Chávez EJI, González MMA, González SR, Cortés GE, Sánchez CRM, Chávez FA

Language: Spanish
References: 17
Page: 139-147
PDF size: 340.47 Kb.

ABSTRACT

It’s alarming the increase of the pleural pathology at world-wide level specially the one due to traumatic and industrial pneumonic processes as well as the mesothelioma and the iatrogenic pathology. 1,243 clinicosurgical files of patients are analyzed who presented different processes in the visceral and mediastinal parietal pleura. The closed pleurotomy was used in 1,028 cases and the pulmonary decortication in 88 cases. It is worth to mention that pleural mesothelioma initially is diagnosed in our medical branch like one due to a neumonic process. The mediastinitis also has numbers worthy to be taken in to consideration, these 2 affections must be diagnosed quite in advance to give the suitable solution. Mortality is low, represented by less than 3% of the presented cases. Iatrogenia occurs in surgery specially in the subclavian puncture or in a pleurotomy the same technical failure is brought about in hiatal hernioplasty complicated with esophageal rupture. The preservative measures in these cases offer us optimistic results to like in the mediastinitis in general. We considered as important data in the nontumorlike cases not to out off the visceral pleura and its results will be reflected in the functional and respiratory tests with their corresponding gasometry. We recommend an early solution to the pleural pathology, the shut pleurotomy next the utmost pulmonary decortication with suture of the bronchial fistulas if these exist. Also we recommend that the corresponding authorities take the pertinent measures in those factories working with asbestos, more actions against the use of obsolete pesticides and plaguicides already useless in any country, but ours unfortunately. Hence the increase in pleural and broncogenic cancers.

REFERENCES

1. Wagner JC, Sleggsm CA, Marchand P. Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province. Br J Ind Med 1960; 17: 260-71.

2. Roggli VL. Asbestos bodies and nonasbestos, ferruginous bodies. In: Roggli VL, Greenberg SK, Pratt PC (Eds.). Pathology of asbestos associated diseases. Boston Litle Brown and Company; 1992, pp. 39-75.

3. Churg A. Criostyl, tremolite and malignant mesothelioma in mam. Chest 1988; 93: 621-8.

4. Orringer MB, Bluett M, Debb M, Mich A. Aggressive treatment of chylothorax complicating transhiatal esophagectomy without thoracotomy. Surgery 1988; 104: 720-6.

5. Breaux JR, Marks Ch. Chylothorax causing reversible T-cell Depletion. J Trauma 1988; 28: 705-7.

6. Jensen GL, Mascioli L, Meyer SM, et al. Dietary modification of chyle composition in chylothorax. Gastroenterology 1989; 97: 761-5.

7. Marty-Ané Ch, Berthet JP, Alric P. et al. Management of descending necrotizing mediastinitis: an aggressive treatment for an aggressive disease. Ann Thorac Surg 1999; 68: 212-17.

8. Wheatley MJ, Stirling Mc, Kirsh MM, et al. Descending necrotizing mediastinitis: transcervical drainageis not enough. Ann Thorac Surg 1990; 49: 780-4.

9. Kirsh M, Mekontso A, Houel R, et al. Closed drainage using redon catheters for poststernotomy mediastinitis; results and risk factors for adverse outcome. Ann Thorac Surg 2001; 71: 1580-6.

10. Lucet JC, Batisse D, Brucker G. Pour le groupe Parisien d’Etude des Sternotomie Mediastinitis aprčs sternotomie. Mortalitč et durče de sčjour (Mediastinitis after Sternotomy. Mortality and hospital length of say). Arch Mal Caur Vaiss 1997; 90: 471-5.

11. El Oakley RM, Wright JE. Postoperative mediastinitis: classification and management. Ann Thorac Surg 1996; 61: 1030-6.

12. El Gamel A, Yonan NA, Asan R, et al. Treatment of mediastinitis early modified Robicsek closure and pectoral major advancement flaps. Ann Thorac Surg 1998; 65: 41-7.

13. Chávez EJI, Chávez FJA, Sánchez RO. Error diagnóstico en neumología (Falacia o paralogismo en el diagnóstico de algunos procesos intratorácicos). Rev Med Hosp Gral 1977; 40: 15-39.

14. Chávez EJI, Chávez FJA, Del Castillo RH. Iatrogenia en tórax traumático, análisis de 300 casos. Cir y Cir 1989; 66: 203-8.

15. Chávez EJI, García EBC, Chávez FJA. Tratamiento quirúrgico de las complicaciones torácicas del absceso hepático amibiano. Rev Med Hosp Gral 1980; 43: 133-41.

16. Chávez EJI, Reyes BL, Mora RB. Toracoplastia de Kergin y sutura bronquial en el tratamiento de la cavidad pleural residual con fístula bronquial. Rev Med Hosp Gral 1969; 32: 609-21.

17. Chávez EJI, Chávez FJA. Decorticación pulmonar, sutura bronquial más toracoplastia económica de Kergin en cavidad pleural crónica. Rev Med Hosp Gral 1976; 39: 115-37.