Objectives: A prospective randomized study designed to compare results of intra-operative applications of povidone-iodine with those of hydrogen peroxide during surgery for hydatid cysts. Methods: This study includes 160 patients with pulmonary and/or hepatic univesicular hydatid cysts. Group A consisted of 80 patients for whom we used hydrogen peroxide; Group B consisted of 80 patients for whom we used povidoneiodine. Each cyst was examined both macroscopically and microscopically to identify effects of the used scolicidal agent on the wall. Post-operatively, patients received Albendazole as a scolicidal drug for one year. Follow up times ranged between 48 and 84 months. Chest x-rays and abdominal ultrasound examinations were performed every six months to detect any recurrences. Results: There was no peri-operative mortality in either of the two groups. Group A: one case of postoperative prolonged air-leak and two cases of wound infection. No recurrences were reported. Mean hospital stay was 5.5 ± 1.1 days. Group B: two cases of prolonged air leak, three cases of persistent cough and hemoptysis, one developing broncho-pleural fistula that healed (air leak ceased after 19 days), two cases of wound infection, one had subphrenic abscess, nine cases of recurrences, one on the diaphragmatic pleura, two with deep chest wall cysts at sites of thoracostomy tubes, four intraperitonial recurrences, two in the same liver lobe. Recurrences occurred in 11% of the subjects (9/80; p value = 0.028). Mean hospital stay was 9.6 ± 1.5 days. On histologic examination of Group A, the cyst wall lost its integrity, luster and viability and became friable. In Group B the cyst wall maintained most of its luster, integrity, viability and did not become friable. Conclusions: Hydrogen peroxide is a more effective and safer scolicidal drug than povidone-iodine as shown by the differences in mean duration of hospital stay and postoperative recurrence rate significance.

Objectives: This study was designed to compare effectiveness of intra-pleural instillation of Bleomycin with instillation of Povidone-iodine for control of malignant pleural effusion among patients with non-small cell lung cancer, guided by results of thoracic Echography.Methods: Fifty one patients had the possibility of full lung expansion. Drainage of the effusion was followed by instillation of bleomycin or povidone-iodine through the thoracostomy tube. Four weeks after discharge, thoracic echography was performed and repeated 4 weeks later. Follow-up ranged between 4-32 months (mean: 21 ± 3.5 months). Results:We received 79 patients with malignant pleural effusion as stage IV non-small cell lung cancer during the last four years. Seventeen patients had centrally-located tumors with persistent lung atelectasis. Intrapleural injection of streptokinase to breakdown intra-pleural fibrinous adhesions was carried out in 9 cases; and was successful in 6 cases 66% (6/9). Finally, 54 patients had an evidence of possible lung expansion but three died before pleurodesis. Thus, 51 patients received intra-pleural instillation of bleomycin or povidone-iodine in a randomized prospective comparative study. Among bleomycin group (n = 26), echography showed excellent pleurodesis (n = 21), effective pleurodesis (n= 2) with one or two areas of free mobility and one area of fluid component, weak pleurodesis (no. = 3) with three areas of free lung movement (lung sliding sign) and areas of fluid component. Among povidone-iodine group (n= 25) excellent pleurodesis (no. = 20), effective (n= 2) and weak pleurodesis (n= 3). The six cases with weak pleurodisis in both groups were those who had streptokinase before pleurodesis. Complications and hospital stay were comparable for both groups. Chest X-ray proved recurrence of effusion in the six cases with weak pleurodesis after symptom-free intervals that varied between 4 and 6 weeks among these 6 patients. Conclusions:Both bleomycin and povidone-iodine produced comparable excellent and effective pleurodesis among patients with malignant pleural effusion. The cost is much lower with povidone-iodine.

Recently, it has been shown that even in patients with unresectable stage III, a short course of cisplatin and vinblastine prior to radiation significantly improved median survival and doubled the number of long-term survivors, as compared with radiation therapy alone [2]. Our hypothesis was that tri modality therapy for lung cancer will

Introduction: Myxomas are the most significant cardiac tumors, not only because of their frequency but also because the potential for total cure after surgical removal is high. The major determinant of this cure is supposed to be complete excision of these atrial myxomas whatever the pathological or clinical features of the tumor mass.

Background: Trapped lung syndrome is defined by the inability of the lung to expand and fill the thoracic cavity because of a restricting "peel." Video-assisted thoracoscopic surgery (VATs) can take part in the management of trapped lung syndrome more easily on the behalf of pleurectomy/ decortications Aim: to evaluate the prevalence of postoperative complications of thoracoscopic management of trapped lung syndrome. Patients and Methods: This study was held at Suez Canal university hospitals and as a randomized control clinical trial. It included all patients who presented with trapped lung syndrome. Patients were divided into 2 equal groups (conventional thoracotomy group and VATs group). Results: the total mean age was 52.45±13.6 yrs. (range 19-80 yrs.). 64% of the patients were males. The preoperative symptoms were fever in 70% of patients, cough in 30%, chest pain in 24%, and dyspnea in 66%. The mean operative time was 130.31±38.024 min. (Range 50-240 min.). The Mean postoperative air leak days were 4.71±2.802 days (Range 0-11 days). The mean postoperative VAS score for pain was 3.28±3.178, (Range 0-9). The mean Postoperative total hospital stays. Group A (7.06±1.69 days), group B (5.13± 2.45 days) (Multiport VATS 4.95±3.0 days Uniportal VATS 5.33±2.22 days) (p = 0.0001). The mean VAS score for pain at 6 months follow-up was 0.29± 0.72, (Range 0-3). Conclusion: operative time was lesser in VATs group than thoracotomy despite being no statistical significance between 2 groups regarding concomitant techniques which mean that VATs can do the same job in lesser operative time and decrease operative bleeding & risk, also zero conversion rate displays the learning curve and feasibility of both VATs techniques.