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Acta Radiologica Apr 1955
Topics: Humans; Pleura; Radiography; Thorax
PubMed: 14387789
DOI: 10.3109/00016925509172770 -
Journal of Surgical Oncology Feb 2022This study aimed to explore the effect of suturing upper mediastinum pleura on postoperative complications, surgery-related mortality, and hospital stay.
OBJECTIVES
This study aimed to explore the effect of suturing upper mediastinum pleura on postoperative complications, surgery-related mortality, and hospital stay.
METHODS
Four hundred and thirty-eight patients with esophageal cancer who underwent esophagectomy were identified. Patients were divided into two groups: those in the test group who received reconstruction of upper mediastinal pleura, those in the conventional group who did not. The incidence of postoperative complications, surgery-related mortality, and hospital stay were compared. To reduce the impact of confounding factors, a propensity score matching (PSM) method was performed.
RESULTS
A total of 273 patients were treated with suturing upper mediastinal pleura and 165 were not. After PSM, compared with the conventional group, the incidence of atelectasis (7.2% vs. 1.4%, p = 0.035), anastomotic leakage (5.8% vs. 0.7%, p = 0.036), and delayed gastric emptying (10.8% vs. 3.6%, p = 0.034) were significantly lower in the test group. And suturing the upper mediastinal pleura could reduce the severity of leakage (p = 0.045), consistent with the results before PSM. Moreover, there were no significant differences in the incidence of other complications, postoperative hospital stay, and 30-day mortality (all p > 0.05).
CONCLUSIONS
In this study, suturing the upper mediastinal pleura can reduce the incidence of atelectasis, anastomotic leakage, and delayed gastric emptying, and the severity of leakage, without increasing the incidence of other complications, surgery-related death, and postoperative hospital stay.
Topics: Adult; Aged; Anastomotic Leak; Enhanced Recovery After Surgery; Esophageal Neoplasms; Esophagectomy; Female; Humans; Length of Stay; Male; Mediastinum; Middle Aged; Pleura; Postoperative Complications; Propensity Score; Plastic Surgery Procedures
PubMed: 34555187
DOI: 10.1002/jso.26686 -
Ultraschall in Der Medizin (Stuttgart,... Apr 2024The CME review presented here is intended to explain the significance of pleural sonography to the interested reader and to provide information on its application. At...
The CME review presented here is intended to explain the significance of pleural sonography to the interested reader and to provide information on its application. At the beginning of sonography in the 80 s of the 20th centuries, with the possible resolution of the devices at that time, the pleura could only be perceived as a white line. Due to the high impedance differences, the pleura can be delineated particularly well. With the increasing high-resolution devices of more than 10 MHz, even a normal pleura with a thickness of 0.2 mm can be assessed. This article explains the special features of the examination technique with knowledge of the pre-test probability and describes the indications for pleural sonography. Pleural sonography has a high value in emergency and intensive care medicine, preclinical, outpatient and inpatient, in the general practitioner as well as in the specialist practice of pneumologists. The special features in childhood (pediatrics) as well as in geriatrics are presented. The recognition of a pneumothorax even in difficult situations as well as the assessment of pleural effusion are explained. With the high-resolution technology, both the pleura itself and small subpleural consolidations can be assessed and used diagnostically. Both the direct and indirect sonographic signs and accompanying symptoms are described, and the concrete clinical significance of sonography is presented. The significance and criteria of conventional brightness-encoded B-scan, colour Doppler sonography (CDS) with or without spectral analysis of the Doppler signal (SDS) and contrast medium ultrasound (CEUS) are outlined. Elastography and ultrasound-guided interventions are also mentioned. A related further paper deals with the diseases of the lung parenchyma and another paper with the diseases of the thoracic wall, diaphragm and mediastinum.
