Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Clinicopathological aspects of and survival in patients with clinical stage I bronchioloalveolar carcinoma

Aspectos clínico-patológicos do carcinoma bronquioloalveolar e sobrevida em pacientes no estágio clínico I

Daniel Sammartino Brandão, Rui Haddad, Giovanni Antonio Marsico, Carlos Henrique Ribeiro Boasquevisque

J Bras Pneumol.2010;36(2):167-174

Abstract PDF PT PDF EN Portuguese Text

Objective: To analyze the clinicopathological aspects of bronchioloalveolar carcinoma (BAC) and the survival in a sample of patients at clinical stage I. Methods: A retrospective study involving 26 patients diagnosed with clinical stage I BAC and undergoing surgery at the Thoracic Diseases Institute of the Federal University of Rio de Janeiro, in the city of Rio de Janeiro, Brazil, between 1987 and 2007. We analyzed clinicopathological and radiological aspects, as well as mortality and survival. The data, which were collected from the medical charts of the patients, were statistically analyzed. Results: Females predominated (n = 16). The mean age at diagnosis was 68.5 years. Most patients were active smokers (69.2%). The most common forms of presentation of BAC were the asymptomatic form (84.6%) and the nodular form (88.5%). Involvement of the upper lobes predominated (57.7%). Stage IB was the most common pathological stage, followed by stages IA and IIB (46.2%, 38.4% and 15.4%, respectively). There was no in-hospital mortality. Four patients died during the postoperative follow-up, with a mean disease-free survival time of 21.3 months. The overall five-year survival rate was 83%. The probability of survival for the patients diagnosed after 1999 showed a trend toward an increase when compared with that for those diagnosed up through 1999 (three-year survival rate: 92% vs. 68%; p = 0.07). Conclusions: The clinicopathological aspects of this study sample were similar to those of patients with BAC evaluated in previous studies.

 


Keywords: Adenocarcinoma, bronchiolo-alveolar; Carcinoma, non-small-cell lung; Lung; Smoking.

 


Mitral valve obstruction by tumor embolus as a cause of irreversible cardiac arrest during right pneumonectomy

Obstrução de valva mitral por embolização tumoral per-operatória (pneumectomia direita) com parada cardíaca irreversível

Rui Haddad, Carlos Henrique Ribeiro Boasquevisque, Tadeu Diniz Ferreira, Mario Celso Martins Reis, Fernando D'Imperio Teixeira

J Bras Pneumol.2008;34(7):537-540

Abstract PDF PT PDF EN Portuguese Text

A 26-year-old patient with a voluminous primary pulmonary hemangiopericytoma in the right lung, diagnosed through previous surgical biopsy, presented irreversible cardiac arrest during the hilar dissection portion of a right pneumonectomy. The patient did not respond to resuscitation efforts. Autopsy showed total obstruction of the mitral valve by a tumor embolism. In cases of large lung masses with hilar involvement, as in the case presented, we recommend preoperative evaluation using transesophageal echocardiography, magnetic resonance imaging or angiotomography. If injury to the pulmonary vessels or atrial cavities is detected, surgery with extracorporeal circulation should be arranged in order to allow resection of the intravascular or cardiac mass, together with pulmonary resection. We recommend that care be taken in order to recognize and treat this problem in patients not receiving a preoperative diagnosis.

 


Keywords: Embolism; Heart arrest; Pneumonectomy.

 


Pneumothorax and tension pneumopericardium following cardiothoracic surgery

Pneumotorax e pneumopericárdio hipertensivo em cirurgia cardiotorácica

Rui Haddad, Carlos Eduardo Teixeira Lima, Carlos Henrique Boasquevisque, Guilherme Saraiva Haddad, Tadeu Diniz Ferreira

J Bras Pneumol.2006;32(1):84-87

Abstract PDF PT PDF EN Portuguese Text

Herein, we report two cases of pneumothorax and tension pneumopericardium after cardiothoracic surgery. Both patients underwent pericardiotomy during the primary operation and developed pericardial tamponade as a complication. The treatment was tube thoracostomy, and both patients recovered completely.

