Solitary fibrous tumor of the pleura. Analysis about 41 cases Solitary fibrous tumor of the pleura (TFSP) is an uncommon and mostly benign neoplasm. It grows slowly and presents with scant symptoms. Recurrence after surgical excision has been described. The aim of this report is to show our experience in managing this disease. Clinical as well as radiological, surgical, histopathological and follow-up data were analyzed in a clinical series. Forty one cases of TFSP that underwent surgery at our institution between 1991 and 2004 were retrospectively analyzed; 27 were females and 14 males with a median age of 60.4 years old; 24.4% of the cases were asymptomatic. All tumors were surgically excised, in average they weighed 945 g and 36.5% of the lesions showed a pedicle. Most of the lesions were originated in the visceral pleura. Surgical morbidity was 12.1% and no mortality was recorded. Three tumor recurred. TFSP is usually a benign neoplasm but it can recur. Complete surgical excision is the treatment of choice of primary and recurrent tumors.

Thymic epithelial tumors. Retrospective review of 54 patientsBackground: Thymic epithelial tumors are uncommon and can be associated with myasthenia gravis. Aim: To describe variables associated with survival and treatment of thymic epithelial tumors. Material and Methods: Retrospective review of surgical databases of a respiratory diseases hospital, identifying patients operated for a thymic epithelial tumor between 2000 and 2010. Follow up lasted from 12 to 156 months and information was obtained from medical records and death certificates of the Chilean national identification service. Results: Data from 54 patients aged 52.5 ± 16.4 years (33 women) was retrieved. Forty two patients were symptomatic and 47 were subjected to resective surgery. The pathological diagnosis was thymoma in 46 cases and thymic carcinoma in eight. Fourteen patients had postoperative complications and one died. Mean survival time was 101.8 ± 10.2 months. One, three and five years survival was 90.7 ± 3.9, 81.4 ± 5.7 and 71.8 ± 8.2%, respectively. Preoperative performance status of patients, histological type of the tumor and associated myasthenia gravis were predictors of survival. Conclusions: More commonly, thymic epithelial tumors appear in women, their histological type corresponds to thymomas and their resection is feasible

Minimally invasive correction of pectus excavatum among adults. Report of eighteen cases Background: A minimally invasive technique or Nuss procedure was devised for children with pectus excavatum (funnel chest), but it is also used in adult patients. Aim: To report the experience with the Nuss procedure in adults patients with pectus excavatum. Material and methods: Prospective study of patients operated between January 2007 and January 2009. Clinical features, symptoms, operative time, postoperative complications, hospital stay and quality of life, using the Nuss questionnaire adapted for adults, were recorded. Results: Eighteen patients aged 18±2 years (14 males) were operated. Seven patients had scoliosis, two had depression, two had asthma and one had a Marfan syndrome. All patients were concerned about aesthetic issues, nine had dyspnea, three had compression of cardiac cavities and three had pulmonary function disturbances. Haller index was 3.8. Mean operative time was 92 minutes. Postoperative complications were a pneumothorax without chest tube management in two patients, a peridural hematoma in one patient and a bar stabilizer infection that required a reoperation in one patient. No patient died and the mean hospital stay was six days. The Nuss questionnaire scores in the pre and postoperative periods were 33 and 48, respectively (p <0.05). Conclusions: Nuss operation is feasible and safe in adults with pectus excavatum (Rev Méd Chile 2009; 137: 1583-90).

Littre hernia is defined as the presence of a Meckel diverticulum in any hernial sac. We report a 19 years old male that consulted in an emergency hospital due to a painful lump in the right inguinal region after a blunt trauma. He was operated and a loop of terminal ileon with a Meckel diverticulum of approximately 12 cm. was found in the hernial sac. The segment that contained the diverticulum was excised and the hernial sac was repaired. The patient was discharged three days later in good conditions.

Pleural empyema. Retrospective review of 343 patientsBackground: Pleural empyema still has a dismal prognosis. Aim: To describe features and prognostic factors of patients with pleural empyema subjected to surgical procedures. Material and Methods: Retrospective review of 343 patients with pleural empyema (mean age 52 years, 71% males), that were subjected to any type of surgical procedure. Criteria for diagnosis of empyema were a positive culture, a fluid pH of less than 7.2 or a compatible macroscopic appearance of the fluid. Results: Empyema was secondary to pneumonia in 243 patients (71%), secondary to surgical procedures in 41 patients (12%), secondary to trauma in 19 patients (5.5%), secondary to a lung abscess in 10 patients (3%), tuberculous in 10 patients (3%), neoplastic in two cases (0.6%), secondary to pneumothorax in 2 cases (0.6%) and of unknown origin in 13 patients (4%). A microorganism was isolated from pleural fluid in 89 patients (26%). The surgical procedures performed were 251 decortications by thoracotomy (73%), 70 pleurotomies (20%), 11 video assisted surgeries (3%), seven decortications with lung resections and four fenestrations. Complications were recorded in 104 patients (30%), 29 patients were re-operated (8.5%) and 31 died (10%), all due to sepsis. Conclusions: The main cause of pleural empyema is pneumonia. In most patients, microorganisms are not isolated from pleural fluid, thoracotomy with decortication is the most frequent surgical procedure. There is a high rate of complications and mortality.