Brazilian Journal of Pulmonology

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

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Therapeutic management of tracheobronchial stenosis with stent application

A correção das estenoses traqueobrônquicas mediante o emprego de órteses

Maurício Guidi Saueressig, Amarílio Vieira de Macedo Neto, Alexandre Heitor Moreschi, Rogério Gastal Xavier, Paulo Roberto Stefani Sanches

J Bras Pneumol.2002;28(2):84-93

Abstract PDF PT

The surgical treatment of patients with tracheobronchial stenosis requires individualized attention due to the complexity of its origin though tracheoplasty is considered to be the ideal procedure. The most common causes of stenosis are tracheal intubation and the development of neoplasias. These are the very conditions that most benefit from endoscopic treatment when surgical correction is not indicated. Today, endoscopic procedures include the application of different kinds of laser and dilators usually delivered with a rigid bronchoscope, as well as radiotherapy and stents that may be used separately or associated. Basically, there are two types of stents, metal or silicone. The metallic ones are more frequently indicated in cases of tracheomalacia and extrinsic compressive stenosis. Silicone are more applicable in cases of tracheobronchial obstruction resultant from acute inflammation or endoluminal tumor. Although these methods can be used interchangeably in some cases, the best way to correct tracheobronchial stenosis is to correctly decide upon the treatment as early as the preliminary steps.

 


Keywords: Tracheal stenosis. Orthopedics fixation devices. Angioplasty.

 


Correspondence about the article - Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions

Correspondência sobre o artigo - Ecobroncoscopia radial para o diagnóstico de lesões pulmonares periféricas

Juliana Guarize1, Stefano Donghi1, Maurício Guidi Saueressig1,2,3

J Bras Pneumol.2017;43(1):76-76

PDF PT PDF EN Portuguese Text



Chylothorax after surgical treatment of right-sided thoracic outlet syndrome

Fístula linfática após tratamento cirúrgico de síndrome do desfiladeiro torácico à direita

Luiz Felipe Lopes Araujo, Alexandre Heitor Moreschi, Guilherme Baroni de Macedo, Laura Moschetti, Eduardo Lopes Machado, Maurício Guidi Saueressig

J Bras Pneumol.2009;35(4):388-391

Abstract PDF PT PDF EN Portuguese Text

Chylothorax as a complication of the surgical treatment of thoracic outlet syndrome is a quite rare event. We report a case of right-sided chylothorax and present a brief review on the treatment of postoperative chylothorax.

 


Keywords: Chylothorax; Thoracic outlet syndrome; Cervical rib syndrome; Postoperative complications.

 


Extracorporeal membrane oxygenation for postpneumonectomy ARDS

Oxigenação extracorpórea por membrana no tratamento da SARA pós-pneumonectomia

Maurício Guidi Saueressig, Patrícia Schwarz, Rosane Schlatter, Alexandre Heitor Moreschi, Orlando Carlos Belmonte Wender, Amarilio Vieira de Macedo-Neto

J Bras Pneumol.2014;40(2):-

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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.

 


Aggressive treatment using muscle flaps or omentopexy in infections of the sternum and anterior mediastinum following sternotomy

Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

Alexandre Heitor Moreschi, Amarilio Vieira de Macedo Neto, Gilberto Venossi Barbosa, Mauricio Guidi Saueressig

J Bras Pneumol.2008;34(9):654-660

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the impact of an aggressive treatment approach using muscle flaps or omentopexy in infections of the sternum and anterior mediastinum following sternotomy on mortality, as compared to that of a conservative treatment approach. Methods: Data were collected prior to, during and after the surgical procedures. Group A (n = 44) included patients submitted to conservative treatment- debridement together with resuture or continuous irrigation with polyvinylpyrrolidone-iodine solutions, or even with second-intention wound healing (retrospective data). Group B (n = 9) included patients in whom infection was not resolved with conservative treatment, and who therefore underwent aggressive treatment (intermediate phase). Group C (n = 28) included patients primarily submitted to aggressive treatment (prospective data). Results: Postoperative hospital stays were shorter in the patients submitted to aggressive treatment (p < 0.046). There were 7 deaths in group A, 1 in group B, and 2 in group C. However, the classical level of significance of α = 0.05 was not reached. Conclusion: Aggressive treatment also proved to be effective when the infection was not resolved with conservative treatment. These findings demonstrate that the proposed treatment provides excellent results.

 


Keywords: Surgical flaps; Osteomyelitis; Mediastinitis; Thoracic surgery.

 


 

 


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