Papers by stefan dumitrache-rujinski
Cureus, Jun 26, 2023
Introduction: The abnormal presence of free air in the thorax, pneumothorax, and pneumomediastinu... more Introduction: The abnormal presence of free air in the thorax, pneumothorax, and pneumomediastinum are complications for critically ill patients suffering from coronavirus disease 2019 (COVID-19). The development of these events may lead to a poor prognosis and make the management of this category of patients more difficult. Study design: We performed an observational retrospective study, including patients with SARS-CoV-2 infection and pneumonia who were hospitalized, to analyze the cases that developed pneumothorax or pneumomediastinum as a complication. Results: A total of 28 cases (1.51%) from 1844 patients with SARS-CoV-2 pneumonia developed pneumothorax or pneumomediastinum during hospitalization. Of them, 21 (75%) needed intensive care unit admission and ventilation, and 10 (35.71) were cured. Conclusion: The male gender is more probable to be involved in the development of pneumothorax or pneumomediastinum in patients with SARS-CoV-2 pneumonia. The incidence of these events is low, and conservative treatment could provide a better outcome.
Revista medicală română, Jun 30, 2016
Introducere. Sindromul de apnee în somn de tip obstructiv (SASO) este cea mai frecventă afecţiune... more Introducere. Sindromul de apnee în somn de tip obstructiv (SASO) este cea mai frecventă afecţiune în cadrul tulburărilor respiratorii în timpul somnului şi determină multiple fragmentări ale somnului, asociindu-se cu somnolenţă diurnă excesivă. Accidentul vascular cerebral (AVC) reprezintă o importantă cauză de deces la nivel mondial şi cauza principală a dizabilităţii pe termen lung. În studiul de faţă doresc să evidenţiez îmbunătăţirea calităţii vieţii la pacienţii cu sindrom de apnee în somn şi accident vascular cerebral care urmează terapie cu presiune pozitivă continuă (CPAP), comparativ cu cei care au refuzat acest tratament. Material şi metodă. Am efectuat un studiu pe 262 de pacienţi cu vârste cuprinse între 18 şi 83 de ani, internaţi în Spitalul Clinic de Urgenţă "Bagdasar-Arseni" şi Institutul de Pneumologie "Marius Nasta", în perioada 01.01.2014-25.05.2015, şi diagnosticaţi cu sindrom de apnee în somn de tip obstructiv, aflaţi sau nu în tratament cu CPAP, 12 dintre aceşti pacienţi având în antecedente un accident vascular cerebral. Rezultate. Toţi pacienţii cu accident vascular cerebral, aflaţi sau nu în tratament cu CPAP, au fost rugaţi să completeze chestionarul de calitate a vieţii SF-36. În grupul pacienţilor care au urmat tratament CPAP s-a observat o ameliorare a calităţii vieţii. Concluzii. Datele disponibile până în prezent arată că SASO poate fi factor de risc predispozant pentru accidentul vascular cerebral. Încă nu există ghiduri care să precizeze dacă pacienţii cu accident vascular cerebral ar trebui să fie investigaţi de rutină pentru prezenţa SASO.
Pneumologia (Bucharest, Romania), Dec 1, 2020
English: Background: It is recognised that systemic inflammation plays an important role in the d... more English: Background: It is recognised that systemic inflammation plays an important role in the development and progression of lung cancer. Several affordable biomarkers could be used to evaluate systemic inflammation: neutrophil-to-lymphocyte ratio (NLR), plateletto-lymphocyte ratio (PLR) and erythrocyte sedimentation rate (ESR). These biomarkers may be linked with survival in lung cancer. Aim: To assess the relation between systemic inflammation evaluated by NLR, PLR and ESR, tumour nodes metastasis (TNM) staging and negative outcome in lung cancer. Materials and methods: Patients with lung cancer were classified (7th TNM lung cancer staging) into two groups: Group A (resectable stages) and Group B (nonresectable stages). Each group was divided into two subsets: survivors (As, Bs) and deceased (Ad, Bd) patients. Complete blood count (CBC) and ESR were determined. NLR and PLR were calculated. NLR, PLR and ESR values were compared between the two groups and their subsets. Results: 102 consecutive patients completed the protocol.
