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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of an analysis of results of studying 541 patients with lung cancer the authors consider that bronchoscopy can diagnose the central lung cancer practically in all the patients including the early stages of the disease before the development of changes in the lungs on roentgenograms. The histological verification of the peripheral lung cancer of the root and median zones is ensured in 77% of patients by bronchofibroscopy under local anesthesia with the transbronchial peripheral forcepts and brush biopsy under the roentgen and TV control. Bronchological diagnosis of cancer of the subpleural zone still remains less effective.
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PMID:[Current bronchological methods of diagnosis of lung cancer]. 661 33

Nd-YAG laser surgery via the fiberoptic bronchoscope can vaporize lesions causing airway obstruction or stenosis located from the trachea to segmental bronchi with minimized danger of bleeding, and improve ventilatory disturbances. 35 lesions in the trachea and bronchus consisting of 27 malignant lesions and 8 benign lesions were treated with endoscopic Nd-YAG laser surgery. The procedures were performed under local anesthesia, and no significant side effects were recognized. The lesions was irradiated with 20-80 W. power. In most cases a continuous wave was used, but in cases of early stage squamous cell carcinoma intermittent irradiation of 0.5 second laser spots were used. In 21 of 35 cases effective results were obtained. The non-effective results obtained in 14 cases were considered to be due to inexact preprocedural evaluation of the extent of the lesions. Effective results were obtained in 11 of 13 lesions located in the trachea, in 3 of 5 lesions in the trachea and bronchus and in 7 of 17 lesions in the bronchus. Tumor in the trachea with severe ventilatory disturbance is a good indication for Nd-YAG laser surgery to rapidly alleviate symptoms. But in cases of lung cancer, indications even as a palliative procedure are limited to those cases in which the lung parenchyma distal to the stenotic portion is viable. However, the indications for this procedure as a curative modality are extremely limited.
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PMID:Indications for endoscopic Nd-YAG laser surgery in the trachea and bronchus. 662 39

Successful canine lung cancer models have required repeated focal bronchial carcinogen exposure under general anesthesia. To simplify serial studies of the respiratory mucosa during carcinogenesis, bistomal autologous heterotopic tracheal pedicle grafts have been made. These grafts can readily be returned to the original orthotopic site, and this has been shown to be a method with which to study reversibility of mucosal changes. Polycyclic aromatic hydrocarbons were applied topically to the mucosa three times a week for 21 to 22 months in 21 grafts. Implants of Silastic polymer from which carcinogen was released in sustained-release fashion were then left in the grafts for 4 to 6 weeks. Serial cytological and histological examinations showed development of atypical squamous metaplasia in the graft mucosa. Mucosal papillomatosis was noted in 4 of 7 grafts surgically excised 17 to 18 months after completion of carcinogen exposure. The heterotopic bistomal tracheal graft provides a useful method for studying respiratory epithelial carcinogenesis without repeated general anesthesia.
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PMID:Carcinogenesis in canine bistomal heterotopic tracheal grafts. 669 43

This report details a bone marrow harvest procedure performed outside the hospital setting under local anesthesia, thereby avoiding many of the risks associated with the traditional surgical procedure. In approximately 30 minutes, 450 milliliters of marrow can be collected from eight bone punctures, containing a median of 4.18 x 10(9) cells and 33 x 10(6) progenitor cells as defined by CD34 expression. Reinfusion of a median 1.2 x 10(6) CD34+ cells/kg in 10 breast cancer and lung cancer patients after dose-intensive chemotherapy resulted in the recovery of granulocytes > 100/mm3 by day 14 and platelets > 20,000 by day 21. Without progenitor cell support, such recoveries could take 30 and 40 days, respectively. Collection of marrow using this protocol does not compromise the engraftment capability of the progenitor cells, seldom necessitates blood product support, is safer for the patient, and reduces the cost of harvesting by 75% compared to inpatient or day surgery procedures.
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PMID:A marrow harvest procedure under local anesthesia. 755 35

Central to risk assessment for lung resection is the fact that surgery offers the only chance of long-term survival and cure in non-small carcinoma of the lung. The challenge is, therefore, to offer surgery to as many patients as possible, whilst avoiding the risk of death from postoperative respiratory failure. Risk assessment is based on careful evaluation of the patient's existing cardiac and respiratory disease. The use of a cardiac risk index, such as that described by Detsky, will ensure that cardiac risk factors are recognised and, where possible, ameliorated prior to surgery. Pre-existing respiratory disease may be assessed by arterial blood gas analysis, exercise testing, whole and regional lung function tests. Criteria based on these tests have been proposed to aid patient selection prior to lung resection. However, these criteria take no account of the beneficial influence on outcome of modern anaesthesia and postoperative care. The elimination of postoperative pain, along with techniques such as minitracheostomy and incentive spirometry have allowed surgery to be offered to many patients who would have been deemed unsuitable by standard criteria. Patients with potentially resectable lung cancer must never be arbitrarily excluded from surgery on the basis of any single criteria or test. Referral for assessment by an experienced team consisting of a thoracic physician, surgeon and anaesthetist will maximise the number of patients offered surgery for this otherwise incurable disease.
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PMID:Is this patient fit for thoracotomy and resection of lung tissue? 764 93

