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Biomedical subjects

K S Matar

Publications and source records attributed to K S Matar.

9 recordsLinked to original sources
PubMed2001

Lung volume reduction surgery in emphysema: a systematic review.

The aim of this study was to systematically review the literature regarding the safety and efficacy of lung volume reduction surgery (LVRS) in patients with emphysema. Studies on LVRS to August 2000 were identified using MEDLINE, Embase, Current Contents, and the Cochrane Library. Human studies of patients with upper, lower or diffuse distributions of emphysema were included. All types of bullous emphysema were excluded. A surgeon and researcher independently assessed the retrieved articles for their inclusion in the review. When LVRS was compared with medical management, at 2 years LVRS was associated with a higher FEV1 and at least equivalent survival. The use of staple excision of selected areas of lung appeared to be more efficacious than laser ablation. There is insufficient evidence to show preference for median sternotomy or videoscopically assisted thoracotomy, as the more safe and efficacious procedure. In highly selected patients with emphysema LVRS is deemed an acceptable treatment. To fully evaluate the safety and efficacy of LVRS, outcomes beyond 2 years must be included. The results of prospective randomized trials between medical management and LVRS, now in progress, are essential before a final assessment can be made.

Hospital Mortality↗
PubMed1997

The efficacy of open lung biopsy.

BACKGROUND: The morbidity and mortality of open lung biopsy was assessed, and the ability to provide a specific diagnosis in the assessment of patients with diffuse radiographic pulmonary infiltrates was determined. METHODS: A retrospective analysis was undertaken from January 1990 to May 1995 of all patients undergoing open lung biopsy during the study period. A total of 127 biopsies were performed. The indications were diffuse, infiltrative or multinodular disease. Forty-two (33%) patients had previously undergone non-diagnostic trans-bronchial biopsy. RESULTS: Open lung biopsy obtained a histological diagnosis in 121 (95.3%) patients. Postoperative in-hospital mortality was 4.7% (six patients). Three of the four patients being ventilated at the time of biopsy died. Thirty-six (28.3%) patients suffered one or more morbid events. Patients with decreased lung function, as measured by forced expiratory volume, experienced a higher risk of a morbid event (P < 0.01). There was no significant correlation between the chance of a morbid event and age, sex or the use of multiple biopsy sites. A presumptive diagnosis was made prior to biopsy in 71 patients (55.9%) and was proven correct in 43.6% of cases. CONCLUSIONS: Open lung biopsy in patients with diffuse pulmonary disease is an accurate diagnostic tool and has an acceptable morbidity and mortality associated with the procedure.

Adolescent↗
PubMed1994

Asphyxia while swallowing solid food caused by bronchial compression: a variant of the pneumonectomy syndrome.

A 40 year old man presented with recurrent episodes of dyspnoea whilst swallowing solid food. He had undergone right pneumonectomy and thoracoplasty for recurrent pneumonias and empyema 23 years previously. Solid food boluses appeared to cause bronchial obstruction by compressing the surgically distorted left main bronchus. This is a new variant of the post pneumonectomy syndrome.

Adult↗
PubMed1993

Chronic intrapulmonary foreign bodies.

Two cases of chronically retained foreign bodies are presented, demonstrating that a long delay may exist between a penetrating injury and the manifestation of a severe symptom, such as haemoptysis or recurrent infection, referable to a retained foreign body. In only one of these cases was the diagnosis of retained foreign body considered the most likely pre-operatively. Some diagnostic and management problems arising in such situations are discussed.

Chronic Disease↗
PubMed1991

Endobronchial zygomycosis.

Pulmonary zygomycosis is an uncommon opportunistic fungal infection. Diabetics have a tendency to develop major airway lesions. This can lead to invasion of the airway wall and hilar vessels with infarction and severe haemoptysis. Aggressive early surgery appears to offer the best chance of recovery.

Aged↗
PubMed1989

Cisplatinum-based chemotherapy in malignant mediastinal teratoma.

Five patients with primary malignant mediastinal non-seminomatous germ cell tumours have been treated with a multimodality approach, including cisplatinum-containing chemotherapy, at this institution over the past 7 years. All patients had bulky disease (greater than 10 cm maximum diameter) at presentation and showed raised serum concentrations of human chorionic gonadotrophin or alpha-fetoprotein. Two patients are alive with no evidence of disease at 22 months and 6 years, respectively, from initial diagnosis; two patients have died from progressive disease and one from acute non-lymphocytic leukaemia without evidence of residual germ cell tumour. Long-term survival is achievable for these poor risk patients with a combined modality approach.

Adult↗
PubMed1989

Intramural haematoma of the oesophagus complicated by perforation.

A case is presented where spontaneous bleeding into the wall of the oesophagus was exacerbated by anticoagulant therapy. Subsequently, iatrogenic, full-thickness perforation of the oesophagus occurred during endoscopy and, ultimately, oesophagectomy was required. If this condition is suspected on clinical grounds, the most appropriate sequence of investigations would appear to be contrast radiography in the first instance with cautious use of oesophagoscopy.

Aged↗
PubMed1989

Initial chemotherapy followed by surgery in malignant thymoma.

Initial combination chemotherapy with cisplatinum, adriamycin and cyclophosphamide was given prior to surgery in a young woman with an unresectable malignant thymoma. Complete remission was achieved following three cycles of chemotherapy. Subsequent thymectomy revealed no evidence of residual malignancy. Prolonged remissions following cisplatin-based chemotherapy have recently been achieved in metastatic thymoma. Initial chemotherapy should now be considered prior to surgery or radiotherapy in those patients presenting with very bulky or unresectable disease.

Adult↗