Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Therapeutic management of tracheobronchial stenosis with stent application

A correção das estenoses traqueobrônquicas mediante o emprego de órteses

Maurício Guidi Saueressig, Amarílio Vieira de Macedo Neto, Alexandre Heitor Moreschi, Rogério Gastal Xavier, Paulo Roberto Stefani Sanches

J Bras Pneumol.2002;28(2):84-93

Abstract PDF PT

The surgical treatment of patients with tracheobronchial stenosis requires individualized attention due to the complexity of its origin though tracheoplasty is considered to be the ideal procedure. The most common causes of stenosis are tracheal intubation and the development of neoplasias. These are the very conditions that most benefit from endoscopic treatment when surgical correction is not indicated. Today, endoscopic procedures include the application of different kinds of laser and dilators usually delivered with a rigid bronchoscope, as well as radiotherapy and stents that may be used separately or associated. Basically, there are two types of stents, metal or silicone. The metallic ones are more frequently indicated in cases of tracheomalacia and extrinsic compressive stenosis. Silicone are more applicable in cases of tracheobronchial obstruction resultant from acute inflammation or endoluminal tumor. Although these methods can be used interchangeably in some cases, the best way to correct tracheobronchial stenosis is to correctly decide upon the treatment as early as the preliminary steps.

 


Keywords: Tracheal stenosis. Orthopedics fixation devices. Angioplasty.

 


Chylothorax after surgical treatment of right-sided thoracic outlet syndrome

Fístula linfática após tratamento cirúrgico de síndrome do desfiladeiro torácico à direita

Luiz Felipe Lopes Araujo, Alexandre Heitor Moreschi, Guilherme Baroni de Macedo, Laura Moschetti, Eduardo Lopes Machado, Maurício Guidi Saueressig

J Bras Pneumol.2009;35(4):388-391

Abstract PDF PT PDF EN Portuguese Text

Chylothorax as a complication of the surgical treatment of thoracic outlet syndrome is a quite rare event. We report a case of right-sided chylothorax and present a brief review on the treatment of postoperative chylothorax.

 


Keywords: Chylothorax; Thoracic outlet syndrome; Cervical rib syndrome; Postoperative complications.

 


Extracorporeal membrane oxygenation for postpneumonectomy ARDS

Oxigenação extracorpórea por membrana no tratamento da SARA pós-pneumonectomia

Maurício Guidi Saueressig, Patrícia Schwarz, Rosane Schlatter, Alexandre Heitor Moreschi, Orlando Carlos Belmonte Wender, Amarilio Vieira de Macedo-Neto

J Bras Pneumol.2014;40(2):-

PDF PT PDF EN Portuguese Text



Granulomatous foreign body reaction simulating chest wall tumor over previous thoracotomy site

Reação granulomatosa do tipo corpo estranho simulando tumor de parede torácica em cicatriz de toracotomia prévia

Amarílio Vieira de Macedo Neto, Alexandre Heitor Moreschi, Antonio Azambuja Neto, Daniela Fedrizzi

J Bras Pneumol.2000;26(3):139-141

Abstract PDF PT

A male patient presented with a painless, slowly-growing chest wall mass in the site corresponding to the surgical wound of a previous thoracotomy for correction of aortic coarctation done fifteen years before. Chest CT scan showed tumor-like lesions with well-defined edges and osteolysis of the adjacent ribs. The patient was submitted to a chest wall resection and reconstruction, whose histological examination showed granular histiocytes and granulomatous reaction to necrohemorragic material. This is a rare event on medical practice. A review of the subject has been done in the literature.

 


Keywords: thoracic neoplasms; foreign body reaction; thoracotomy

 


Aggressive treatment using muscle flaps or omentopexy in infections of the sternum and anterior mediastinum following sternotomy

Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

Alexandre Heitor Moreschi, Amarilio Vieira de Macedo Neto, Gilberto Venossi Barbosa, Mauricio Guidi Saueressig

J Bras Pneumol.2008;34(9):654-660

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the impact of an aggressive treatment approach using muscle flaps or omentopexy in infections of the sternum and anterior mediastinum following sternotomy on mortality, as compared to that of a conservative treatment approach. Methods: Data were collected prior to, during and after the surgical procedures. Group A (n = 44) included patients submitted to conservative treatment- debridement together with resuture or continuous irrigation with polyvinylpyrrolidone-iodine solutions, or even with second-intention wound healing (retrospective data). Group B (n = 9) included patients in whom infection was not resolved with conservative treatment, and who therefore underwent aggressive treatment (intermediate phase). Group C (n = 28) included patients primarily submitted to aggressive treatment (prospective data). Results: Postoperative hospital stays were shorter in the patients submitted to aggressive treatment (p < 0.046). There were 7 deaths in group A, 1 in group B, and 2 in group C. However, the classical level of significance of α = 0.05 was not reached. Conclusion: Aggressive treatment also proved to be effective when the infection was not resolved with conservative treatment. These findings demonstrate that the proposed treatment provides excellent results.

 


Keywords: Surgical flaps; Osteomyelitis; Mediastinitis; Thoracic surgery.

 


 

 


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CNPq, Capes, Ministério da Educação, Ministério da Ciência e Tecnologia, Governo Federal, Brasil, País Rico é País sem Pobreza
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E-mails: jbp@jbp.org.br
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