Patología pleural, modalidad clínico-quirúrgica
2005
It’s alarming the increase of the pleural pathology at world-wide level specially the one due to traumatic and industrial pneumonic processes as well as the mesothelioma and the iatrogenic pathology. 1,243 clinicosurgical files of patients are analyzed who presented different processes in the visceral and mediastinal parietal pleura. The closed pleurotomy was used in 1,028 cases and the pulmonary decortication in 88 cases. It is worth to mention that pleural mesothelioma initially is diagnosed in our medical branch like one due to a neumonic process. The mediastinitis also has numbers worthy to be taken in to consideration, these 2 affections must be diagnosed quite in advance to give the suitable solution. Mortality is low, represented by less than 3% of the presented cases. Iatrogenia occurs in surgery specially in the subclavian puncture or in a pleurotomy the same technical failure is brought about in hiatal hernioplasty complicated with esophageal rupture. The preservative measures in these cases offer us optimistic results to like in the mediastinitis in general. We considered as important data in the nontumorlike cases not to out off the visceral pleura and its results will be reflected in the functional and respiratory tests with their corresponding gasometry. We recommend an early solution to the pleural pathology, the shut pleurotomy next the utmost pulmonary decortication with suture of the bronchial fistulas if these exist. Also we recommend that the corresponding authorities take the pertinent measures in those factories working with asbestos, more actions against the use of obsolete pesticides and plaguicides already useless in any country, but ours unfortunately. Hence the increase in pleural and broncogenic cancers.
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