Tracheal Resection and Anastomosis: Surgical Procedure, Indications, Techniques, Risks, and Recovery

Tracheal Resection and Anastomosis: Surgical Procedure, Indications, Techniques, Risks, and Recovery

pediagenosis    August 02, 2026    Comment   

TRACHEAL RESECTION AND ANASTOMOSIS

Tracheal stenosis can be idiopathic but is most commonly the result of prior intubation or tracheostomy. Common areas of stenosis were previously located in the mid-trachea related to high-pressure, low-volume endotracheal tube cuffs; however, contemporary endotracheal appliances have low-pressure cuffs. Today stenotic lesions are typically found in the proximal or subglottic trachea at the site of a prior stoma. Mid- to distal tracheal resections are more likely performed as therapy for benign or malignant airway tumors. In most cases of symptom-producing stenosis of the trachea, conservative therapy, consisting of repeated dilatations, is either contraindicated or has proven to be ineffective. Consequently, surgical correction is necessary. The procedure of choice is resection of the stenotic tracheal segment with primary reconstruction via an end-to-end anastomosis (see illustration).

Removal of Mediastinal Tumors: Surgical Approaches, Mediastinal Anatomy, Diagnosis, and Treatment Guide

Removal of Mediastinal Tumors: Surgical Approaches, Mediastinal Anatomy, Diagnosis, and Treatment Guide

pediagenosis    August 02, 2026    Comment   

REMOVAL OF MEDIASTINAL TUMORS

Tumors of the mediastinum are a challenging group both diagnostically and in terms of treatment. A host of pathologic entities is involved, and for many of these, surgical excision is the treatment of choice. Recognition and identification of mediastinal abnormalities are almost always based on chest radiographs. Although the radiologic appearance is sometimes characteristic or (rarely) pathognomonic, most often it is the location within the mediastinum that is most influential in correct diagnostic interpretation.

Congenital Radioulnar Synostosis: Causes, Symptoms, Diagnosis, Treatment & Functional Outcomes

Congenital Radioulnar Synostosis: Causes, Symptoms, Diagnosis, Treatment & Functional Outcomes

pediagenosis    July 31, 2026    Comment   

CONGENITAL RADIOULNAR SYNOSTOSIS

Congenital radioulnar synostosis is an uncommon condition in which the proximal ends of the radius and ulna are joined, fixing the forearm in pronation. The deformity is due to a failure of the developing cartilaginous precursors of the forearm to separate during fetal development. Radioulnar synostosis is bilateral in 60% of patients and is frequently associated with other musculoskeletal abnormalities. Chromosomal abnormalities have been reported in some patients with bilateral involvement. Two types of synostosis are seen. In the first, called the headless type, the medullary canals of the radius and ulna are joined and the proximal radius is absent or malformed and fused to the ulna over a distance of several centimeters. The radius is anteriorly bowed and its diaphysis is larger and longer than that of the ulna. In the second type, the fused segment is shorter and the radius is formed normally but the radial head is dislocated anteriorly or posteriorly and fused to the diaphysis of the proximal ulna. The second type is often unilateral and sometimes associated with deformities such as syndactyly or supernumerary thumbs.

Scurvy (Vitamin C Deficiency): Symptoms, Causes, Diagnosis, Treatment, and Prevention

Scurvy (Vitamin C Deficiency): Symptoms, Causes, Diagnosis, Treatment, and Prevention

pediagenosis    July 31, 2026    Comment   

DIETARY SOURCES OF VITAMIN C AND CLASSIC CUTANEOUS MANIFESTATIONS OF SCURVY

SCURVY

Scurvy is a well-known nutritional disease that results from a lack of the water-soluble vitamin, ascorbic acid (vitamin C). Scurvy has a well-documented history. It was first recognized in the fourteenth century in sailors who spent long amounts of time at sea. The symptoms were recognized as being related to a lack of fresh foods, especially citrus products. In 1753, James Lind, a British surgeon aboard the HMS Salisbury, performed the first documented clinical trial proving that scurvy was caused by a lack of citrus fruit in the diet of sailors. After Lind’s discovery, citrus fruits were included in ships’ provisions, and the incidence of scurvy in sailors plummeted. It was not until 1928 that ascorbic acid was isolated by the Hungarian chemist, Albert von Szent-Grörgyi, who was eventually awarded the Nobel Prize for this discovery. Scurvy is still present in some areas of the world due to inadequate dietary intake of vitamin C. Scurvy is uncommon in North America but can be seen in individuals with abnormal diets.

Sublobar Resection and Surgical Lung Biopsy: Segmentectomy vs Wedge Resection Explained

Sublobar Resection and Surgical Lung Biopsy: Segmentectomy vs Wedge Resection Explained

pediagenosis    July 30, 2026    Comment   

SUBLOBAR RESECTION AND SURGICAL LUNG BIOPSY

Segmental Resection

Resection of lung tissue anatomically less than a lobe is carried out for localized lesions such as benign tumors, granulomas, tuberculous foci, bronchiectasis, metastatic cancers, and others and to obtain tissue specimens required for the diagnosis of diffuse pulmonary disease processes. Recent evidence suggests anatomic segmentectomy may provide survival equivalent to lobectomy for small (2 cm) primary lung cancers in the absence of regional node involvement.

