Kyobu geka. The Japanese journal of thoracic surgery
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A central bronchogenic cyst was excised thoracoscopically from a 44-year-old woman in whom a tumor had been pointed out in the left upper posterior mediastinum at a screening examination. Since the tumor was diagnosed to be benign, only conservative follow-up was undertaken, but the patient consulted our department desiring active therapy. On the basis of the chest CT and MRI findings a bronchogenic cyst was diagnosed. ⋯ Although this is an easy procedure, a relatively large operative scar is left and considerable wound pain may develop. In contrast, thoracoscopic treatment is characterized by minimal surgical invasiveness, little postoperative wound pain, and small scars. These advantages suggest that this technique may be indicated for benign mediastinal tumors, particularly cysts.
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Four dialysis patients received aorto-coronary bypass grafting (CABG) at Fukuyama cardiovascular hospital from April 1989 to March 1992. We employed continuous ambulatory peritoneal dialysis (CAPD) in two cases, hemodialysis with extracorporeal ultrafiltration method (ECUM + HD) in one case and hemodiafiltration with continuous veno-venous hemofiltration (CVVHF + HDF) in one case for perioperative management. In each cases, intermittent HD was undergone during 4 days before operation. ⋯ Blood pressure in the postoperative course changed more frequently in CAPD cases than ECUM + HD or CVVHF + HDF case. Especially, CVVHF + HDF stabilized the movement of circulation and kept balance of serum BUN, Cr after the operation (BUN; 27.2 +/- 6.3, Cr; 5.0 +/- 0.6). We concluded that CVVHF + HDF would be the most favorable method to maintain the fluid balance stably for the uremic patients after CABG.