Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near ...

A 58-year-old man with esophageal cancer underwent a transhiatal esophagectomy and presented to the surgical intensive care unit (SICU) with progressively worsening shortness of breath 14 days after his surgery. The patient was found to have a left empyema, possibly from an anastomotic leak, and underwent a left video-assisted thoracotomy (VATS) decortication and empyema drainage, and endoscopi...

The aim of this prospective study was to determine the rate of recurrence for spontaneous pneumothorax (SP) after tetracycline pleurodesis (TCP), using that of observation, tube thoracostomy alone, and thoracotomy as references. From 1985 to the end of 1991, 78 patients were treated with tetracycline pleurodesis and 135 patients served as control subjects. Pleurodesis was induced by instillatio...

The aim of this study was to evaluate the effectiveness of the use of ice for the control of pain associated with chest tube irritation. The randomized and single-blinded study consisted of 40 patients (20 in the control and 20 in the study group) who underwent thoracotomy with chest tube placement. The same general anesthesia protocol was used for all patients, and the procedure was performed ...

BACKGROUND Thoracostomy tube insertion is one of the common bedside procedures in emergency medicine and many acute specialties. Dislodgement of thoracostomy tube from the connection tube of chest drainage system is an important problem with potential complications such as contamination, infection and pneumothorax. Besides, mere loosening can also lead to malfunction. It is a common practice to...

I read with puzzlement the “Communication to the Editor” by Dean P. Sandifer, MD, FCCP,1 in regard to the article by Trottier et al,2 pertaining to percutaneous dilatational tracheostomy (PDT) using the PDT kit manufactured by Smith Industries (Keene, NH). Dr. Sandifer justifiably criticized the high rate of complications that occurred in the 24 PDT cases studied. But then Dr. Sandifer stated, ...

Empyema necessitans (EN) is a rare long-term sequela of poorly or untreated empyema thoracis, characterized by the dissection pus through soft tissues and skin chest wall, ultimately forming fistula between pleural cavity. We herein present male patient in his late 30s, known case tuberculosis (TB) on anti-tubercular therapy (ATT) under directly observed treatment short-course (DOTS), who recen...

Objective: Empyema is an important problem that develops after pneumonia in children. Antibiotherapy and drainage of purulent fluid form the basis treatment. Various methods are used for drainage. Thoracoscopic debridement widely today with development minimally invasive methods. In this study, patients who were treated empyema period before use thoracoscopic our clinic compared debridement. Ma...