standard reflux test. Of the 16 patients with severe reflux complications before reoperation, 12 had shortened esophagus, combined with stricture in 6 cases, and 4 had isolated stricture. The results were less satisfactory in this complicated group, though all were postoperatively improved. There was no operative mortality. Initial failure to recognize esophageal shortening and inadequate repair were common causes of recurrent hernia. Symptomatic relief after reoperation was comparable with that after primary repair.
Adult↗
[The first heart transplantation in Sweden--background, course, future perspectives].
Explore the source record for details and available documents.
Heart Transplantation↗
Foreign bodies in the mediastinum perforating the oesophagus.
A patient attempting suicide put four unsterile objects into a stab wound in his neck. These objects remained in the tissues unnoticed for about three months before they were removed from the upper mediastinum by operation. Owing to penicillin treatment, no diffuse mediastinitis developed but the oesophagus was perforated by the objects. In spite of severe damage to the gullet by the perforation and by operative incision, the oesophagus could be repaired without development of stenosis. The method of preventing stenosis is presented.
Adult↗
Aortic cross-clamping for more than 2 hours in open-heart surgery. Early results in 87 patients.
Myocardial protection with cold cardioplegia has made it possible to prolong the time of aortic cross-clamping during open-heart surgery. Myocardial ischemia for up to 120 minutes is considered acceptable under these conditions. Eighty-seven patients operated upon for various heart lesions with cardiopulmonary bypass and aortic cross-clamping for more than 2 hours (mean time 146 minutes) were reviewed. Myocardial protection was achieved with cold cardioplegia, in some cases with additional topical cooling of the heart. Ten patients died and 77 were discharged from the hospital. Perioperative and early postoperative deaths could not be correlated to aortic cross-clamping time or the method of myocardial protection. Aortic cross-clamping can be safely performed for a period far longer than 2 hours with myocardial preservation by cold cardioplegia.
Adult↗
A case of total bilateral spontaneous pneumothorax.
Bilateral spontaneous pneumothorax with almost complete collapse of the lungs in a 29-year-old man is reported. On admission to hospital the patient was in moderate respiratory distress, but the arterial blood gases were normal. Initially he was treated with bilateral tube drainage. Thoracotomy with parietal pleurectomy was later done on the right side to prevent recurrence.
Adult↗
Shrinking pleuritis with atelectasis.
During a 10-year period 28 patients with shrinking pleuritis with atelectasis (SPA) were observed and operated upon. This lesion has been given different names in the literature, for instance rounded atelectasis, pleuroma, pulmonary pseudotumour, and lung folding. All patients except two were operated upon because of a diagnosis of pulmonary tumour. However, at operation no tumour was found. The aetiology and pathogenesis of SPA are discussed on the basis of X-ray, operative, and histopathological findings.
Diagnosis, Differential↗
Oesophagocardiomyotomy and antireflux procedures.
Although oesophagocardiomyotomy has been the method of choice for surgical treatment of achalasia cardiae for several decades, there are still great discrepancies in the technical details of the procedure as performed in different centres. This is one of the main explanations for the diverging results reported, particularly with regard to the incidence of postoperative gastro-oesophageal reflux. Sixty-three patients underwent primary oesophagocardiomyotomy with a total length of 12 cm, including incision of about 2 cm onto the stomach. Forty-one patients were not examined preoperatively for conditions now recognized as predisposing to reflux and were managed with oesophagocardiomyotomy only, except one patient. Eight patients developed severe reflux complications from 1 to 5 years (mean 2 years) after the operation. In 11 out of 22 patients examined preoperatively for such conditions, Heller's operation was combined with an antireflux procedure. The results were good in all patients and pathological gastro-oesophageal reflux was not detected in any of the 22 patients during a follow-up period of 2 to 7 years (mean 4 years). It is concluded that oesophagocardiomyotomy should be combined with an antireflux procedure in selected patients. The indications for an antireflux procedure are discussed.
Adult↗
Differentiated treatment of intrathoracic oesophageal perforations.
A series of 44 consecutive patients with oesophageal perforation treated during the ten-year period 1969-1978 has been reviewed. Thirty perforations were caused by oesophagoscopy using a rigid instrument, often combined with dilation and/or biopsy, 4 were caused by a fibreoptic instrument and 10 were spontaneous ruptures. A benign stricture was the most commonly associated lesion in the oesophagus. Six patients with an iatrogenic perforation were treated conservatively without mortality. These patients were characterized by mild symptoms, early recognition, minor leakage from the oesophagus and no communication to the pleural cavity. Fourteen patients were treated with closed thoracic drainage. The overall mortality among these patients was 70%, but for those with a spontaneous rupture it was 100%. Twenty-four patients were treated surgically with a mortality of 20%. Individualized treatment is recommended.
Aged↗