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ABSTRACT: Unlike lung metastases of extrapulmonary sarcomas, primary sarcoma of the lung is very rare. We analyzed 7 primary sarcomas treated surgically in Hospital Universitario La Paz, Madrid, Spain between 1985 and 2001. Preoperative histologic diagnosis was correct for 2 patients. Surgery was performed in all 7 patients. Resection was extended to the left atrium in 1 patient, to the chest wall in another, and the parietal pleura were removed from 2 others. Surgical resection was considered complete in 6 cases. Histology revealed 4 cases of malignant fibrous histiocytoma, 1 angiosarcoma, 1 osteogenic sarcoma, and 1 undifferentiated sarcoma. Enlarged lymph nodes removed during surgery were tumor free. Three patients received complementary treatment. The 3 longest-surviving patients were treated with surgery alone; at the end of the study, these patients remained alive 16, 9, and 4 years after surgery. One patient has a recurrent lymph node tumor in a single lung. Three patients died within 1 year and another died 24 months after surgery. In conclusion, surgical treatment of primary sarcoma of the lung can achieve good survival.
Archivos de Bronconeumología 12/2005; 41(11):634-7. · 2.17 Impact Factor
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ABSTRACT: Seventy-three interventions for chest wall tumors were performed at our hospital from 1978 through 2003. Six (8.2%) tumors were vascular. Four of them were soft tissue tumors, and two involved bone. The histologic diagnoses were hemangioendothelioma (1), low-grade angiosarcoma (1), and hemangioma (4). The diagnosis was established after surgery in all cases except one that had been previously diagnosed during an attempted resection before the patient came to our hospital. Fine needle aspiration carried out in 4 patients was inconclusive in all cases. Complete tumor resection with a margin greater than 3 cm was performed in each patient. Embolization followed by ligation of the intercostal vessels was performed prior to tumor resection in 1 patient with arteriovenous fistula and diffuse angiomatosis. Chest wall reconstruction after tumor removal was carried out using autologous tissues except in 1 case in which a Marlex mesh (CR Bard Inc., Burlington, USA) and a metallic prosthesis was inserted to prevent deformity in the lower costal arch. All patients have been followed and have survived with no evidence of recurrence after follow up ranging from 2 to 25 years.
Archivos de Bronconeumología 02/2005; 41(1):53-6. · 2.17 Impact Factor
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ABSTRACT: To analyze the results of thymectomy in our series of patients with myasthenia gravis (MG) and to study the influence of the most common prognostic factors.
Eighty MG patients over a period of 23 years underwent thymectomy consecutively in our hospital. Preoperative assessment included clinical evaluation of muscle weakness, edrophonium testing, electromyography, lung function testing, chest X-rays and CAT scans. Symptoms were assessed by the Osserman scale. The surgical approach was amplified transsternal thymectomy. The prognostic factors studied were sex, age, clinical stage, duration of disease before surgery and histology of the thymus. Clinical outcome was assessed using Millichap and Dodge's criteria. Follow-up was by the chest surgery and neurology departments.
Complete remission was observed in 29 cases (36.2%) and significant improvement in 42 (52.5%). Complications developed in 9 patients (11.2%). Most patients were women (53/27) and outcomes for men and women were not statistically different. Mean age was 36 years (range 11-79), with no significant difference in outcome for patients who were older or younger than 60 years of age. Nor were differences evident related to presurgical clinical stage or levels of severity (I + IIa/IIb + III). Differences in outcome were highly significantly related to duration of disease (< 24 / > 24 months) (p = 0.0022), such that outcome was more satisfactory when the pre-surgical course of disease was shorter, provided that no thymoma was present.
Amplified transsternal thymectomy was safe and effective for those patients with MG. When disease had been present for less than two years, the prognosis was better.
