Surgery today
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Postoperative vital capacity (VC) and the 6-min walking (6MW) test were used to compare the differences in impairment of the pulmonary function and walking capacity in patients undergoing a lobectomy by video-assisted thoracoscopic surgery (VATS), an anterior limited thoracotomy (ALT), an anteroaxillary thoracotomy (AAT), or a posterolateral thoracotomy without muscle sparing (PLT). ⋯ The PLT without a muscle sparing procedure therefore cannot be recommended for general lung cancer surgery because of the impairment of both walking capacity and pulmonary function which continues long after surgery. VATS and ALT are better procedures than AAT regarding the recovery of walking capacity early after surgery. VATS and ALT are similar to each other regarding the impairment of pulmonary function and walking capacity after surgery.
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We report a case of severe corrosive gastritis caused by alkali ingestion, which was successfully treated by laparoscopic gastrectomy. A 38-year-old Japanese woman attempted suicide by ingesting Drano. ⋯ The patient had an uneventful postoperative course and was discharged on the 13th day after her operation. She was subsequently able to tolerate a normal diet, gained weight, and is now emotionally stable.
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Case Reports
Rupture of the descending thoracic aorta caused by blunt chest trauma: report of a case.
A 66-year-old man fell from a tree and was diagnosed to have multiple fractured ribs and hemopneumothorax based upon the chest roentgenogram findings. He underwent chest tube drainage and evacuation using video-assisted thoracic surgery. ⋯ We performed a direct closure of the penetrated portion of the descending thoracic aorta. The patient has remained well for 1 year following the second operation.
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This report describes a rare case of acute life-threatening stridor due to membranous tracheitis that occurred as a complication of endotracheal intubation, performed for video-assisted thoracotomy. An obstructive fibrin clot was found in the subglottic region by bronchofiberscopy, and removal provided complete relief of the airway obstruction. The mechanism of the development of this fibrin membrane may have interacted with local tracheal trauma from the endotracheal tube. Membranous tracheitis should be considered in the differential diagnosis of stridor and airway obstruction after endotracheal intubation because it is a life-threatening complication of this procedure.
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We investigated the postoperative complications that developed in patients who underwent surgery after induction chemotherapy (IC) for primary lung cancer. ⋯ These findings indicate the feasibility of treating primary lung cancer with IC followed by surgery as long as a cautious operative procedure is used and careful postoperative management is given, paying particular attention to the risk of ARDS and bronchial complications.