Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsApplication of ECMO to the treatment of benign double tracheoesophageal fistula: report of a case.
This report presents the extracorporeal membrane oxygenation (ECMO)-assisted surgical as a treatment of benign double tracheoesophageal fistula. The patient was a 43-year-old woman who presented the airway obstruction for 3 weeks after the esophagus metal stent implantation for the tracheoesophageal fistula 1 year ago. ⋯ In view of the failure of endotracheal intubation, we finally used ECMO-assisted surgery to remove the stent. And at the same time, cervical esophagostomy externa, exclusion of the thoracic tracheoesophageal fistulas and gastrostomy were performed.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsFour cases of invasive anterior mediastinal tumors definitively diagnosed by the chamberlain procedure.
Percutaneous needle biopsy, commonly used for a definitive diagnosis of anterior mediastinal tumors, is sometimes inconclusive because of the small size of the biopsy specimens and the histologic heterogeneity of the tumors. We herein report 4 cases of invasive anterior mediastinal tumors, in which the definitive diagnosis was made using the Chamberlain procedure. [Case 1] A 33-year-old man was found to have an anterior mediastinal tumor on chest X-ray and computed tomography (CT). The tumor was histologically diagnosed as thymic carcinoma (squamous cell carcinoma) using the Chamberlain procedure. ⋯ This was followed by a decrease in the tumor size and avoidance of invasive surgery. The patient remains well, 15 months after the biopsy. [Conclusion] The Chamberlain procedure proved useful for definitive diagnosis in all 4 cases of invasive anterior mediastinal tumors. We recommend the Chamberlain procedure for biopsy since it enables safe, rapid, and successful collection of tissue samples.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsExtracorporeal membrane oxygenation with double venous drainage.
We report on a successful configuration strategy of extracorporeal membrane oxygenation(ECMO) in two consecutive cases of acute lung injury. A 60-year-old woman with Streptococcus pneumoniae infection and a 22-year-old man with hemothorax were admitted to our hospital with failing lungs. ⋯ However, not enough oxygen support was provided. To minimize the venous mixture at the right atrium, we added venous drainage from the right jugular vein which resulted in better oxygenation and patient survival.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsSpinal epidural hematoma during anticoagulant therapy for pulmonary embolism: postoperative complications in a patient with lung cancer.
Spinal epidural hematoma (SEH) is rare but causes neurological disorders. Rapid diagnosis and treatment maximize neurological recovery. We present the case of SEH after lung cancer surgery under epidural and general anesthesia. ⋯ Emergency decompression laminectomy and hematoma evacuation were performed. After 2.5 months of rehabilitation, he regained almost all motor function and sensation. Late after epidural anesthesia, attention should be paid to possible SEH even though appropriate anticoagulant therapy had been initiated after epidural catheter removal.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsComplex regional pain syndrome following the Nuss procedure for severe pectus excavatum.
Complex regional pain syndrome (CRPS) is not an uncommon complication after surgery, but has never been reported after the Nuss procedure for repairing pectus excavatum. A 22-year-old man with pectus excavatum had type I CRPS that developed 2 weeks after the Nuss procedure. ⋯ Following intensive rehabilitation, the degree of pain, weakness and edema were ameliorated. He recovered 6 months after surgery and the pectus bars were removed uneventfully 3 years after the repair.