Biomedical subjects

R H Overholt

Publications and source records attributed to R H Overholt.

17 recordsLinked to original sources

PubMed1985

Metastatic melanoma to the lung: long-term results of surgical excision.

The only long-term survivor of multiple bilateral pulmonary metastases from malignant melanoma after staged thoracotomies has been described, and a series of 18 patients who underwent pulmonary resection for metastatic malignant melanoma at one clinic have been reviewed. Median survival was 16.5 months and the 5 year survival rate was 11.1 percent. Forty-four percent of the patients had multiple metastases and 11.1 percent had bilateral metastases. There was no correlation between length of survival and disease-free interval, number of metastases, or the presence of unilateral versus bilateral tumor nodules. Twenty-seven percent of the patients had more metastases found intraoperatively than suspected preoperatively. Unfavorable results occurred when the extent of the disease required pneumonectomy. The current literature has also been reviewed and arguments have been made to support the surgical approach to carefully selected patients with metastatic melanoma to the lung.

Adult↗

PubMed1979

Bilateral pulmonary resection for bronchiectasis: a 40-year experience.

Ninety-nine patients underwent bilateral pulmonary resection for severe multisegmental bilateral bronchiectasis at the Overholt Thoracic Clinic during the period 1937 to 1977. A total of 216 operations were performed, and 20 patients underwent three or more procedures. The operative mortality was 1.4% and the incidence of severe complications, 7%. Follow-up ranged from 1 to 30 years (average 10.2 years). Only 1 patient was lost to follow-up. Improvement in pulmonary symptoms was achieved in 83 patients; there was no improvement in 9 patients; and 4 patients were worse following resection. The results suggest that bilateral bronchiectasis need not be a contraindication to operation. In properly selected patients, lasting symptomatic improvement can be provided by resection.

Adolescent↗

PubMed1977

Esophageal myectomy for recurrent multiple leiomyomas of the esophagus: manometric and cineradiographic documentation.

This is a report of recurrent multiple leiomyomas of the esophagus treated initially by enucleation and subsequently by myectomy of the involved portion of the esophagus to prevent further recurrence. Experimental studies support the clinical observation that the esophagus will function as a conduit for food in the absence of an orderly progression of peristalsis. Preservation of hilar truncal vagus nerve function must be accomplished if normal lower esophageal sphincter function is to be maintained. We believe this is the first report of deliberate esophageal myectomy in a human patient with manometric and cineradiographic documentation of satisfactory function postoperatively. Limited myectomy may be considered, as circumstances require, in the treatment of multiple esophageal leiomyomas, although enucleation remains the treatment of choice.

Adult↗

PubMed1975

Primary cancer of the lung. A 42-year experience.

Between April, 1932, and July, 1974, 3,808 patients with primary lung cancer were studied and 1,848 underwent resection. Among untreated patients, 95% were dead with a year. Unresected cancer of the lung is so lethal that efforts to streamline surgical management should not be neglected. In good-risk patients with isolated lesions the approach can be direct. If surgical excision is indicated, regardless of a positive or negative sputum cytology, bronchoscopic biopsy, or brush biopsy, such investigations become superfluous. Needle biopsy is also inconclusive and in addition is hazardous. Preoperative investigation should focus on cardiopulmonary reserve more than on ways to obtain tissue for verification. With the passage of time, the extent of resection has become more conservative. The value of palliative resection is now better appreciated in terms of quality of life, its prolongation, and, for some, a possibility for cure.

Humans↗

PubMed1971