Showing papers by "Yasunori Sohara published in 2003"
TL;DR: Early pulmonary resection is indicated in patients with hemoptysis of multiple branches from the cavity and chest wall, such as in fungal infections, and superselective embolotherapy should be considered prior to surgery even if the localized focus of the bronchial branch shows minor vascularity on the angiography.
Abstract: Objective: Massive hemoptysis is a life-threatening condition. Surgery is effective but we are sometimes reluctant to operate on patients with this condition. We reviewed our experience with patients who underwent emergency surgery for massive hemoptysis to verify the indications for non-emergency surgical intervention. Methods: We reviewed chest computed tomography (CT) and angiographic and pathological findings and the postoperative course of 25 patients who underwent emergency pulmonary resection in our department between 1979 and 2001 due to life-threatening hemoptysis. Results: CT revealed a persistent cavity within the radiological opacity before massive hemoptysis in 12 patients (48%). Of the 21 patients who underwent angiography, nine showed focal bleeding in one bronchial branch and the others showed bleeding in multiple branches. Of these nine patients, seven did not undergo embolotherapy mainly due to minor vascularity. In the remaining patients, embolotherapy was not indicated in six due to multiple bleeding feeders and recurrence after embolotherapy was seen in six. Pathological findings showed that eight of the 12 patients with multiple systemic shunts had a fungal infection. Operative morbidity and hospital mortality were 32 and 4%, respectively. There was no recurrence in patients who underwent surgical treatment. Conclusions: Early pulmonary resection is indicated in patients with hemoptysis of multiple branches from the cavity and chest wall, such as in fungal infections. When a bronchial branch is the only bleeding focus, superselective embolotherapy should be considered prior to surgery even if the localized focus of the bronchial branch shows minor vascularity on the angiography. q 2003 Elsevier Science B.V. All rights reserved.
52 citations
TL;DR: This case illustrates that incompletely resected mediastinal bronchogenic cyst may recur with later symptoms, and recommended treatment for bron chogenic cysts is complete surgical excision.
Abstract: OBJECTIVES Bronchogenic cysts of the mediastinum are rare congenital anomalies that arise early in gestation from abnormal budding of the developing respiratory system. Recommended treatment is surgical resection and incomplete resection may lead to local recurrence more than 10 years later with or without various symptoms. METHODS We reported a case and reviewed literatures. RESULTS A case of a recurrent bronchogenic cyst in a 42-year-old man 15 years after first resection is presented. The patient had a persistent high fever resistant to antibiotic therapy. Magnetic resonance imaging and subsequent thoracotomy revealed a recurrent bronchogenic cyst. This case illustrates that incompletely resected mediastinal bronchogenic cyst may recur with later symptoms. CONCLUSIONS Recommended treatment for bronchogenic cysts is complete surgical excision.
32 citations
TL;DR: The excellent alveolar recruitment suggests that liquid ventilation ameliorates ventilator-associated lung injury.
3 citations
Journal Article•
TL;DR: The rare case of 26-year-old woman with a traumatic laceration of the right middle lobar bronchus, who suffered blunt chest trauma in a traffic accident, is described.
Abstract: We described the rare case of 26-year-old woman with a traumatic laceration of the right middle lobar bronchus. The patient suffered blunt chest trauma in a traffic accident. Chest roentgenography showed bilateral pneumothorax, right multiple rib and clavicle fractures and emphysema in the subcutaneous and mediastinal lesions. Bilateral thoracic drainages were performed under controlled mechanical ventilation. Massive air leakage from the right chest tube was observed. Bronchofiberscopy 2 days after the accident revealed laceration of the right middle lobar bronchus. A right middle lobectomy was performed via thoracotomy. The patient was discharged on hospital day 51. In terms of the rare bronchial laceration is discussed.
1 citations
Journal Article•
TL;DR: A 70-year-old woman referred to hospital because of abnormal shadows which had been increasing in size for 4 years, was diagnosed with a metastatic lung tumor from an occult thyroid oncocytic carcinoma, growing into the bronchial lumen.
Abstract: We report a case of a metastatic lung tumor from an occult thyroid oncocytic carcinoma, growing into the bronchial lumen. A 70-year-old woman was referred to our hospital because of abnormal shadows which had been increasing in size for 4 years, in the chest radiograph. Bronchoscopy revealed an endobronchial tumor at the orifice of the left B4b. Histological and immunohistological examination of the lesion showed tumor cells with immunoreactivity for thyroglobulin, and a metastatic oncocytic carcinoma from the thyroid was diagnosed. Closer examination of the neck revealed thyroid carcinoma, and total thyroidectomy was performed. Endobronchial metastasis of thyroid oncocytic carcinoma is very rare. In this case, immunohistological examination was useful for detecting the primary site.
1 citations