Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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In the period from 1983-1991 133 patients (102 men, 31 women) with lung cancer were treated in our pain clinic for 8083 days. Pain was associated with tumour infiltration in 86% of patients and related to therapy in 15%. Even in 6 of 8 patients who were admitted with a diagnosis of "postthoracotomy syndrome" and in all 4 patients with "postradiation syndrome" local recurrence was diagnosed during follow-up. ⋯ The incidence of dyspnea decreased from 51% of the patients to 16%. Strong opioids were used on 56% of treatment days. Parenteral or spinal administration of opioids was necessary on 3% of days only.
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Video-assisted thoracoscopy is an innovative technique which now allows the surgeon to approach various intrathoracic pathologic conditions without thoracotomy. In a 20-year-old male with pneumothorax urgent surgical intervention was necessary because of severe hemothorax following chest tube placement. The successful management of this patient by video-assisted thoracoscopy is presented.