Journal of Thoracic Oncology, 2017
Background: Stent placement is an increasingly used treatment for malignant tracheobronchial sten... more Background: Stent placement is an increasingly used treatment for malignant tracheobronchial stenosis. The main complication related to airway stents is bacterial colonization causing chronic cough and sputum, halitosis, recurrent bronchial infections, pneumonia and even sepsis. The main objectives were to describe potentially pathogenic bacteria (PPM) involved in stent colonization and to analyze PPM dynamics during follow-up. Methods: Prospective study in patients with malignant stenosis treated with stent placement. Bronchial washings (BW) were performed before and at least 1 month after stent placement. Qualitative cultures of PPM isolated in BW were performed. Statistical analyses with R-3.2.3. Results: Total of 65 patients, 56 (86%) men, mean age 64 (±10) y/o, 58 (89%) current or former smokers, 2 (3%) bronchiectasis, 28 (43%) COPD. Cancers were: primary lung cancer (n¼52, 80%) followed by thyroid (n¼4, 6%), esophagus (n¼2, 3%) and other (n¼7, 11%); stenosis were located in trachea (n¼14, 21%), main carina (n¼16, 25%) and main bronchi (n¼35, 54%); and stent types included metal (n¼30, 46%) and silicone (n¼35, 54%). Isolated PPM in BW (table 1). Airway colonization was absent in 14 (21.5%) and present in 79%, of which it was persistent in 33 (50.8%) and intermittent in 16 (24.6%). Only 2 (3.1%) became negative. Median time until colonization was 35 days (IQR 28-116), with no significant differences between stent types or location. Conclusion: The majority of patients with malignant stenosis treated with airway stents develop early and persistent colonization by PPM, regardless of stent type.
Pneumologia (Bucharest, Romania), Dec 1, 2020
Aim: Postoperative complications, especially pulmonary complications, are described after lung re... more Aim: Postoperative complications, especially pulmonary complications, are described after lung resections, with different risk factors involved. We evaluate the relationship between lung function, exercise test parameters and the occurrence of postoperative outcomes in patients with pulmonary resections. Methods: A 5 years prospective observational study on patients with lung resection (lobectomy, bilobectomy and pneumonectomy) for lung cancer and other pulmonary pathologies has been performed. All the patients were preoperatively evaluated using spirometry, plethysmography, diffusing capacity test and cardio-pulmonary exercise test (CPET). Data were analysed regarding the linkage between cardiopulmonary fitness and postoperative outcomes (respiratory complications and 90-day mortality). Results: Of 155 consecutive patients (109 male, mean age 61.2 ± 9.8 years), 130 (83.9%) underwent pulmonary resection for lung cancer. Nearly 24% of patients developed postoperative respiratory complications (mainly atelectasis, prolonged air leak and respiratory failure). The 90-day mortality was 5.2%. A reduced absolute value of forced expiratory volume in 1 s (FEV1) was found to be associated with postoperative atelectasis [odds ratio (OR) 0.33; 95% confidence interval (CI) 0.11-0.99], but with low accuracy. The most related variable and a predictor to prolonged air leak was FEV1/vital capacity (VC) ratio (OR 0.90; 95% CI 0.83-0.99). Patients who developed respiratory failure had lower values of static volumes and breathing reserve (BR%) compared to those without respiratory failure, but with no significant difference (P > 0.050). No relationship to mortality was noted. Conclusion: In our study group, lower values of FEV1 were related to postoperative atelectasis and obstructive dysfunction with persistent air leak, with no significant association with mortality. Testele funcționale respiratorii, capacitatea la efort și consecințele postoperatorii la pacienții cu rezecții pulmonare Romanian: Scopul: Complicațiile postoperatorii, în special respiratorii, sunt descrise după rezecțiile pulmonare, implicând diverși factori de risc. Am evaluat legătura dintre parametrii testelor funcționale pulmonare, ai capacității la efort și consecințele postoperatorii, la pacienții cu rezecții pulmonare. Metoda: S-a efectuat un studiu prospectiv, observațional, cu durata de 5 ani, la pacienți cu rezecții pulmonare (lobectomie, bilobectomie, pneumonectomie) pentru cancer pulmonar și alte patologii pulmonare. Pacienții au fost evaluați preoperator cu ajutorul spirometriei, pletismografiei, testului de difuziune și a celui de efort cardio-pulmonar (TECP). S-au analizat relațiile dintre "performanța' cardiopulmonară și efectele postoperatorii. Rezultate: Din 155 pacienți consecutivi (109 bărbați, vârsta medie 61.2 ± 9.81 ani), 130 (83.9%) au avut rezecție pulmonară pentru cancer pulmonar. Aproximativ 24% dintre pacienți au avut complicații respiratorii postoperatorii (în special atelectazie, pierdere prelungită de aer și insuficiență