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World Journal of Advance Healthcare Research (WJAHR)Honored the authors with best paper award, monthly based on the innovation of research work. Best paper will be selected by our expert panel.
Best Article of current issue
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CARINA RECONSTRUCTION SURGERY: INDICATIONS, TECHNIQUES AND RESULTS
M. Lakranbi*, F. Z. Ammor, S Rabiou, L. Bellirej, H. Harmouchi, Y. Ouadnouni and M. Smahi
Introduction: Indications for carina surgery are rare, limited to tumors of the lower trachea or the main bronchi, offering carcinologic resection R0 and a better prognosis at the expense of a operative tactic specially adapted to each case It’s about a Retrospective study about 5 cases, benefiting from a resection of the hull with or without pulmonary resection, associated with a carinoplasty under different techniques (8 years), 3 men and 2 women, whose average age was 41 years. The radiological assessment objectified a central tumor process (Hilar 2cases, subcarinary 2cases, endobronchial 1case), associated with mediastinal lymphadenopathy in 4cases and an aspect of right lung destroyed in 3cases. By a right postero lateral thoracotomy (4cases) and a sternotomy (1cases), the gestures carried out were: right intrapericardial pneumonectomy enlarged to the carina with reconstruction by a KERGIN type (1case), inverted KERGIN (1case), a V-plasty 1 case); tumor excision enlarged to the carina with angular section and V-shaped plasty (1case); resection of the carina with tracheobronchial anastomosis in double rifle barrel (1 case), associated with radical mediastinal lymph node dissection. The histological diagnosis was : moderately differentiated ADK, poorly differentiated carcinoma, mucoepidermoide carcinoma, typical carcinoid tumor (2cases). During an average follow-up of 4.75 years, an immediate postoperative death and a recurrent cervical lymph node were noted Conclusion: Carinoplasty is technically difficult, requiring perfect collaboration between pulmonologists, surgeons and anesthesiologists, to deal with a problem linked to: approaches, mobilization techniques, type of resection-anastomosis and postoperative.[Full Text Article]