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S.N. Alma Leticia



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    P3.24 - Poster Session 3 - Supportive Care (ID 160)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P3.24-012 - Usefulness Of Thoracoscopy In Thoracic Tumors: Diagnosis, Staging and Therapeutic. (ID 844)

      09:30 - 09:30  |  Author(s): S.N. Alma Leticia

      • Abstract

      Background
      Study in tertiary hospital in the thoracic surgery service by a group of surgeons, during which corroborate the usefulness of thoracoscopy in the diagnosis and management of different chest tumors that were presented in the thoracic surgery service for a period of one year: 2011 – 2012. During the procedure was used in all patients selective lung intubation, was performed intraoperative intercostal block for pain control, postoperative management was all endopleural tube, pain control with morphine and radiographic control to assess each 24hr endopleural catheter in 2 patients (15.3%) underwent incision of 2 and 4 cm to remove the tumor.

      Methods
      In one year 23 patients was admited to the Pachuca General Hospital with the diagnosis of lung tumors, all patients complete preoperative protocol wich include chest CT, lung or tumor biopsy, assesment by anesthesiology, internal medicine, pulmonomogist an medical oncology, the procedures include no anatomic segmentectomy with tumor free margin, exceresis tumor, lung and pleural biopsy, VATS lobectomy, lymph node dissection was performed mainly from stations 4, 5 and 7. Pathology reports were branchial cyst, mesothelioma sarcomatoid, bonchogenic cyst with ulcerated necrotic pneumonia, chondroid hamartoma with congestion and sclerosis, moderately differentiated adenocarcinoma and small cell carcinoma. In patients who had pleural effusions was performed on the basis of lung expansion chemical pleurodesis with 20ml yodopovidona more 10ml xylocaine 1% dilute to 100cc with saline.

      Results
      Radiological and histopathological diagnosis was corroborated in 95% of cases, the procedures include no anatomic segmentectomy, exceresis tumor, lung and pleural biopsy, VATS lobectomy, lymph node dissection. Pathology reports were branchial cyst, mesothelioma sarcomatoid, bonchogenic cyst with ulcerated necrotic pneumonia, chondroid hamartoma with congestion and sclerosis, moderately differentiated adenocarcinoma and small cell carcinoma. All patients continue managemnent with a multidiciplinary team getting support with other institutions in cancer management. In patients who had pleural effusions was performed on the basis of lung expansion chemical pleurodesis with 20ml yodopovidona more 10ml xylocaine 1% dilute to 100cc with saline was done and chest drain mainteined for 3 to 4 days. In cases of recurrence of pleural effusion a tunelized thoracic catheter was put on and in cases of persistent pneumothorax a Heimlich valve was colocated.

      Conclusion
      Pleuropulmonary tumors in patients with, sensitivity and specificity for the diagnosis and treatment by thoracoscopy is over 90% to reliably be able to obtain sufficient tissue for histopathological examination or final intraoperative complete resections and procedures, achieving an aesthetic addition.