The late management of spontaneous esophageal perforation is the most challenging problem for the surgeon. In this paper, we present a case in whom a spontaneous esophageal perforation was successfully treated by T-tube drainage after unsuccessful conservative treatment. The patient, a 68-year-old male, was admitted to the hospital with sudden upper abdominal pain. After 2 days, esophageal perf...

Jejunostomy, which requires the fixation of the jejunum to the abdominal wall, is commonly used as an enteral feeding access after esophagectomy. However, this procedure sometimes causes severe complications, such as mechanical bowel obstruction. In 2009, we developed a modified approach to insert an enteral feeding tube through the reconstructed gastric tube using the round ligament of the liv...

pain control is a major concern in post-thoracotomy patients. the current prospective randomized double-blind study was designed to evaluate the analgesic effects of morphine and fentanyl given interpleurally after posterolateral thoracotomy. thirty patients undergoing elective posterolateral thoracotomy in a teaching hospital in tehran were divided into 3 groups with equal number of patients. ...

OBJECTIVE Although the thoracotomy incision is guided in part by the exposure required, both cosmesis and the potential for improved recovery are important factors to be taken into account. We conducted a prospective randomized study in order to compare muscle sparing thoracotomy (MST) and standard posterolateral thoracotomy (PLT) for postoperative pain and physical function during and after ho...

BACKGROUND Video-assisted thoracic surgery (VATS) is currently performed to diagnose and treat solitary pulmonary nodules (SPN). However, the intra-operative identification of deep nodules can be challenging with VATS as the lung is difficult to palpate. The aim of the study was to report the utility and the results of pre-operative computed tomography (CT)-guided hook wire localization of SPN....

AIM To compare the outcomes of patients who underwent upper mini-sternotomy or right mini-thoracotomy and those who underwent full sternotomy and to report a technical improvement in venous drainage by means of double venous cannulation of the superior vena cava (SVC) in mini surgical procedures. METHODS We retrospectively analyzed the outcome of 217 patients who underwent aortic valve replac...

Esophagectomy is the appropriate treatment for patients with resectable esophageal cancer. In common with conventional surgeries, controversy exists about what is the best approach and extent of the dissection. For many years, the procedure of choice for the incision has been the Ivor Lewis procedure, later modified. The tumor is resected through a right thoracotomy combined with a laparotomy w...

A 51-year-old man with a 5 days history of mild dysphagia was referred to our hospital. Computed tomography of the chest and abdomen showed a bulge tumor of the lower third esophageal wall and a malignant lesion in the antrum in the distal part of the stomach. The patient underwent a left anterolateral thoracotomy through the sixth intercostal space via a ventral midline incision, with a two-fi...