respiratorie). Mortalitatea la 90 de zile a fost de 5.2%. O valoare absolută scăzută a volumului expirator în prima secundă (VEMS) s-a asociat cu atelectazia postoperatorie [risc relativ (OR) 0.33; 95% interval de confidență (CI) 0.11-0.99], dar cu slabă acuratețe. Cea mai importantă variabilă și un predictor pentru pierderea prelungită de aer a fost raportul VEMS/capacitatea vitală (CV) (OR 0.908; 95% CI 0.833-0.991). Pacienții cu insuficiență respiratorie au avut valori mai mici ale volumelor statice și rezervei respiratorii (BR%), comparativ cu cei fără insuficiență respiratorie, dar fără diferențe semnificative (P > 0.050). Nu s-au găsit legături cu mortalitatea. Conculzii: În grupul nostru, valori scăzute ale VEMS s-au asociat cu atelectazia postoperatorie iar disfuncția obstructivă cu pierderea persistentă de aer, fără vreo legătură semnificativă cu mortalitatea. Rezumat Cuvinte-cheie rezecție pulmonară • complicații postoperatorii • teste funcționale respiratorii Data collection and statistical analysis The data such as demography, tests variables, comorbidities, the extension of the resections and postoperative events were recorded. The results of lung function tests and CPET were expressed as absolute values and percent of the predicted values. Data were analysed using IMB SPSS Statistics version 20. The parameters were expressed as mean ± standard deviation (SD). According to the distribution of parameters, Independent-Sample t-test or Man-Whitney U test was used to compare continuous variables between the groups. Potential predictive parameters for a postoperative outcome were identified by univariate logistic regression. Finally, the receiver-operating characteristic (ROC) curve was plotted to highlight the predictor feature of variables. A P-value <0.050 was considered significant. Results General characteristics A total of 155 patients were enrolled in which there were 109 men with mean age 61.2 ± 9.8 (range 19-85 years). Seventytwo patients had a current smoker status. Nearly 90% of patients had comorbidities, the most common being chronic obstructive pulmonary disease (COPD), arterial hypertension and obesity. Descriptive characteristics of patients are presented in Table 1.
ARS Medica Tomitana, Nov 27, 2017
Lung cancer remains one of the most frequent pathologies in Pulmonology Departments. Tumor extens... more Lung cancer remains one of the most frequent pathologies in Pulmonology Departments. Tumor extension, histopathological types, and treatment influence the prognosis and survival in lung cancer. Five years survival dramatically decreases for the 4th-stage of the disease. Non-small cell lung cancer (NSCLC) represents the vast majority of lung cancers. In the last decades, important findings have been made on identifying standardized molecular biomarkers that control tumor growth in lung adenocarcinoma. The discovery of new drugs led to the increased survival, even in extensive forms of the disease. The greatest advances could be obtained by targeting EGFR genetic mutations or EML4-ALK translocate in patients diagnosed with adenocarcinoma lung cancer.
Revue Des Maladies Respiratoires, 2014
Les anti-TNF␣ sont avérées efficaces dans le traitement de la polyarthrite rhumatoïde, la spondyl... more Les anti-TNF␣ sont avérées efficaces dans le traitement de la polyarthrite rhumatoïde, la spondylarthrite ankylosante, le psoriasis. Nous présentons quatre cas de tuberculose miliaire avec adénopathies médiastinales survenus lors du traitement par anti-TNF, diagnostiquée dans le service7 de l'institut de pneumologie M. Nasta en 2011-2012. Deux hommes âgés de 56 et 41 ans, ont été traités par infliximab pour la spondylarthrite. Un homme âgé de 32 et une femme de 47 ans ont été traités avec l'adalimumab pour le psoriasis. Tous les patients ont effectué Rx pulmonaire, test cutané à la tuberculine/test Quantiféron pour la tuberculose latente. Les signes cliniques de la maladie étaient syndrome fébrile, dyspnée, toux et la perte de poids. Dans le premier cas, le diagnostic a été réalisé sur une biopsie pulmonaire et culture positive pour BK dans les crachats. Dans le deuxième cas, ont été révélés BK dans l'aspiration bronchique. Dans les derniers cas, le diagnostic a été réalisé sur biopsie pulmonaires et ganglionnaire médiastinale. Dans tous les cas, nous observons un aspect de miliaire avec adénopathies médiastinales sur le scanner thoracique. L'évolution a été lentement favorable après le traitement anti-TB dans 2 cas, on observe l'apparition 2 ans plus tard d'un abcès cervicomediastinal d'étiologie tuberculeuse dans un autre cas et une évolution compliquée par tuberculose osseuse, abcès du psoas, méningite tuberculeuse et décès dans un autre cas, prouvé avec chimiorésistance HRS. Conclusions.-Les 4 cas sont formes graves de tuberculose miliaire durant le traitement par anti-TNF, compliquée avec tuberculose disséminée et décès dans un cas et récidive à distance dans un autre cas.