Archivos de Bronconeumología 04/2001; 37(4):166-70. · 2.17 Impact Factor
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ABSTRACT: Bronchoplasty in oncological surgery is performed to remove a tumor while preserving most of the pulmonary parenchyma. Survival in selected patients is similar to survival after lung removal. We report a series of 50 bronchoplastic procedures performed in 37 patients with bronchopulmonary cancer. Twelve had carcinoid tumors and 1 had single lung metastasis from adenocarcinoma of the colon. Twenty-seven operations were performed on the right side and 23 on the left. The pulmonary parenchyma was not resected in 2 patients. The pulmonary artery was also repaired in 5 patients. Mortality at 30 days was 2% (1 patient) and survival at 5 years was 47% calculated according to the method of Kaplan-Meier. Survival was 37 months in only 1 of the 8 patients with mediastinal adenopathy, for whom complementary radiation therapy was provided. Survival among the patients with carcinoid tumors is 91.6% to date, as all but 1 are alive at present. The single death was due to intestinal diverticulosis. The patient with metastasis is alive 12 years after surgery. Spirometric function tests were performed in 17 patients 1 year after surgery and ventilation perfusion was studied in 13. A slight loss of forced vital capacity and maximum expiratory volume in 1 second, while ventilation perfusion corresponding to the parenchyma preserved was normal. Bronchoplasty is the treatment of choice for endobronchial tumors with low degrees of malignancy. Bronchoplasty is an effective surgical treatment for a select group of carcinomas.
Archivos de Bronconeumología 11/1996; 32(8):388-93. · 2.17 Impact Factor
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Revista de medicina de la Universidad de Navarra 04/1981; 25(1):47-50.
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Revista Clínica Española 08/1970; 118(4):347-54. · 2.01 Impact Factor
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Revista Clínica Española 01/1969; 111(5):505-12. · 2.01 Impact Factor
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ABSTRACT: Seventy-three interventions for chest wall tumors were performed at our hospital from 1978 through 2003. Six (8.2%) tumors were vascular. Four of them were soft tissue tumors, and two involved bone. The histologic diagnoses were hemangioendothelioma (1), low-grade angiosarcoma (1), and hemangioma (4). The diagnosis was established after surgery in all cases except one that had been previously diagnosed during an attempted resection before the patient came to our hospital.Fine needle aspiration carried out in 4 patients was inconclusive in all cases. Complete tumor resection with a margin greater than 3 cm was performed in each patient. Embolization followed by ligation of the intercostal vessels was performed prior to tumor resection in 1 patient with arteriovenous fistula and diffuse angiomatosis. Chest wall reconstruction after tumor removal was carried out using autologous tissues except in 1 case in which a Marlex mesh (CR Bard Inc., Burlington, USA) and a metallic prosthesis was inserted to prevent deformity in the lower costal arch.All patients have been followed and have survived with no evidence of recurrence after follow up ranging from 2 to 25 years.En el período de 1978 a 2003 realizamos 73 intervenciones en tumores de la pared del tórax, de los cuales 6 eran tumores vasculares, un 8,2%. Cuatro eran tumores de partes blandas y 2 tenían afectación ósea. El diagnóstico histológico fue de 4 hemangiomas, un hemangioendotelioma y un angiosarcoma de bajo grado. En todos el diagnóstico se estableció tras la cirugía, excepto en un caso que había sido diagnosti-cado previamente en un intento de resección antes de llegar a nuestro servicio.A 4 enfermos se les realizó una punción-aspiración con aguja fina, que no fue concluyente en ningún caso. Se practicó resección completa del tumor en todos los pacientes, con un margen superior a 3 cm. En un enfermo con fístula arte-riovenosa y angiomatosis difusa se practicó embolización con posterior ligadura quirúrgica de los vasos intercostales antes de la resección tumoral. La reconstrucción parietal del defecto tras la extirpación del tumor se llevó a cabo con teji-dos propios, excepto en un caso en que utilizamos placa de Marlex y prótesis metálica para evitar la deformidad de la arcada costal inferior.Hemos realizado seguimiento de todos los enfermos, que en la actualidad están vivos y sin signos de recidiva, entre 2 y 25 años tras la cirugía.
Archivos de Bronconeumología ((English Edition)).
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ABSTRACT: En el período de 1978 a 2003 realizamos 73 intervenciones en tumores de la pared del tórax, de los cuales 6 eran tumores vasculares, un 8,2%. Cuatro eran tumores de partes blandas y 2 tenían afectación ósea. El diagnóstico histológico fue de 4 hemangiomas, un hemangioendotelioma y un angiosarcoma de bajo grado. En todos el diagnóstico se estableció tras la cirugía, excepto en un caso que había sido diagnosticado previamente en un intento de resección antes de llegar a nuestro servicio. A 4 enfermos se les realizó una punción-aspiración con aguja fina, que no fue concluyente en ningún caso. Se practicó resección completa del tumor en todos los pacientes, con un margen superior a 3 cm. En un enfermo con fístula arteriovenosa y angiomatosis difusa se practicó embolización con posterior ligadura quirúrgica de los vasos intercostales antes de la resección tumoral. La reconstrucción parietal del defecto tras la extirpación del tumor se llevó a cabo con tejidos propios, excepto en un caso en que utilizamos placa de Marlex y prótesis metálica para evitar la deformidad de la arcada costal inferior. Hemos realizado seguimiento de todos los enfermos, que en la actualidad están vivos y sin signos de recidiva, entre 2 y 25 años tras la cirugía.
Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax (ALAT), ISSN 0300-2896, Vol. 41, Nº. 1, 2005, pags. 53-56.
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ABSTRACT: Los sarcomas primitivos pulmonares son muy raros, pero no los metastásicos. Se analizaron 7 sarcomas primarios operados en nuestro servicio entre 1985 y 2001. El diagnóstico histológico preoperatorio fue correcto en 2 pacientes. Se realizó cirugía en todos. En uno se amplió la resección a aurícula izquierda, en otro a pared torácica y en otros 2 se extirpó pleura parietal. Se consideró cirugía completa en 6 casos. En el estudio histológico 4 fueron fibrohistiocitomas malignos, uno angiosarcoma, uno sarcoma osteogénico y uno sarcoma indiferenciado. Las adenopatías extirpadas estaban libres de tumor. Se hizo tratamiento complementario en 3 pacientes. En los 3 de mayor supervivencia se realizó sólo cirugía, con un seguimiento de 16, 9 y 4 años, respectivamente. Uno tiene actualmente una recidiva tumoral nodular en pulmón único. En cuanto a los fallecidos, 3 murieron antes de un año y otro después de 24 meses de evolución. En conclusión, la cirugía en los sarcomas pulmonares primitivos puede conseguir una elevada supervivencia
Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax (ALAT), ISSN 0300-2896, Vol. 41, Nº. 11, 2005, pags. 634-637.
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ABSTRACT: Unlike lung metastases of extrapulmonary sarcomas, primary sarcoma of the lung is very rare. We analyzed 7 primary sarcomas treated surgically in Hospital Universitario La Paz, Madrid, Spain between 1985 and 2001. Preoperative histologic diagnosis was correct for 2 patients. Surgery was performed in all 7 patients. Resection was extended to the left atrium in 1 patient, to the chest wall in another, and the parietal pleura were removed from 2 others. Surgical resection was considered complete in 6 cases. Histology revealed 4 cases of malignant fibrous histiocytoma, 1 angiosarcoma, 1 osteogenic sarcoma, and 1 undifferentiated sarcoma. Enlarged lymph nodes removed during surgery were tumor free.Three patients received complementary treatment. The 3 longest-surviving patients were treated with surgery alone; at the end of the study, these patients remained alive 16, 9, and 4 years after surgery. One patient has a recurrent lymph node tumor in a single lung. Three patients died within 1 year and another died 24 months after surgery. In conclusion, surgical treatment of primary sarcoma of the lung can achieve good survival.Los sarcomas primitivos pulmonares son muy raros, pero no los metastásicos. Se analizaron 7 sarcomas primarios operados en nuestro servicio entre 1985 y 2001. El diagnósti-co histológico preoperatorio fue correcto en 2 pacientes. Se realizó cirugía en todos. En uno se amplió la resección a aurícula izquierda, en otro a pared torácica y en otros 2 se ex-tirpó pleura parietal. Se consideró cirugía completa en 6 ca-sos. En el estudio histológico 4 fueron fibrohistiocitomas malignos, uno angiosarcoma, uno sarcoma osteogénico y uno sarcoma indiferenciado. Las adenopatías extirpadas es-taban libres de tumor.Se hizo tratamiento complementario en 3 pacientes. En los 3 de mayor supervivencia se realizó sólo cirugía, con un seguimiento de 16, 9 y 4 años, respectivamente. Uno tiene actualmente una recidiva tumoral nodular en pulmón ünico. En cuanto a los fallecidos, 3 murieron antes de un año y otro después de 24 meses de evolución.En conclusión, la cirugía en los sarcomas pulmonares primitivos puede conseguir una elevada supervivencia.
Archivos de Bronconeumología ((English Edition)).
