Surgical repair for post-tuberculosis tracheobronchial stenosis

2020 ◽  
pp. 021849232096397
Author(s):  
Vu Huu Vinh ◽  
Nguyen Van Khoi ◽  
Nguyen Viet Dang Quang ◽  
Huynh Quang Khanh
Keyword(s):  
Tracheal Stenosis ◽  
Treatment Plan ◽  
Argon Plasma Coagulation ◽  
Case Series ◽  
The Other ◽  
Segmental Resection ◽  
Stent Insertion ◽  
Bronchial Stenosis ◽  
Tracheobronchial Stenosis ◽  
End To End

Aim Post-tuberculosis tracheobronchial stenosis is rare but one of the most dangerous complications of tracheobronchial tuberculosis. Balloon dilatation, stent insertion, laser photoresection, argon plasma coagulation, and cryotherapy are some of the initial treatments recommended for mild to moderate cases. Here, we report a case series of patients who underwent segmental resection and end-to-end anastomosis for bronchial stenosis and a sliding technique for severe and long-segment tracheal stenosis. Methods We retrospectively reviewed the medical records of patients with post-tuberculosis tracheobronchial stenosis operated on in our thoracic surgery department. Of the 7 cases that were treated, two had severe tracheal stenosis stretching over 50% of the tracheal length, one was operated on using resection and end-to-end anastomosis, and the other had sliding tracheoplasty. The other 5 cases of bronchial stem stenosis were treated with segmental resection and end-to-end anastomosis. Results All five patients with bronchial stenosis had a good outcome; the ipsilateral lung was well ventilated and respiratory function was good. One patient with tracheal stenosis, treated with segmental resection and end-to-end anastomosis, died after the surgery, and the other patient, treated with slide tracheoplasty, had a good recovery. Conclusion The treatment plan for patients with post-tuberculosis tracheobronchial stenosis should be on a patient-by-patient basis. Sliding tracheoplasty can be a treatment option in patients with long-segment tracheal stenosis.

scholarly journals Use of an Insulation-Tipped Knife during Rigid Bronchoscopic Treatment of Benign Tracheobronchial Stenosis

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 251
Author(s):  
Ji-Won Park ◽  
Yousang Ko ◽  
Changhwan Kim
Keyword(s):  
Tracheal Stenosis ◽  
Treatment Success ◽  
Stable State ◽  
Forced Expiratory Volume ◽  
Rigid Bronchoscopy ◽  
Bronchial Stenosis ◽  
Tracheobronchial Stenosis ◽  
Acute Complications ◽  
The Mean ◽  
Post Intubation

Background and Objectives: Tracheal or bronchial tears are potential complications of rigid bronchoscopy. This study aimed to investigate the acute complications and outcomes of using an insulation-tipped (IT) knife in combination with rigid bronchoscopic dilatation for treating benign tracheobronchial stenosis. Materials and Methods: We conducted a chart review of patients with benign tracheobronchial stenosis who were treated with rigid bronchoscopy and an IT knife at two referral centers. Treatment success was defined as a clinically stable state without worsening symptoms after 3 months of treatment. Results: Of the 23 patients with benign tracheobronchial stenosis, 15 had tracheal stenosis and 6 had main bronchial stenosis. Among them, three cases were of simple stenosis (13%), while the others were of complex stenosis (87%). The overall treatment success rate was 87.0%. Pneumomediastinum and subcutaneous emphysema occurred due to bronchial laceration in two cases of distal left main bronchial stenosis (8.7%), and no other significant acute complications developed. Silicone stents were inserted in 20 patients, and successful stent removal was possible in 11 patients (55.0%). Six of the seven stents inserted in patients with post-intubation tracheal stenosis were removed successfully (85.7%). However, most of the patients with post-tracheostomy tracheal stenosis required persistent stenting (80%). Pulmonary function was significantly increased after treatment, and the mean increase in the forced expiratory volume in 1 s was 391 ± 171 mL (160–700 mL). Conclusion: The use of an IT knife can be suggested as an effective and safe modality for rigid bronchoscopic treatment of benign tracheobronchial stenosis.

