[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Sep 1990
[Brachial plexus injury and fracture of the first rib as complications of median sternotomy].
In 192 patients following median sternotomy during from 1978 to 1988, we studied the incidence, cause, prognosis and correlation of brachial plexus injury and fracture of the first rib as complications of median sternotomy. Four brachial plexus injuries were identified, an incidence of 2.1%, seven first-rib fractures were identified, an incidence of 3.6% and one patient had both complications in this series. ⋯ Stretching of the nerve by the displaced first rib, ischemia of the nerve by pressure on it, and direct injury by the fractured rib end are causes of the brachial plexus injury following median sternotomy. It is due to the difference of position of the fracture, the difference of direction and degree of the protrusion of the fractured rib end, whether presence or absence of the brachial plexus injury in patients with first-rib fracture.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1990
Comparative Study[Long-term results of valve replacement in the right side of the heart in congenital heart disease--comparative study of bioprosthetic valve and mechanical valve].
Valve replacements in the right side of the heart (TVR and PVR) were done on 16 patients with congenital heart disease, mainly tetralogy of Fallot and Ebstein anomaly. Including reoperations, 19 operations were performed on them and 20 artificial valves were inserted. Ten mechanical valves (7 St. ⋯ Calcified bioprosthetic valve occurred in one patient with I-S valve 8.5 years after the implantation. Five-year complication-free rate was 87.5 +/- 11.7% for bioprosthesis, whereas it was 50.0 +/- 15.8% for mechanical valve (p less than 0.056). It is concluded that the bioprosthesis is the first choice for the valve replacement in the right side of the heart in congenital heart disease.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1990
Case Reports[A case of thyroid carcinoma required the incision of the thyroid cartilage for inserting the silicone T tube after extensive tracheal resection and reconstruction].
A 57-year-old female with thyroid carcinoma, who had developed tracheal stenosis, underwent extensive tracheal resection and reconstruction. After the tracheal sleeve resection 5.2 cm in length, primary tracheal reconstruction was performed. Although complication did not occur at the anastomotic site, the patient had dyspnea due to cord dysfunction by bilateral recurrent nerve paralysis. ⋯ The patient inserting the T tube through the laryngeal stoma had no dyspnea and no aspiration about two years after the operation in spite of palliative operation. It seemed likely that the trouble that tracheostomy could not be done would occur in some patients who had undergone extensive tracheal resection and reconstruction. But the insertion of silicone T tube through the laryngeal stoma provided a satisfactory result for airway problem.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1990
Case Reports[A case of intralobar pulmonary sequestration associated with abnormal connection between the aberrant artery and the pulmonary artery].
The patient was a 5-year-old girl and had a history of recurrent pneumonia. Angiogram demonstrated that the aberrant arteries arising from descending aorta communicated with left pulmonary A10 where the multi-lobulated cystic lesion was seen by chest X-P. ⋯ The connection between aberrant arteries and pulmonary artery in this case might be caused by the chronic inflammation in the sequestrated lung. We found 4 case reports in which the communication between aberrant arteries and pulmonary artery was evident.
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Nihon Kyobu Geka Gakkai Zasshi · Jul 1990
Case Reports[A two-year-old child with tracheal stenosis due to tracheostomy treated by end-to-end anastomosis of the trachea].
Successful operation performed on a 2-year-old boy with tracheal stenosis due to long-term intubation was reported. He was admitted to our department 1 year after a neurosurgical operation. Endoscopically, destruction of cartilage rings was observed just above the site of tracheostomy, and the tracheal wall was collapsed without a help of tracheal tube. ⋯ During the operation, the patient was uniformly ventilated by tracheal tube through nasal intubation. After the operation, tracheal intubation was continued for 7 days, and anterior fixation of neck for 8 days. The postoperative course was uneventful and the patient remains asymptomatic 8 months after operation.