Aim: To compare the malignant and non-malignant acquired tracheoesophageal fistulae management strategies. Study design: Prospective study Place and duration of study: Bolan Medical College Teaching Hospital, Quetta from 1st January 2022 to 31st December 2022. Methodology: Sixty patients suffering from tracheoesophageal fistulae were enrolled. The patients were then divided into two groups where depending upon convenient sampling the first group was named as malignant while second was non-malignant group. The underlying etiology of each patient was recorded and assessments of clinical conditions were made through imaging and endoscopic techniques. The preoperative, intraoperative and stenting management strategies were applied on the enrolled cases. Single, double stenting was based on case to case. Results: The mean age of the cases with benign tracheoesophageal fistula was 10.5±1.2 years while those having malignant tracheoesophageal fistula was 51.2±6.5 years. There were total 20 cases of tracheoesophageal fistula with nonmalignant diagnosis while 40 cases with malignant tracheoesophageal fistula. Within the primary outcomes of the cases the preoperative mortality was higher in non-malignant cases than malignant while morbidity was much higher in the malignant cases with 35% in that presenting fistula recurrence. Practical Implication: Malignancy appeared to be the main cause of TEF in patients and their survival chances are also less. Conclusion: Stenting is best managing strategy in patients with improved survival rate malignant as well as non-malignant cases. Keywords: Malignancy, Fistula, Esophagus, Ventilator, Stenting
Background: Subcutaneous emphysema is infiltration of air under dermis layers in tracheobronchial injuries and needs to be immediately addressed for proper management. Aim: To assess the management protocols for tracheobronchial injuries with subcutaneous emphysema. Study design: Retrospective study. Place and duration of study: Dept of Thoracic Surgery, Sandeman Provincial Hospital Quetta from 01-01-2020 to 31-03-2021. Methodology: Fifty patients were assessing for their management techniques in tracheobronchial injuries with subcutaneous emphysema. Patients with conservative as well as surgical management were completely analyzed. Their data regarding traumatic injury was recorded. Results: The mean age of patients was 22.3±5.2 years with 85% being males and 15% females enrolled. Patients who had less traumatic injury and were managed by conservative treatment has better recovery rate than surgically operated cases. Conclusion: Timely management with surgical procedure in severe injuries is required for better recovery outcomes. Keywords: Tracheobronchial injury, Subcutaneous emphysema, Traumatic surgery
Aim: To determine the frequency of airways foreign body bronchus in children pneumothorax. Study Design: Cross-sectional/descriptive study Place and Duration of Study: Department of Thoracic Surgery, Sandeman Provincial Hospital Quetta from 1st January 2020 to 31st December 2020. Methodology: Forty five patients of both genders and aged between 1 to 15 years were enrolled. Patients details demographics age, gender, residence and body mass index were recorded after taking informed consent. Chest computed tomography and X-ray to bronchus were performed to examine the nature and site of foreign body. Bronchoscopy was performed and outcomes were analyzed. Results: There were 30 (66.67%) males and 15 (33.33%) females. Majority of patients 27 (60%) were ages <6 years. Mean body mass index was 12.08±6.33 kg/m2. Mean time interval between foreign body aspiration and admitted to hospital was 4.08±2.08days. Foreign body bronchus was found in 14 (31.11%) patients. The right main bronchus was the most common site in 9 (64.28%) followed by left bronchus in 5(35.71%).Most common foreign body retrieved was seeds found in 9 (64.28%), piece of plastic in 3 (21.43%), peanut in 1 (7.14%) and nuts in 1 (7.14%) patients respectively. Bronchoscopy performed in 14 patients and none of patients had developed any complication. Conclusion: Foreign body bronchus was found in 31.11% patients presented with pneumothorax and most common foreign body aspiration was seeds. Bronchoscopy was safe and effective with no major complication. Keywords: Children, Foreign body aspiration, Bronchus, Pneumonia
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