Conclusion Our results allow us to conclude the conditions in which the conservative resection of parenchyma in carcinoid tumours is advisable. In central typical carcinoid the use of lungsparing bronchoplastic techniques demands the intraoperative pathologic verification of the existence of an adequate surgical margin 5mm by frozen section avoiding local recurrence. In peripheral atypical carcinoids the increase in the local recurrence probability after a limited resection makes it not advisable.
Survival analysis of pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol ; Limited and radical resection for tracheal and bronchopulmonary carcinoid tumour. Report on cases. Eur J Cardiothorac Surg ; neuroendocrine cancer explained Typical and atypical pulmonary carcinoids. Outcome in patients presenting with regional limph node involvement. Chest ; Bronchial carcinoid neuroendocrine cancer explained surgical management and long-term outcome.
J Thorac Cardiovasc Surg ; Bronchial carcinoid tumors: nodal status and long-term survival after resection.
Ann Thorac Surg ; Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol ; Typical and atypical carcinoid: analysis of the experience of the Spanish multicenter study of neuroendocrine tumors of the lung.
Eur J Cardiothorac Surg ; Outcome and surgical strategy in bronchial carcinoid tumors:single institution experience with patients.
Eur J Cardiothorac Surg Neuroendocrine lung tumors. Current Opinin Oncology ; Pulmonary neuroendocrine. Carcinoid tumors. Cancer ; 1: Typical and atypical carcinoid tumors: year experience with 89 patients. J Cardiovasc Surg ; Detterbeck FC. Management of carcinoid tumors. When compared to open lobectomy, the technique has been reported to have the same oncological results and many benefits in term of postoperative pain, perioperative outcomes, length of stay, biological impact and costs in a North-American setting.
Although there is variability in the technique between surgeons, the procedure is safe, can be easily learned, and is performed every year in a growing proportion of cases. Lymph-node sampling or dissection can and should be included. Locally advanced tumors have been resected through VATS with concomitant chest-wall resection, pneumonectomy, or sleeve resection, but the benefit of performing theses more extensive resections remains cancer esofagian manifestari. In many countries, the cost of the additional staplers necessary to perform the technique may limit its development, but alternative solutions exist.
The knowledge of some simple intraoperative details and concepts will help surgical neuroendocrine cancer explained to switch from open to VATS lobectomy.
Lung resection in COPD patients: where is the lower limit? Dragan Subotic Clinic for thoracic surgery, Clinical center of Serbia, Belgrade Currently, the preoperative lung function assessment neuroendocrine cancer explained focused to the prediction of postoperative neuroendocrine cancer explained function and to the estimate of cardiorespiratory reserve. It is now established that predicted postoperative FEV1 ppoFEV1 is accurate in predicting FEV1 36 months after surgery, but in the same time it is likely to overestimate the FEV1 in the initial post-operative days, when, in fact, most complications occur.
Results of several reports showing that the lung function can be better preserved after upper lobectomy in COPD patients, can be counterweighted by recent findings that the observed postoperative loss in FEV1 may exceed the predicted loss after upper lobectomies in COPD patients.
It means that COPD strongly influences FEV1 at both the early and late terms after upper lobectomy, so that the exact way of it's influence to the early postoperative lung function preservation still has not been fully elucidated. Furthermore, it was convincingly demonstrated that, in patients with preserved phrenic nerve and normal diaphragm motion, the postoperative FEV1 was significantly better than in patients neuroendocrine cancer explained either immobile diaphragm or with paradoxical diaphragm motion.
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Neuroendocrine cancer explained in mind that many COPD patients have also the increased cardiac neuroendocrine cancer explained, the current review addresses several points that influence the preoperative selection in this challenging patient population.
Is thoracoscopic surgery justified to treat lung metastases? Jos Belda-Sanchis Hospital Universitari Mutua de Terrassa, Barcelona, Spain The advent of new and specific technology in earliest 90s leaded to an increase in interest in videoassisted thoracoscopy surgery VATS as a diagnostic and therapeutic tool in all fields of the thoracic surgery.
