Tuesday Afternoon, April 28, 1964
2:00
P.M. Executive Session (Limited to
Active and Senior Members) Grand Ballroom
3:00 P.M. Scientific
Session: REGULAR PROGRAM Grand Ballroom
Address by the President
Robert E. Gross, Boston
"Thoracic Surgery for Infants"
Address by Honored Guest
Dr. I. Boerema
Professor of Surgery
University of Amsterdam, Netherlands
"The Use of Hyperbaric Oxygen in Thoracic
Surgery"
28. Foregut Cysts of the Mediastinum-A Study of 26 Cases
Joseph W. Peabody, Jr., Sol Katz*, William S. Lyons*,
Edward J. Jahnke, and Edgar W. Davis, Washington,
D.C.
Mediastinal cysts of foregut derivation represent
one of the more bizarre and complex segments of mediastinal neoplasia.
Depending upon the tissue elements they contain and the organ to which they are
attached, these cysts traditionally have been classified as bronchogenic,
esophageal or gastro-enterogenous, when in reality they may be an admixture of
two or even all three. The problem is compounded by the occasional lack of
attachment or the presence of dual attachments, the finding of "respiratory"
epithelium and cartilage in the wall of esophageal and gastric cysts, the
presence of squamous epithelium and muscular layers resembling esophagus within
bronchogenic cysts, etc. As a consequence, no satisfactory classification has
yet been proposed. Twenty-six such cases, the largest series reported, form the
basis for this report. Surprisingly, bronchogenic cysts account for only nine.
The remaining 17 cases constitute an unique assortment of supposedly rare
cysts, some simulating duplications, some traversing the diaphragm and others
presenting bilaterally. Three instances of tracheoesophageal cysts, a very
specific and potentially fatal lesion of infancy, are included. Correlation of
the embryological, clinicopathological and surgical features has proved quite
informative and clarifies both the terminology and classification of cysts
derived from the primitive foregut.
29. Lobar
Emphysema and Congenital Heart Disease in Infancy
John C. Jones, Carl Almond*, Bert W. Meyer,
H. Martin Snyder*, and James Patrick*, Los Angeles, Calif.
Twelve infants with lobar emphysema, three weeks to
seven months of age, have been treated surgically at the Children's Hospital in
Los Angeles. Eight of these had congenital heart defects. Four of the cardiac
defects were ventricular septal defects, two were patent ductus arteriosus, and
two were tetralogy of Fallot. There were two deaths, and both of these patients
had congenital heart disease. One was a very ill infant in acute respiratory
distress with lobar emphysema and tetralogy of Fallot, who did not survive the
operation. The other patient had lobar emphysema of the right middle lobe and a
patent ductus arteriosus. This patient died of postoperative complications
following respiratory and cardiac recovery from his immediate operation. It is
important to stress the diagnosis of lobar emphysema in infants with acute
respiratory distress. We would like to emphasize that two-thirds of these cases
had accompanying congenital heart lesions. The lobar emphysema is an acute
problem and necessitates early surgical intervention even in the presence of
cardiac disease. After recovery from the respiratory emergency, the cardiac
problem may be dealt with at an appropriate later time.
30. Mediastinoscopy:
A Method of Biopsy in the Superior Mediastinum
F. G. Pearson*, Toronto,
Canada
Sponsored by Frederick G. Kercin
Mediastinoscopy is a method for biopsy and
exploration in the superior mediastinum, which is useful both for the
assessment of operability and re-sectability in bronchogenic carcinoma, and for
establishing a tissue diagnosis in certain intrathoracic lesions. Like scalene
node biopsy it is primarily of value in providing information otherwise
obtainable only by thoracotomy. The procedure, originally described by Carlens
of Stockholm in 1959, has since found favour elsewhere in Scandinavia, but to
date there has been little apparent interest generated in North America. The
procedure is a safe and relatively simple one, and the present paper offers a
description of the technique and a presentation of experience with 48 patients
at the Toronto General Hospital. There were 25 patients with proven
bronchogenic carcinoma considered operable by conventional methods of assessment.
In 7 patients mediastinoscopy provided information interpreted as evidence of
inoperability, and thoracotomy was avoided. In the remaining 18 patients
mediastinoscopy indicated an operable lesion, and 17 proved operable and
resectable at subsequent thoracotomy. One patient did not come to operation. Of
23 patients with previously undiagnosed intrathoracic lesions a tissue
diagnosis was obtained at mediastinoscopy in fifteen instances. There have been
no significant complications.
*By Invitation
Tuesday Evening, April 28, 1964
7:00 P.M. Reception
Duluth and MacKenzie Rooms
8:00 P.M. Banquet
and Dancing
Marquette and Jolliet Rooms
Speaker
Dr. Leonard W. Cronkhite, Jr.
"Man in Space"
Attendance limited to Members of the Association and
their ladies, Invited Speakers and their ladies, Invited Guests and their
ladies
Dinner dress preferred
