Publications (21)52.99 Total impact
-
Article: Lung incarceration after anterior mediastinal tracheostomy.
[show abstract] [hide abstract]
ABSTRACT: A 63-year-old man underwent anterior mediastinal tracheostomy for postradiotherapy stoma ulceration exposing the left anterolateral tracheal side, cervical vessels, and pharynx. An anterior chest wall defect (hemiclaviculectomy, manubriectomy, and resection of anterior third of first and second ribs bilaterally) was covered by a myocutaneous pectoral flap, and a new tracheostoma was constructed in the middle of the skin island. At postoperative day 7, a protrusion of the right upper lobe outside the thoracic cavity through the anterior chest wall defect was detected. Surgical repair by a right thoracotomy to reposition the lung and defect repair using an expanded polytetrafluoroethylene (Gore-Tex) internal prosthesis were successful. The patient was discharged home at 63 days after the first operation.The Annals of thoracic surgery 05/2013; 95(5):1795-7. · 3.74 Impact Factor -
Article: [Surgical treatment of solitary adrenal metastases in patients with lung cancer.]
[show abstract] [hide abstract]
ABSTRACT: BACKGROUND AND OBJECTIVE: Lung cancer (LC) can metastasize the adrenal gland. The objective of this study is to describe our experience in patients undergoing surgery for solitary adrenal metastasis of lung cancer in the past 11 years. PATIENTS AND METHODS: It is a retrospective study of patients who underwent the surgical resection of the lung primary tumor and the adrenal metastases. RESULTS: We included 7 patients with a median age of 64 years. Five patients underwent lobectomy, and 2, pneumonectomy with adjuvant therapy according to protocol. The single adrenal metastasis appeared synchronously in 3 patients and metachronously in 4, between 10 and 39 months (median 25 months). Two patients are alive and with good quality of life. The mean survival of patients was 41 months (95% confidence interval [95% CI] 7-74) and median survival was 20 months (95% CI 7-32). CONCLUSIONS: We conclude that surgery adrenal metastases from lung cancer increases life expectancy in selected patients according to the available literature.Medicina Clínica 02/2013; · 1.38 Impact Factor -
Article: False-negative rate after positron emission tomography/computer tomography scan for mediastinal staging in cI stage non-small-cell lung cancer.
[show abstract] [hide abstract]
ABSTRACT: To assess the false-negative (FN) rate of positron emission tomography (PET)-chest computed tomography (CT) scan in clinical non-central cIA and cIB non-small-cell lung cancer (NSCLC) for mediastinal staging. Between January 2007 and December 2010, 402 patients with potentially operable NSCLC were assessed by thoracic CT scan and 18-fluoro-2-deoxy-d-glucose PET-CT for mediastinal staging and to detect extrathoracic metastases, of which 153 surgically treated patients (79 cIA and 74 cIB cases) were prospectively included in the study. Central tumours were excluded on the basis of CT scan criteria, defined as contact with the intrapulmonary main bronchi, pulmonary artery, pulmonary veins or the origin of the first segmental branches. CT scan was considered negative if lymph nodes were <1 cm at the smaller diameter. 18FDG PET-CT was considered negative when the high maximum standard uptake value (SUVmax) was <2.5. Non-invasive surgical staging was carried out in this group, and curative resection plus systematic mediastinal dissection was performed except in the event of unexpected oncological contraindication. Composite non-invasive staging (CT scan, PET-CT) showed a negative predictive value (NPV) of 92% (CI 83.6-96.8) in the cIA group and 85% (CI 74-92) in the cIB group. There were 6 of 79 (7.6%) false-negatives (FNs) in cIA and 11 of 74 (14.8%) in cIB. Multilevel pN2 were detected in four cases, all of them in the cIB group. The most frequently involved N2 was subcarinal (two cases) in cIA and right lower paratracheal (R4) and seven (five cases) in cIB. Occult (pN2) lymph nodes were more frequent in tumour sizes≥5 cm (pT2b, nine cases, four FNs, P=0.03), pN1, adenocarcinoma [excluding minimally invasive adenocarcinoma (MIA) and lepidic predominant growth (LPA)] (P=0.029) and female patients, but no other risk factors for mediastinal metastases were identified (age, clinical stage, tumour location, central or peripheral, P>0.05). Multilevel pN2 was significantly more frequent in the cIB group (P<0.03). In pT≤1 cm (T1a), NPV was significantly better (NPV=100%, P<0.05) than the other subgroups studied (IA>1 cm and IB). Composite results for non-invasive mediastinal staging (CT scan, PET-CT) showed 11% of FNs in cI stage (7.6% in non-central cIA and 14.8% in cIB). In tumours≤1 cm, NPV makes surgical staging unnecessary. In women with adenocarcinoma and non-central cIB, however, the high FN rate makes invasive staging necessary, particularly in pT2b to decrease the incidence of unexpected pN2 in thoracotomy.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 02/2012; 42(1):93-100; discussion 100. · 2.40 Impact Factor -
Article: Sleeve lobectomy after induction chemoradiotherapy.
