Kyobu geka. The Japanese journal of thoracic surgery
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A respiratory morbidity such as atelectasis or pneumonia is possible to be predicted by calculated postoperative pulmonary function. The predicted postoperative 1 second forced expiratory volume (FEV1.0) is exclusively useful for predicting morbidity, but not for predicting mortality. ⋯ Thus, both parameters are helpful to make strategies for perioperative management. A prophylactic tracheostomy, a timely traheostomy and a timely bronchoscopy are applied by these parameters to treat postopeartive respiratory complications such as atelectasis or pneumonia.
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We experienced 2 patients who admitted to our hospital becaus of acute onset of dyspnea and chest pain. Chest X-ray and chest computed tomography showed severe atelectasisi of hemilateral lung. After intathoracic drainage under local anesthesia, we diagnosed a emphysematous giant bulla. We resected the giant bulla.
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There have been recent improvements in the outcome of congenital heart surgery. However, much risk still remains because cardiac surgery itself is not always safe and because the postoperative care of children is very complicated. Accurate risk evaluation is therefore crucial for effective risk management. ⋯ Two well-known indices based on the databases of congenital heart surgery in the United States and Europe exist for predicting preoperative risk; risk adjustment for congenital heart surgery 1 (RACHS 1) and the Aristotle score. They offer reliable preoperative assessments of the risks of each procedure, but there is still room for improvement. No database for congenital heart surgery existed in Japan until this year.
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Thoracic surgery has become to be performed more safely by recent progress of operative method and anesthetic management. The surgery can be applicable for those patients who were formerly difficult for operation because of preoperative poor respiratory function, however, postoperative mortality and morbidity increase in such patients without appropriate perioperative management. ⋯ Coherent risk management from preoperative to postoperative period becomes important. This is achieved by the comprehensive perioperative patient management which is consisted of the cooperation between the surgeon and the anesthetist, correct preoperartive evaluation, preoperative medical treatment with pulmonary rehabilitation, appropriate anesthetic management, and postoperative intensive care.
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A 68-year-old male, pointed out of bilateral lung tumors, was hospitalized for the evaluation of multiple lung tumors. Chest computed tomography demonstrated 10 x 10 mm and 30 x 60 mm tumors in left lower lung and a 16 x 16 mm tumor in right lower lung. ⋯ For purpose of diagnosis, partial resections of left lower lung were performed, and then these tumors were diagnosed as pulmonary metastasis of intracranial meningioma. This is a very rare case of pulmonary metastasis of meningioma 26-years after craniotomy.