The significance of computed tomography of the thorax and mediastinoscopy in pretherapeutic mediastinal assessment for the staging of lung cancer remains controversial. The presents study was designed to establish a standard approach to cervical mediastinoscopy for otolaryngologists, who in Denmark traditionally are involved in the staging of non-small cell lung cancer. Sixty-four potentially operable patients with non-small cell lung cancer underwent thoracic computed tomography prior to bronchoscopy and cervical mediastinoscopy. Thirty-six of the 43 mediastinoscopically negative patients additionally underwent thoracotomy, which in 32 cases was considered curative. Mediastinoscopy alone established the lung cancer diagnosis in 20% of the patients. In diagnosing lymph node metastases in the superior mediastinum, a criterion of 10 mm for abnormal enlargement resulted in an overall sensitivity and specificity of mediastinal computed tomography of 72% and 85%, respectively, and the overall false-negative and false-positive rates appeared to be 18% and 25%, respectively. No clinicopathological characteristics could be identified that influenced the occurrence of mediastinal metastases or the accuracy of computed tomography. It is concluded that mediastinoscopy remains essential in the evaluation of patients with presumed or verified non-small cell lung cancer. For otolaryngologists, the strategy of routine cervical mediastinoscopy, performed under general anesthesia in the same procedure as bronchoscopy, is advocated as a standard approach to preoperative mediastinal assessment for the staging of non-small cell lung cancer.
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PMID:Mediastinal staging of lung cancer. Is mediastinoscopy still essential? 766 77

Tumour necrosis factor alpha (TNF alpha), interleukin-1 alpha (IL-1 alpha) and IL-6, when released in excess, have been suggested to be important host mediators of the immunoinflammatory response to injury and infections. Corticosteroids suppress this response in vitro. This study was undertaken to investigate if a single dose of methylprednisolone (MP) could modify the cytokine response in patients undergoing lung surgery. Twenty-one patients with lung cancer were allocated randomly to treatment with MP 30 mg/kg i.v. (MP group) or isotonic saline (control group). Patients were anaesthetized with a balanced anaesthesia combined with thoracic epidural anaesthesia. MP or saline was administered immediately before induction of anaesthesia. The cytokines in plasma were measured by ELISA, and blood samples were collected preoperatively, at the end of surgery, 4 h later, and 1 and 5 days postoperatively. All patients had detectable IL-6 in plasma. Compared to preoperative values, plasma IL-6 levels in the MP group increased from 114 pg/ml (12-350 pg/ml) (mean, range) to peak value 146 pg/ml (15-580 pg/ml) on the first postoperative day. In the control group, IL-6 levels increased from 99 pg/ml (17-350 pg/ml) preoperatively to 125 pg/ml (10-300 pg/ml) on the first postoperative day. The increases were not significant. TNF alpha was detectable in only two patients, one from each group. Low levels of IL-1 alpha were demonstrated in three patients in the MP group and in four patients in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of methylprednisolone on the cytokine response in patients undergoing lung surgery. 768 9

This study was planned in order to determine the value of antimicrobial prophylaxis in preventing post-operative empyema in patients undergoing lung cancer surgery. Two-hundred consecutive subjects operated upon for lung cancer received teicoplanin and aztreonam, starting at the induction of anesthesia and lasting until removal of the pleural drains. Cultures for aerobic and anaerobic bacteria were taken from: (1) the bronchus at the time of surgical division; (2) the pleural space before closure of the chest; (3) the pleural fluid during the post-operative period; and (4) the tips of chest drains at the time of their removal. In the 200 patients receiving antibiotic prophylaxis, the number of post-operative empyemas (1%) was lower than that (7.5%) found in 53 comparable patients who were previously treated with placebo. In the 'placebo group', empyema was due to gram-positive bacteria, while in the 'prophylaxis group', it was caused by Gram-negative bacteria (Pseudomonas aeruginosa). A significant (P < 0.05) correlation between infected bronchial secretions, pleural space contamination at surgery, contamination of chest fluid and drains during the post-operative period, and empyema development was demonstrated. In conclusion, antibiotic prophylaxis, while being effective in preventing post-operative empyema, may induce the colonization of the respiratory tract with highly resistant gram-negative bacteria.
Lung Cancer 1994 Dec
PMID:Long-term antimicrobial prophylaxis in lung cancer surgery: correlation between microbiological findings and empyema development. 770 92

Tracheobronchoplastic procedures formed part of the operation for lung cancer in 41 patients of a Regional Hospital in Russia over the past 2 and a half years. Twenty-nine patients underwent sleeve lobectomy; in a further 12 patients, right pneumonectomy was combined with resection of other mediastinal structures. In 16 patients, sleeve lobectomy was indicated by the high risk of pneumonectomy. Involvement of the carina in the tumour indicated its resection. High frequency jet ventilation was a particular feature of anaesthesia for carinal resection. Omentopexy was used in 10 patients to prevent dehiscence of the bronchial anastomosis. Postoperative complications were encountered in 10 patients. The most frequent, in patients, was dehiscence of the tracheobronchial anastomosis after resection of the carina. Five patients died after operation, the causes of death being dehiscence of anastomosis, pneumonia, empyema, and acute heart failure. Despite the frequency of complications, tracheobronchoplastic operations are often the only possible option in the surgery of extensive lung cancer.
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PMID:Some problems of tracheobronchoplasty for lung cancer in a Regional Hospital in Russia. 786 92

Mediastinoscopy is an useful tool for mediastinal exploration with minimal surgical trauma. The anatomical and Technical basis of this procedure are simple and safe, and can be adapted to specific purposes. Surgical intervention is performed under general anesthesia and is carried out direct visual inspection. Mediastinoscopy is a diagnostic routine procedure in lung cancer staging and mediastinal adenopathy investigation. Since Carlens described the method of cervical mediastinoscopy, other authors developed new techniques, in order to improve and extend the range of mediatinal exploration. The mediastinoscope and the other tools used to perform the classic mediastinoscopy can also be used to perform pleuroscopy and even the transmediastinal esophagectomy.
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PMID:[Mediastinoscopy: technical aspects and current indications]. 787 25


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