[show abstract] [hide abstract]
ABSTRACT: The effect of induction chemoradiotherapy (CRT) on bronchial anastomoses remains uncertain. This prospective study aimed to assess the impact of neoadjuvant CRT on mortality, morbidity and survival following circular sleeve lobectomy (SL). All consecutive patients undergoing SL between June 2005 and December 2010 were prospectively included. Clinico-demographic variables were sex, age, clinical and pathologic TNM staging, comorbidities, pulmonary function, SL type, complications, neoadjuvant CRT and mortality. Of 79 patients, who underwent SL during this period, 53 (67%) patients were directly assigned to surgery and 26 (33%) patients had pre-induction treatment for N2 pathologically confirmed. Induction treatment (CRT) was based on platinum-based chemotherapy and radiation (range 45-60 Gy). Twenty-one (80%) patients of the CRT group achieved a complete mediastinal pathological response. Mortality occurred in only three cases in the non-CRT [bronchovascular fistula, pulmonary artery thrombosis (reoperation and pneumonectomy and exitus due to pneumonia) and ADRS]. There were no differences with respect to complication rate between the non-CRT and CRT patients (33 versus 37%, P > 0.05), and overall 5-year survival was 69 and 33%, respectively (P = 0.017). Overall survival in the subgroup of CRT patients with mediastinal complete response after induction resulted significantly worse than the non-CRT group (43 versus 69%, P < 0.01). The rate of distant metastases was similar in both groups and only one patient experienced local recurrence. Neoadjuvant CRT does not increase surgical morbidity, anastomotic complications or mortality in SL. Complete mediastinal response after induction therapy overcomes a significant independent prognostic factor for better survival. Although SL following induction CRT carries a good prognosis, the long-term results shows significantly lower survival compared with SL without induction CTR. In addition, patients who had complete pathological responses have a better prognosis than non-responders. SL appears to be safe and reliable after neoadjuvant concurrent CRT and can be considered the primary surgical option to save the complications related to pneumonectomy in central tumours.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 01/2012; 41(5):1052-8. · 2.40 Impact Factor -
Article: Determining the appropriate sleeve lobectomy versus pneumonectomy ratio in central non-small cell lung cancer patients: an audit of an aggressive policy of pneumonectomy avoidance.