S153 – Radiological Balloon Dilatation of Neo-Pharyngeal Strictures

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P127-P128
Author(s):  
Robert L Harris ◽  
Grundy Alan ◽  
Tunde A Odutoye
Keyword(s):  
Total Laryngectomy ◽  
Balloon Dilatation ◽  
Malignant Disease ◽  
Outcome Measure ◽  
Tertiary Care ◽  
Case Series ◽  
Stent Insertion ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Main Outcome Measure

Objectives Radiological balloon dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological dilatation of pharyngeal and upper oesophageal strictures and less still on radiological balloon dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent balloon dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 balloon dilatation only. 9 patients required more than 1 dilatation to maintain swallowing. 2 patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.

scholarly journals Emergency sandwich patch repair via right ventricular incision for postinfarction ventricular septal defects: a case series

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Yusuke Shimahara ◽  
Satsuki Fukushima ◽  
Shin Yajima ◽  
Naoki Tadokoro ◽  
Takashi Kakuta ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Right Ventricular ◽  
Artery Bypass ◽  
Case Series ◽  
The Other ◽  
Patch Repair ◽  
Right Atrial ◽  
Residual Shunt ◽  
Low Cardiac Output Syndrome ◽  
St Segment Elevation

Abstract Background The surgical treatment for postinfarction ventricular septal defect (VSD) remains challenging, especially in emergency cases. Several authors have reported the efficacy of a sandwich patch VSD repair via a right ventricular (RV) incision. However, this procedure remains uncommon, and its efficacy is still unknown, especially when performed under an emergency. Case summary We were able to perform sandwich patch VSD repair via an RV incision on seven consecutive patients with VSD following an ST-segment elevation myocardial infarction (STEMI) from March 2017 to December 2019. Bovine pericardial patches were used for sandwich patches. Two patients developed inferior STEMI, and the other patients developed anterior STEMI. Six patients received intra-aortic balloon pump prior to surgery, and the other received extracorporeal membrane oxygenation with Impella. The interval between the diagnosis of VSD and surgery was within 1 day in all patients except one (5 days). All seven patients underwent VSD repair in the emergency status. Four patients underwent concomitant coronary artery bypass grafting. The hospital mortality rate was 14.3% (1/7). Early postoperative transthoracic echocardiography revealed that only one patient developed more than trace residual shunt. The postoperative right atrial pressure was not significantly elevated at ≤12 mmHg in all patients. No patient developed early postoperative prolonged low cardiac output syndrome. Discussion In patients with postinfarction VSD, a sandwich patch VSD repair via an RV incision is a promising procedure with a low incidence of residual shunt development and hospital mortality, even in emergency cases.

scholarly journals An Integrated Framework Based on Full Monte Carlo Simulations for Double-Scattering Proton Therapy

2019 ◽  
Vol 6 (2) ◽  
pp. 31-41
Author(s):  
Jiankui Yuan ◽  
David Mansur ◽  
Min Yao ◽  
Tithi Biswas ◽  
Yiran Zheng ◽  
...  
Keyword(s):  
Monte Carlo ◽  
Proton Therapy ◽  
Treatment Plan ◽  
Planning System ◽  
Treatment Planning System ◽  
Patient Specific ◽  
Double Scattering ◽  
Integrated Framework ◽  
End To End ◽  
Clinical Cases

