DOI QR코드

DOI QR Code

Analysis of ICU Treatment on Resection of Giant Tumors in the Mediastinum of the Thoracic Cavity

  • Kang, Nai-Min (Department of ICU, Beijing Chest Hospital Affiliated to Capital Medical University) ;
  • Xiao, Ning (Department of Cerebral Surgery, Beijing Chest Hospital Affiliated to Capital Medical University) ;
  • Sun, Xiao-Jun (Department of Thoracic Surgery, Hulunbeier Second People's Hospital) ;
  • Han, Yi (Department of Cerebral Surgery, Beijing Chest Hospital Affiliated to Capital Medical University) ;
  • Luo, Bao-Jian (Department of ICU, Beijing Chest Hospital Affiliated to Capital Medical University) ;
  • Liu, Zhi-Dong (Department of Cerebral Surgery, Beijing Chest Hospital Affiliated to Capital Medical University)
  • Published : 2013.06.30

Abstract

Objective: The purpose of this study was to assess prognosis after resection of giant tumors (including lobectomy or pneumonectomy) in the mediastinum. Materials and Methods: Patients with resection of a giant tumor in the mediastinum of the thoracic cavity received ICU treatment including dynamic monitoring of vital signs, arterial blood pressure and CVP detection, determination of hemorrhage, pulmonary function and blood gas assay, treatment of relevant complications, examination and treatment with fiber optic bronchoscopy, transfusion and hemostasis as well as postoperative removal of ventilators by invasive and non-invasive sequential mechanical ventilation technologies. Results: Six patients were rehabilitated successfully after ICU treatment with controlled postoperative errhysis and pulmonary infection by examination and treatment with fiber optic bronchoscopy without second application of ventilators and tubes after sequential mechanical ventilation technology. One patient died from multiple organ failure under ICU treatment due to postoperative active hemorrhage after second operative hemostasis. Conclusions: During peri-operative period of resection of giant tumor (including lobectomy or pneumonectomy) in mediastinum ofthe thoracic cavity, the ICU plays an important role in dynamic monitoring of vital signs, treatment of postoperative stress state, postoperative hemostasis and successful removal of ventilators after sequential mechanical ventilation.

Keywords

Giant tumor in mediastinum of thoracic cavity;ICU;treatment during the peri-operative period

