Pulmonary function after a segmentectomy for a good-risk patient is slightly better than that after a lobectomy. However, segmentectomy should be still the surgical procedure for only poor-risk patients because of the difficulty in excluding patients with metastatic lymph nodes from the candidates for the procedure.
The diaphragm is an uncommon site for solitary fibrous tumors of the pleura (SFTPs). Diaphragmatic SFTPs are usually found as pedunculated tumors with a clear margin with their surrounding structures. However, preoperative diagnosis of the tumor is difficult because their morphological features are not well detected on radiological images. We presented a case of diaphragmatic SFTP that was successfully diagnosed by ultrasonography (US). The US revealed a well-circumscribed mass with the feeding arteries leading from the diaphragm. Subsequently, this finding was confirmed histopathologically after resection. US can be less invasive and more sensitive than radiological examinations for diagnosing diaphragmatic SFTPs. To our knowledge, this is the first report of a preoperative diagnosis of diaphragmatic SFTP by US.
The effect of fibrin glue on inhibition of pericardial adhesions was tested using 26 beagle dogs. Dacron patches were sutured to the heart and tincture of iodine was applied to promote adhesions. Fibrin glue (3 ml) was sprayed over the patches in 15 dogs (test group), and was not separated in the remaining 11 dogs (control group). All animals in the test group had minimal adhesions between the pericardium and the epicardium or patched region, and an accumulation of gelatinous material was found in the subpericardial space. Marked fibrosis and a poor demarcation of the subpericardial space were found in the control group. The adhesion score and the visibility of coronary anatomy in the test group were significantly better than in the control group. The tension strength in the test group was significantly less than in the control group. We concluded, therefore, that fibrin glue may also be useful as an adhesion inhibitor.
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