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

In this study, a new tracheobronchial stent was used for treating a patient with tracheocarinal stenosis due to lung cancer. The patient was 41 year-old male with lung mass in the right upper lobe and metastatic mediastinal lymph node which caused tracheocarinal stenosis. The stent was introduced under general anesthesia with a jet ventilator. The respiratory condition of the patient could be controlled fairly well, and the ventilation tube didn't interfere with the stenting. The stent was a tracheobronchial silicone stent provided with a flexible posterior membrane and tracheal cartilage-shaped steel struts. Coughing is less difficult than other stents owing to better design. This patient has been able to cough up sputum from the day of the operation and there has been no need for bronchoscopic examination for removal of secretions.
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PMID:[Dynamic stent useful for trachocarinal stenosis due to lung cancer]. 891 Oct 57

We experienced two cases of lung cancer with terminal tracheostomy. Conventional double lumen tubes such as the Broncho-Cath or the Robertshaw were not applicable for one-lung anesthesia for these cases because of anatomical reasons due to the total laryngectomy. One left lower sleeve lobectomy and a right middle lobectomy were performed under one-lung ventilation using an occlusion balloon catheter that was introduced through a seath placed in the spiral type tracheostomy tube through a plastic connector. This method has three advantages: 1) a spiral type tracheostomy tube is easily fitted for the deformed trachea. 2) an occlusion balloon catheter with an extra lumen at its tip enables the airway aspiration and the inflation of the lung. 3) air leakage around a catheter is completely prevented by the use of a catheter introducer. The present method was concluded to be superior to the prior technique with the Forgaty catheter as an endbronchial blocker.
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PMID:[Experience with one-lung anesthesia using balloon catheter for patients with terminal tracheostomy]. 895 81

29 patients over 75 years of age in 221 patients undergoing resection of lung cancer from January of 1990 through December of 1994 were studied for the occurrence of expectoration disturbance (atelectasis), the effect of epidural anesthesia for protection of it. Atelectasis was observed in 8 (27.6%) of 29. In a group received epidural anesthesia (EA) during the early postoperative phase, 1 of 5 patients developed atelectasis. In 192 patients below 75 years of age, atelectasis was observed in 40 (20.8%) of them, so in a group received epidural anesthesia (EA) during the early postoperative phase, only 2 of 42 patients (4.8%) developed atelectasis. This value was significantly lower than that value (25.3%) in a group without EA. In conclusion, in the group below 75 years of age, EA during the early postoperative phase may be useful in inhibiting the occurrence of atelectasis, an important one of the postoperative lung complications.
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PMID:[A study of surgical treatment in lung cancer over 75 years of age-effect of epidural anesthesia for protection of postoperative coughing disturbance]. 899 34

Photodynamic therapy (PDT) in lung cancer was introduced in 1980 to treat tumours located in the major airways. After systemic injection of photosensitizers, tumour illumination is performed using a laser fibre to transmit light of a specific wavelength. PDT can be performed under local anaesthesia using the flexible fibreoptic bronchoscope. Skin photosensitivity is the most important treatment morbidity caused by the prolonged cutaneous retention of photosensitizer molecules. Ample data have shown that PDT is effective in obtaining tumour necrosis, but the skin photosensitivity issue limits its palliative potential. Moreover, competing bronchoscopic techniques, such as electrosurgery, Nd-YAG laser and brachytherapy, are available and seem to be equally palliative for the debulking of intraluminal obstructive lung tumours. The curative potential of PDT in patients with roentgenologically occult lung cancer is the most interesting aspect of this treatment modality. A significant number of patients with lung cancer have limited pulmonary function. A normal tissue sparing treatment such as PDT may provide an alternative, as patients may also have subsequent multiple lung cancer primaries. Since early lung cancer detection is now becoming feasible, PDT may be applied to treat roentgenologically occult tumours with curative intent. This may optimize treatment efficacy in the near future.
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PMID:Photodynamic therapy in lung cancer. A review. 900 61