References

  1. Boyd JD, Juskevicius R (2012). Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia? Thyroid Res, 5, 5. https://doi.org/10.1186/1756-6614-5-5
  2. Cardillo G, Carleo F, Khalil MW, et al (2008). Surgical treatment of benign neurogenic tumors of the mediastinum: a single institution report. Eur J Cardiothorac Surg, 34, 1210-4. https://doi.org/10.1016/j.ejcts.2008.09.006
  3. Cheung R (2012) Poor treatment outcome of neuroblastoma and other peripheral nerve cell tumors may be related to under usage of radiotherapy and socio-economic disparity: a US SEER data analysis. Asian Pac J Cancer Prev, 13, 4587-91. https://doi.org/10.7314/APJCP.2012.13.9.4587
  4. Daiko H, Fujita T, Matsumura Y, et al (2012). A new approach for posterior mediastinal tumors: thoracoscopic resection in the prone position. Asian J Endosc Surg, 5, 138-40. https://doi.org/10.1111/j.1758-5910.2012.00136.x
  5. Dwivedi AN, Goel K, Tripathi S, et al (2013). Primary neuroendocrine mediastinal tumor presenting with carcinoid syndrome and left supraclavicular lymphadenopathy: Clinicoradiological and pathological features. J Cancer Res Ther, 9, 278-80. https://doi.org/10.4103/0973-1482.113385
  6. Fujinaga K, Sakamoto S, Sawada Y, et al (2012). Recurrent mediastinal desmoid tumor treated by surgical resection: report of a case. Kyobu Geka, 65, 252-4.
  7. Han Y, Wang XB, Xiao N, et al (2013). mRNA expression and clinical significance of ERCC1, BRCA1, RRM1, TYMS and TUBB3 in postoperative patients with non-small cell lung cancer. Asian Pac J Cancer Prev, 14, 2987-90. https://doi.org/10.7314/APJCP.2013.14.5.2987
  8. Hui M, Tandon A, Uppin SG, et al (2012). Postchemotherapyrelated changes in mediastinal mixed germ cell tumor masquerading as a vascular neoplasm. Indian J Pathol Microbiol, 55, 531-4. https://doi.org/10.4103/0377-4929.107803
  9. Ipek EG, Demirkan B, Güray Y (2012). A giant mediastinal carcinoid tumor that compresses the pulmonary artery and vein. Anadolu Kardiyol Derg, 12, E1-2.
  10. Ishibashi H, Okubo K (2012). Surgery for mediastinal tumor; by video-assisted thoracoscopic thymo-thymomectomy with sternal lifting. Kyobu Geka, 65, 969-72.
  11. Komatsu T, Takahashi Y (2013). Is this a mediastinal tumor? A case of Morgagni hernia complicated with intestinal incarcerati on mistaken for the mediastinal lipoma previously. Int J Surg Case Rep, 4, 302-4. https://doi.org/10.1016/j.ijscr.2012.12.010
  12. Komasawa N, Noma H, Sugi T, et al (2012). Anesthetic management of a patient with pulmonary hypertension due to a large anterior mediastinal tumor anticipated by preoperative computed tomography. Masui, 61, 202-5.
  13. Kumar S, Satija B, Mittal MK, et al (2012). Unusual mediastinal dumbbell tumor mimicking an aggressive malignancy. J Clin Imaging Sci, 2, 67. https://doi.org/10.4103/2156-7514.103057
  14. Kajiwara N, Kakihana M, Usuda J, et al (2012). Extended indications for robotic surgery for posterior mediastinal tumors. Asian Cardiovasc Thorac Ann, 20, 308-13. https://doi.org/10.1177/0218492311434332
  15. Liu Z, Wang L, Zhang LN, et al (2012). Expression and clinical significance of mTOR in surgically resected non-small cell lung cancer tissues: a case control study. Asian Pac J Cancer Prev, 13, 6139-44. https://doi.org/10.7314/APJCP.2012.13.12.6139
  16. Mitsui K, Masamune T, Okuyama K, et al (2013). A case of severe hypotension caused by external cardiac compression by tumor and doctor's hand in a patient with mediastinal tumor. Masui, 62, 204-8.
  17. Montaruli E, Rosa FM, Martelli H, et al (2013). Mediastinal extramedullary hematopoiesis mimicking a neuroblastic tumor in a patient with beta-thalassemia. Pediatr Blood Cancer, 60, 711-2. https://doi.org/10.1002/pbc.24455
  18. Ong CC, Teo LL (2012). Imaging of anterior mediastinal tumours. Cancer Imaging, 2, 506-15.
  19. Ruan Z, Wang S, Wang Z, et al (2012). A rare case of bilateral massive hemothorax from spontaneous rupture of a primary mediastinal mixed germ cell tumor. Ann Thorac Surg, 93, 664-6. https://doi.org/10.1016/j.athoracsur.2011.07.018
  20. Spartalis ED, Karatzas T, Konofaos P, et al (2012). Unique presentation of a giant mediastinal tumor as kyphosis: a case report. J Med Case Rep, 6, 99. https://doi.org/10.1186/1752-1947-6-99
  21. Sirotkina M, Iwarsson E, Marnerides A, et al (2012). Fetal mediastinal tumor of neuroepithelial origin in a case of missed abortion. Pediatr Dev Pathol, 15, 511-3. https://doi.org/10.2350/12-06-1212-CR.1
  22. Sun JY, Shi L, Gao XD, et al (2012). Physical activity and risk of lung cancer: a meta-analysis of prospective cohort studies. Asian Pac J Cancer Prev, 13, 3143-7. https://doi.org/10.7314/APJCP.2012.13.7.3143
  23. Tu L, Sun L, Zhou Y, et al (2013). Postoperative radiotherapy for residual tumor of primary mediastinal carcinoid teratoma. J Thorac Dis, 5, E61-4.
  24. Takahashi T, Kobayashi R, Nogimura H, et al (2013). Successful thoracoscopic surgery for mediastinal parathyroid tumor with preoperative intravenous methylene blue infusion; report of a case. Kyobu Geka, 66, 259-61.
  25. Tantisattamo E, Bello EF, Acoba JD (2012). Nodular sclerosing Hodgkin's lymphoma presenting with a pseudo-breast mass extending from a necrotizing granulomatous mediastinal tumor. Hawaii J Med Public Health, 71, 212-7.
  26. Zencirci E, Gündüz S, Zencirci AE, et al (2012). Echocardiography in imaging an extremely rare cause of extrinsic pulmonary stenosis: rapidly progressive primary mediastinal embryonal carcinoma. Ann Thorac Surg, 94, e113-4. https://doi.org/10.1016/j.athoracsur.2012.04.126
  27. Zielińska-Krawczyk M, Domagała-Kulawik J, Chazan R (2011). Mediastinal neuroendocrine tumor (atypical carcinoid probably of thymic origin) imitating teratoma--case report. Pol Merkur Lekarski, 31, 280-3.

Cited by

  1. Factors Influencing Ventilator-Associated Pneumonia in Cancer Patients vol.15, pp.14, 2014, https://doi.org/10.7314/APJCP.2014.15.14.5787