Thoracoplasty—Current View on Indication and Technique
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17.05.2018 |
Kuhtin O.
Veith M.
Alghanem M.
Martel I.
Giller D.
Haas V.
Lampl L.
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Thoracic and Cardiovascular Surgeon |
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3 |
Ссылка
Copyright © 2018, Georg Thieme Verlag KG. All rights reserved. Thoracoplasty was invented for removing cavities between thoracic wall and remnant lung or mediastinum. It was initially used in cases of tuberculosis or unspecific infections, while currently it is used mainly for space problems after lobectomy/pneumonectomy. This article presents an overview of the historical and current techniques of this surgical procedure. Nowadays, thoracoplasty is rarely performed due to the low incidence of diseases for which this method is necessary. Therefore, this method has even been discredited. Furthermore, certain technical aspects of the thoracoplasty are not very well known because of the infrequent application of this procedure. Unfortunately, a look into the literature of thoracoplasty is not always usefull due to the biased views of advocates of different techniques such as Schede's thoracoplasty, Heller's Jalousie-Plastik, Alexander's extramusculoperiosteal thoracoplasty, Bjork's osteoplastic thoracoplasty, etc. Not to forget, there has always been a lack of research on the relevance and on the several techniques of thoracoplasty. The point is precise indication and correct execution of thoracoplasty as a final therapeutic option, which allows a safe and definitive solution of the space problem even in complex cases, without creating serious functional and cosmetic impairment for the patient. The main types of thoracoplasty are described in this article. Although the core principle of this operation remains unchanged, modern techniques are often cosmetically more considerable and less destructive, compared with techniques that were used in the past.
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Difficulties in the diagnosis and treatment of tuberculosis pleural empyema complicated with chest wandering abscess, diaphragm destruction and penetration into the liver
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01.01.2018 |
Giller D.
Martel I.
Enilenis I.
Koroev V.
Kesaev O.
Giller B.
Bizhanov A.
Grigoryev Y.
Lavrov V.
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Russian Electronic Journal of Radiology |
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0 |
Ссылка
© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Purpose. To show the difficulty of diagnosis and treatment of atypical course of tuberculous empyema, when the process was complicated by tuberculosis of the chest, destruction of the diaphragm and penetration into the liver. Results. After chest MSCT scan, tuberculosis was suspected. The patient successfully underwent surgery: Pleurectomy with chest wandering abscess excision, resection of the VII rib and abdominal wandering abscess excision combined with the diaphragm and liver resection. The postoperative period was uncomplicated. During examination 4 years after surgery the patient was in a satisfactory condition, has ability to work, was transferred to group III dispensary tuberculosis registration. Discussion. Diagnosis and treatment of pleural empyema in some cases is difficult and, sometimes, requires differentiation from the oncological process. We have not found cases of tuberculous empyema spread of in the abdominal cavity with penetration into the liver in the literature. Conclusion. MSCT scan allowed to timely diagnose the atypical course of tuberculous empyema.
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