ABSTRACT Purpose: We developed an integrated framework that employs a full Monte Carlo (MC) model for treatment-plan simulations of a passive double-scattering proton system. Materials and Methods: We have previously validated a virtual machine source model for full MC proton-dose calculations by comparing the percentage of depth-dose curves, spread-out Bragg peaks, and lateral profiles against measured commissioning data. This study further expanded our previous work by developing an integrate framework that facilitates its clinical use. Specifically, we have (1) constructed patient-specific applicator and compensator numerically from the plan data and incorporated them into the beamline, (2) created the patient anatomy from the computed tomography image and established the transformation between patient and machine coordinate systems, and (3) developed a graphical user interface to ease the whole process from importing the treatment plan in the Digital Imaging and Communications in Medicine format to parallelization of the MC calculations. End-to-end tests were performed to validate the functionality, and 3 clinical cases were used to demonstrate clinical utility of the framework. Results: The end-to-end tests demonstrated that the framework functioned correctly for all tested functionality. Comparisons between the treatment planning system calculations and MC results in 3 clinical cases revealed large dose difference up to 17%, especially in the beam penumbra and near the end of beam range. The discrepancy likely originates from a variety of sources, such as the dose algorithms, modeling of the beamline, and the dose metric. The agreement for other regions was acceptable. Conclusion: An integrated framework was developed for full MC simulations of double-scattering proton therapy. It can be a valuable tool for dose verification and plan evaluation.

scholarly journals Investigation of SARS-CoV-2 RNA in Milk Produced by Women with COVID-19 and Follow-Up of Their Infants: A Preliminary Study

2021 ◽  
Author(s):  
TALAT KILIC ◽  
Sebnem Kilic ◽  
Nurcan Kirici Berber ◽  
Ayten Gunduz ◽  
Yasemin Ersoy
Keyword(s):  
Human Milk ◽  
Prospective Observational Study ◽  
Throat Swab ◽  
Case Series ◽  
The Other ◽  
Breastfed Infants ◽  
Milk Samples ◽  
First Case ◽  
Preliminary Study

Objectives: Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily transmitted from person to person via airborne droplets. It is unclear whether it can be shed into human milk and transmitted to a child via breastfeeding.We investigated the presence of SARS-CoV-2 RNA in human milk samples of 15 mothers with coronavirus disease 19(COVID-19) and in the throat swab samples of their infants. Methods: This is a prospective observational study in which breast milk samples were collected from 15 mothers with COVID-19. The presence of SARS-CoV-2 RNA in the whole human milk samples of the patients was investigated using RT-qPCR. All of the infants underwent a clinical follow-up during their 14-day isolation and their throat swab samples were tested for SARS-CoV-2 RNA. Results: Of 15 mothers with COVID-19, SARS-CoV-2 RNA was detected in milk samples from 4 mothers. The throat swab samples from these mothers’ infants were found to be positive for SARS-CoV-2 RNA. Three of the four mothers were breastfeeding. In addition, during the 14-day isolation, all but three of the mothers breastfed their infants. Of the 12 breastfed infants, while the test for SARS-CoV-2 RNA in throat swab samples was negative in six of the infants, the other six infants, who had mild COVID-19 symptoms, tested positive for SARS-CoV-2 RNA.Clinical outcomes of all mothers and infants were uneventful. Conclusion: To our knowledge, this is the first case series with the largest number of cases with SARS-CoV-2 RNA positivity in human milk samples of mothers with COVID-19. However, we believe that the benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants

scholarly journals Unilateral Maxillary Sinusitis Caused By Dental Bur, A case Report

2019 ◽  
Vol 41 (2) ◽  
pp. 8-10
Author(s):  
Sahar Abdualkader Ismaeel ◽  
Saif Saadedeen Abdulrazaq
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Maxillary Antrum ◽  
Maxillary Sinusitis ◽  
Treatment Plan ◽  
The Other ◽  
Trauma Patients ◽  
Review Of Literature ◽  
Serious Infection ◽  
Careful Clinical Examination

the entrance of a foreign body (FB) into the maxillary antrum is common in trauma patients where bullets or any other materials trapped in the maxillary sinus; however, iatrogenic cause by a dentist that results in FB entrapment in the maxillary antrum is rare. All these FBs can cause sinusitis. If not treated properly they will cause serious infection, which may spread to the other paranasal sinuses. A careful clinical examination and treatment plan will prevent further complications. In this review, we present a rare case of dental bur (DB) found in the left maxillary antrum. A review of literature revealed only a few cases published which describe a dental bur dislodged in the maxillary antrum.

Sign in / Sign up

Export Citation Format

Share Document