 


Keywords: Pneumopericardium/etiology; Pneumothorax/etiology; Thoracic surgical procedures/adverse effects; Postoperative complications

 


Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study)

Ressecção pulmonar anatômica por videotoracoscopia: experiência brasileira (VATS Brasil)

Ricardo Mingarini Terra1, Thamara Kazantzis1, Darcy Ribeiro Pinto-Filho2, Spencer Marcantonio Camargo3, Francisco Martins-Neto4,5, Anderson Nassar Guimarães6, Carlos Alberto Araújo7, Luis Carlos Losso8, Mario Claudio Ghefter9, Nuno Ferreira de Lima10, Antero Gomes-Neto5, Flávio Brito-Filho10, Rui Haddad11, Maurício Guidi Saueressig12, Alexandre Marcelo Rodrigues Lima13, Rafael Pontes de Siqueira5, Astunaldo Júnior de Macedo e Pinho14, Fernando Vannucci15

J Bras Pneumol.2016;42(3):215-221

Abstract PDF PT PDF EN Portuguese Text

Objective: The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil. Methods: Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy. Demographic, surgical, and postoperative data were collected with a standardized instrument, after which they were compiled and analyzed. Results: The surgeons provided data related to a collective total of 786 patients (mean number of resections per surgeon, 43.6). However, 137 patients were excluded because some data were missing. Therefore, the study sample comprised 649 patients. The mean age of the patients was 61.7 years. Of the 649 patients, 295 (45.5%) were male. The majority-521 (89.8%)-had undergone surgery for neoplasia, which was most often classified as stage IA. The median duration of pleural drainage was 3 days, and the median hospital stay was 4 days. Of the 649 procedures evaluated, 598 (91.2%) were lobectomies. Conversion to thoracotomy was necessary in 30 cases (4.6%). Postoperative complications occurred in 124 patients (19.1%), the most common complications being pneumonia, prolonged air leaks, and atelectasis. The 30-day mortality rate was 2.0%, advanced age and diabetes being found to be predictors of mortality. Conclusions: Our analysis of this representative sample of patients undergoing pulmonary resection by video-assisted thoracoscopy in Brazil showed that the procedure is practicable and safe, as well as being comparable to those performed in other countries.

 


Keywords: Thoracic surgery, video-assisted; Thoracoscopy; Pneumonectomy.

 


Trauma-related thoracoplasty: case report

Toracoplastia traumática: relato de caso

Gabriela Addor, Andreia Salarini Monteiro, David Henrique Nigri, Luiz Felippe Judice, Rui Haddad, Carlos Alberto de Barros Franco

J Bras Pneumol.2007;33(3):351-354

Abstract PDF PT PDF EN Portuguese Text

Trauma primarily affects young people and is the leading cause of death in the first three decades of life. Flail chest is observed in approximately 10% of all patients with severe chest trauma, and the mortality rate among such patients is 10-15%. We report herein the case of a car accident victim with chest trauma causing hemopneumothorax and multiple rib fractures, intense pain and deformity of the chest wall. Surgical stabilization was performed, with good results. Therapeutic options are also discussed.

 


Keywords: Thoracic injuries; Flail chest; Thoracoplasty.

 


Surgical treatment of a paratracheal bronchogenic cyst using cervical mediastinoscopy

Tratamento cirúrgico de cisto broncogênico paratraqueal por mediastinoscopia cervical

Daniel Sammartino Brandão, Carlos Henrique Ribeiro Boasquevisque, Rui Haddad, Eduardo de Souza Ponzio

J Bras Pneumol.2005;31(4):365-364

Abstract PDF PT PDF EN Portuguese Text

Bronchogenic cysts of the mediastinum are benign congenital lesions, usually found in adults. When surgery is indicated, the classical approach is resection of the lesion by thoracotomy or thoracoscopy. Herein, we describe the complete resection of a paratracheal bronchogenic cyst by cervical mediastinoscopy. We also include a brief review and discussion of the literature.

 



 

 


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