Topics: Humans; Child; Pleura; Pleural Effusion; Lung; Lung Diseases; Thorax; Ultrasonography
PubMed: 38237634
DOI: 10.1055/a-2189-5050 -
Medical Ultrasonography Dec 2014Pleural ultrasonography (US) represents nowadays a useful diagnostic tool in the management of pleural diseases. Detection and evaluation of pleural effusions,... (Review)
Review
Pleural ultrasonography (US) represents nowadays a useful diagnostic tool in the management of pleural diseases. Detection and evaluation of pleural effusions, pneumothorax and pleural-based lesions can be performed with US, which has the advantages of wide availability, low cost, absence of radiation exposure, and portability. It is the best method for guiding interventional procedures in the pleural space. It has also limitations, due to the interposition of bony parts of the thorax, subcutaneous emphysema and inability to visualize the mediastinal pleura. US of the thorax is an operator dependent technique demanding an experienced operator in order to obtain reliable results. This pictorial essay presents various ultrasound findings of the diseases which concern the pleura.
Topics: Humans; Pleura; Pleural Diseases; Ultrasonography
PubMed: 25463891
DOI: 10.11152/mu.201.3.2066.164.racc -
Der Radiologe Feb 2022In the case of lesions of the pleura, the thoracic wall and the diaphragm, chest x‑ray is of great relevance in everyday clinical practice. In many clinical... (Review)
Review
In the case of lesions of the pleura, the thoracic wall and the diaphragm, chest x‑ray is of great relevance in everyday clinical practice. In many clinical situations, it is already sufficient for the initial diagnosis or for monitoring the course of the disease; these include, for example, pleural effusion and pneumothorax. In some cases, however, supplementary cross-sectional imaging may be necessary, e.g., if there is a possible pleural empyema or if the soft tissues of the mediastinum and pleural wall are also affected. Further diagnostic workup is also necessary for more advanced questions such as staging or surgical planning. This article is intended to provide an overview of the most common diseases of the pleura, thoracic wall, and diaphragm with their typical appearances on radiographs and, at the same time, to demonstrate the importance and limitations of conventional diagnostics.
Topics: Diaphragm; Humans; Pleura; Pleural Effusion; Thoracic Wall; Tomography, X-Ray Computed
PubMed: 35029724
DOI: 10.1007/s00117-021-00958-5 -
Advances in Anatomic Pathology Nov 2019Primary mediastinal non-Hodgkin lymphomas (PM-NHLs) represent ~5% of all NHLs and comprise lymphomas of B-cell and T-cell origin. PM-NHLs are defined as involvement of... (Review)
Review
Primary mediastinal non-Hodgkin lymphomas (PM-NHLs) represent ~5% of all NHLs and comprise lymphomas of B-cell and T-cell origin. PM-NHLs are defined as involvement of mediastinal lymph nodes, thymus, and/or mediastinal organs (heart, lung, pleura, pericardium) by NHL without evidence of systemic disease at presentation. The clinical scenario is variable and depends on the lymphoma subtype. The radiologic presentation is also variable ranging from a mediastinal mass with or without superior vena cava syndrome, a pleural or a cardiac mass associated with an effusion, or as an effusion only. The diagnosis of PM-NHLs can only be established by microscopic evaluation, and therefore, general pathologists should be aware of these tumors and familiar with their diagnostic approach. The most common anterior mediastinal NHLs (90% to 95%) are primary mediastinal large B-cell lymphoma and T lymphoblastic lymphoma. Thymic marginal zone lymphoma and mediastinal gray zone lymphoma are very rare. The remainder PM-NHLs involving middle or posterior mediastinum include diffuse large B-cell lymphoma (DLBCL) and rare cases of T-cell lymphoma, including anaplastic large cell lymphoma and breast implant-associated anaplastic large cell lymphoma extending to the anterior mediastinum. Primary pleural and cardiac NHLs are mostly DLBCLs. Other rare subtypes of PM-NHLs include DLBCL associated with chronic inflammation/pyothorax-associated lymphoma, fibrin-associated DLBCL (both EBV), and pleural and/or pericardial primary effusion lymphoma (HHV-8/EBV). We review the historical aspects, epidemiology, clinico-radiologic features, histopathology, immunohistochemistry, differential diagnosis, and relevant cytogenetic and molecular features of PM (thymic) LBCL, PM "nonthymic" DLBCL, BCL, unclassifiable, with features intermediate between DLBCL and classic Hodgkin lymphoma (mediastinal gray zone lymphoma), DLBCL associated with chronic inflammation (pyothorax-associated lymphoma), fibrin-associated DLBCL, and primary effusion lymphoma. This review represents the first part of 2 manuscripts covering PM-NHLs.
