Annales de chirurgie
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Annales de chirurgie · Jan 1995
[Surgical treatment of pneumothorax. Study of a series of 400 cases].
Surgical management is indicated for recurrent forms of pneumothorax as well as for failures of tube drainage. We report a series of 400 patients treated surgically mainly by pleural abrasion over the past 17 years. Statistical analysis of the results identifies two groups: 308 patients under the age of 45 years had surgery mainly for spontaneous idiopathic pneumothorax, where as 92 patients over the age of 45 years had surgery mainly for emphysema. ⋯ The main complication was a residual pneumothorax after drain removal requiring further drainage (10%). A single recurrence occurred (0.25%). Pleural abrasion is a very effective way to treat recurrent forms of pneumothorax.
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We report a series of 40 patients treated by intraoperative radiotherapy between 1988 and 1992 (18 primary tumors, 13 local recurrences and 9 nodal extensions). The doses delivered were 15 Gy to 25 Gy, completed by external radiotherapy (15 to 45 Gy) in 13 cases. The local tumor control rate was 61% for initial therapy in primary tumors (70% for adenocarcinoma of the stomach) and 80.9% after complete en bloc surgery. ⋯ Two patients died (5%) during the postoperative period. We observed 2 hemorrhages and 3 cases of stone-free cholecystitis. The value of this approach must be confirmed in rigorous indications in comparison with surgery alone in controlled and randomised clinical trials.