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Castel Guelfo di Bologna, Italy

Kawamukai K.,Maggiore and Bellaria Hospitals
BMJ case reports | Year: 2011

Multimodality treatment, with chemotherapy and surgery, is potentially curative in case of non-seminomatous germ cell tumours. The authors present the case of a primitive mediastinal GTC with bilateral lung metastases. The patient was treated with five cycles of chemotherapy. Restaging showed reduction of the extent and of 18 FDG intake and β-HCG serum levels. The patient underwent two-step surgical excision of the tumours: mediastinal lesion and 35 lung metastases were resected by a right thoracotomy and 39 metastases were removed by a left thoracotomy. Histology showed absence of viable tumour in all the specimens. Twelve months after surgery the patient is free of disease. Source


Boaron M.,Maggiore and Bellaria Hospitals | Kawamukai K.,Maggiore and Bellaria Hospitals | Parri S.N.F.,Maggiore and Bellaria Hospitals | Trisolini R.,Thoracic Endoscopy and Pulmonology Unit
Interactive Cardiovascular and Thoracic Surgery | Year: 2010

We report on the successful surgical treatment of an esophageal-bibronchial fistula originating from an iatrogenic mediastinal abscess. Endoscopic treatment had been excluded due to the extensive damage to the right main stem bronchus wall. The surgical treatment was carried out as follows: 1) Endoscopic stenting of the left main bronchus with a self-expanding metallic stent followed by selective left main bronchus intubation; 2) Laparotomic harvesting of the omentum pedicled on both gastro-epiploic vessels; 3) Right thoracotomy, complete dissection of both main bronchi and esophageal wall at the site of the leakage; 4) Harvesting of a pericardial vascularized graft; 5) Deployment of a self-expanding metallic stent from the surgical field into the right main stem bronchus; 6) Reconstruction of the right bronchus wall with the pericardial patch; 7) Positioning a T-tube in the esophageal leak; and 8) Intrathoracic transposition of the omental graft for buttressing all sutures and potential leakage points. The postoperative course was uneventful from a surgical point of view and the patient recovered completely. Source


Kawamukai K.,Maggiore and Bellaria Hospitals | Di Saverio S.,University of Bologna | Antonacci F.,Maggiore and Bellaria Hospitals | Lacava N.,Maggiore and Bellaria Hospitals | Boaron M.,Maggiore and Bellaria Hospitals
BMJ Case Reports | Year: 2011

Multimodality treatment, with chemotherapy and surgery, is potentially curative in case of non-seminomatous germ cell tumours. The authors present the case of a primitive mediastinal GTC with bilateral lung metastases. The patient was treated with five cycles of chemotherapy. Restaging showed reduction of the extent and of 18 FDG intake and β-HCG serum levels. The patient underwent two-step surgical excision of the tumours: mediastinal lesion and 35 lung metastases were resected by a right thoracotomy and 39 metastases were removed by a left thoracotomy. Histology showed absence of viable tumour in all the specimens. Twelve months after surgery the patient is free of disease. Copyright 2011 BMJ Publishing Group. All rights reserved. Source


Kawamukai K.,Maggiore and Bellaria Hospitals | Antonacci F.,Maggiore and Bellaria Hospitals | di Saverio S.,Maggiore Hospital | Boaron M.,Maggiore and Bellaria Hospitals
Interactive Cardiovascular and Thoracic Surgery | Year: 2011

Acute herniation of the heart is an uncommon complication in patients undergoing pneumonectomy with associated pericardial resection. We report the case of a postoperative cardiac herniation after a right extrapleural pneumonectomy following neoadjuvant chemotherapy for malignant pleural mesothelioma. After surgery the patient was completely asymptomatic, but a postoperative chest X-ray revealed unexpected massive dextrocardia. The patient was immediately brought back to the operating room: a cardiac herniation was found to be caused by a partial dehiscence of the pericardial prosthesis suture. The defect was repaired without consequences. © 2011 Published by European Association for Cardio-Thoracic Surgery. Source


Leuzzi G.,Maggiore and Bellaria Hospitals | Kawamukai K.,Maggiore and Bellaria Hospitals | Lacava N.,Maggiore and Bellaria Hospitals
Lung | Year: 2013

We report a case of a 71-year-old Caucasian woman who was referred to our emergency department for acute onset of dyspnoea and dry cough. She underwent dental filling for caries ~2 h before. During the treatment, the distal part of the odontoiatric drill unintentionally fell off into the patient's oral cavity and was accidentally inhaled. Posteroanterior chest X-ray evidenced the foreign body localized in the right bronchial tree. A chest computed tomography scan showed the drill (with the tip pointed upward) wedged at the beginning of the right basal pyramid. A subsequent fiberoptic bronchoscopy confirmed the tip of the drill in the right lower bronchus, and the foreign body was easily removed due to the favorable position of the tip. The patient was discharged in first postoperative day without consequences. © 2013 Springer Science+Business Media New York. Source

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