Brazilian Journal of Pulmonology

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

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The search for the author or contributors found : 10 results


Mediastinal cyst as a cause of severe airway compression and dysphonia

Cisto mediastinal como causa de grave compressão da via aérea central e disfonia

Vanessa Costa Menezes, Paulo Francisco Guerreiro Cardoso, Hélio Minamoto, Márcia Jacomelli, Paulo Sampaio Gutierrez, Fabio Biscegli Jatene

J Bras Pneumol.2013;39(5):636-640

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Intratracheal stent: prosthesis or orthesis?

Dispositivos intra-traqueais: próteses ou órteses?

Ricardo Mingarini Terra, Helio Minamoto, Fabio Biscegli Jatene

J Bras Pneumol.2006;32(6):606-607

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Self-expanding stent made of polyester mesh with silicon coating (Polyflex®) in the treatment of inoperable tracheal stenoses

Endoprótese auto-expansível de malha de poliéster revestida por silicone (Polyflex®) no tratamento de estenoses traqueais não-cirúrgicas

Ricardo Mingarini Terra, Helio Minamoto, Miguel Lia Tedde, José Luiz Jesus de Almeida, Fabio Biscegli Jatene

J Bras Pneumol.2007;33(3):241-247

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the Polyflex® stent in terms of its efficacy, ease of implantation, and complications in patients with tracheobronchial affections. Methods: This was a prospective study, in which sixteen patients with inoperable tracheal stenosis secondary to orotracheal intubation (n = 12), neoplasia (n = 3), or Wegener's granulomatosis (n = 1) were monitored. Of these patients, eleven were women, and five were men. The mean age was 42.8 years (range, 21-72 years). Patients were submitted to implantation of a total of 21 Polyflex® stents. All procedures were carried out in the operating room under general anesthesia, and the stents were implanted via suspension laryngoscopy using the stent applicator. Results: Stents were implanted and symptoms were resolved in all cases. The stents remained in place for a mean period of 7.45 months, ranging from 2 to 18 months. The complications observed in the immediate postoperative period were dysphonia (in two patients, 12.5%) and odynophagia (in two patients, 12.5%). Late complications were cough (in ten patients, 62.5%), migration (in seven patients, 43.75%), granuloma formation (in two patients, 12.5%), and pneumonia (in one patient, 6.25%). Conclusion: The Polyflex® stent is easily implanted, easily removed, well tolerated by patients and effective in resolving symptoms. However, its use is associated with a high rate of migration, especially in patients with post-orotracheal intubation stenosis.

 


Keywords: Tracheal stenosis; Intubation, intratracheal; Prostheses and implants; Stents.

 


Subglottic and mediastinal hemangioma in a child:treatment with propranolol

Hemangioma subglótico e mediastinal em criança:tratamento com propranolol

Mauro Tamagno, Benoit Jacques Bibas, Helio Minamoto,Fernanda Sobreiro Alfinito, Ricardo Mingarini Terra, Fabio Biscegli JateneCarta

J Bras Pneumol.2011;37(3):416-418

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Suspension laryngoscopy for the thoracic surgeon: When and how to use it

Laringoscopia de suspensão para o cirurgião torácico: Quando e como utilizá-la

Antonio Oliveira dos Santos Júnior, Hélio Minamoto, Paulo Francisco Guerreiro Cardoso, Tales Rubens de Nadai, Rafael Turano Mota, Fabio Biscegli Jatene

J Bras Pneumol.2011;37(2):238-241

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Suspension laryngoscopy is one of the most common otolaryngological procedures for the diagnosis and surgical approach to the larynx. However, most thoracic surgeons are not familiar with the procedure and seldom use it. The indications for its use are similar to those for that of rigid bronchoscopy (dilatation, endoprosthesis insertion, and tumor resection). It can be performed in children and adults. Suspension laryngoscopy is an alternative when rigid bronchoscopy is unavailable and is therefore a viable option for use at smaller facilities. In this communication, we describe the technique and the applications of suspension laryngoscopy in thoracic surgery.

 


Keywords: Trachea; Dilatation; Thoracic Surgery; Laryngoscopy.

 


A new model of a self-expanding tracheal stent made in Brazil: an experimental study in rabbits

Novo modelo de endoprótese traqueal autoexpansível de fabricação nacional: estudo experimental em coelhos

Celso Murilo Nálio Matias de Faria, Olavo Ribeiro Rodrigues, Helio Minamoto, Patricia Maluf Cury, José de Mendonça Costa Neto, Domingo Marcolino Braile

J Bras Pneumol.2012;38(2):214-217

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We aimed to test a new model of self-expanding tracheal stent so that it might be made available for clinical use. Using direct laryngoscopy, we placed polyurethane-coated, nitinol stents into the middle third of the trachea in 25 New Zealand rabbits. After a mean observation period of 26 days, we evaluated stent migration, degree of expansion, attachment, adherence, formation of granulation tissue, presence of inflammatory infiltrate, parietal involvement, and epithelial lining. The results showed complete radial expansion, little adherence to the tracheal mucosa, and low tissue attachment, as well as high rates of granuloma formation and stent migration. This new model proved to be biocompatible and showed a behavior similar to that of other stents on the market.

 


Keywords: Prosthesis implantation; Tracheal stenosis; Rabbits; Stents.

