Biomedical subjects

Ricardas Janilionis

Publications and source records attributed to Ricardas Janilionis.

4 recordsLinked to original sources

PubMed2002

[Tracheobronchial surgery].

UNLABELLED: During the flowering of cardiothoracic surgery over the past 50 years, surgery of the major airway failed to develop correspondingly. The relative rarity of such cases accounts in past for this laggardness. Surgical diseases of the trachea, whether inflammatory or neoplastic, largely are presented as an obstructive problems of the airway. Surgical management of these lesions is based on simple concept of resection of the involved area of the trachea, when the larynx has not been lost because of affection by the primary disease. Primary end-to-end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, based on Belsey's experience it was widely believed, that only 2 cm at most could be removed and the trachea reconstruction by end-to-end suture in any dependable fashion. During the period of 30 years tracheobronchial surgical reconstructions have been accomplished in 187 patients. CONCLUSION: Management of the patients with stenosis of the trachea and main bronchi must be started promptly. Emergency treatment for the patients with severe tracheal stenosis is rigid bronchoscopy under general anesthesia. Circular tracheal resection is the best method of radical treatment for patients with benign and malignant tracheal narrowing. Sleeve resection is the ideal form of excisional therapy for benign endobronchial tumors, neoplasms of low-grade malignant potential, and bronchostenosis. For patients with tracheobronchial stenosis who are no candidates for surgical reconstruction, tracheobronchial stenting is the management of choice.

Bronchi↗

PubMed2002

[Esophageal achalasia].

UNLABELLED: The purpose of this study was to analyze results of pneumatic dilatation due to esophageal achalasia at the Clinic of General Thoracic Surgery of Vilnius University. MATERIAL AND METHODS: During 25-year period (1973-1998) we have treated 133 achalasia patients. On 125 patients pneumatic dilatation was performed. One hundred five (84%) patients recovered fully. Single course of pneumatic dilatations was sufficient. Recurrence rate was 16% - 3 courses of pneumatic dilatations were performed on 2 (1.6%), 2 - on 18 (14.4%) patients. Complications. The major complication of pneumatic dilatation is esophageal perforation. Most series report its incidence at about 2%. In our study 2 cases (1.6%) of esophageal perforation occurred. Both patients were operated immediately. One (0.8%) died because of purulent complications. CONCLUSION: Pneumatic dilatation is safe and effective method of treatment. In our opinion, it would be the best initial approach. If it failed, then myotomy would be treatment of choice.

Catheterization↗

PubMed2002

[Empyemectomy-treatment of pleural empyema].

Empyema thoracis has been recognized as a disease entity since the time of Hippocrates and historically has been associated with high mortality. Over 30 years ago, the American Thoracic Society described three stages in the natural course of empyema, namely the exudative, fibrinopurulent, and organizing phases. Decortication and suction drainage usually result in lung re-expansion, otherwise pleurocutaneous window, intrathoracic transposition of skeletal muscle, or thoracoplasty remain life-saving but now uncommon options for treating a closed-space infection. During last 9 years (1993-2001) 50 patients underwent empyemectomy due to pleural empyema. Three patients died (6%). In 4 cases we had complications-hydropneumothorax. They received punction (3 patients) and 1 received tube toracostomy. In one case urgent retoracotomy was performed due to acute intrapleural bleeding. After successful empyemectomy 47 patients stay at hospital 14 days approximately.

Adult↗

PubMed2002

[Odontogenic mediastinitis. Diagnostics and treatment].

UNLABELLED: The aim of our work was to evaluate the diagnostic and treatment of patients with odontogenic mediastinitis. METHODS: The last 10 years (1991-2001) 13 males and 4 females, mean age 43 years, with odontogenic mediastinitis were submitted to surgical treatment. Primary odontogenic abscess occurred in all. Before admission to our clinic, 14 patients were treated at stomatological department. Diagnosis was made by clinical manifestation, roentgenographical features and confirmed by findings at mediastinum tissues during operation. RESULTS: All patients at the admission day underwent broad cervicotomies with transcervical mediastinal drainage. In 5 cases this management was associated with mediastinal drainage by transthoracic approach. For another 5 patients thoracotomies were performed late, the last 7 survived without thoracotomy. Six patient died, mortality rate was 35.2%. The reason of the high mortality rate-delay of transthoracic mediastinal drainage in 5 cases, when transcervical was inadequate. CONCLUSION: Ample cervicotomy, associated with transcervical and transthoracic mediastinal drainage can significantly reduce the mortality rate for odontogenic mediastinitis.

Adult↗