[show abstract] [hide abstract]
ABSTRACT: To study the outcomes of broncho ± angioplastic sleeve lobectomy (SL) versus pneumonectomy (PN), and the PN:SL ratio after an aggressive policy of parenchyma-sparing surgery to improve postoperative complications rate and long-term quality of life (QoL). A prospective study was conducted in 490 patients with non-small cell lung cancer between 2005 and 2009. All patients not suitable for standard lobectomy were scheduled for SL, if possible, or for PN; eight patients with functional impairment were directly scheduled for SL. Of 76 procedures, 21 (4%) were PN and 55 (11%) SL (29 bronchoplastic, seven bronchovascular, seven angioplastic; 11 extended to more than one lobe). There were no surgical, oncological or physiological preoperative differences between the groups. The 5-year PN:SL ratio was 1:2.6 (2005: 1:2.1; 2006: 1:2.6; 2007: 1:3.6; 2008: 1:3; 2009: 1:3.5). SL and PN mortality were 2 (3.6%) and 1 (5%), respectively. Postoperative complications occurred in 18 (32%) SL and 7 (33%) PN patients. pN1 (p = 0.04), vascular reconstruction and upper-left SL were risk factors for postoperative complications of SL (p = 0.03) but were not detected as a mortality risk. Overall 5-year survival was 61% for SL and 31% for PN. Survival at 5 years was significantly higher for SL (p = 0.03, Kaplan-Meier). Age <70 years and SL were positive factors for long-term survival. In multivariate modelling, both remained positive factors. Surviving PN patients experienced significantly greater loss of respiratory function and lower QoL than those who avoided this surgery (preoperative score, PN vs SL: 52 vs 51; 3 months, 41 vs 43; and 6 months, 42 vs 51, p = 0.04). The adjuvant treatment complement was higher in SL at 34 (62%) than at PN 10 (47%). The side effects of this treatment were more frequent in patients with more extirpated parenchyma (p = 0.04). Parenchyma-sparing procedures can reduce the PN rate to less than 10%. A PN:SL index lower than 1:1.5 as a quality standard in a specialised thoracic unit should encourage the use of broncho-angioplastic procedures and improve patient outcomes. Long-term survival, QoL, postoperative lung function test and tolerance of adjuvant therapies are significantly better after SL than PN intervention.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 03/2011; 39(3):352-9. · 2.40 Impact Factor -
Article: Apnoeic oxygenation on one-lung ventilation in functionally impaired patients during sleeve lobectomy.
[show abstract] [hide abstract]
ABSTRACT: We describe a useful salvage method for hypoxaemia during one-lung ventilation (OLV) in functionally impaired patients during a sleeve bronchial reconstruction. When dependent-lung OLV strategies for hypoxaemia fail during bronchial anastomosis (increasing the oxygen administration to fraction of inspired oxygen (FiO(2)) 1 and positive end-expiratory pressure (PEEP), recruitment strategy and perfusion modulation), a very simple and efficient method for oxygen administration to the non-dependent lung can be easily employed. Oxygen flow of 5-10 l min(-1) administered by a paediatric intra-field catheter placed in the distal bronchi during bronchial anastomosis of the spared lobe(s), following the principles of apnoeic (hyper)oxygenated ventilation, successfully improves oxygenation without significant impairment of the operation field.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 01/2011; 39(4):e77-9. · 2.40 Impact Factor -
Article: Lung sparing surgery by means of extended broncho-angioplastic (sleeve) lobectomies.