The technical feasibility and safety of a suprasternal approach in the computed tomography (CT)-guided biopsy of lesions in the middle mediastinum was studied in 30 patients. Patients were positioned on their back with their head hyperextended. Biopsies were performed with local anesthesia and 22-gauge needles. Adequate biopsy material for diagnosis was obtained in 25 (83%) of 30 patients. A single biopsy specimen was sufficient in 14 patients, but as many as three biopsy specimens were necessary in 16 patients. Nineteen (63%) patients had various histotypes of lung cancer. In 24 (89%) of 27 adequate specimens, findings at fine-needle aspiration biopsy were consistent with findings at pathologic examination. No major complications were observed. CT-guided biopsy of middle mediastinum lesions was safe and successful with a suprasternal approach.
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PMID:Middle mediastinum lesions: preliminary experience with CT-guided fine-needle aspiration biopsy with a suprasternal approach. 905 Oct 49

Mechanisms and therapeutic procedures for emergencies induced by chest tumors are reviewed. 1) Carcinomatous pleuritis is the most frequently encountered situation for clinicians. At first, pleural effusion should be punctured for diagnosis and chest drainage should be performed consequently. Intrathoracic chemotherapy and pleurodasis (OK-432 is usually used) are then used if necessary. 2) Airway stenosis is the most critical state. Conventionally, violent incubation throughout the stenotic portion of the airway has been used with poor results. Recently, however, irradiation of Nd:YAG laser can be utilized, and the prognosis of the airway stenosis is much improved. Another effective procedure is the insertion of several kinds of airway stent. Silicon stents like T-tube, Dumon tube and Dynamic stent or metallic stents like EMS (Expandable Metallic Stent) are generally used. The advantages of EMS are easy installation and little disturbance of sputum excretion. The disadvantages of EMS are difficult removal and re-stenosis of the airway. On the other hand, silicon tubes are easy to be removed, re-insertion is possible and re-stenosis is rare, but the insertion should be performed under general anesthesia and sputum excretion may pose problems. A case of laser irradiation and two cases of stent insertion are presented. 3) Airway bleeding is also emergent. Bronchofiberscopic ethanol injection (BEI) is effective against continuous bleeding of the central airway. We performed BEI for 33 lung cancer cases, and the method was effective for all cases. 4) Cardiac tamponade, SVC syndrome, esophago-bronchial fistula, bronchial stump fistula are also important emergencies induced by chest tumors. Standard therapeutic procedures are explained for all oncology surgeons and physicians.
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PMID:[Surgical emergency induced by chest tumors]. 905 Nov 27

As live expectancy increases, the number of elderly patients 70 and more years of age are also increasingly represented in a thoracic surgical series. The preponderance of malignant disease in this group, particularly lung cancer, is common. Progress in anesthesia, intensive care and operative techniques in recent years has reduced the risk of morbidity and operative mortality in this age group. Operative and 30-day hospital mortality was 4.8% in our series.
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PMID:[Surgical treatment of bronchial carcinoma in advanced age]. 910 1

Life-threatening complications can occur unexpectedly during general anesthesia in operations for superior vena caval (SVC) syndrome due to intrathoracic tumors. To prevent such sequelae, we have placed a temporary extracorporeal axillofemoral venous bypass graft with satisfactory results. In six patients (malignant mediastinal tumor, four; lung cancer, two), under local anesthesia before induction of general one, the cannulas, each appropriately sized in accordance with the diameter of the axillary and femoral veins, were directly introduced into the corresponding veins after systemic heparinization. The two cannulas were connected with a tube to which a side arm, which was usually clamped, was connected. The venous pressure of the internal jugular vein decreased immediately after establishment of the temporary bypass in all patients. The symptoms that accompanied SVC syndrome did not worsen and the life-threatening complications at the time of induction of general anesthesia were avoided with this procedure. In each case cardiopulmonary bypass on stand-by was unnecessary at this time. Venous bypass grafting with vascular prostheses were mainly performed under cardiopulmonary bypass, which was required for such operative procedures. In three patients the side arms were used for part of the venous drainage during cardiopulmonary bypass. The SVC syndrome instantly disappeared after operations in all patients including one in hospital death. No serious complications related to the temporary bypass procedure have been observed. This temporary bypass procedure has several advantages. It can be safely performed under local anesthesia with no special technique for the cannulation. Venous blood naturally drains from the upper part to the lower part of the body by pressure gradient, that warrants the safe induction of general anesthesia and ensuing operative procedures. The side arm is available for venous drainage during cardiopulmonary bypass. There are no serious complications related to the bypass procedure. Thus this temporary bypass is recommended as a life-saving and auxiliary device in urgent operations for acute progressive SVC syndrome with symptoms of cerebral edema and upper airway obstruction due to intrathoracic malignancies.
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PMID:[Temporary extracorporeal axillofemoral venous bypass--a beneficial device in operation for superior vena caval syndrome due to intrathoracic malignancies]. 943 Sep 60