Chest, Mar 1, 2014
6.9%-a statistically significant increase. Preoperatively the most frequent abnormality of the ca... more 6.9%-a statistically significant increase. Preoperatively the most frequent abnormality of the cardiac contour was eleva¬ tion of the apex, indicative of right ventricular enlargement. This finding was present in 62 and was maintained postoperatively. Only 18 of the 67 children exhibited a decrease in the undivided pulmonary artery segment, while 29 showed some increase in this segment following surgery. The decreased pulmonary vasculature in tetralogy of Fallot is stressed in the literature. Pulmonary vascular markings were definitely decreased in 38 of the 67 cases in this series. Following surgery, 91% presented an increase by compari¬ son with the preoperative films. Three case histories with films are presented. The Two Types of Right Aortic Arch\p=m-\B.Felson and M. J. Palayew Radiology 81:745 (Nov) 1963 A large series of cases of right aortic arch was studied clinically, pathologically, and roentgenologically. It was found that there are two types of right aortic arch, an anterior and a posterior. The anterior arch is almost invari¬
Introduction: Obstructive sleep apnea (OSA) is more prevalent in psychiatric patients than in gen... more Introduction: Obstructive sleep apnea (OSA) is more prevalent in psychiatric patients than in general population. Early diagnosis and adequate management of OSA could improve prognosis in this category. Methods: We present a case of moderate OSA in a patient with attention deficit and hyperreactivity disorder (ADHD) with prominent symptoms following a H1N1 viral encephalitis. Results and discussion: 31 years-old male, night shift-worker, active smoker, overweight, on long-term psychotropic therapy (extended release methylphenidate), with partial response to therapy. Reports frequent arousals, sometimes feeling like gasping or choking, unrefreshing sleep, chronic fatigue. Epworth Sleepiness Scale score was 10/24 (excessive daytime sleepiness). STOP-Bang Questionnaire score was 3/8 (high risk of OSA). Home unattended cardio-respiratory poligraphy identified moderate OSA and Positive Airway Pressure (PAP) therapy was prescribed. At 1 year follow-up: works during daytime, improved perfo...
European Respiratory Journal, Sep 1, 2014
Introduction: The bronchiolo-alveolar carcinoma is a rare form of adenocarcinoma, which is more o... more Introduction: The bronchiolo-alveolar carcinoma is a rare form of adenocarcinoma, which is more often diagnosed at non-smokers. Description: We present a series of 8 patients (7 women), evaluated for bronchiolo-alveolar carcinoma in our clinic between 1th January 2009 and 31th December 2013. Five cases were non-smokers. The median age was 50 years old (range 33-62). The clinical examination showed progressive dyspnea(8), cough(8), increased sputum production (5), fever(2), thoracic pain (3). In 7 patients the chest radiography revealed multiple bilateral pulmonary opacities, with air bronchogram and tendency to necrosis at 1. One patient had 2 pulmonary nodules. The diagnosis required bronchoscopy and tumor cells were identified at broncho-alveolar lavage (5). At 2 patients lung biopsy was needed for the diagnosis and 1 diagnosis was made on necropsy. The most important challenge was the differential diagnosis with the Staphylococcus pneumonia, tuberculosis, vasculitis due to clinical pictures and the bilateral pulmonary abscesses. Four patients received antibiotics and 2 tuberculosis treatment, with no improvement. The delay of diagnosis was between 2 to 15 months. Two patients had lobectomy. All patients received chemotherapy. Survival was poor in 2 cases with 3 and 6 weeks survival from diagnosis. Conclusion: The bronchiolo-alveolar carcinoma is a form of adenocarcinoma, with a high prevalence in nonsmoker women. The diagnosis is often delayed due to the clinical pattern, which may resemble to infectious disease. Due to the extension of the disease at diagnosis, the prognosis in this subtype of lung cancer is poor in most cases.
