No abstract

Features of excised pulmonary nodules in 100 patients Background: Pulmonary nodules are common, and surgery is the only alternative that allows a diagnostic and therapeutic management in a single procedure. Aim: To report the epidemiological, radiological, surgical and pathological features of excised pulmonary nodules. Material and Methods: Review of medical records of patients in whom a pulmonary nodule was excised between 2014 and 2018. Those with incomplete data or without a pathological study were excluded from analysis. Results: We retrieved 108 records and 8 had to be excluded, therefore 100 patients aged 34 to 82 years (57% females) were analyzed. Sixty percent had a history of smoking. Mean nodule size was 16 mm and the solid type was the most common (65%). Forty five percent of nodules had irregular margins and 55% were in the superior lobes. All patients operated by video-assisted thoracoscopic surgery and 40% underwent a lobectomy. Malignant lesions were observed in 87% of biopsies and a pulmonary adenocarcinoma was found in pathology in 40%. Conclusions: A multidisciplinary approach of pulmonary nodules, using adapted international guidelines, accomplishes an appropriate management, decreasing unnecessary surgical interventions.

Pulmonary subsolid nodules. surgical outcomes based on institutional algorithmBackground: Nowadays, there is no consensus in the management of pulmonary subsolid nodules (SSNs). Aim: describe the results of surgical management of SSNs, based on institutional algorithm. Material and Methods: cross-sectional, descriptive study, with revision of clinical electronic records, that included all patients intervened for SSNs, suggestive of malignancy, by the judgment of a multidisciplinary team, from January 2014 to January 2018 at the Department of Adult Surgery, Clinica Las Condes. Results: 35 patients were studied. The average age was 65.8 years. The average size of the nodules was 15 mm. All patients were approached by video-assisted thoracoscopic surgery. 88.6% of biopsies turned out to be malignant neoplasm. Conclusions: the acquisition of a local algorithm established by a multidisciplinary team is an appropriate alternative for the management of the patients with SSNs.

Thoracic trauma is a frequent medical consult in emergency rooms. The initial approach is no different than the one used in polytraumatized, oriented by current trauma guidelines resulting of surgery and emergency consensus. Most thoracic injuries can be managed with simple maneuvers such as tube thoracostomy; however, 10% to 15% of patients who present with thoracic trauma require definitive operative repair. This article reviews the most common trauma related thoracic injuries in our medical setting: hemothorax, simple pneumothorax, tension pneumothorax, open pneumothorax, rib fractures, flail chest, lung contusion and cardiac tamponade. We also describe different forms of thoracotomy depending on the physiological status of patient at the emergency room and new treatments.