Scandinavian journal of thoracic and cardiovascular surgery
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Scand J Thorac Cardiovasc Surg · Jan 1986
Mediastinal neurogenic tumours. Early and late results of surgical treatment.
Early and late results of surgery for neurogenic mediastinal tumour were evaluated in 66 cases with a mean follow-up of 12 years. The series comprised 48 neurilemmomas, 8 neurofibromas, 7 ganglioneuromas, and neurinoma, neurofibrosarcoma and ganglioneuroblastoma each in one case. There were two early deaths (3%), one due to peroperative bleeding from the left subclavian artery and the other to acute myocardial infarction. ⋯ One neurilemmoma was a dumb-bell tumour, and operation in this case resulted in paraplegia. Malignant transformation appeared in 2 of the 8 neurofibromas 5 and 13 years postoperatively. Because of the risks of malignant degeneration and of recurrence, patients operated on for neurogenic mediastinal tumour should be carefully followed up for many years.
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Scand J Thorac Cardiovasc Surg · Jan 1986
Comparative StudyIntraoperative cryolysis of intercostal nerves in thoracic surgery.
Pain is a major problem associated with thoracotomy. Intraoperative cryolysis of the intercostal nerves around the incision can essentially reduce the postoperative analgesic requirement and diminish the impairment of ventilatory capacity. To obtain maximum effect, it is recommended that the sites of drainage should also be treated with cryolysis.
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Scand J Thorac Cardiovasc Surg · Jan 1986
Case ReportsLate cardiac tamponade following open-heart surgery. Diagnosis and treatment.
Late cardiac tamponade is a rare but serious complication following open-heart surgery. It occurred in 9 (0.8%) of 1 094 consecutive patients 6 to 13 (median 8) days after operation. Six patients had undergone valve replacement and three coronary bypass surgery. ⋯ The cardiac silhouette was radiographically enlarged in all cases, but this finding was seldom diagnostic. Computed tomography gave the surest diagnosis and permitted quantitative assessment of the fluid in the pericardium. Pericardial needle puncture was effective in temporarily relieving the tamponade, but insertion of a tube by the subxiphoid approach gave definitive drainage.
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Scand J Thorac Cardiovasc Surg · Jan 1986
Case ReportsRecurrent anaphylactic shock as a manifestation of echinococcosis. Report of a case.
Hydatid disease, caused by the cestode Echinococcus granulosus, is common in Mediterranean regions, being highly endemic in Greece. Depending on its size, an intact hydatid cyst may be "silent" or may cause symptoms from compression of adjacent organs. ⋯ A case is presented in which there was a two-year history of recurrent anaphylactic shock due to small, incomplete ruptures of hydatid cyst. The case emphasizes the potentially life-saving importance of early diagnosis of hydatid cyst.
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A report is presented of 93 patients referred for specialist management of thoracic injuries in the 5-year period 1973-1978. Penetrating trauma to the thorax had been sustained by 18 patients and blunt trauma by 75. Falls and traffic accidents were the most common causes (32 and 35 cases). ⋯ Closed pleural drainage was the most commonly used treatment. Thoracotomy was performed in 10 of the 93 patients. The mortality rate in the series (10%) agreed with findings from other, similar studies.