[show abstract] [hide abstract]
ABSTRACT: To determine the morbidity, mortality and survival of sleeve lobectomy procedures compared to simple broncho-angioplasty procedures. A total of 535 patients diagnosed with bronchogenic cancer between September 2005 and May 2010 who fulfilled the criteria of clinical, oncological and functional operability were treated in our unit. Unresectable central tumours (n=95) using simple lobectomy were scheduled for broncho-angioplasty techniques and a pneumonectomy in those where this was impossible. A total of 58 (11%) were performed, 46 simple broncho-angioplastic lobectomies (SBAL) and 12 extended broncho-angioplastic lobectomies (EBAL). In the SBAL group there were 32 bronchial (70%) and 7 (15%) bronchovascular reconstructions and only vascular (15%). In the EBAL group, 8 (66.7%) were bronchial and 4 (33.3%) were bronchovascular reconstructions. The most common type of resection was the right upper lobe (RUL)+segment 6 in five (41%) cases, followed by RUL+middle lobe. There were 2 (3%) deaths in the SBAL group. There was 34% morbidity in the SBAL and 33% in the EBAL group (P>0.05). Fifteen patients received neoadjuvant chemo-radiotherapy treatment, due to histologically confirmed cN2; however, the number of complications was not significantly higher. No risk factors were detected in any variable studied that would affect EBAL compared to the SBAL group (P>0.05). The patients in both groups with a higher morbidity were pN1, located in the left upper lobe and associated with vascular reconstruction (P<0.05). The overall survival at 5 years was 61.6%, SBAL (61%) and EBAL (68.9%) with no differences between groups (P>0.05). EBALs are technically more demanding procedures, but do not increase morbidity or mortality compared to simple broncho-angioplasty techniques, and with a similar survival.Archivos de Bronconeumología 01/2011; 47(2):66-72. · 2.17 Impact Factor -
Article: [Extracorporeal lung assist in severe respiratory failure and ARDS. Current situation and clinical applications].
[show abstract] [hide abstract]
ABSTRACT: Despite improvements in ventilation support techniques, lung protection strategies, and the application of new support treatment, acute respiratory distress syndrome continues to have a high mortality rate. Many strategies and treatments for this syndrome have been investigated over the last few year. However, the only therapeutic measure that has systematically shown to be able to improve survival is that of low volume lung protective ventilation. Thus, using a low tidal volume prevents added lung damage by the same mechanical ventilation that is essential for life support. In this context, the use of extracorporeal lung assist systems is considered an exceptional use rescue treatment in extreme cases. On the other hand, it could be a potentially useful complementary method for an ultra-protective ventilation strategy, that is, by using even lower tidal volumes. The currently available extracorporeal lung assist systems are described in this article, including high flow systems such as traditional extracorporeal membrane oxygenation, CO₂ removal systems (interventional lung assist or iLA, with or without associated centrifugal pumps), and the new low flow and less invasive systems under development. The aim of this review is to update the latest available clinical and experimental data, the indications for these devices in adult respiratory distress syndrome (ARDS), and their potential indications in other clinical situations, such as the bridge to lung transplantation, multiple organ dysfunction syndrome, or COPD.Archivos de Bronconeumología 10/2010; 46(10):531-7. · 2.17 Impact Factor -
Article: Azygos reconstruction for non-small cell lung cancer involvement in agenesis of inferior vena cava.
The Annals of thoracic surgery 06/2010; 89(6):2041. · 3.74 Impact Factor -
Article: Incidence of occult mediastinal node involvement in cN0 non-small-cell lung cancer patients after negative uptake of positron emission tomography/computer tomography scan.
[show abstract] [hide abstract]
ABSTRACT: This study sought to assess the real incidence of pN2 among patients with non-small-cell lung cancer (NSCLC) (cN0) with negative mediastinal uptake of 2-deoxy-2-(18F)-fluoro-o-glucose (FDG). During 30 consecutive months (January 2007-May 2009), all patients with NSCLC scheduled for surgery in our unit had a preoperative FDG-positron emission tomography (PET)/computed tomography (CT) in our institution, after a dedicated chest CT (n=259). Only patients with both FDG-PET/CT and negative dedicated chest CT scan (N1 and N2 nodes <1cm) were prospectively included (n=125). Patients with cN1/cN2/cN3 and patients who had undergone preoperative chemo-radiotherapy were excluded. No invasive surgical staging was carried out in this group and curative resection plus systematic mediastinal dissection was performed except in the event of unexpected oncological contraindication. All variables were collected prospectively and, when pathological information was obtained, all the cases were carefully reviewed. Mediastinal assessment by FDG-PET/CT, negative predictive value (NPV) was 85.6%, confidence interval (CI): [77-91]; false negatives (FNs) for mediastinal lymph nodes involvement was 14.4% (18 cases). The pN2 stations most frequently involved were: 4R (six cases), seven (six cases) and five (five cases). Multiple-level pN2 occurred in six (4.8%) cases. Occult (pN2) lymph nodes were more frequent in women (p<0.01), adenocarcinoma (p<0.05) and pN1 (p<0.05). Pathological N2 prevalence for pN1 was 34 (27.7%). Considering pathological staging as the gold standard, the agreement was 70% and 47.5% for stage IA and IB (Kappa's index: 0.72 and 0.76) and, in all patients, 47% (Kappa's index: 0.27). In general, down-staging is more frequent than up-staging. Mediastinal staging of NSCLC by FDG-PET/CT showed a considerable incidence of FNs. NPV is lower than previously reported and the preoperative mediastinal staging by 18FDG-PET/CT may jeopardise the accurate treatment for early stage NSCLC patients.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 05/2010; 37(5):1168-74. · 2.40 Impact Factor -
Article: [Broncho-angioplasty surgery in the treatment of lung cancer].
