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Results for “PNEUMOTHORAX, ARTIFICIAL”

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At least 289 records · Page 16Linked to original sources
PubMed1994

[Artificial pneumothorax in the surgical treatment of progressing bilateral destructive lung tuberculosis].

23 patients with fibrous-cavernous pulmonary tuberculosis received surgical treatment at the Novosibirsk Research Tuberculosis Treatment Institute. In the contralateral lung all the patients had recent infiltrative lesions with destruction. M. tuberculosis were determined in all the cases. The patients underwent resection of the lung, osteoplastic thoracoplasty, osteoplastic thoracoplasty followed by pulmonary resection, open treatment of the caverns (10, 5, 2, 6 cases, respectively). Therapeutic pneumothorax eliminated destruction in the contralater lung in 18 patients. The other 5 patients achieved stabilization of the specific process in remaining destruction for which they subsequently underwent segmental resection. The cure was documented in all the patients treated.

Adult↗
PubMed1993

Artificial pneumothorax can be used to prevent lung toxicity in chest wall radiotherapy.

We report two patients in whom an artificial pneumothorax was induced to reduce the risk of radiation pneumonitis and fibrosis after treatment for chest wall tumours. The procedure was well tolerated; the only complication observed was a single episode of syncope following over-inflation. High doses of radiation were given to large chest wall fields with no clinical or radiological evidence of pneumonitis or fibrosis, either during or after treatment. The available literature on the use of artificial pneumothorax with radiation is reviewed, and the technique of induction is described.

Adolescent↗
PubMed1996

[A case of T-cell malignant lymphoma developing in the chest wall of chronic pyothorax after artificial pneumothorax].

A 66-year-old man, with a past history of artificial pneumothorax for pulmonary tuberculosis at the age of 17, was admitted to our hospital because of progressive left precordial pain and left anterior chest wall tumor. Because of chronic pyothorax complicated by a tumor suggested by imaging diagnosis, surgery was performed for the purpose of fenestration. A diagnosis of diffuse large cell T-cell malignant lymphoma was made by the biopsy taken at surgery. Postoperatively the patient received 6 courses of combination chemotherapy with CHOP, the course turned favorable. The left precordial pain and tumor disappeared. The patient is doing well at 11 months postoperatively. Recently, cases of malignant lymphoma developing in the chest wall of chronic pyothorax have been increased and the majority of cases of the malignant lymphoma is B-cell type. T-cell type is rare. Follow-up of chronic pyothorax's patients necessarily are attentioned on the developing of the malignant lymphoma.

Aged↗
PubMed1979

Systemic air embolism following induction of artificial pneumothorax under anaesthesia, with successful management.

Systemic air embolism occurred in a patient during general anaesthesia, with positive pressure ventilation, following induction of artificial pneumothorax to assist in the diagnosis of a mediastinal mass. A sudden change in vital signs together with neurological abnormalities suggested involvement of both coronary and cerebral arteries. A trace of blood was noticed in the syringe which the surgeon had used to create the artificial pneumothorax. The patient was treated with hyperbaric oxygen and recovered satisfactorily, despite a 10-h interval between the air embolus and the institution of definitive therapy.

Adult↗
PubMed1992

[Malignant lymphoma developing from the wall of chronic empyema following artificial pneumothorax].

A 60-year-old man who had had chronic empyema following an artificial pneumothorax for pulmonary tuberculosis when he was 26 years old developed malignant lymphoma of the chest wall. The patient was admitted because of right pyothorax as a result of pseudomonas aeruginosa infection and underwent right thoracotomy. During lavage of the right thoracic cavity a tumor was found arising from the empyematic wall. Pathologic examination revealed that it was malignant lymphoma (diffuse large, immunoblastic, B cell type). Treatment with VEAP-Bleomycin elicited a good response. Seven months after chemotherapy, the patient underwent thoracoplasty in addition to packing the cavity with the latissimus dorsi and the greater omentum. Following this, the patient received chemotherapy once a month for one and a half years, after which he was kept under close observation without treatment. Complete remission has now lasted for 49 months since the initial treatment. This is the first reported lymphoma case with closure of the empyematic wall and is remarkable since this patient has remained in complete remission for the last two years without any treatment.

