K T Ganeshakrishnan, R B Pandey, J M Khandeparkar, N B Agarwal, C J Hemantkumar, A G Tendolkar, R A Magotra
{"title":"Surgical considerations in the management of thoraco-abdominal aortic aneurysms.","authors":"K T Ganeshakrishnan, R B Pandey, J M Khandeparkar, N B Agarwal, C J Hemantkumar, A G Tendolkar, R A Magotra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nineteen patients of Thoraco-abdominal aortic aneurysm were operated during a nine year period. All were larger than 10 cm. in size. Four were operated in emergency. Seven underwent patch aortoplasty while eleven required tube inlay aortoplasty with visceral vessel reimplantation. One patient continued to be paraplegic postoperatively. Two (10.52%) had acute renal failure and there were two (10.52%) deaths. A sincere effort to keep the aortic and renal occlusion times to minimum and successful reimplantation of lower intercoastals and visceral branches appear to offer significant help in accomplishing successful repair with justifiable expectancy.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"41-5"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Takahashi, S Ishikawa, A Otaki, K Sakata, Y Otani, H Ichikawa, Y Sato, M Suzuki, O Kawashima, Y Morishita
{"title":"[Surgical repair of an extreme type of tetralogy of Fallot using valved extracardiac conduit].","authors":"T Takahashi, S Ishikawa, A Otaki, K Sakata, Y Otani, H Ichikawa, Y Sato, M Suzuki, O Kawashima, Y Morishita","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three patients with an extreme type of tetralogy of Fallot underwent corrective surgery using the valved extracardiac conduit for reconstruction of the main pulmonary arteries. The conduit consisted of bicuspid valve which was made of heterogeneous pericardium of 18 or 20 mm in diameter. The conduit was sutured to the pulmonary artery followed by an end-to-end anastomosis between the conduit and a Dacron tube which was sutured to the right ventricular outflow tract. Postoperative echocardiography showed little pulmonary regurgitation. Postoperative courses of all the patients have been uneventful.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"53-5"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Present status of cardiomyoplasty].","authors":"K Koyanagi, H Kurosawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Direct ventricular assist and myocardial replacement using skeletal muscle, so-called dynamic cardiomyoplasty, are promised as an effective treatment of choice in severe cardiac failure. Owing to the use of autologous muscle, the risk of rejection can be ignored, which is problematic in cardiac transplantation. More than 300 cases have been reported in the world. Since a cardiac transplant protocol has not been started yet in our country, we are hoping that clinical experience with these treatments solves our problem.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Thoracoscopic surgery for benign esophageal disease].","authors":"M Ohgami, N Ando, S Ozawa, M Kitajima","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two patients with benign esophageal disease were successfully treated by thoracoscopic surgery. First case was a 66 year old male with esophageal diverticulum, who had complained of progressive dysphasia. The esophagogram showed a giant epiphrenic diverticulum which was 8 cm in diameter. Entire procedure was performed thoracoscopically under general anesthesia, while left side univentilation was applied. A flexible videoelectronic thoracoscope was introduced into thoracic cavity at the 5th intercostal space, and 4 additional trocars were inserted. The pleura over the diverticulum was divided, and the diverticulum was fully dissected and exposed. A multifire endoscopic stapler, an Endo GIA, was applied to resect the diverticulum. For security, uninterrupted suture of muscular layer of the esophagus over the stapled line was performed. Second case was a 60 year old male with esophagobronchial fistura, who had complained of choking during liquid intake for 20 years. The bronchogram showed a communication between a esophageal diverticulum and a right B6 bronchus. The operation was performed thoracoscopically. A thoracoscope was introduced as mentioned above, and the esophagus and the peripheral lung around the fistura was dissected and fully exposed. The diverticulum was divided at its base using an Endo GIA, and the fistura was resected with lung parenchyma using also an Endo GIA. The postoperative courses of the both patients were uneventful. The patients started diet on the 4th and the second postoperative day respectively, and the symptoms had disappeared after surgery.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"30-6"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N Sasahashi, F Ando, F Okamoto, K Yamanaka, S Otani, K Oda, K Sogabe, T Hanada, Y Murakami, T Takechi
{"title":"[Right-sided infective endocarditis with ventricular septal defect].","authors":"N Sasahashi, F Ando, F Okamoto, K Yamanaka, S Otani, K Oda, K Sogabe, T Hanada, Y Murakami, T Takechi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two patients underwent surgical treatment for right-sided infective endocarditis with ventricular septal defect. In both cases, blood cultures showed Peptostreptococcus, and the operation was performed at non-active phase after antibiotics therapy. The case 1 was a 7-year-old girl who was observed a vegetation on the chorda of the anterior paillary muscle by echocardiography. The defect was directly closed and the vegetation was excised. The case 2 was 22-year-old female who had been diagnosed of VSD in her infancy. A high fever continued and echocardiography revealed a vegetation attached to the septal tricuspid leaflet. Partial excision of the leaflet and autopericard patch plasty was performed, and the VSD was directly closed. Postoperatively intravenous antibiotic therapy was given for periods of 6 weeks, and clinical course were uneventful in both cases. Local excision of vegetation and leaflet repair by autopericard patch plasty should be performed in cases with localized vegetation and minor valvular regurgitation.