Aim Destroyed lung refers to destruction of a large portion of a lung induced by chronic or recurrent lung infections. The aim of this single-center retrospective review was to evaluate patients with a diagnosis of destroyed lung undergoing pneumonectomy via video-assisted thoracoscopic surgery, in terms of surgical technique, postoperative morbidity and mortality, and long-term outcomes. Methods Data of 15 patients who underwent video-assisted thoracoscopic pneumonectomy for destroyed lung during a 4-year period were analyzed retrospectively. There were 9 (60%) males and 6 (40%) females with a median age of 33.87 years (range 8–52 years). Bronchiectasis ( n = 7), tuberculosis ( n = 5), and fungal infection ( n = 3) were the main etiologies. Hemoptysis was the most common presenting symptom ( n = 8, 53.3%). Destroyed lung was detected on the left side in 13 (86.7%) patients and on the right side in 2 (13.3%). Seven patients showed narrowing or thickening of the main bronchus. Results Video-assisted thoracoscopic pneumonectomy was attempted in all patients but 5 (33.3%) were converted to a thoracotomy. The mean operative time was 273.8 min. The postoperative morbidity rate was 13.3%. The mortality rate was 6.67%. The median length of hospital stay was 3.5 days. The mean follow-up period was 23.7 months. Significant improvement was observed in inflammatory symptoms and quality of life in all patients. The overall 1-year survival was 93.3%. Conclusion Video-assisted thoracoscopic pneumonectomy for destroyed lung is a safe and feasible option in selected patients, which can be used as an alternative to thoracotomy.
Background: Primary bronchial cancer is the leading cause of cancer deathwith an estimated incidence of 1.6 million new cases per year and a mortality rate of 1.4 million per year. In Morocco, according to the Casablanca Cancer Registry, itaccounts for 22.1% of all cancers. The objective of this work is to describe the epidemiological, clinical, pathological and therapeutic characteristics of patients diagnosed with primary bronchial cancer. Method: This is a descriptive retrospective study of a series of 74 cases, conducted by the Thoracic Oncology Intergroup (IGOT) of the Ibn Rochd University Hospital Center in Casablanca from January 2016 to October 2018 and which met the inclusion criteria. All records of patients diagnosed with primary bronchial cancer were retained based on histopathological examination of operative specimens. Result: The majority of patients were diagnosed in the later stages of the disease:stage I and II:9,3%, stage III: 16% and the stage IV: 73,7%. We were able to operate only 6.3% of the 9.3% resecable which is 74 patients. There were 56 men (76%) and 18 women (24%) with a sex ratio calculated at 3.11. The average age was 58.5 years, with age extremes ranging from 24 to 82 years. 35% of our patients had histological confirmation at the time of the diagnosis carried out by the flexible bronchoscopy or the scannoguided biopsy puncture. Occupational exposure was not noted in our patients. 65% of our patients were smokers. The medical pathological antecedents were tuberculosis in 10% of cases, arterial hypertension in 10% of cases, diabetes in 8% of cases and chronic obstructive pulmonary disease in 4% of cases. Neoplastic antecedents were lung cancer in 4% of cases, digestive cancer in 4% of cases, breast cancer in 3% of cases, cancer of the Otorhinolaryngology sphere in 6% of cases. The average consultation time exceeded three months in 80% of cases. The symptomun derlying the consultation was chest pain in 46% of cases. The radiological lesions were preferentially located at the level of the right lower lobe. The PET-Scan was performed in 65% of the cases and the respiratory functional exploration in 93% of the cases. Neoadjuvant chemotherapy was necessary in 32% of cases and neoadjuvan tradiotherapy in 19% of cases. The treatment was surgical. Surgical approache was postero lateral thoracotomy in 21 cases (28%) and video-assistedt horacic surgery (VATS) in 53 cases (72%). Conversion to thoracotomy was necessary in 9 cases. The interventions performed were 63 lobectomy (85%) and 11 pneumonectomy (15%).The average size of the tumor was 5.5 cm (0.5-12 cm). The predominant histological type was adenocarcinoma in 64% of cases. On the evolutionary level, in the short term, the operative follow-up was simple in 80% of the cases. The other cases had various complications. The main complication recorded was prolonged bubbling in 3.2% of cases. Conclusion: The very low level of stage I and II at the time of diagnosis requires sensitization on the interest of screening and early diagnosis so that ...
Introduction: Bronchial cancer is the leading cause of cancer death in the world. We conducted this work in order to describe the epidemiological, clinical, therapeutic and evolutionary characteristics of primary operated bronchopulmonary cancers. Methods: Retrospective study including all operated patients from January 2016 to October 2018. The data was entered on an Excel file and then transferred to SPSS software for analysis. Results: The rate of primary operated bronchopulmonary cancers was 6,3 %. The sex ratio was 3,11. The average age was 58,5 years old. The average consultation time exceeded three months in 80% of cases. Adenocarcinoma was the most common histological type. Conclusion: The very low rate of stages I and II at the time of diagnosis requires awareness of the value of screening and early diagnosis so that patients can benefit from surgical treatment.
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