Lobectomy Surgery: Procedure, Indications, Surgical Technique, Risks, Recovery, and Postoperative Care

Lobectomy Surgery: Procedure, Indications, Surgical Technique, Risks, Recovery, and Postoperative Care

pediagenosis    July 30, 2026    Comment   

LOBECTOMY

Lobectomy is a more difficult procedure to perform than pneumonectomy, particularly in the presence of chronic inflammatory changes or where tumor (or involved lymph nodes) involves the lobar hilum. Not only must the critical lobar structures be individually identified and controlled by the surgeon, but the remaining structures must be painstakingly protected and preserved. Incomplete fissures may add to the problem, and the surgeon must possess a precise knowledge of hilar anatomy and common anomalies.

Pneumonectomy: Procedure, Indications, Surgical Technique, Risks, Recovery, and Postoperative Care

Pneumonectomy: Procedure, Indications, Surgical Technique, Risks, Recovery, and Postoperative Care

pediagenosis    July 30, 2026    Comment   

PNEUMONECTOMY

Pneumonectomy was first successfully performed in 1933 by Evarts Graham. The procedure was carried out for bronchogenic carcinoma in a fellow physician, James Gilmore, who eventually outlived his surgeon. The event is a milestone in surgical history. The technique of pneumonectomy has been improved and standardized in the intervening years, and the results are quite gratifying when the operation is carefully performed in appropriately selected cases. Current indications are chiefly as an operation for cure for lung cancer (usually centrally located) or for a destroyed lung as a result of infection or trauma. Palliative pneumonectomy is generally not warranted unless it is directed at alleviation of sepsis or control of recurrent hemorrhage. Before embarking upon resection of an entire lung, the surgeon must have a histologic diagnosis and a full assessment of the patient’s cardiopulmonary reserve; little is gained if the pneumonectomized patient survives but has severe respiratory disability.

Video-Assisted Thoracoscopic Surgery (VATS): Procedure, Benefits, Indications, Risks, Recovery & Surgical Technique

Video-Assisted Thoracoscopic Surgery (VATS): Procedure, Benefits, Indications, Risks, Recovery & Surgical Technique

pediagenosis    July 30, 2026    Comment   

VIDEO-ASSISTED THORACOSCOPIC SURGERY

Video-assisted thoracoscopic surgery (VATS) has become a common tool for thoracic surgeons. It is useful in the evaluation and management of patients with pleural disease, benign and malignant pulmonary parenchymal neoplasms or diseases, mediastinal masses or adenopathy, and esophageal pathology and for resection of posterior mediastinal neurogenic tumors or conditions responsive to sympathectomy. A VATS operation is defined by use of two or more port incisions and video display of the involved hemithorax on operating room monitors, and it does not involve rib spreading. Most standard thoracic surgical instruments have been modified for thoracoscopic surgery.

Extracorporeal Shock Wave Lithotripsy (ESWL): Procedure, Indications, Risks, Recovery & Success Rate

Extracorporeal Shock Wave Lithotripsy (ESWL): Procedure, Indications, Risks, Recovery & Success Rate

pediagenosis    July 28, 2026    Comment   

Plate 10-12

EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

Extracorporeal shock wave lithotripsy (ESWL) is a noninvasive procedure for the treatment of nephrolithiasis. In this procedure, acoustic shock waves are generated external to the patient and focused on the renal stones, which are fragmented into small pieces that can be spontaneously passed in the urine. The skin and surrounding renal parenchyma receive a much smaller dose of energy and therefore remain largely unharmed.

Lung Volume Reduction Surgery (LVRS): Procedure, Benefits, Risks, Recovery, and NETT Trial Explained

Lung Volume Reduction Surgery (LVRS): Procedure, Benefits, Risks, Recovery, and NETT Trial Explained

pediagenosis    July 28, 2026    Comment   

LUNG VOLUME REDUCTION SURGERY

The goal of lung volume reduction surgery (LVRS) is to safely palliate dyspnea in patients with emphysema. Successful LVRS demands attention to the details of patient selection, preoperative preparation, intraoperative anesthetic and surgical technique, and multidisciplinary postoperative care. Expertise and effective communication among pulmonary medicine, thoracic surgery, thoracic anesthesia, pain management services, critical care medicine, respiratory therapy, and rehabilitation medicine departments are vital components to any LVRS program. In experienced centers, bilateral approaches yield nearly twice the physiologic benefit to unilateral LVRS without adversely affecting operative morbidity or mortality. Current practice favors stapled bilateral resection over plication or laser ablation to achieve lung volume reduction.