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Video-assisted thoracic surgery (VATS) for intrathoracic tumors].","authors":"H Asamura, T Naruke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Owing to the advent of new thoracoscopic instrument and technique, video-assisted thoracic surgery (VATS) has become a new standard in the resection of intrathoracic tumors. Thoracoscopy can be used as both exploratory and therapeutic means. Included as the indication for VATS resection are as follows: benign and malignant lung tumors such as lung cancer, metastatic lung tumor, and etc., benign mediastinal tumors, and benign pleural tumors. Still the indication for VATS resection for malignant disease, especially for lung cancer, is not defined. Further improvement is required in the resectional technique and instruments.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"22-5"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Maehara, K Kokaji, Y Yamashita, K Nohga, M Ohgami
{"title":"[A new video-assisted thoracoscopic surgical interruption of patent ductus arteriosus].","authors":"T Maehara, K Kokaji, Y Yamashita, K Nohga, M Ohgami","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A new video-assisted thoracoscopic surgery was applied to patients with patent ductus arteriosus (PDA). After the ductus was carefully dissected and exposed, two or one titanium clips which were 11 mm in length were used to interrupt the ductus completely. Eight patients with PDA were successfully treated by the new technique between July 1992 and September 1993, which was the first successful series in Japan. Mean age was 4.3 years (range 1.7 approximately 6.7 years) and mean weight was 15.6 kg (range 10.0 approximately 24.0 kg). All patients had immediate complete PDA closure after the procedure which was proved to be successful by an esophageal stethoscope and color doppler echocardiogram. One patient had mild left recurrent laryngeal nerve dysfunction which was completely cured on 7th postoperative day. There were no other complications and the usual hospital stay was 4 or 5 days. No residual PDA shunt in all cases was revealed by color doppler echocardiogram during follow-up periods (range 3 approximately 12 months). The advantages of thoracoscopic surgery for PDA are: less postoperative pain and discomfort, early recovery and short hospital stay, and cosmetic preservation. Availability of smaller sized surgical instruments should allow this technique indicated for smaller children and premature infants.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"13-7"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Thoracoscopic surgery of spontaneous pneumothorax and partial lung resection].","authors":"K Kaneko, R Omoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fourty-five thoracoscopic operations were done from April 1992 to November 1993. There were 27 cases of pneumothorax, 13 cases of partial lung resection (8 lung biopsies, 3 resection of metastatic lesions, 2 benign lung tumors), 2 cases of mediastinal tumor and 3 other lesions. All procedures were performed under general anesthesia using a double lumen endobronchial tube, and the patient was positioned for a lateral or an axillary thoracotomy as in a standard operation. We operated through three or four trocar wounds of 5 to 12 mm. In case of pneumothorax, we basically used Nd-YAG laser ablation of the bullae but in a few cases that shrinkage of the bullae was not obtained by laser ablation alone we resected them by endoscopic stapler. All cases of partial lung resection were done using endoscopic stapler. Five patients(11.1%) were converted to standard thoracotomy. All the postoperative courses were uneventful and 8 patients(17.7%) did not use any drugs for pain postoperatively. Thoracoscopic surgery is a usefull procedure and has many advantages compared with conventional thoracotomy. However, if the procedure could result incomplete, thoracotomy should be followed without hesitation.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 1","pages":"26-9"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Repeat coronary artery bypass grafting.","authors":"T Miyamoto, S Enomoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Repeat coronary bypass grafting was performed in 19 patients. The mean age was 59.8 +/- 6.9 years, 26% being female. One or more coronary risk factors were observed in 10 to 37% and none in 37%. The mean interval from the initial procedure was 35.6 +/- 34.4 months, but 42% of patients were reoperated within one year. Eleven patients had unstable angina two requiring emergency surgery to achieve hemodynamic stabilization. A mean of 2.63 grafts/patient achieved 87.7% revascularization. Two patients died late postoperatively from surgical complications. Sixteen patients consented to have postoperative coronary angiography: IMA was used as conduit in one third of the grafts and had a patency of 100% (15/15), compared to 86.7% of the venous grafts (26/30), for an overall patency of 91%. Follow up for 1 to 65 months (28.2 +/- 20.1 months) showed that 75% (12/16) are asymptomatic, and 4 patients (25%) have mild angina (NYHA II). Three of these 4 patients with recurrent angina have evidence of incomplete revascularization. Thus, repeat coronary bypass operation can be offered with acceptably low risk, and the long term benefits are similar to those obtained with primary operation providing complete revascularization is achieved, preferably with multiple internal mammary artery grafting techniques.</p>","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"10 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"1990-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}