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One-stage repair with separated cardiopulmonary bypass for coarctation of the aorta with left aortic arch and right thoracic descending aorta.

We treated a 7-day-old neonate with aortic coarctation, left aortic arch, right-side descending aorta, aberrant right subclavian artery, and outlet ventricular septal defect. Surgical one-stage repair consisting of coarctation repair by extended direct anastomosis, patch closure of the ventricular septal defect, and translocation of the right subclavian artery was performed under a separated (upper and lower body) perfusion with ascending and thoracic descending aortic cannulation. The postoperative course was complicated with massive chylous effusion, which was successfully treated by thoraci

Minimally Invasive Right Thoracotomy Versus Median Sternotomy for Atrial and Ventricular Septal Defect Closure: A Propensity-Matched Analysis.

BackgroundMinimally invasive cardiac surgery aims to reduce surgical trauma while maintaining excellent outcomes. Evidence comparing minimal … [5/79]), whereas sternotomy patients had higher incidences of pleural effusion (1.3% [1/79] vs 0%), chylothorax (1.3% [1/79] vs 0%), pericardial effusion (5.1% [4/79] vs 0%), and ventilation >48 h duration (5.1% [4/79] vs 0%). Reintervention was required in 1 of 79 thoracotomy patients (1.3%) for ASD closure revision. At median follow-up of 0.1 to 0.3 years, …

Characteristics of benign neuroblastic tumors: Is surgery always necessary?

PURPOSE: Ganglioneuroma (GN) and ganglioneuroblastoma-intermixed (GNB-I) represent benign variants of neuroblastic tumors in children; howev … 7/50, 14%) patients experienced perioperative complication (temporary paralysis, Horner's syndrome, chylothorax, vocal cord paralysis). Recurrence was noted in 1 patient with GN (1/50, 2%) and 3 with GNB-N (3/50, 6%). There were no tumor-related deaths. Patients with GN were older than those with GNB (8.8 years (IQR 6-11.25) vs 5.6 years for GN (IQR 3-7); p = …

Simplified method to quantify valve back-leak uncovers severe mesenteric lymphatic valve dysfunction in mice deficient in connexins 43 and 37.

KEY POINTS: Lymphatic valve defects are one of the major causes of lymph transport dysfunction; however, there are no accessible methods for … of the same mutations in mice result in valve defects that subsequently lead to chylous ascites or chylothorax. At present the only experimental technique for the quantitative assessment of lymphatic valve function utilizes the servo-null micropressure system, which is highly accurate and precise, but relatively inaccessible and difficult to use. We develope …

Transjugular Intrahepatic Portosystemic Shunt (TIPS): Pathophysiologic Basics, Actual Indications and Results with Review of the Literature.

BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is a non-selective portosystemic shunt created using endovascular technique … of complications of abdominal surgery, very rarely bleeding in ectopic varices or in patients with chylothorax or chylous ascites. CONCLUSION: TIPS placement is an established procedure with a new indication as "early TIPS". In the European recommendations it is only the second-line therapy for prevention of recurrent variceal hemorrhage and for secondary p …

Failed Nissen fundoplication in children: causes and management.

INTRODUCTION: Nissen fundoplication (NF) is the gold standard procedure for the treatment of gastroesophageal reflux (GER) in children. Howe … dumping syndrome, 8 gastrostomy related complications, 7 intestinal obstruction, 5 evisceration, 2 chylothorax, and 1 pneumothorax). Reflux recurred in 42 patients (11.7%) and 35 patients (9.7%) underwent redo NF 1.01 years (0.02-8.4 years) after the initial surgery. A total of nine patients (2.5%) required further interventions (five another redo NF, three …

[Stented elephant trunk and femoral artery bypass grafting surgery for extended aneurysmal dilation of Stanford A aortic dissection or aortic aneurysm].