Topics: Hodgkin Disease; Humans; Lymph Nodes; Lymphoma, Non-Hodgkin; Mediastinal Neoplasms; Mediastinum
PubMed: 31567132
DOI: 10.1097/PAP.0000000000000249 -
Current Oncology (Toronto, Ont.) Apr 2022Leiomyomas are a common type of benign soft tissue tumor arising from smooth muscle, most often occurring within females' genitourinary and gastrointestinal tract.... (Review)
Review
Leiomyomas are a common type of benign soft tissue tumor arising from smooth muscle, most often occurring within females' genitourinary and gastrointestinal tract. However, primary leiomyomas of the chest wall residing in the extra-pleural space are an extremely rare subset of leiomyomatous lesion presentation. We present a case of a fifty-two-year-old male who initially presented complaining of dyspnea worsening with exertion. Computed tomography imaging was performed showing an extra-pleural mass residing under the left sixth rib. Subsequent core needle biopsy and immunohistochemical staining were performed, and the definitive diagnosis of primary leiomyoma of the posterior mediastinal chest wall. Although extremely rare, this neoplastic condition should be included in your differential diagnosis when diagnostic imaging reveals a benign mass residing in the extra-pleural space, and subsequent biopsy specimens consist of smooth muscle fibers.
Topics: Female; Humans; Leiomyoma; Male; Middle Aged; Pleura; Soft Tissue Neoplasms; Thoracic Wall; Tomography, X-Ray Computed
PubMed: 35621630
DOI: 10.3390/curroncol29050240 -
Pediatric Radiology May 2016The acceptance of applications for the use of chest MRI in children has been somewhat slow and selective. The use of MRI to image chest wall lesions is likely the most... (Review)
Review
The acceptance of applications for the use of chest MRI in children has been somewhat slow and selective. The use of MRI to image chest wall lesions is likely the most common and widely used indication, aside from the widespread and somewhat sophisticated use of MRI in imaging the cardiovascular structures of the chest. In this respect, fairly standard variations of T1-W, T2-W and contrast-enhanced imaging can be used, similar to the sequences used for musculoskeletal lesions elsewhere in the body. Imaging of the anterior mediastinal masses should be performed in conjunction with a detailed pre-test clinical examination to determine potential cardiovascular compromise. MRI in the setting of middle mediastinal adenopathy, congenital mediastinal cysts or posterior mediastinal masses, however, has been shown to be more effective and more comprehensive than multidetector CT. Although sonographic imaging is the initial modality of choice for pleural abnormalities, MR imaging is extremely effective and clinically useful in the setting of a potentially ambiguous sonographic examination. Faster imaging protocols are likely to increase the acceptance of MRI to replace multidetector CT for many pediatric chest lesions.
Topics: Child; Humans; Magnetic Resonance Imaging; Mediastinal Neoplasms; Mediastinum; Pleura; Thoracic Wall
PubMed: 27229507
DOI: 10.1007/s00247-016-3598-7 -
Surgical and Radiologic Anatomy : SRA Jan 2022There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum's fat...
PURPOSE
There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum's fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position.
METHODS
The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity.
RESULTS
For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura.
CONCLUSION
The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.
Topics: Esophagectomy; Humans; Lymph Node Excision; Mediastinum; Prone Position; Thoracic Surgery, Video-Assisted; Thoracoscopy
PubMed: 34426859
DOI: 10.1007/s00276-021-02820-8 -
Respiration; International Review of... 2003Sonography (US) has inherent limitations for thoracic imaging because sound waves are reflected by bone and air space (such as in lung parenchyma). However, US is less... (Review)
Review
Sonography (US) has inherent limitations for thoracic imaging because sound waves are reflected by bone and air space (such as in lung parenchyma). However, US is less expensive and more convenient than computed tomography (CT) or magnetic resonance imaging (MRI); it provides immediate information with real-time imaging, and can give information not available from a standard radiograph. This review describes the utility and limitations of US and compares US with radiography.
Topics: Critical Illness; Humans; Lung Diseases; Lymph Nodes; Mediastinal Diseases; Pleura; Pleural Diseases; Pulmonary Embolism; Punctures; Ultrasonography
PubMed: 12584397
DOI: 10.1159/000068420