Empyema, Pleural↗
PubMed1996

Treatment of tuberculous pleurisy with effusion by artificial pneumothorax.

57 patients were divided into two groups at random. The patients of two groups were all given standard treatments with anti-tuberculous drugs. Treatment group received artificial pneumothorax to help the cure. Results showed that the frequency and quantity of drawing liquid in the treatment group were obviously less than those in the control group and the duration of the complete liquid absorption was shortened markedly in the treatment group and that total effective rate in treatment group (92.5%) was obviously higher than that of the control group (83.33%). We found that the artificial pneumothorax could raise the intra-pleural pressure by 0.20-0.39 kPa, reduce leakage in parietal pleurae and increase the absorption in visceral layer evidently. As it can isolate the two layers of pleurae from one another by the air in thorax, the incidence of pleurae adhesion can be decreased.

Adolescent↗
PubMed2006

Reviving an old idea: can artificial pneumothorax play a role in the modern management of tuberculosis?

OBJECTIVE: To determine the usefulness of artificial pneumothorax (AP) in the management of pulmonary tuberculosis (PTB) patients when anti-tuberculosis treatment is ineffective. DESIGN: We evaluated the outcome of therapy in 214 patients with cavitary PTB bacteriologically confirmed by culture treated during 1998-2004, 78.9% of whom had multidrug resistance. AP was applied in 109 patients (56 newly diagnosed TB and 53 retreatment cases). A control group consisted of 105 patients (respectively 55 and 50) treated without AP. The average period of AP application was 4.5 months for newly diagnosed patients and 9 months in retreatment cases. Anti-tuberculosis treatment regimens in both groups were based on drug susceptibility test results. RESULTS: Culture negativity was achieved in patients treated with AP in all new cases and in 81.1% of retreatment cases. Cavity closure occurred in 94.6% and 67.9% respectively. In the control group, culture negativity was achieved in respectively 70.9% and 40.0%, and cavity closure occurred in respectively 56.3% and 24.0%. CONCLUSION: AP considerably improved the treatment outcome in both newly diagnosed and retreatment patients. This procedure can be considered a useful addition in managing certain patients with cavitary TB, particularly those with drug resistance.

Adult↗
PubMed1991

Chest CT combined with artificial pneumothorax: value in determining origin and extent of tumor.

To determine the presence of chest wall and mediastinal invasion by lung cancer and to establish the origin of chest tumors, we studied 12 patients with intrathoracic tumors by using chest CT combined with artificial pneumothorax. Six patients had primary lung cancer, two had metastases, and one each had neurofibroma, pericardial cyst, chondroma of the rib, and malignant mesothelioma. All 12 tumors abutted the chest wall or mediastinum and could not be separated by conventional CT. Between 400 and 800 ml of air was injected into the pleural space before a second CT scan was obtained. No invasion was found at surgery in cancers that were separated from chest wall or mediastinum on CT scans. Surgery revealed chest wall invasion in three patients in whom the CT scans showed that the tumor was not separated from the chest wall. Only one patient with a tumor that was not separated from the mediastinum on CT did not have mediastinal invasion: in this case, only adhesions were found at surgery. Thus, in the eight patients with primary lung cancer and metastasis, sensitivity, specificity, and accuracy were 100%, 80%, and 88%, respectively. In four patients with mediastinal or pleural tumor, CT combined with pneumothorax was useful for establishing the origin of tumors. In all, 11 of the 12 patients were correctly evaluated by using this method. No complications occurred, except for mild chest discomfort in one patient. This study suggests that chest CT combined with artificial pneumothorax is useful for the evaluation of the extension of lung cancer into the chest wall and mediastinum and for the diagnosis of the site of origin of intrathoracic tumors.

Adult↗
PubMed1986

Results of treatment of primary breast carcinoma by radical radiotherapy with artificial pneumothorax.

