Sample mediastinal lymphadenectomy may not be appropriate in surgery for non-small cell lung cancer because skip metastases were found in 25% of patients without N1 nodal involvement.

Results: in all the patients a successful outcome has been observed with a complete resolution of pain symptom. extravertebral vascular cement leakage has been observed in 3 patients, without any clinical radicular syndrome onset due to the epidural diffusion. clinical and radiological follow-up showed stability of the treatment and absence of pain in all patients.Conclusion: percutaneous treatment with vertebroplasty for symptomatic vertebral hemangiomas is a valuable, less-invasive, and a quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of the vertebral body's fracture.

RESEARCH • RECHERCHE Subbrachial approach to humeral shaft fractures: new surgical technique and retrospective case series studyBackground: There are few surgical approaches for treating humeral shaft fractures. Here we present our results using a subbrachial approach. Methods:We conducted a retrospective case series involving patients who had surgery for a humeral shaft fracture between January 1994 and January 2008. We divided patients into 4 groups based on the surgical approach (anterior, anterolateral, posterior, subbrachial). In all patients, an AO 4.5 mm dynamic compression plate was used.Results: During our study period, 280 patients aged 30-36 years underwent surgery for a humeral shaft fracture. The average duration of surgery was shortest using the subbrachial approach (40 min). The average loss of muscle strength was 40% for the anterolateral, 48% for the posterior, 42% for the anterior and 20% for the subbrachial approaches. The average loss of tension in the brachialis muscle after 4 months was 61% for the anterolateral, 48% for the anterior and 11% for the subbrachial approaches. Sixteen patients in the anterolateral and anterior groups and 6 patients in the posterior group experienced intraoperative lesions of the radial nerve. No postoperative complications were observed in the subbrachial group. Conclusion:The subbrachial approach is practical and effective. The average duration of the surgery is shortened by half, loss of the muscle strength is minimal, and patients can resume everyday activities within 4 months. No patients in the subbrachial group experienced injuries to the radial or musculocutaneous nerves. Contexte :Il existe peu d'approches chirurgicales pour corriger la fracture de la diaphyse humérale. Nous présentons ici les résultats que nous avons obtenus avec une approche sous-brachiale.Méthodes : Nous avons réalisé une série de cas rétrospective regroupant des patients ayant subi une chirurgie pour réparation de fracture de la diaphyse humérale entre janvier 1994 et janvier 2008. Nous avons divisé les patients en 4 groupes selon l'approche chirurgicale employée (antérieure, antérolatérale, postérieure et sousbrachiale). Nous avons utilisé une plaque de compression dynamique AO de 4,5 mm.Résultats : Pendant la période de l'étude, 280 patients de 30 à 36 ans ont subi une chirurgie pour fracture de la diaphyse humérale. La durée moyenne de la chirurgie a été la plus courte avec l'approche sous-brachiale (40 min). La perte moyenne de force musculaire a été de 40 %, 48 %, 42 % et 20 % avec les approches antérolatérale, postérieure, antérieure et sous-brachiale, respectivement. La perte moyenne de tension dans le muscle brachial après 4 mois était respectivement de 61 %, 48 %, et 11 % avec les approches antérolatérale, antérieure et sous-brachiale. Seize patients des groupes soumis aux approches antérolatérale et antérieure et 6 patients du groupe soumis à l'approche postérieure ont subi des lésions peropératoires du nerf radial. Aucune complication postopératoire n'a été observée dans...

Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.

In our series of patients, the presented technique of percutaneous embolization proved to be efficacious and easy to perform. It may have potential as a first-line treatment of low-output ECFs but a prospective study with a larger series of patients and a longer follow-up is required.