In the following report, we describe our investigation of the diagnosis and operative methods for benign tumors of the lung, in which the surgical treatment was selected due to suspicious malignancy. This study included 22 patients with benign tumors. The patients' mean age was 55 years old. The histological diagnosis was made postoperatively prior to 1985 and intraoperatively after 1986. Hamartoma was the most common of the benign tumors. In benign tumors, the preoperative diagnosis was almost the same as the postoperative one. Of the patients with benign tumors, 78% underwent lobectomy or segmentectomy prior to 1985, and none have undergone any invasive procedures since 1986. Malignant tumors are sometimes difficult to distinguish from benign tumors preoperatively. Therefore, intraoperative histological examinations are necessary in cases in which malignancy is suspected. In such cases, a smaller invasive procedure should be selected due to the possibility of the tumor being benign.

No abstract

Pulmonary aspergillosis associated with old tuberculosis is generally resistant to treatment. Thus, if patients are treated only with conservative therapy, their condition continues to deteriorate due to repetitive hemoptysis, and may even become critical. Surgical treatment is required for these patients; however, it is extremely difficult to resect the lesion due to severe adhesions to the chest wall and vascular proliferation surrounding the lesion. We performed preoperative arterial embolization, achieving good results in three patients with hemoptysis caused by pulmonary aspergillosis. The feeding arteries were embolized using microcoils and/or gelatin sponges, and a lobectomy was safely carried out in all patients. We concluded that preoperative arterial embolization is a safe and effective technique to prevent massive hemorrhage occurring at the time of surgery.

An artificial stent was intubated using extracorporeal lung assist (ECLA) in two patients with inoperable tracheal stenosis. In a patient with an endotracheal tumor, an airway obstruction due to a partial stent collapse was overcome by an immediate ECLA perfusion. In another patient with chronic inflammatory tracheal stenosis, a repetitive balloon dilation of the trachea could be safely performed utilizing ECLA perfusion. Preventive femoral cannulation, employing the assistance of an ECLA circuit, is thus considered to be a safe and effective procedure for the treatment of inoperable tracheal stenosis.

We describe our technique for performing direct thoracoscopic closure of a congenital partial pericardial defect, which was successfully employed in a 15-year-old boy. This is the first such report of a procedure that is noninvasive and may therefore become the treatment of choice for patients with a small congenital pericardial defect.