Freise, G., Gabler, A., and Liebig, S. (1978). Thorax, 33,[228][229][230][231][232][233][234] (Table 1). Thirty-eight patients (8%) had tumours which were not resectable. Sixty-three (13-4%) died within the first four weeks after operation. Follow-up was not possible after discharge from hospital in 10 cases. The remaining 398 patients were followed up at outpatient consultations or from information sent by practitioners or other hospitals. One hundred and twenty-five patients (28-9%) survived five years; this survival rate is similar to those in other published studies.
ResultsThe incidence of bronchial carcinoma in women is less than in men. In our series, females represented 10% of all thoracotomies, which is an average rate (Buchberger and Jenny, 1967;Sriboonma, 1967;Kutschera, 1968). The reason why women have a better prognosis (Berndt, 1965;Watson, 1965) is uncertain. Our five-year survival rate in women is 34% and in men 27%. The women
Chylous ascites is a rare complication following pancreaticoduodenectomy. We report on a case of chylous ascites following pancreaticoduodenectomy in a 76-year-old patient diagnosed with pancreatic cancer. There are various known conservative management strategies, including dietary measures or total parenteral nutrition. Unfortunately, conservative treatment-with total parenteral nutrition and fasting over a period of 4 weeks-was not successful in the present case. The daily output volume of chylous ascites was up to 2500 ml/day. Based on clinical experiences with successfully treated lymphocutaneous fistulas, low-dose radiotherapy was initiated. External beam radiotherapy comprising a total dose of 8.0 Gy to the paraaortic lymph node region was administered in daily single fractions of 1.0 Gy (five fractions/week). Throughout the course of external beam radiotherapy, the secretion of abdominal ascites rapidly decreased, resulting in complete resolution after 2 weeks. There was no clinical evidence of chylous ascites on follow-up. As a result of this experience, we believe that external beam radiotherapy should be considered as an alternative therapy in refractory cases of chylous ascites.
After a primary operation for bronchial carcinoma, 17 patients underwent reoperation for local recurrence or intrathoracic metastasis (nine squamous cell, five alveolar cell, and three adenocarcinomas). One year ago, the work of Schulte et a12 induced us to analyse our own cases. We were also influenced by the work published by Abbey Smith34 and Neptune et a15 as well as that of Doring6 who in 1976 reported on the largest number of cases. We found that in the last 25 years, 11 reoperations for bronchial carcinoma had been performed at our hospital. In the same year, after we had reported our findings at a meeting of the Berlin Pneumologists,5 six additional reoperations for recurrent bronchial carcinoma were performed.In this paper we consider only those cases where a reoperation for recurrent bronchial carcinoma was performed after a previous resection for bronchial carcinoma. We are not concerned with the many possible alternative surgical procedures after resection of the lung because of bronchial carcinoma.
Grade of differentiation cannot be assessed Gx Differenzierungsgrad kann nicht beurteilt werden G1 Well differentiated G, Gut differenziert G2 Moderately differentiated GZ Mäßig differenziert G3 Poorly differentiated G3 Schlecht differenziert G4 Undifferentiated G4 Undifferenziert.
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