Publications (3)1.75 Total impact
Article: [Safe extraction of an intrapulmonary foreign body after a penetrating thoracic trauma: vascular control and primary suture is the treatment of choice].Cirugía Española 05/2011; 90(5):340-2. · 0.87 Impact Factor
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ABSTRACT: Since the International Registry of Lung Metastases established the factors that determine survival after performing lung metastasectomy in 1997, numerous studies have attempted to determine these prognostic factors of survival. Our objective has been to analyse the mortality, survival and disease-free survival lung metastasis surgery by studying the different variables that determine them. All patients subjected to surgery for lung metastasectomy between 1998 and 2008 were included in this study. The Kaplan-Meier and log-rank tests were performed, as well as a Cox regression using multivariate analysis. A total of 178 lung metastases were removed in 146 patients during this period. The mean age was 62.22 years (median 63 years) and 64.6% were males. There were 2 cases (1.1%) of mortality and the incidence of complications was 5.02% (9 cases). The overall survival was 67.75 months with a 3 and 5 year survival of 67.4% and 52.4%, respectively. The variables that showed statistical significance in the multivariate analysis were: age disease free interval, number of nodules and size of nodules. The "state of the margins" variable was almost significant (P=.054). To have only one metastasis and it is less than 1cm, a long disease free interval, and a resection with free margins, are the most favourable prognostic factors after resection of lung metastasis.Cirugía Española 02/2011; 89(4):243-8. · 0.87 Impact Factor
Article: Video-assisted thoracoscopic surgery for the treatment of primary pneumothorax: talc pleurodesis or pleural abrasion? Retrospective multicentre study[show abstract] [hide abstract]
ABSTRACT: In the treatment of primary spontaneous pneumothorax (PSP) the latest guidelines rec-ommend video-assisted thoracoscopy, but do not specify the best technique for performing pleurodesis. Indeed, there are no clinical trials comparing the effectiveness of talc pleurode-sis, mechanical pleurodesis and pleurectomy. Our objective was to compare outcomes in patients who underwent surgery for primary pneumothorax with the talc procedure or with pleural abrasion using dry gauze. Patients undergoing video-assisted thoracoscopic sur-gery for PSP in two hospitals were retrospec-tively recruited between 2007 and 2008, and followed-up until December 2010. The vari-ables measured to compare the outcomes were: recurrence, complications, and mortality, as well as the duration of air leaks and of drainage and the length of postoperative hos-pital stay (in days). Statistical analysis: The two groups were compared using the Chi square test for qualitative variables and non-parametric tests for continuous variables. A total of 106 interventions were carried out in 104 patients (74 in group A: pleural abrasion with dry gauze; 32 in group B: chemical pleu-rodesis with talc), with a mean age of 28 years (median 25) and 85.6% were male. Complications were observed in nine patients (8.5%) and there were no deaths in the 30 days after surgery; there were, however, four cases of recurrence (3.8%). The mean air leak dura-tion was 0.78 days (median 0), the mean drainage duration 1.95 days (median 1) and the mean length of postoperative hospital stay 2.68 days (median 2). In 74 cases (69.8%), mechanical pleurodesis was performed, while 32 cases were treated with talc (30.2%). Comparing the two groups, we did not find sta-tistically significant differences in recurrence (4.1% vs 3.1%, P=0.82), complications (6.8% vs 12.5%, P=0.45) or mortality (no cases of death). On the other hand, the mean postoper-ative hospital stay was lower in the mechanical pleurodesis group than in the talc group (2.2 vs 3.8 days, P=0.005). Video-assisted surgery in the treatment of PSP is a safe technique. In the mechanical pleurodesis group, we observed the same rate of recurrence, half the number of complications and a shorter hospital stay. We consider it necessary that well-designed multicentre clinical trials be carried out to compare these techniques and determine which produces the best outcomes, providing stronger scientific evidence given that the data available to date are not conclusive.