[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1995
Case Reports[Complete disruption of the trachea due to blunt neck trauma--a case report].
A complete disruption of the cervical trachea due to blunt trauma is relatively rare. Because of dislocation of the disrupted trachea and/or bleeding into airway, this is a mostly fatal accident. This article reports the author's experience with the successful surgical treatment of the complete disruption of the cervical trachea. ⋯ Tracheostomy was performed two months later, because of his bilateral recurrent nerve paralysis. The patient is alive and well 25 months after surgery. It should be emphasized that early diagnosis and adequate management are important to save patients with complete disruption of the trachea due to blunt trauma.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1995
Case Reports[Venovenous extracorporeal membrane oxygenation in an elderly patient with severe respiratory failure--report of a case].
A 69-year-old woman, who developed acute respiratory distress syndrome (ARDS) after coronary artery bypass grafting, underwent venovenous extracorporeal membrane oxygenation (V-V ECMO) because conventional ventilatory support was ineffective. We used a covalently bonded heparin surface ECMO system, including an artificial lung, a centrifugal pump, cannulas, tubing and connectors, that was maintained with low-dose systemic heparinization, the patient was weaned from ECMO after 186 hours. During ECMO, her platelet count was about half of the initial level and markedly elevated thrombin-antithrombin complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC) and D-dimer were decreased by the use of heparin and protease inhibitors. V-V ECMO seems to be useful even in patients with severe adult respiratory failure and can be performed safely if a heparin covalent circuit is applied.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1995
[Combined lung resection for advanced thoracic esophageal carcinoma].
We performed lung resection together with esophagectomy in 2 patients with advanced thoracic esophageal cancer. Both patients survived more than 2 years with no evidence of disease. The first case was a 60-year-old man who had a cancer lesion in middle of the intra-thoracic esophagus (Im) and the right lower lobe of the lung was involved. ⋯ Pathologic examination showed N3 lymph node metastasis. Postoperatively, the patient received 48 Gy of radiation and was free from cancer after 30 months. In conclusion, better surgical results are expected in cases of advanced thoracic esophageal cancer with lung involvement which can be completely resected en bloc with the primary tumor even in a3 cases than in those with aortic or tracheobronchial involvement.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1995
Case Reports[A case of extirpation of the extrapleural plombs].
A 75-year-old male, who had undergone left extrapleural plombage for left pulmonary tuberculosis 46 years before, was admitted because of cough and sputum. The Chest X-ray and CT-scan films on admission show fluid collection in plombs. Left postero-lateral thoractomy was performed on January 14, 1994. ⋯ There were two damaged plombs and fluid collection in another two plombs. No findings of residual tuberculosis were found on postoperative pathological and bacteriological examinations. He has been well for 8 months postoperatively.
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1995
Case Reports[A case of acute dissecting aortic aneurysm associated with congenital bicuspid aortic valve].
The congenital bicuspid aortic valve is recognized as a cause of aortic dissection. But in Japan, the case of aortic dissection associated with bicuspid aortic valve is rare. A 66-year-old man was referred to our hospital with a diagnosis of acute Stanford A type dissecting aneurysm associated with stenotic bicuspid aortic valve. ⋯ An operation consisting of aortic valve replacement and graft replacement of the aneurysm was performed on emergency basis because of remarkable dilation of the ascending aorta. He has been doing well after the operation and discharged from the hospital on the 46th postoperative day. It is though to be important to follow up with special concern about possible dilation of sinus of Valsalva due to intrinsic weakness of the aortic wall.