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Revista Cubana de Cirugía

versión On-line ISSN 1561-2945


LEAL MURSULI, Armando et al. Reducción simultánea del enfisema bulloso bilateral por esternotomía media. Rev Cubana Cir [online]. 2000, vol.39, n.3, pp. 195-203. ISSN 1561-2945.

It is reported that pulmonary emphysema is a chronic and disabling disease in which the bilateral giant bullae (that occupy more than 50% of each hemithorax) may produce a clinical form characterized by dyspnoea and impossibility of a satisfactory quality of life treated by the conventional method (2 thoracotomies, synchronic or not) until 1973. The mean sternotomy for bilateral and simultaneous resection of the bilateral emphysema was performed for the first time in Cuba in 1987 by the Multidisciplinary Group of Thoracic Surgery at the "Miguel Enriquez"< Clinical and Surgical Teaching Hospital. Age, sex, personal pathological history, preoperative complementary tests, the time of removal of the pleural tubes, complications, mortality, and postoperative evolution at 6 and 12 months were evaluated as part of a prospective research and the usefulness of this technique was compared with the conventional one. The data obtained were processed by a computerized pogram in order to express them in tables and figures. The fifth decade of life and the male sex were the most affected. The most used preoperative complementary tests were chest X-rays and fluoroscopy, gasometry and the functional ventilatory tests. Dyspnoea was the most frequent syndrome. The average time of removal of the pleural tubes was of 8 days. The airway leak was the commonest complication. There was no operative mortality. Postoperative evolution was excellent and the comparison between both surgical techniques showed the scientific, economic and social superiority of the simultaneous resection of the bilateral bullous emphysema by mean sternotomy. It is concluded that the simultaneous surgical treatment of bilateral bullous emphysema by mean sternotomy is the elective procedure for this disease due to its benefits. This procedure is considered at present as a modality of surgery for reducing the pulmonary volume, a state-of-the art technique in modern thoracic surgery

Palabras clave : TORACOTOMIA [métodos]; PULMONARY EMPHYSEMA [surgery]; STERNUM [surgery]; THORACOTOMY [methods].

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