Annales de chirurgie
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From 1974 to 1990, 61 patients were admitted for pulmonary (55) or bronchial (6) aspergilloma; 50 were treated by surgery. Operative treatment was mandatory because of disabling symptoms in 17 patients, rapid growth on radiological survey in 7 others, diagnostic doubt in 10 and association with bronchogenic cancer in 2. 14 were operated on in order to prevent evolutive complications. Complete resection was possible in 39 patients: with lobectomy or segmentectomy in 34 and with pleuro-pneumonectomy in 5. ⋯ Nevertheless, among 10 patients with either bronchial aspergilloma or pulmonary aspergilloma without underlying disease, only one had a complicated outcome. In conclusion, surgical treatment is well tolerated in the absence of underlying parenchymal disease. However, despite the major operative risk, surgery remains the only efficient treatment in symptomatic patients.
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With intensive care, pleural drainage and judicious physiotherapy most thoracic injuries can be treated adequately. 571 patients were treated for severe thoracic injuries over the last 10 years. A thoracotomy was necessary in 14% of the patients with blunt trauma (BT) and 33% with penetrating trauma (PT). Thoracotomy for PT was performed earlier and had better results than thoracotomy for BT. ⋯ Postoperative mortality for PT was three times lower than for BT (18% vs 56%). Reasons for this are the higher rate of injuries associated with BT. Surgical procedure depends on the type and extent of the thoracic and general injuries and on the patient's general condition.