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Biomedical subjects

L Swoboda

Publications and source records attributed to L Swoboda.

32 records · Page 2Linked to original sources
PubMed1990

Decortication in chronic pleural empyema. Investigation of lung function based on perfusion scintigraphy.

The study presents measurements in spirometry and scintigraphic lung perfusion, before and after decortication, in 9 patients treated for chronic pleural empyema with special emphasis on measuring changes by perfusion scintigraphy. Preoperatively, the average vital capacity (VC) was 60% and the average FEV1 was 65% of the predicted. Perfusion of the affected side showed an average reduction to 22%. After decortication all functional data showed an improvement (average VC 78.5%, average FEV1 79.5%) the percentage of lung perfusion having increased to a mean of 37.8%.

Adolescent↗
PubMed1990

[Developments in surgery of pulmonary metastases].

Two groups of patients between 1977-1986 and 1987-1989 underwent surgery for pulmonary metastases. The most frequent primary sites were the kidney and the colon-rectum. While metastases from testicular cancer have become rare indications, metastases from breast cancer are increasing. Our results show that more metastatic lesions are usually found at operation than indicated by CT scan. The discrepancy amounts to 18% in presumably solitary metastases and increases to 50% if three or more lesions were identified preoperatively. Therefore, bilateral exploration is advocated. Lesions of the posterior lower lobes are more satisfactorily approached by a bilateral transverse incision and sternotomy. The mortality was 1% in the former and 0% in the more recent group of patients.

Carcinoma↗
PubMed1990

[Is bronchoscopy a useful additional preoperative examination in esophageal carcinoma?].

Between 1980 and 1987 95 patients with esophageal carcinoma had a bronchoscopy. In 67 patients (70.5%) no pathological findings could be detected. In 24 patients (25.3%) signs of impingement were present and in 4 patients (4.2%) tumor infiltration into the tracheobronchial tree was visible. The correlation between tumor length and bronchoscopic findings revealed a marked increase of direct and indirect tumor evidence in esophageal carcinomas of more than 5 cm in length. Pathologic bronchoscopic findings were detected twice as often in patients with carcinoma of the upper third of the esophagus in comparison with those of the middle third. In 5 patients (5.3%) bronchoscopy revealed an unknown additional bronchial carcinoma. 67 of the 95 patients underwent operation. In 59 patients the esophagus was resected. Among the normal bronchoscopic findings the operability rate was 77.6%. In contrast, only half of the patients with pathological bronchoscopic findings were operable, the other patients received radiotherapy. We recommend, therefore, preoperative bronchoscopy as an important investigation for assessment of operability and for evaluation of synchronous neoplasms in patients with an esophageal carcinoma.

Adenocarcinoma↗
PubMed1990

[Results of surgical treatment of lung metastases].

Between 1977 and 1988, 301 surgical interventions were performed in patients with pulmonary metastases. In 174 of these patients the procedure was considered to be potentially curative. In this group of patients, we observed a three-year survival rate of 57%, and a five-year survival rate of 38%. Among those patients who were not curatively treatable, only 7% were still alive after three years.

Adolescent↗
PubMed1990

[Unilateral lung transplantation--an initial report of experiences].

Lung transplants have been attempted since 1963 but with little success. After fundamental work by the Toronto group with improved surgical techniques and after the introduction of cyclosporin that group was able to present convincing results. Of 16 unilaterally transplanted patients with pulmonary fibrosis in the final stage, 10 are still living, one of them for now 5 years. With bilateral lung transplantation the indication was extended to cover further pulmonary diseases in the final stage, such as emphysema, bronchiectases, eosinophilic granuloma, primary pulmonary hypertension and bronchiolitis obliterans. The unilateral lung transplantation performed by us failed after initially excellent functioning, on the 9th postoperative day because of a Pseudomonas infection that had been transferred with the donor organ.

Adult↗
PubMed1989

Bilobectomy in a 90-year-old patient.

A 90-year-old patient was admitted to our clinic after two weeks of dangerously increasing hemoptysis. Bronchoscopy showed the segment bronchi of the right lower lobe to be subtotally occluded by a tumour. A biopsy was not taken because of simultaneous bleeding. After weighing the risks, surgery was decided on despite the advanced age of the patient. The centralized position of the tumour necessitated a bilobectomy. Histology showed a small-cell bronchial carcinoma T2N1M0. After initial secretion retention and mild transitional syndrome, the postoperative course was uncomplicated. Four weeks after surgery, the patient could be transferred to his local hospital where he was discharged home after a further two months. There was no reappearance of hemoptysis. At the last check-up, one year postoperatively, there was no tumour recurrence. The patient lives alone in his flat as prior to surgery. This case shows that, in individual patients, larger pulmonary resections are also possible and justified in the tenth decade of life.

Aged↗
PubMed1987

[Chest wall replacement with resorbable synthetic mesh].

The dreaded thoracic wall instability occurring after chest wall resection can be avoided with the use of modern synthetic materials. Extensive resections which are sometimes necessary, especially in the field of tumor surgery on curative or palliative grounds, are possible without significantly affecting thoracic wall function. The use of absorbable mesh has further increased the range of application. Thoracic wall resection and reconstruction can also be carried out in primary infected regions. The indications and operative procedures are presented based on 47 cases.

Adult↗
PubMed1986

Results of surgical treatment for pulmonary metastases.

One hundred and fifty-seven patients underwent surgery for pulmonary metastases in our hospital between 1977 and 1985. Potentially curative surgery was possible in 96 cases. We recorded survival rates of 60% after 3 years and 43% after 5 years. The median survival time was 47 months. When compared to radical surgery, the 5-year survival rate for patients treated by palliative operations was less than 6%. The preoperative diagnostic examinations do not permit an exact determination of the number of metastases and their localization. When comparing the suspected number of metastases with the number determined during surgery using sternotomy we found an underestimate in 40% of the patients with suspected solitary metastasis and in 85% of the patients with multiple metastases. We therefore recommend median sternotomy with exploration of both pleural cavities and lungs as standard access also for patients with suspected solitary metastasis.

Adolescent↗