The curative potential of bronchoscopic intervention, e.g. photodynamic therapy (PDT) and brachytherapy, for resectable radiographically occult lung cancer has been reported previously. Bronchoscopic electrocautery is currently feasible using an insulated flexible bronchoscope to coagulate and vaporize tumour tissue. Since the lesions are usually small, noninvasive bronchoscopic electrocautery may be able to eradicate radiographically occult lung cancer completely. In a prospective study, 13 patients with 15 radiographically occult lung cancer lesions were treated with bronchoscopic electrocautery. The duration of follow-up was > or = 16 months. The median age of the patients was 69 yrs (range 48-79 yrs). Fibreoptic bronchoscopy under local anaesthesia was used to coagulate the occult lung cancer. Approximately 30 W of energy was applied until visible necrosis of the tumour area became apparent. There were no immediate complications. In 10 patients with 12 lesions, a complete response (CR) was obtained (CR rate 80%; 95% confidence interval (95% CI) 52-96%). Median duration of follow-up was 21 months (range 16-43 months). Bronchoscopic electrocautery did not obtain a CR in the remaining three patients, but PDT also failed to achieve CR. Two patients underwent radical resection, and the tumours were histologically confirmed to be more invasive. One patient received external radiotherapy. Three patients with a CR died during follow-up, two as a result of myocardial infarction and apoplexy, and one because of metastasis from his previously resected T3N1 primary large cell cancer. Current data show bronchoscopic electrocautery to be equally effective and potentially as curative as photodynamic therapy for treating patients with radiographically occult lung cancer. Obvious advantages are that it is an inexpensive and simple procedure, which does not cause photosensitivity.
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PMID:Radiographically occult lung cancer treated with fibreoptic bronchoscopic electrocautery: a pilot study of a simple and inexpensive technique. 954 88

"Medical" thoracoscopy as compared with "surgical" thoracoscopy (which is more precisely known as video-assisted thoracic surgery (VATS)) has the advantage that it can be performed under local anaesthesia or conscious sedation, in an endoscopy suite, using nondisposible rigid instruments. Thus, it is considerably less invasive and less expensive. The main diagnostic and therapeutic indications for medical thoracoscopy are pleural effusions and pneumothorax. Due to its high diagnostic accuracy, approaching almost 100% in malignant and tuberculous pleural effusions, it should be used when pleural fluid analysis and needle biopsy are nondiagnostic. In addition, medical thoracoscopy provides staging for lung cancer and diffuse malignant mesothelioma. Talc poudrage, as the best conservative method for pleurodesis in 1998, can also be performed with medical thoracoscopy. It can also be effectively used in the early management of empyema. In spontaneous pneumothorax it allows staging, thereby facilitating treatment decisions, and in addition coagulation of eventual blebs and talc poudrage for efficient pleurodesis. Medical thoracoscopy is a safe procedure which is even easier to learn than flexible bronchoscopy. Due to its high diagnostic and therapeutic efficiency, it should be applied increasingly in the management of the above-mentioned pleuropulmonary diseases.
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PMID:Thoracoscopy--state of the art. 954 95


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