 


Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and staging of mediastinal lymphadenopathy: initial experience in Brazil

Punção aspirativa guiada por ultrassom endobrônquico no diagnóstico e estadiamento de linfadenopatia mediastinal: experiência inicial no Brasil

Miguel Lia Tedde, Viviane Rossi Figueiredo, Ricardo Mingarini Terra, Hélio Minamoto, Fábio Biscegli Jatene

J Bras Pneumol.2012;38(1):33-40

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Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of mediastinal lymph nodes. The objective of this study was to evaluate the preliminary results obtained with EBUS-TBNA in the diagnosis of lesions and mediastinal lymph node staging. Methods: We evaluated patients with tumors or mediastinal adenopathy, diagnosed with or suspected of having lung cancer. The procedures were performed with the patients under sedation or under general anesthesia. Material was collected by EBUS-TBNA, after which it was prepared on slides, fixed in either absolute alcohol (for cytology) or formalin (for cell-block analysis). Results: We included 50 patients (30 males). The mean age was 58.3 ± 13.5 years. We performed 201 biopsies of 81 lymph nodes or mediastinal masses (mean of 2.5 punctures/biopsy). The quantity of material was considered sufficient for cytology in 37 patients (74%), 21 (57%) of whom were thus diagnosed with malignancy. Of the remaining 16 patients, 1 was diagnosed with tuberculosis, 6 entered clinical follow-up, and 9  underwent further investigation (2 diagnosed with neoplasm-false-negative results). The yield was higher when the procedure was performed for diagnostic purposes, as well as being higher in patients with lesions in multiple stations and in biopsies involving the subcarinal lymph node station. One patient had endobronchial bleeding, which was resolved with local measures. There were no deaths among the patients evaluated. Conclusions: This preliminary experience shows that EBUS-TBNA is a safe procedure. Our diagnostic yield, although lower than that reported in the literature, was consistent with the learning curve for the method.

 


Keywords: Ultrasonography, interventional; Biopsy, fine-needle; Neoplasm staging; Lung neoplasms; Bronchoscopy.

 


Surgical treatment of congenital tracheal stenoses

Tratamento cirúrgico das estenoses traqueais congênitas

Ricardo Mingarini Terra, Helio Minamoto, Lívia Caroline Barbosa Mariano, Angelo Fernandez, José Pinhata Otoch, Fabio Biscegli Jatene

J Bras Pneumol.2009;35(6):515-520

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Objective: To analyze the outcomes of patients undergoing repair of congenital tracheal stenosis. Methods: This was a retrospective review of congenital tracheal stenosis patients treated between 2001 and 2007 at the University of São Paulo School of Medicine Hospital das Clínicas in São Paulo, Brazil. Results: Six boys and one girl (age at diagnosis ranging from 28 days to 3 years) were included. Five of the patients also had cardiac or major vessel malformations. The stenosis length was short in three patients, medium in one and long in three. The techniques used were pericardial patch tracheoplasty in three patients, resection and anastomosis in two, slide tracheoplasty in one and vascular ring correction in one. One patient died during surgery due to hypoxia and hemodynamic instability, and one died from septic shock on postoperative day 11. Other complications included pneumonia, arrhythmia, stenosis at the anastomosis level, residual stenosis, granuloma formation and malacia. The mean follow-up period was 31 months; four patients were cured, and one required the use of a T-tube to maintain airway patency. Conclusions: Congenital tracheal stenosis is a curable disease. However, its repair is complex and is associated with high rates of morbidity and mortality.

 


Keywords: Tracheal stenosis/congenital; Tracheal diseases; Surgical procedures, operative.

 


Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results

Tratamento endoscópico de fístulas da árvore traqueobrônquica com dispositivos para a correção de defeitos do septo interatrial: resultados preliminares

Paulo Rogério Scordamaglio, Miguel Lia Tedde, Hélio Minamoto, Carlos Augusto Cardoso Pedra, Fábio Biscegli Jatene

J Bras Pneumol.2009;35(11):1156-1160

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Fistulas in the tracheobronchial tree (bronchopleural and tracheoesophageal fistulas) have a multifactorial etiology and present a variable incidence in the literature. In general, the related morbidity and mortality are high. Once such a fistula has been diagnosed, surgical closure is formally indicated. However, the clinical status of affected patients is usually unfavorable, which precludes the use of additional, extensive surgical interventions. In addition, attempts at endoscopic closure of these fistulas have seldom been successful, especially when the fistula is large in diameter. We report the cases of three patients submitted to endoscopic closure of fistulas, two of which were larger than 10 mm in diameter, by means of the insertion of atrial septal defect occluders. The procedure was minimally invasive, and the initial results were positive. The results indicate that this is a promising technique for the resolution of tracheobronchial tree fistulas.

 


Keywords: Bronchial fistula; Tracheoesophageal fistula; Bronchoscopy; Respiratory therapy.

 


Treatment of bronchial stenosis after lung transplantation using a self-expanding metal endobronchial stent

Utilização de endoprótese metálica no tratamento de estenose brônquica após transplante pulmonar

Marcos Naoyuki Samano, Marlova Luzzi Caramori, Ricardo Henrique de Oliveira Braga Teixeira, Helio Minamoto, Paulo Manuel Pêgo Fernandes, Fabio Biscegli Jatene, Sérgio Almeida de Oliveira

J Bras Pneumol.2005;31(3):269-272

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Although the incidence of bronchial anastomosis as a complication of lung transplantation has decreased in recent years, it remains a significant cause of morbidity and mortality in these patients. Treatment options include balloon dilatation, laser photocoagulation, placement of a stent (silicone or metal), and performing a second operation. We report the case of a patient who presented bronchial stenosis after left lung transplantation and was treated with a self-expanding metal alloy (nitinol) stent (UltraflexÒ). Despite the fact that this was the first case of stenosis treated in this fashion in Brazil, the positive clinical response, in agreement with results reported in the literature, indicates that this treatment is a viable alternative in such cases.

 


Keywords: Lung transplantation. Tracheal stenosis. Prosthesis and implants. Stents. Postoperative complications.

 


 

 


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