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      Hidatidosis cardiopericárdica: evolución alejada infrecuente Translated title: Cardiopericardial hydatidosis: infrecuent postoperative outcome

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          Abstract

          La hidatidosis de localización torácica extrapulmonar es infrecuente, más aún si es cardiopericádica asintomática. Se presenta un caso con evolución inicial extrapericárdica que, extirpada por videotoracos-copia, un año más tarde presentó una forma múltiple de quistes intrapericárdicos, algunos con compromiso miocárdico que necesitaron para su extirpación completa el uso de una bomba de circulación extracorpórea. No se indicó tratamiento con Albendazol en las 2 oportunidades, y a 50 meses de la segunda operación la enferma se encuentra asintomática, con pruebas serológicas negativas y sin imágenes radiológicas (TAC) y ecocardiográficas patológicas

          Translated abstract

          Extrapulmonary localization of thoracic hydatidosis, specially when it is asymptomatic, is uncommon. We report a 29 years old woman with a hydatid cyst located besides the pericardium. The cyst was removed by video thoracoscopy. One year later an echocardiography showed a cystic image in the pericardium. She was operated by open thoracoscopy and multiple intrapericardiac cysts were removed. Fifty months after the procedure, the patient is asymptomatic without serological or imaging evidence of relapse of the hydatidosis

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          Multicenter VATS experience with mediastinal tumors.

          The use of video-assisted thoracic surgery for diagnosis and treatment of mediastinal tumors in a multiinstitution patient population is not well understood. We studied 48 cases from Cancer and Leukemia Group B thoracic surgeons. Of 21 men and 27 women, aged 41 +/- 16 years, 22 patients were asymptomatic. In the others, 92% of tumor-related symptoms improved or resolved after treatment. Five tumors involved the anterior compartment, 19 the middle, and 24 the posterior compartment. Diagnoses were typical for each compartment but also included uncommon problems such as superior vena cava hemangioma and a histoplasmosis cyst causing hoarseness. Of the lesions, a biopsy of 12 was done without excision and the rest were excised completely. Fifteen were cystic and 10 were malignant (8 biopsy only). Maximal dimensions were 5.2 +/- 3.3 cm. Operations were briefer for 24 posterior (93 +/- 41 min) than 5 anterior (195 +/- 46 min, p < 0.01) or 19 middle mediastinal tumors (170 +/- 78 min, p < 0.01). Although 96% had vital mediastinal relations, only six open conversions were performed because of bleeding (n = 3), large size, impaired exposure, or rib attachments, and no patient had morbidity beyond that expected for the thoracotomy. Postoperative stay was shorter for the nonconversion group (3.2 +/- 2.8 versus 5.5 +/- 2.1 days, p = 0.05), as was chest tube duration (1.7 +/- 1.4 days versus 3.2 +/- 1.9 days, p = 0.03). There were no postoperative deaths or major complications, but 7 patients had minor complications. During a mean of 20 months of surveillance (range, 1 to 52 months), one cyst recurred (asymptomatic) as did one sarcoma that was excised. Video-assisted thoracic surgery is a safe technique for benign mediastinal tumors, typically those in the middle and posterior mediastinum.
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            Guidelines for treatment of cystic and alveolar echinococcosis in humans.

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              State of the art in thoracospic surgery: a personal experience of 2000 videothoracoscopic procedures and an overview of the literature.

              Herein we compare our personal experience with a series of > 2000 videothoracoscopic procedures with those reported in the literature to identify the procedures now accepted as the gold standard, those still regarded as investigational, and those considered unacceptable. Between June 1991 and December 2000, we performed 2068 videothoracoscopic procedures, including lung cancer staging (n = 910), wedge resections (n = 261), lobectomies (n = 221), pneumonectomies (n = 6), the diagnosis and treatment of pleural diseases (n = 200), the treatment of pneumothorax (n = 170), giant bullae (n = 57), lung volume reduction surgery (LVRS) for emphysema (n = 41), the diagnosis and treatment of mediastinal diseases (n = 133), the treatment of esophageal diseases (n = 39), and 30 other miscellaneous procedures. A review of the literature indicates that videothoracoscopy is usually considered the preferred approach for the treatment of spontaneous pneumothorax, the diagnosis of indeterminate pleural effusions, the treatment of malignant pleural effusions, sympathectomy, and the diagnosis and treatment of benign esophageal or mediastinal diseases. The videoendoscopic approach to LVRS for emphysema is still under evaluation. Videothoracoscopic wedge resections for the diagnosis of indeterminate nodules and the treatment of primary lung cancer, metastases, and other malignancies are still controversial due to oncologic concerns. Videoendoscopic major pulmonary resections are usually considered investigational or even unacceptable due to oncologic concerns, technical difficulties, and the risk of complications. Although we generally agree with the foregoing recommendations, we consider videoendoscopy the best approach for LVRS and particularly useful for the staging of lung cancer, where we always perform it as the first step of the operation. We widely perform videoendoscopic major pulmonary resections, but we believe that these procedures should only be used in strictly selected cases and at specialized centers.
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                Author and article information

                Journal
                rchcir
                Revista chilena de cirugía
                Rev Chil Cir
                Sociedad de Cirujanos de Chile (Santiago, , Chile )
                0718-4026
                February 2008
                : 60
                : 1
                : 55-58
                Affiliations
                [02] Buenos Aires orgnameHospital de Clínicas orgdiv1División de Cirugía Cardíaca Argentina
                [01] Buenos Aires orgnameHospital de Clínicas orgdiv1División de Cirugía Torácica Argentina piedralta@ 123456hotmail.com
                Article
                S0718-40262008000100012 S0718-4026(08)06000100012
                10.4067/S0718-40262008000100012
                5e749310-a4b0-465d-ba75-250881ff20b6

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 13 May 2007
                : 17 July 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 7, Pages: 4
                Product

                SciELO Chile

                Categories
                CASOS CLÍNICOS

                cirugía videotoracoscópica,cirugía cardíaca,videothoracoscopic surgery,Cardiopericardial hydatidosis,Hidatidosis cardiopericárdica

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