Archivos de Bronconeumología 09/2009; 45(11):531-2. · 2.17 Impact Factor -
Article: [Air leak syndrome due to graft versus host disease].
Archivos de Bronconeumología 05/2009; 45(7):358-9. · 2.17 Impact Factor -
Article: [Treatment of catamenial pneumothorax with diaphragmatic defects].
Archivos de Bronconeumología 05/2009; 45(8):414-5; author reply 415-6. · 2.17 Impact Factor -
Article: Cryopreserved arterial allograft reconstruction after excision of thoracic malignancies.
[show abstract] [hide abstract]
ABSTRACT: The purpose of this study was to evaluate the long-term clinical and immunologic outcome of cryopreserved arterial allograft (CAA) revascularization of intrathoracic vessels invaded by malignancies. Since January 2002, consecutive patients whose intrathoracic vessels were invaded by malignancies were operated on and revascularizion made using human lymphocyte antigen (HLA)- and ABO-mismatched CAAs. Immunologic studies were performed preoperatively, and 1, 3, 6, 12, and 24 months postoperatively. Postoperative oral anticoagulation therapy was not given. Twenty-six patients aged 53.1 +/- 15 years with a nonsmall-cell lung cancer (n = 10), invasive mediastinal tumors (n = 7), pulmonary artery sarcoma (n = 3), laryngeal (n = 2), or other rare lung neoplasms (n = 4) underwent operation. Cardiopulmonary bypass was used in 10 cases (38%), and all resections were pathologically complete. Revascularization was either for venous (n = 12) or arterial (n = 14) vessels, and a total of 30 allografts revascularized the superior vena cava (n = 6), pulmonary artery (n = 7), innominate vein (n = 3) or artery (n = 2), ascendent (n = 4) or descending (n = 1) aorta, and subclavian vein (n = 3) or artery (n = 4). Hospital morbidity and mortality were 50% (n = 13) and 3.8% (n = 1), respectively, all CAA unrelated. With a median follow-up of 18 months (range, 3 to 60+), 5-year survival and allograft patency were 84% and 95%, respectively. Preoperative anti-HLA antibodies were detected in 2 patients (7.7%) and a postoperative anti-HLA antibody response, clinically irrelevant, in 1 of 24 patients (4%). Revascularization of intrathoracic venous and arterial vessels in patients with malignancies using HLA- and ABO-mismatched CAA is technically feasible and clinically attractive because of no infection risk and postoperative anticoagulation, and excellent long-term survival, patency, and nonimmunogeneicity.The Annals of thoracic surgery 01/2009; 86(6):1753-61; discussion 1761. · 3.74 Impact Factor -
Article: Blunt traumatic bronchial transection.
The Annals of thoracic surgery 04/2008; 85(3):1107. · 3.74 Impact Factor -
Article: Technique to avoid innominate artery ligation and perform an anterior mediastinal tracheostomy for residual trachea of less than 5 cm.