European Respiratory Journal, Sep 1, 2011
Background: In the past 2 years, we have encountered in our clinic an increased number of patient... more Background: In the past 2 years, we have encountered in our clinic an increased number of patients with multicentric pneumonia related to non-heroin intravenous drug use (so-called “ethnobotanic substances”), probably favorised by the low cost and legal status of these substances. We present three clinical cases with this pathology, in the attempt not only to describe the well-known clinical picture, but to warn about the severity of this community problem related to the usage of legal etnobotanic drugs. The clinical cases: The three patients had a very similar clinical picture: poor social background (disorganized families, homeless, prisoners), history of intravenous drug use (especially heroin), recently using etnobotanic powders intravenously, positive HCV, negative HIV and VHB, multiple bilateral lung opacities on X-Ray, similar symptomatology (fever, dyspnea, cough with mucopurulent sputum), tricuspid valve endocarditis (confirmed by echocardiography). The bacteriological exam (hemocultures and sputum) were negative probably related to the empirical antibiotic usage prior hospitalisation. Two patients improuved slowly with antibiotic treatment. One critically ill patient died with septic shock and multiple organ insufficiency. Conclusions: The increased number of cases with multicentric pneumonia and endocarditis related to the usage of the ethnobotanic drugs of legal status reveal their harmful effect when used intravenously.
ILD / DPLD of known origin, 2021
Pneumologia
Considering the wide range of both histological and imaging types found in a small group of tumou... more Considering the wide range of both histological and imaging types found in a small group of tumours as an incidence, they can pose real problems in both diagnosis and therapeutic conduct, being difficult to differentiate clinically, imagistically, or histologically from lung tumours commonly found in the clinic (1). Adenocarcinoma, squamous cell carcinoma, and small cell carcinoma together account for approximately 95% of all lung tumours, but the lung is the site of many other types of tumours that may be of epithelial, mesenchymal, neuroendocrine, or lympho-haematopoietic origin, and these latter together account for approximately 5% of all pulmonary tumours (2,3). With a few exceptions, both the clinical manifestations and the imaging aspect are nonspecific, many of them having features in common with the other tumours with high incidence (3). The present study was performed on a group of 82 patients diagnosed with low-incidence lung tumours, aiming at presenting the main epidemi...
Sleep disorders and comorbidities: cardiopulmonary diseases, weight and other, 2017
Background Obesity and obstructive sleep apnea (OSA) are associated with systemic inflammation, s... more Background Obesity and obstructive sleep apnea (OSA) are associated with systemic inflammation, secondary cardiovascular comorbidities and low exercise capacity. Aim To assess the relations between exercise capacity and systemic inflammation in obese patients with severe OSA. Method Newly diagnosed severe OSA patients (AHI>25/hour, cardiorespiratory polygraphy) were evaluated by anthropometric measurements (Body Mass Index, BMI; neck, waist and hip circumference and ratio, WHR); complete blood count, including red cell distribution width (RDW); erythrocyte sedimentation rate (ESR), fibrinogen (Fb), neutrophil and platelets to lymphocyte ratios (Ne/Ly; Pl/Ly) as surrogates of systemic inflammation. All subjects underwent an incremental cardiopulmonary exercise test with peak oxygen uptake (VO 2,peak ), oxygen uptake at the ventilatory threshold (VT), VT percent VO 2,peak (VT %peak ), peak heart rate (PHR) in order to asses maximal exercise capacity. Relations between these parameters were analyzed. Results In 19 (14 men) severe OSA patients, with median values for age 39 years (33-48), BMI 36.6 kg/m2 (26.6-39.7), WHR 1 (1-1.1), AHI 68/hour (33.5-99.3), ODI 64/hour (17.5-95.6), hemoglobin (Hb) 16 g/dl (14-17), ESR 3 mm/1 h (1-10), FB 277 mg/dl (232-395), Ne/Ly 1.18 (1-3.73), Pl/Ly 75 (55-129.47), RDW 12% (11-13), we found a VO 2,peak 2358 ml/min (1206-2668), VT 1336 ml/min (906-1990), VT %peak 65% (34-91.8), PHR 160/min (119-171). Statistically significant negative correlation between BMI and exercise capacity (r -0.491, p 0.033) was found. OSA severity (AHI, ODI) also negatively correlated with exercise capacity (r -0.663, p 0.002; r -0.473, p 0.047). BMI negatively correlated with Pl/Ly (r -0.715, p 0.009). No correlation between exercise capacity or OSA severity and Pl/Ly was found. Conclusion Both obesity and severe OSA decrease exercise capacity. Obesity is related with systemic inflammation but OSA severity and exercise capacity are not. Systemic inflammation may not be the main mechanism of reduced exercise capacity in severe OSA, other mechanisms being probably involved (cardiac dysfunction).