OBJECTIVES: To summarize the clinical experience of stented elephant trunk with femoral artery bypass grafting procedure to treat severe ane … mm graft in the same femoral incision. RESULTS: There was no operative mortality. One patient had chylothorax which recovered with medical treatment and one patient got paraplegia after surgery. The cardiopulmonary bypass time was (176 ± 42) minutes, aortic cross clamping time was (88 ± 25) minutes and deep hypothermia and low flow rate time was (23 ± 8) mi …

A comparison of on-site and off-site patent ductus arteriosus ligation in premature infants.

INTRODUCTION: Persistent patent ductus arteriosus (PDA) often produces hemodynamic and respiratory derangement necessitating use of inotropi … The incidence of perioperative complications did not differ between groups: 3 in group 1 (bleeding, chylothorax, and pleural effusion) and 3 in group 2 (pneumothorax [3]). There were no anesthetic-related complications. Seven patients died (4 in group 1 and 3 in group 2), none within 96 hours of surgery and none secondary to the procedure. DISCUSSION: The da …

[Arterial switch operation in older infants with severe pulmonary hypertension].

OBJECTIVE: To investigate the clinical efficacy of arterial swith operation on transposition of great artery (TGA) and Tausing-Bing anomaly. … ardiac output syndrome post-operatively and died 20 hours after the operation. Another patient with chylothorax died of allergy from iodophor 22 days postoperatively. The pulmonary pressure decreases significantly in 22 patients who had severe pulmonary hypertension preoperatively with the mean pressure 46.7 mm Hg preoperatively and 31.3 mm Hg postoperatively …

Additional neoadjuvant immunotherapy does not increase the risk of anastomotic leakage after esophagectomy for esophageal squamous cell carcinoma: a multicenter retrospective cohort study.

PURPOSE: Neoadjuvant chemoimmunotherapy (nICT) is a novel and promising therapy model for locally advanced esophageal squamous cell carcinom … pneumonia. After IPTW, the nICT group had a higher incidence of bleeding (3.36 vs. 0.30%, P =0.01), chylothorax (5.79 0.30%, P =0.001), and cardiac events (19.53 vs. 9.20%, P =0.04). recurrent laryngeal nerve palsy (7.85 vs. 0.54%, P =0.003). After PSM, both groups were similar in palsy of the recurrent laryngeal nerve (1.22 vs. 3.66%, P =0.31) and cardiac ev …

The impact of right-sided aortic arch on surgical outcomes in esophageal atresia: A systematic review.

OBJECTIVE: The management of esophageal atresia and tracheoesophageal fistula (EA/TEF) in the presence of a right-sided aortic arch (RAA) re … r rings. Postoperative morbidity included anastomotic leaks (0%-42.8%), strictures (14.3%-53%), and chylothorax (0%-25%). CONCLUSION: While right-sided repair is technically feasible for most surgeons due to anatomical familiarity, it might be associated with increased long-term morbidity. Preoperative identification of RAA and associated vascular rings is c …

Characterization of a balanced complex chromosomal rearrangement carrier ascertained through a fetus with dup15q26.3 and del5p15.33: case report.

Complex chromosomal rearrangements (CCRs) are structural aberrations involving more than two chromosomes which rarely appear in individuals with normal phenotypes. These individuals report fertility problems, recurrent miscarriages, or congenital anomalies in newborn offspring as a consequence of either meiotic failure or imbalanced chromosome segregation. A CCR involving chromosomes 5, 15, and 18 was discovered in a phenotypically normal man through a fetus with congenital malformations and partial trisomy of chromosome 15 and monosomy of chromosome 5. Ultrasound examination at 20 weeks of ge

A complication of thoracic surgery: a late-onset chylomediastinum resulting from a left upper lobectomy and lymph node dissection through a median sternotomy.

A 63-year-old male with lung cancer underwent a left upper lobectomy and mediastinal lymph node dissection through a median sternotomy. Postoperatively, he received 4 cycles of adjuvant chemotherapy with cisplatin and gemcitabin. Chest computed-tomography (CT) scan after the adjuvant chemotherapy showed a large cystic mass originating from the tracheal bifurcation. Fiberoptic bronchoscopy (FOB) revealed chylomediastinum during the aspiration biopsy of the mass. The chylous effusion was first removed by aspiration under FOB, though 2 weeks later the patient returned with a fever, and the CT lea

Reflections on the applicability of palliative thoracentesis in Primary Care.

