We report a case of intercostal muscle flap used in tracheobronchial reconstruction for extensive necrosis after burn lesions of the posterior wall. A 32-year-old man attempted suicide by ingestion ...of caustic material. He underwent emergency total esogastrectomy, tracheostomy, and feeding jejunostomy. Ten days later, endoscopy showed complete destruction of the membranous trachea, extending from the tracheostomy to the carina. Reconstruction was conducted with the patient under venovenous extracorporeal membrane oxygenation by use of a pedicled intercostal muscle flap. The patient was weaned from respiratory support on the 14th postoperative day. Examination of a biopsy specimen from the flap 7 months after tracheoplasty showed ciliated neoepithelium.
Occupational lung cancer cases remain largely under-reported and under-compensated worldwide. In order to improve the detection and compensation of work-related lung cancers, we implemented a ...systematic screening of occupational exposures, combining a validated self-administered questionnaire to assess occupational exposures and a specialized occupational cancer consultation. After a pilot study, the present prospective, open-label, scale-up study aimed to assess this systematic screening of occupational exposures in lung cancer patients in five sites in France by associating university hospitals with cancer centers. Patients with lung cancer were sent a self-administered questionnaire to collect their job history and potential exposure to lung carcinogens. The questionnaire was assessed by a physician to determine if a specialized occupational cancer consultation was required. During the consultation, a physician assessed if the lung cancer was occupation-related and, if it was, delivered a medical certificate to claim for compensation. Patients were offered help from a social worker for the administrative procedure. Over 15 months, 1251 patients received the questionnaire and 462 returned it (37%). Among them, 176 patients (38.1%) were convened to the occupational cancer consultation and 150 patients attended the consultation. An exposure to occupational lung carcinogen was identified in 133 patients and a claim for compensation was judged possible for 90 patients. A medical certificate was delivered to 88 patients and 38 patients received compensation. Our national study demonstrated that a systematic screening of occupational exposures is feasible and will bring a significant contribution to improve the detection of occupational exposures in lung cancer patients.
Resection of a Large Lipoma Invading the Right Atrium Galvaing, Geraud; D’Ostrevy, Nicolas; Filaire, Laura ...
The Annals of thoracic surgery,
March 2022, 2022-03-00, 20220301, Volume:
113, Issue:
3
Journal Article
Les luxations sternoclaviculaires sont rares, concernent généralement le sujet jeune et résultent le plus souvent de choc violent. À travers une revue de la littérature, les auteurs font le point sur ...l’épidémiologie, les mécanismes, les signes cliniques, l’imagerie et les traitements des luxations sternoclaviculaires d’origine traumatique. Les instabilités chroniques ne sont pas discutées.
Sternoclavicular joint dislocations are rare and generally occur in young adults as a consequence of a high-energy trauma. In this article, the authors review the epidemiology, the physiopathology, the clinical presentation, the radiology, and the treatment of acute sternoclavicular joint dislocations. Chronic instability is not discussed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Introduction
The coronavirus disease 2019 (COVID‐19) causes a small proportion of patients to be admitted to intensive care units, where they sometimes require extracorporeal membrane oxygenation ...(ECMO). The literature on pregnant women with COVID‐19 who require ECMO is sparse.
Case report
We describe here the earliest‐fetal‐age pregnant patient with COVID‐19 who underwent ECMO yet reported, who kept her child while under close follow‐up with magnetic resonance imagery and ultrasound.
Conclusion
The management of acute respiratory distress syndrome (ARDS) in pregnant women, including ARDS secondary to COVID‐19 and those cases which are not eligible for fetal delivery, may benefit from the assistance of ECMO even in the early pregnancy.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
The aim of this study was to evaluate the impact of the ipsilateral arm position on ipsilateral shoulder pain after lung cancer resection by video-assisted thoracic surgery.
A prospective randomized ...controlled trial.
A single academic center study.
Patients undergoing video-assisted thoracic surgery pulmonary resection for cancer at the Institut Universitaire de Cardiologie et de Pneumologie de Québec from May 2020 to May 2022 were included.
Patients randomly were assigned with a 1:1 ratio to a supported or suspended ipsilateral arm position.
Ipsilateral shoulder pain incidence, pain score, and opioid use were recorded in the postanesthesia care unit (PACU) on postoperative days 1 and 2. One hundred thirty-three patients were randomized, 67 in the suspended-arm group and 66 in the supported-arm group. Of the patients, 31% reported ipsilateral shoulder pain in the PACU with no difference between groups (19/67 28.4% v 22/66 patients (33.3%), p = 0.5767). There was no significant difference between the pain score in the PACU (3 0-6 v 4 0-6, p = 0.9055) at postoperative day 1 (4 2-6 v 3 2-5, p = 0.4113) and at postoperative day 2 (2 0-5 v 2 1-4, p = 0.9508). Ipsilateral shoulder pain score decreased rapidly on postoperative day 2. There was no statistical difference in opioid and gabapentinoid use between the groups.
Ipsilateral arm position seems to have no impact on ipsilateral shoulder pain.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
A 58-year-old man presented with fever and chest pain 11 days after atrial fibrillation catheter ablation. The diagnosis of pericardio-oesophageal fistula was made. Aggressive surgical ...management was decided. The patient was managed using extracorporeal life support, aortic valve replacement and a pulmonary patch, as well as an oesophageal stent. The patient was discharged from hospital approximately 2 months later. The use of a pulmonary patch is a rare but a highly effective technique that can be used in this indication.
Étudier l’évolution des pressions inspiratoire et expiratoire maximales (PIM et PEM) après lobectomie pulmonaire.
Lors d’une étude prospective unicentrique, PIM, PEM, performance en spirométrie ...incitative (SI), exploration fonctionnelle respiratoire, dyspnée et douleur d’un groupe patient (n=10) étaient évaluées en préopératoire (Préop), entre le cinquième et septième jour postopératoire (j5–7) et à un mois de la sortie (j41). Dès le premier jour postopératoire (j1), techniques de désencombrement, SI et reprise d’activité étaient associées.
PIM et PEM étaient respectivement à 103±25 % et 120±30 % des théoriques en préopératoire, puis chutaient à j5–7 respectivement de 30±14 % et 32±22 % (p<0,05). La récupération était complète pour PIM et partielle pour PEM à j41 (p<0,05).
PIM et PEM chutent significativement après lobectomie pulmonaire. La SI en postopératoire est bien tolérée mais son effet sur les performances inspiratoires reste à préciser.
Niveau II.
Study maximal inspiratory and expiratory pressures (MIP and MEP) evolution after lung lobectomy.
During a unicentric prospective trial, MIP, MEP, incentive spirometry (IS) performance, lung function test, dyspnea and pain in a patient group (n=10) were assessed preoperatively (Preop), between the 5th and 7th postoperative day (D5–7) and one month after discharge (D41). From the first postoperative day (D1), chest physiotherapy, IS and return to activities of daily life were associated.
PIM and PEM were respectively at 103±25% and 120±30% of theoretical values at Preop, and decreased on D5-7 respectively of 30±14 % and 32±22% (P<0.05). The recovery was complete for PIM and partial for MEP on D41 (P<0.05).
MIP and MEP decrease significantly after lung lobectomy. Postoperative IS shows its excellent tolerance, nevertheless, its effect on inspiratory performances remains to be specified.
Level II.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Resection surgery is the main treatment for non-small cell lung cancer (NSCLC).Postoperative complications and mortality are mostly linked to respiratory failure consecutive to respiratory muscle ...overload.
Randomized controlled trial.
Patients eligible for NSCLC resection.
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