[show abstract] [hide abstract]
ABSTRACT: A 47-year-old man was admitted with recurrent autolimited bleeding arising from a cervical tracheostoma made 2 years earlier during a total laryngectomy. Stomal recurrence of the past laryngeal cancer invading the neighboring innominate artery was diagnosed by angiographic computer tomography and bronchoscopic biopsies. The malignant tracheostoma-innominate fistula was approached through an extended transversal supraclavicular incision, bilateral hemiclaviculectomy, and manubriectomy. It was treated with an anterior mediastinal tracheostomy with omental major transposition, right latissimus dorsi myocutaneous flap for tissue coverage, and brachiocephalic artery rerouting with cadaveric homograft. The patient was discharged on postoperative day 14 after an uneventful postoperative course.The Annals of thoracic surgery 12/2007; 84(5):1777-9. · 3.74 Impact Factor -
Article: The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy.
[show abstract] [hide abstract]
ABSTRACT: To evaluate two different approaches used to perform fused fissures in lobectomies in terms of persistent air leak (PAL) and their impact on length of hospital stay. One hundred and nineteen patients underwent lobectomy or bilobectomy in our unit. We focused on patients with fused fissures (63 patients), all of whom were selected intraoperatively based on predefined criteria. These patients with incomplete fissures were randomly assigned to two groups: Group A patients who underwent a 'traditional technique' to approach fused fissures and Group B patients who underwent a 'fissureless technique'. The latter technique avoids dissecting the lung parenchyma over the pulmonary artery, reducing the chances of air leak. Patients in both groups had shown no significant difference in preoperative variables (p>0.05). The incidence of PAL was significantly higher among patients with incomplete or fused fissures (0 case vs 8 cases (Groups A and B), p<0.005). Furthermore, the incidence of PAL was significantly higher in the Group A (traditional technique) (7 vs 1) (p<0.05, OR=3.1, CI 0.22-0.51). The probability for air leak cessation was significantly higher in patients of Group B (fissureless technique) (log rank p<0.0001). The length of hospital stay was higher in Group A (5.76+/-3.1) compared with Group B (4.9+/-1.7) (p<0.05). No other variables were identified as risk factors for PAL in this series. The fissureless technique appears to be a superior approach for fused fissures in terms of both preventing persistent air leak and reducing the length of hospitalisation. This technique can be performed safely at no additional cost and without adverse consequences.European Journal of Cardio-Thoracic Surgery 02/2007; 31(2):203-8. · 2.55 Impact Factor -
Article: Role of conservative medical management of tracheobronchial injuries.
[show abstract] [hide abstract]
ABSTRACT: The purpose of this study is to describe and assess the effectiveness of conservative treatment as the chosen treatment for tracheobronchial injury (TBI) management. This is a retrospective and descriptive study, which took place at a single center. From January 1993 to July 2004, 33 TBIs were treated in our hospital. Eighteen (54.5%) were iatrogenic injuries and 15 (45.5%) were traumatic noniatrogenic injuries. Eighteen (55%) of the TBI patients were women and 15 (45.5%) were men, with a mean age of 46.7 +/- 23.4 years (range, 14-88 years). Eighteen (54.5%) of the injuries were caused by orotracheal intubation or tracheostomy, 13 (39.4%) by blunt trauma, and 2 (6.1%) by penetrating tracheal injuries. The average diagnostic delay was 18.29 +/- 19.8 hours. The mean injury size was 2.6 +/- 1.3 cm (range, 1-7 cm). Fourteen (42.4%) injuries were located in the cervical trachea, 8 (24.2%) in the thoracic trachea, 10 (30.3%) in the bronchi, and 1 (3%) involved both trachea and the main bronchi. Conservative treatment was applied in 20 (60.6%) of the 33 cases. Surgery should be performed in cases of esophageal-associated injuries, progressive subcutaneous or mediastinal emphysema, severe dyspnea requiring intubation, difficulty with mechanical ventilation, pneumothorax with an air leak through the chest drains, or