[Critical study of treatment of myasthenia by thymectomy].
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Biomedical subjects
Publications and source records attributed to M Merlier.
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The authors study the modalities of the surgical treatment of bronchial carcinoid tumors with regard to personal series of 129 cases and to 595 observations of the literature.
Considering 36 observations, the authors show the relative infrequency of pleural aspergillosis localizations by comparison with pulmonary aspergillomas. Twenty four pleural aspergilloses developed on post-operative residual cavities, particularly after pulmonary exeresis and not only for aspergilloma; 11 forms were apparently primitive after therapeutical pneumothorax; 3 anatomo-clinical forms were found, aspergillomas and pyothoraxes were the most frequent. Pleural involvement can be associated to pulmonary, even bronchial involvement. Discovery circulstances vary: 4 times symptomatology was noisy, other times diagnosis was founded on radiological changes or hemoptysis or on the systematic fungal detection. Therapeutical indications are discussed. A major intervencal changes or hemoptysis or on the systematic fungal detection. Therapeutical indications are discussed. A major intervention with a radical aim (pulmonary decortication or pleuro-pneumonectomy) is rarely envisaged (7 times out of 35). Parietopleurectomy and rooting out with thoracoplasty are often the only possible ways or even a simple pleurotomy or a medical treatment with is modalities. Post-operative complications are often serious, particularly acute mycotic outbursts. Out of 35 patients, one was never seen again, 13 died, rather late of cardio-respiratory insufficiency, 21 are still alive but only 13 can truly be considered cured.
Late trans-diaphragmatic migration of a postoperative abdominal foreign body followed a left hepatectomy for injury. Operative treatment, by means of the low posterior thoracic approach consisted of partial resection of the right inferior lobe with immediate closure of the diaphragm and subphrenic drainage. The natural history of the course taken by this abdominal foreign body is used as a basis for discussing diagnostic and therapeutic factors, particularly the surgical route of approach.