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Boudaya M.-S.,Tunis el Manar University | Smadhi H.,Tunis el Manar University | Marghli A.,Tunis el Manar University | Charmiti F.,Abderrahmen Mami University Hospital | And 6 more authors.
Asian Cardiovascular and Thoracic Annals | Year: 2013

Background: The treatment of patients with locally advanced non-small-cell lung cancer is controversial. Surgery remains the gold standard, even in this group. Neoadjuvant chemotherapy could allow surgical resection in patients initially judged inoperable. Methods: From January 2009 to May 2010, neoadjuvant chemotherapy was indicated in 27 patients with NSCLC (25 men, 2 women). Their mean age was 65 years. The stages were: IIB in 5, IIIA in 17 (6 in stage IIIAN2), IIIB in 2, and IV in 3. Results: 23 patients received neoadjuvant chemotherapy, 2 refused induction treatment, and 2 had impaired status. The neoadjuvant chemotherapy regimen was gemcitabine-cisplatin in 17 patients and vinorelbine-cisplatin in 6. Only 5 patients underwent complete surgical treatment after induction: 1 in stage IIB, 1 in stage IIIAN0, 1 in IIIB, and 2 in stage IV (1 operated brain metastasis, and 1 operated adrenal metastasis). Surgical treatment was not achieved after neoadjuvant chemotherapy in 18 patients because of progressive disease. Conclusion: Neoadjuvant chemotherapy offers several potential benefits, but it may delay surgery or eliminate eligibility as a surgical candidate. Rigorous patient selection for this type of multimodal treatment is essential. © 2012 The Author(s).

Boudaya M.-S.,Abderrahmen Mami University Hospital | Abid W.,Abderrahmen Mami University Hospital | Mlika M.,Abderrahmen Mami University Hospital
Indian Journal of Surgery | Year: 2016

Sleeve resection is a valid option in the surgical treatment of lung tumors, avoiding large resection. To ensure a good functional result and avoid post-operative complications like recent broncho-pleural fistulas and long-term stenosis, anastomosis between bronchi must be well performed. We report two cases of sleeve resection of the right lower lobe and show how we managed caliber discrepancy between the middle lobe bronchus and the truncus intermedius. © 2016, Association of Surgeons of India.

Boudaya M.-S.,Abderrahmen Mami University Hospital | Boudaya M.-S.,Tunis el Manar University | Mohamed J.,Abderrahmen Mami University Hospital | Mohamed J.,Tunis el Manar University | And 8 more authors.
Surgery Today | Year: 2014

Background: The combination of pulmonary and hepatic hydatid cysts is frequently encountered, and poses a challenge in terms of surgical accessibility. The surgical treatment of the two locations by the same incision (thoracotomy with phrenotomy) has been proposed, but always from the right side. However, applying this technique to the left side seems to be more difficult and unusual. We herein describe a new left-sided technique that was used to treat two patients with pulmonary and hepatic hydatid cysts. Methods: The first patient was 14-year-old; he had bilateral pulmonary hydatid cysts and one type I cyst of the left lobe of the liver. The second patient was a 10-year-old female who had a hydatid cyst of the upper left lobe with one type III cyst of hepatic segments 2 and 3. Results: Both patients were operated on via a left lateral thoracotomy through the sixth intercostal space. They underwent cystectomy for the left pulmonary hydatid cysts, followed by padding, and then the hepatic cyst was treated by Lagrot’s method via a radial phrenotomy. The postoperative course was uneventful in both cases, with postoperative hospital stays of 3 and 5 days, respectively. Conclusion: This combined treatment of pulmonary and hepatic hydatid cysts by the left-sided thoracic approach is feasible and provides a good outcome. It should be indicated under the same conditions of accessibility and feasibility applied for the right thoracic side. © 2013, Springer Japan.

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