Under normal conditions, there is a small volume of fluid in the pleural space as a result of the balance between its inflow from the pleural capillaries and its drainage through the lymphatics. Pleural effusion (PE) will occur when this balance is disturbed. The initial step in its study is to determine whether PE it is a transudate or an exudate. The first is caused by an alteration in the hydrostatic or oncotic pressure of both the pleural capillaries and the pleural space, without any structural damage to the pleura and with a simple differential diagnosis. In the second, there will be an

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… Other situations, such as obstruction of the lymphatic flow, through which the PF drains (neoplasia), or rupture of the thoracic duct (chylothorax), could also produce PE. This second group consists of exudates. … In the presence of a milky PF, triglycerides >110 mg/dL confirm chylothorax. 32 PF cholesterol >250 mg/dL is diagnostic of pseudochylothorax. …

Vascular and lymphatic complications after thoracic duct cannulation.

OBJECTIVE: The objective of this study was to determine the incidence of vascular and lymphatic complications after attempted transabdominal thoracic duct cannulation. METHODS: There were 58 patients who underwent attempted thoracic duct cannulation. Patients presented with chyle leak in the chest (n = 40), abdomen (n = 9), neck (n = 8), and pelvis (n = 1). Vertebral body level and geographic access, needle gauge, additional access for treatment, technical success, intervention performed, immediate and delayed complications, and follow-up duration were recorded. Imaging and electronic medical

[83-year-old patient with cough and dyspnea].

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Perioperative outcomes and survival of indocyanine green-guided minimally esophagectomy in patients with esophageal cancer: a retrospective comparison study.

BACKGROUND: A growing body of clinical research has highlighted the potential of intraoperative fluorescence imaging for precise lymph node … ps in terms of the postoperative complications (e.g., anastomotic fistula: 10.0% vs. 6.9%, P=0.559; chylothorax: 6.7% vs. 14.7%, P=0.121) and operative metrics (total operative time: 245.3±32.6 vs. 238.5±29.4 min, P=0.215; intraoperative blood loss: 125.6±35.2 vs. 132.3±38.7 mL, P=0.324). In the survival analysis, the ICG group had significantly better DFS (m …

[The Initial Experience of Video-assisted Thoracic Surgery Segmentectomy for Early Stage Lung Cancer].

BACKGROUND: Segmentectomy can retains more healthy lung tissue than lobectomy, but it remains controversial in oncology for early stage lung … r operation, all of which were not more than 3 days. There was contralateral atelectasis in 1 case, chylothorax in 1 case. The average length of hospitalization was 6.1 days. There was no other complications outpatient related to surgery, in 30 days after discharge. The pathological changes were as follow, 2 cases of metastatic tumor, 8 cases of benign lung d …

Surgical treatment of scoliosis in Marfan syndrome: outcomes and complications.

PURPOSE: To investigate surgical outcomes and complications of scoliosis associated with Marfan syndrome. METHODS: Inclusion criteria were … of instrumentation loosening with one removed, one case of instrumentation breakage and one case of chylothorax and hemothorax during video assisted thoracoscopic release. 66 patients (28 males, 38 females) with a mean age at surgery of years 16.4 years (range: 10-20 years) were included in Group 2. Complications in Group 2 included six cases of cerebro-spina …

Lymphangiomatosis of the spine: two cases requiring surgical intervention.

STUDY DESIGN: Two cases of lymphangiomatosis of the spine are presented. OBJECTIVES: To report two cases of lymphangiomatosis of the spine requiring surgical intervention and to review the literature. SUMMARY OF BACKGROUND INFORMATION: Lymphangiomatosis is a rare childhood disease characterized by abnormal lymph tissue at multiple sites. Skeletal and visceral involvement are both common. Prognosis depends on the extent of extraskeletal disease. METHODS: Two cases of lymphangiomatosis causing neural compression and instability at the cervicothoracic junction are presented. Both patients unde