One hundred and forty-three women with primary breast carcinoma were treated by radical radiotherapy associated with artificial pneumothorax to include the breast and lymphatics en bloc with large opposed fields. Surgery was restricted to local excision or drill biopsy. Most patients received a tumour dose of 5200-5600 cGy in 19-22 fractions over 4 weeks and were followed up for at least 5 years. Local control was achieved in 87% of T1, 52% of T2, 27% of T3 and 23% of T4 tumours. For T2 tumours local control was greater following excision biopsy (75%) than when surgery was more limited (21%). Acute morbidity was mostly minor and self-limiting. The commonest permanent late complication was restriction of shoulder movement in 20 patients. This method although safe and feasible does not offer significant advantages over conventional techniques.

Adult↗
PubMed1976

A prospective survey on chest malignancies following multiple fluroscopies during artificial pneumothorax therapy for pulmonary tuberculosis.

Patients with pulmonary tuberculosis treated in 4 sanatoria in Niigata prefecture during the period from 1941 to 1961 were followed up. Of 2,756 patients, 1,193 responded and sent us effective information. However, 1,224 did not come into contact because of changed and unknown adress, 326 did not respond, and 13 were omitted because of incomplete answers. Of 1,193 effective responders, 568 had been treated by artificial pneumothorax (the pneumothorax group), and 552 had been treated by the other measures than pneumothorax (the control group). There were 65 deaths in the pneumothorax, group, and 40 deaths in the control group. No deaths from chest malignancies were reported in the pneumothorax group, while 4 chest malignancies in the control. In this survey, no evidence of increased frequency of chest malignancies including leukemia following multiple fluoroscopies during artificial pneumothorax was detected.

Adult↗
PubMed2005

Thoracoscopic diaphragmatic procedures under artificial pneumothorax.

Diaphragmatic plication is technically simple using a conventional operative technique, but it requires a large skin incision and rib injury. We present an alternative technique for thoracoscopic plication of the diaphragm and evaluate the advantages of the procedure. Six patients (five with diaphragmatic eventration and one with diaphragmatic hernia with a sac) ranging in age from 8 to 20 months were treated by this method. Three of the six cases were right-sided, and three were left-sided. The operation was performed under artificial pneumothorax using carbon dioxide gas at 4 mmHg. Three trocars for laparoscopy were inserted at the 4th and 5th intercostal spaces. An adequate operative view was obtained by pressing the diaphragm throughout the operation. The eventrated diaphragm was plicated with several rows of nonabsorbable sutures in the anterolateral-to-posterolateral direction to prevent injury to the main phrenic nerve. A tight diaphragm was confirmed by decompressing the artificial pneumothorax. The technique was successfully performed in all cases, and the patients' postoperative courses were uneventful. During the operation, the hemodynamic effects of carbon dioxide gas at 4 mmHg were minimal. Over a mean follow-up period of 3.1 years (range, 1-6 years), no recurrence of diaphragmatic eventration was seen. Judging from the satisfactory postoperative course, this procedure is suitable for children with all forms of diaphragmatic eventration.

Diaphragmatic Eventration↗
PubMed1996

[False empyema after artificial pneumothorax. An original entity: type B non Hodgkin malignant lymphoma].

Malignant lymphoma developing in the lung after therapeutic pneumothorax is a rare condition in Europe. The authors report one case admitted after a 40-year history of pyothorax resulting from artificial pneumothorax for treatment of pulmonary tuberculosis. The diagnosis at admission was an infection of the chronic pyothorax associated with a lung mass. Histology confirmed the presence of non-hodgkin lymphoma B in the lung mass associated with Epstein-Barr virus. After surgery, chimiotherapy was not effective. Diagnosis before surgery could optimize the medical management. The long-term outcome is pejorative in most cases.

Aged↗
PubMed2005

[Artificial pneumothorax in the treatment of destructive pulmonary tuberculosis complicated by its drug-resistant pathogen].

A hundred and nine patients with complicated destructive pulmonary tuberculosis who had received chemotherapy with reserve drugs, artificial pneumothorax (AP), pneumoperitoneum (PN), physiotherapy, and resection surgery were followed up. The application of video thoracoscopy made it possible to eliminate any types of pleural adhesions. Individualization of therapeutic measures considerably increases the efficiency of treatment. AP is the method of choice in therapy of newly detected patients who have undergone ineffective routine treatment regimens.

Adolescent↗