Izhodišča: Optimalna kirurška tehnika eksplantacije donorskih pljuč in ustrezna izvedba ohranitvenega postopka organa sta ključna dejavnika pri zagotavljanju dobrega delovanja presajenih pljuč, kar je še posebej pomembno v procesu vzpostavljanja programa transplantacije pljuč. Metode: Retrospekitvno smo analizirali prva tri leta trajanja programa eksplantacije donorskih pljuč, ki smo ga opravili v sklopu programa presaditev pljuč v naši ustanovi. Glavni namen raziskave je bil oceniti učinkovitost eksplantacije donorskih pljuč z določitvijo PGD (angl. primary graft dysfunction) pri prejemnikih in morebitni vpliv trajanja eksplantacije in razdalje do donorske ustanove na PGD. Rezultati: Od septembra 2018 do avgusta 2021 smo izvedli 56 eksplantacij donorskih pljuč, od teh smo 37 (66,1 %) pljuč sprejeli, 19 (33,9 %) pa smo jih zavrnili. Od vseh 37 transplantiranih bolnikov jih je 33 (89,2 %) imelo PGD 0, 2 bolnika (5,4 %) sta imela PGD 3, pri 2 (5,4 %) bolnikih pa je bil ta nedoločljiv; PGD 1 ali 2 pa ni bil izmerjen pri nobenem od bolnikov. Čas eksplantacije (p = 0,542) in oddaljenost donorske ustanove (p = 0,605) nista bila statistično pomembno povezana s PGD pri prejemnikih. Zaključek: Analiza prvih treh let našega dela je pokazala, da smo vzpostavili uspešen in učinkovit program eksplantacije donorskih pljuč, kar je pomemben prispevek dobremu rezultatu zdravljenja bolnikov s presaditvijo pljuč.
Purpose: We evaluated our one– year experience in the intraoperative measurement of parathyroid hormone (IOPTH) in parathyroid adenoma surgery. We also compared surgical outcome after minimally invasive parathyroidectomy (MIP) and conventional neck exploration (CNE). Methods: Between April 2011 and April 2012, eight consecutive patients with primary hyperparathyroidism (PHP) underwent parathyroidectomy with IOPTH in our institution. Parathyroidectomy was defined as successful when a >50% decrease of IOPTH was observed 10 minutes after resection of the abnormal gland. The second criterion for success was a six month period of postoperative normocalcaemia. Results: We performed four MIPs, two unilateral neck explorations, and two bilateral neck explorations, resulting in a total of seven solitary and one double adenomas. IOPTH level decrease expectations were met in all cases. The average length of surgery for MIP was 31 minutes, and 69 minutes for CNE. All patients were eucalcaemic with normal PTH levels during the 6 month follow–up period. Three patients had postoperative hypocalcaemia after CNE and there were no recurrences 6 months postoperatively. Conclusion: The review of our series of eight consecutive patients with PHP showed a 100% cure rate after employing IOPTH measurement in both surgical approaches. The advantages of MIP are: shorter operating time, better cosmetic results, and a lower incidence of hypocalcaemia.
Purpose: This paper discusses the diagnostic approach, treatment and certain complications in the treatment of patients with hydatid lung disease. The objective of surgical treatment is removal of the cyst and preservation of the healthy lung parenchyma. In cases of overgrowth of the pulmonary artery, which are rare, it is sometimes necessary to remove the lung;this is linked with the possibility of serious postoperative complications. Case report: We present the case of a 27–year–old patient with a hydatid cyst overgrowing the pulmonary artery and requiring removal of the left lung. After the surgery, acute respiratory distress syndrome (ARDS) developed in the remaining right lung. Extracorporeal membrane oxidation (ECMO) was required. Despite a serious complication of the extensive surgical resection, the patient left the hospital after four weeks without major health problems. Conclusion: In patients with giant pulmonary hydatidcysts it is possible to perform surgery, preserve the lung and continue treatment with the addition of albendazole therapy. The removal of the lung, on account of overgrowth of the pulmonary artery, can significantly affect the course of postoperative treatment. When planning the surgical procedure, a precise image of the pulmonary hilar structures is essential.
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