mediastinitis. Conservative medical or surgical treatments achieved good outcomes in 28 (84.8%) cases. Five patients (15.2%) died while in the hospital; 4 of these were medically treated and 1 was surgically treated. Mortality was related to older patients and patients that had been diagnosed during mechanical ventilation. Major symptoms (progressive subcutaneous emphysema, dyspnea, sepsis) were detected more often in cartilaginous injuries (p < 0.05). Conservative treatment was considered more effective in membranous injuries (p < 0.05), and these sorts of injuries were not related to a high mortality rate (p > 0.05). Mortality was not related to conservative treatment, sex, diagnostic delay, injury mechanism, location, or length of the TBI (p < 0.05). Conservative treatment for TBI is effective regardless of the mechanism of production, length, or site of the injury. Conservative treatment should be carefully assessed in patients who meet strict selection criteria. Membranous injuries can be treated more often with a conservative approach, however, cartilaginous injuries should be treated surgically if major symptoms are detected.The Journal of trauma 12/2006; 61(6):1426-34; discussion 1434-5. · 2.48 Impact Factor -
Article: Surgical Treatment of Solitary Metastasis in the Male Breast from Non‐Small Cell Lung Cancer
[show abstract] [hide abstract]
ABSTRACT: Detection of metastases in the breast from extramammary neoplasms is rare. We present a case of metastases in breast tissue from surgically treated non-small cell bronchogenic carcinoma. A histologic and immunohistologic study was essential for choosing the appropriate treatment for the patient. The patient is alive and disease-free 18 months after the breast surgery.The Breast Journal 06/2006; 12(4):366 - 367. · 1.64 Impact Factor -
Article: Successful use of a single chest drain postlobectomy instead of two classical drains: a randomized study.
[show abstract] [hide abstract]
ABSTRACT: To compare surgical results and complications in the immediate postoperative course between the use of a single drain and two-drain post-anatomical pulmonary resections. Between January 2004 and September 2005, 143 patients were scheduled for pulmonary lobectomy or bilobectomy for non-small cell lung cancer (NSCLC) in our department. Pneumonectomies, wedge resection, and nonresectable thoracotomies were excluded from the study. Hundred and nineteen patients were enrolled in this study. Clinical and surgical variables were collected prospectively. Lobectomy or bilobectomy and systematic mediastinal node dissection were performed in all cases. The patients were randomly assigned to receive single (group A) or two (group B) drains, independent of any preoperative or intraoperative variables. Group A consisted of 60 patients who had one single drain sited in the mid-position and group B consisted of 59 patients who had two classical drains (apical and basal). There were no surgical, oncological, or physiological differences between the groups (p=NS). There were no statistically significant differences detected between the groups in relation to postsurgical morbidity or mortality and other issues studied, except in analgesia requirements (group A less than group B, p<0.05). After drain removal there were no significant differences between the groups in terms of subcutaneous emphysema, new drains needed, residual pleural effusion, or residual space (p>0.05). In our study, we did not find significant differences between the use of one or two drains after lobectomy or bilobectomy in relation to early postoperative outcome. However, the use of only one drain is more economical and is less painful for patients, without any additional adverse consequences.European Journal of Cardio-Thoracic Surgery 05/2006; 29(4):562-6. · 2.55 Impact Factor
Top co-authors
Top Journals
Institutions
-
2009–2013
-
University of Barcelona
Barcelona, Catalonia, Spain
-
-
2007–2013
-
Hospital Clínic de Barcelona
Barcelona, Catalonia, Spain
-
-
2011
-
Hospital Clínico, Maracaibo
Maracaibo, Estado Zulia, Venezuela
-
-
2006–2007
-
Hospital Universitario Virgen de la Arrixaca
Murcia, Murcia, Spain
-
-
2005–2006
-
Hospital 12 de Octubre
- Servicio de Cirugía Torácica
Madrid, Madrid, Spain
-