Chest, 2016
PURPOSE: Obstructive sleep apnea (OSA) is increasing in prevalence worldwide. The gold standard f... more PURPOSE: Obstructive sleep apnea (OSA) is increasing in prevalence worldwide. The gold standard for diagnosis remains polysomnography which is costly and resource consuming. Nocturnal nasal flowmetry may represent a valuable screening method in a high pretest probability population The aim of this study is to assess the role of nocturnal nasal flowmetry to screen for patients with high pretest probability of OSA. METHODS: We prospectively evaluated subjects with high pretest probability of OSA (presenting at least three of the following four conditions: daytime sleepiness, snoring, obesity, witnessed apneas). A nocturnal nasal flowmetry (nF) followed by overnight cardiorespiratory poligraphy (PG) was performed in 2 consecutive nights. We analyzed the correlations between Apnea Hypopnea Index (AHI) determined by nF (AHI-nF) and by PG (AHI-PG). Sensibility and specificity of AHI-nF for severe OSA (AHI>30/hour) was also evaluated. RESULTS: 61 patients were enrolled in the study (43 males), with a median age: 56 (24-75) years, median BMI of 32 kg/m 2 (22-50), median AHI-nF: 26.7/hour (2-75) and AHI-PG: 27.7/hour (1.4-76.6). A statistically significant positive correlation (r¼0.65, p<0.001) between AHI-nF and AHI-PG was found. The sensitivity and specificity of AHI-nF for severe OSA was 1, respectively 0.62. CONCLUSIONS: In patients with high pretest probability of OSA, nocturnal nasal flowmetry may represent a valuable screening method. CLINICAL IMPLICATIONS: Nocturnal nasal flowmetry could be an affordable tool to identify patients with severe OSA.
European Respiratory Journal, Sep 1, 2013
European Respiratory Journal, Sep 1, 2013
Revue des Maladies Respiratoires, 2007
Évaluer pour le mésothéliome pleural malin (MPM), la capacité du bilan radiologique pré opératoir... more Évaluer pour le mésothéliome pleural malin (MPM), la capacité du bilan radiologique pré opératoire à déterminer l'étendue et le caractère résécable de la maladie. Matériel et méthodes : Étude prospective portant sur des patients bénéficiant d'un protocole associant une pneumonectomie extrapleurale associée à une irradiation de l'hémithorax à 40 Gy. Une classification TNM selon l'IMIG est réalisée par l'imagerie associant scanner et/ou IRM. Elle est comparée à celle fournie par l'examen anatomopathologique de la pièce de résection. Résultats : 28 patients inclus de 2001 à 2006, 21 hommes pour 7 femmes, 21 ont été exposés à l'amiante, âge médian 62 ans. Tous les patients ont eu un examen tomodensitométrique dont 6 un scanner multi coupe ; 21 ont eu scanner et IRM. Évaluation de l'extension locale (T) par scanner et/ou IRM : 13 cas sous estimés, 2 cas correctement estimés, 13 cas surestimés. Évaluation de l'extension locale (T) par scanner uniquement (7 cas dont 5 scanners multi coupe) : 0 cas sous estimé, 6 cas correctement estimés, 1 cas surestimé. Évaluation de l'extension ganglionnaire (N) par scanner et/ou IRM : 10 cas sous estimés, 13 cas correctement estimés, 2 cas sur estimés, un cas n'a pas eu de curage ganglionnaire. Un cas n'a pu bénéficier d'une pneumonectomie extrapleurale. Conclusion : L'étude montre une sous-évaluation de l'extension des lésions par le scanner et l'IRM. Cependant l'imagerie reste performante pour définir la résécabilité.
Revue des Maladies Respiratoires, 2006
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Papers by stefan dumitrache-rujinski