Bagheri R, Haghy Sz, Rahim Mb, Attaran D, Silanian Toosi M,
Volume 67, Issue 2 (5 2009)
Abstract
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Background: Pleural
malignant mesothelioma is an uncommon but extremely invasive tumor which
originates from mesothelial cells and usually occures after prolonged exposure
to asbestos. The aim of this study was to clinicopathologically evaluation of 40
patients with pleural malignant mesothelioma and the main factors influencing
their prognosis.
Methods: In this
study patients with definitive diagnosis, who had been followed up for at least
three years were studied based on gender, age presenting symptoms, and
clinicopathological patterns.
Results: Male to
female ratio of the study patients was three to one any the average age of them
was 55 years. Chest pain was the most common symptoms in 34(85%) patients. Most
of the study patients were in Buchard stage I (37/5%) and the epithelial form
was the most common pathological pattern 25(62.5%). 19(47.5%) of cases received
only radiotherapy and chemotherapy. Extrapleural pneumonectomy was performed on
eight (20%) patients, seven (17.5%) patients underwent decortication and
pleurectomy beside adjuvant therapy and 15% of the cases rejected any type of
treatment. Surgical mortality occurred in one patient and the most common surgical
complication was wound infection. The average survival rate was 12±1.2 months and the main factors influencing it
were the patient's physiologic status, pathological form, stage of the disease
and the pattern of pleural involvement.
Conclusions: Because the low survival rate after multimodality invasive treatments in
mesothelioma, aggressive therapeutic methods were recommended in selected
patients
Reza Bagheri , Seyed Ziaollah Haghi , Mohammadtaghi Rajabi Mashhadi , Alireza Tavassoli , Davoud Attaran , Saeed Akhlaghi , Neusha Barekati , Maryam Esmaeeli ,
Volume 71, Issue 9 (December 2013)
Abstract
Background: Acquired paralysis of the diaphragm is a condition caused by trauma, surgical injuries, (lung cancer surgery, esophageal surgery, cardiac surgery, thoracic surgery), and is sometimes of an unknown etiology. It can lead to dyspnea and can affect ventilatory function and patients activity. Diaphragmatic plication is a treatment method which decreases inconsistent function of diaphragm. The aim of this study is to evaluate the outcome of diaphragmatic plication in patients with acquired unilateral non-malignant diaphragmatic paralysis. Methods: From 1991 to 2011, 20 patients with acquired unilateral diaphragmatic paralysis who underwent surgery enrolled in our study in Ghaem Hospital Mashhad University of Medical Science. Patients were evaluated in terms of age, sex, BMI, clinical symptoms, dyspnea score (DS), etiology of paralysis, diagnostic methods, respiratory function tests and complication of surgery. Some tests including dyspnea score were carried out again six months after surgery. We evaluated patients with SPSS version 11.5 and Paired t-test or nonparametric equivalent. Results: Twenty patients enrolled in our study. 14 were male and 6 were female. The mean age was 58 years and the average time interval between diagnosis to surgical treatment was 38.3 months. Acquired diaphragmatic paralysis was mostly caused by trauma (in 11 patients) and almost occurred on the left side (in 15 patients). Diagnostic methods included chest x-ray, CT scan, ultrasonography and sniff. Test prior to surgery the average FVC was 41.4±7 percent and the average FEV1 was 52.4±6 percent and after surgery they were 80.1±8.6 percent and 74.4±1 percent respectively. The average increase in FEV1 and FVC 63.4±4, 61.1±7.8. Performing surgery also leads to a noticeable improvement in dyspnea score in our study. Conclusion: In patients with acquired unilateral non-malignant diaphragm paralysis diaphragmatic plication is highly recommended due to the remarkable improvement in respiratory function tests and dyspnea score without mortality and acceptable morbidity.