At that time, many surgeons changed the traditional open approach to pulmonary resection of colorectal metastases for less invasive thoracoscopic techniques.
Still now, there are many areas of controversy concerning the capability of VATS in detecting and removing all the lung metastases. For the moment, there are not randomized controlled trials comparing VATS to the open approach for the curative pulmonary metastasectomy. In the CALGB planned a prospective randomized trial comparing the treatment of pulmonary metastases by VATS vs open surgery but the study was closed early due to the slow accrual 1. There are two systematic reviews of published series neuroendocrine cancer explained evaluate the current status of the surgical treatment of colorectal lung metastases 2,3.
Many others studies specifically review the results of pulmonary metastasectomy by means of open and VATS approach in terms of safety and long term survival.
neuroendocrine cancer explained Many case series and cohort studies have pointed out the main controversial aspects regarding thoracoscopic pulmonary metastasectomy.
Does VATS approach allow the identification and resection of pulmonary metastases equal than open approach? VATS metastasectomy is based on the preoperative images, in the ability or inability to adequately explore the entire lung using the thoracoscope, in neuroendocrine cancer explained palpation with the surgeons finger of the most external part of the lung or in the marking of the pulmonary node with a spiral type harpoon.
According these results, an open approach allows for more complete resection of malignant metastases.
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At the moment, the clinical relevance in terms of prognosis and survival of the disagreement between the number of preoperative detected nodules and pathologically confirmed metastases is unknown. It is well known that a complete resection is an independent prognostic factor of survival after pulmonary metastasectomy for colorectal cancer 2,9, Nevertheless, the term incomplete resection is used in the majority of studies for describing an unresectable disease due to the local extension the disease involves vital structures, mediastinal lymph nodes or the patient can not afford the magnitude of the neuroendocrine cancer explained.
Probably this meaning is not equivalent to radiologically undetectable nodules that could remain into the lung after a VATS neuroendocrine cancer explained. There is not evidence that such undetectable non-resected nodules confer a neuroendocrine cancer explained prognosis.
Such small nodules undetected at the time of the thoracoscopy will grow and they will be diagnosed as new metastases. Many oxiurose tratamento sintomas have shown that repeated metastasectomy is associated to a 5-years survival equal than first metastasectomy 11,12,13, As Dr.
Cerfolio state in their study published in the European Journal of Cardio-thoracic Surgery inthe optimal surgical approach to pulmonary metastases may be patient-dependent rather than surgeon-dependent. There are few studies of case series which addressed to this topic 15,16,17, In these studies, the selective use of VATS metastasectomy is associated with a long term outcome 5 years survival, disease free survival that is comparable with that after resection by thoracotomy.
These authors recommend a VATS resection for patients with small nodules, fewer nodules or single pulmonary metastases and lesions located in the outer third of the lung Kohman LJ. Clin Cancer Res ; 12 11 suppl s Pfannschidt J, Dienemann H, Hoffmann.
Surgical resection of pulmonary metastases from colorectal cancer: A systematic review of neuroendocrine cancer explained series.
Ann Thorac Surg ; Surg Today ; Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg ; 5. Accuracy of lung imaging in metastases with implications for the role of thoracoscopy. Estudio retrospectivo.
Role of video-assisted thoracic surgery in the treatment of pulmonary metastases: Results of a prospective trial.
Comparison of the number of pre- intra- and postoperative lung metastases. Eur J Cardio-thorac Surg ; Non-imaged pulmonary nodules discovered during thoracotomy for metastasectomy by lung palpation. The International Registry of Lung Metastases. Long-term results of lung metastasectomy: Prognostic analyses based on cases. J Thorac Cardiovasc Surg ; Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer.
Br J Surg ; Pulmonary metastasectomy for patients with colorectal carcinoma: a prognostic assessment.
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Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: Experiences in patients.
Repeat pulmonary resection for isolated recurrent lung metastases yields results comparable to those after fi rst pulmonary resection in colorectal neuroendocrine cancer explained.
World J Surg ; Long-term survival after repeated resection of pulmonary metastases from colorectal cancer.