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D.L., Radical pleurectomy/ decortication and intraoperative radiotherapy followed by conformal radiation with or without chemotherapy for malignant pleural mesothelioma. The Journal of Thoracic and Cardiovascular Surgery, 124, 6:1183-1189, 2002. 28.Mattson K., Holsti L.R., Multimodality treatment programs for malignant pleural mesothelioma. International Journal of Radiation Oncology, Biology, Physics, 24, 4:643-650, 1992. 29.Mehta P., Mesothelioma cancer. www.ezinearticles.com accesat în data de 23 februarie 2007. 30.Miller B.H., Rosado-de-Christenson M.L., Mason A.C., Fleming M.V., White C.C., Krasna M.J.

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
International Journal of Radiation Oncology, Biology, Physics, 24, 4:643-650, 1992. 29.Mehta P., Mesothelioma cancer. www.ezinearticles.com accesat în data de 23 februarie 2007. 30.Miller B.H., Rosado-de-Christenson M.L., Mason A.C., Fleming M.V., White C.C., Krasna M.J.: Malignant pleural mesothelioma. RadioGraphics, 16, 3: 613-644. 1996. 31.Nisman B., Barak V., Cytokeratin markers in malignant pleural mesothelioma. Cancer Detection and Prevention, 22, 5:416-421, 1998. 32.Ogura H., Naoki O., An autopsy case of sarcomatoid malignant pleural mesothelioma. Nihon Kokyki

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
www.ezinearticles.com accesat în data de 23 februarie 2007. 30.Miller B.H., Rosado-de-Christenson M.L., Mason A.C., Fleming M.V., White C.C., Krasna M.J.: Malignant pleural mesothelioma. RadioGraphics, 16, 3: 613-644. 1996. 31.Nisman B., Barak V., Cytokeratin markers in malignant pleural mesothelioma. Cancer Detection and Prevention, 22, 5:416-421, 1998. 32.Ogura H., Naoki O., An autopsy case of sarcomatoid malignant pleural mesothelioma. Nihon Kokyki Gakkai Zasshi, 44,10:689-694, 2006. 33.Pass H. I., Lott D., Asbestos exposure, pleural mesothelioma

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
Krasna M.J.: Malignant pleural mesothelioma. RadioGraphics, 16, 3: 613-644. 1996. 31.Nisman B., Barak V., Cytokeratin markers in malignant pleural mesothelioma. Cancer Detection and Prevention, 22, 5:416-421, 1998. 32.Ogura H., Naoki O., An autopsy case of sarcomatoid malignant pleural mesothelioma. Nihon Kokyki Gakkai Zasshi, 44,10:689-694, 2006. 33.Pass H. I., Lott D., Asbestos exposure, pleural mesothelioma and serum osteopontin levels. New England Journal of Medicine, 353, 15:1564-1573, 2005. 34.Porter R.S., Kaplan J.L. (editori on line

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
malignant pleural mesothelioma. Cancer Detection and Prevention, 22, 5:416-421, 1998. 32.Ogura H., Naoki O., An autopsy case of sarcomatoid malignant pleural mesothelioma. Nihon Kokyki Gakkai Zasshi, 44,10:689-694, 2006. 33.Pass H. I., Lott D., Asbestos exposure, pleural mesothelioma and serum osteopontin levels. New England Journal of Medicine, 353, 15:1564-1573, 2005. 34.Porter R.S., Kaplan J.L. (editori on line), Pleural mesothelioma. http://www.merck.com/mmpe accesat în data de 14 Februarie 2007; 35.Reck M., Gatzemeier

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
mesothelioma. Nihon Kokyki Gakkai Zasshi, 44,10:689-694, 2006. 33.Pass H. I., Lott D., Asbestos exposure, pleural mesothelioma and serum osteopontin levels. New England Journal of Medicine, 353, 15:1564-1573, 2005. 34.Porter R.S., Kaplan J.L. (editori on line), Pleural mesothelioma. http://www.merck.com/mmpe accesat în data de 14 Februarie 2007; 35.Reck M., Gatzemeier U., Pemetrexed-cisplatin combination in mesothelioma. Expert Review of Anticancer Therapy, 5, 2:231-237, 2005. 36.Roberts J.R., Surgical treatment of mesothelioma: Pleurectomy. Chest

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
Gatzemeier U., Pemetrexed-cisplatin combination in mesothelioma. Expert Review of Anticancer Therapy, 5, 2:231-237, 2005. 36.Roberts J.R., Surgical treatment of mesothelioma: Pleurectomy. Chest, 116: 446S-9S, 1999. 37.Rusch V.W., A proposed new international TNM staging system for malignant pleural mesothelioma, Chest, 108, 4:895-897, 1995. 38.Rusch V. W., Rosenzweig K., A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesotheliom. Journal of Thoracic and Cardiovascular Surgery, 122:788-795, 2001. 39.Rusch V.

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
37.Rusch V.W., A proposed new international TNM staging system for malignant pleural mesothelioma, Chest, 108, 4:895-897, 1995. 38.Rusch V. W., Rosenzweig K., A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesotheliom. Journal of Thoracic and Cardiovascular Surgery, 122:788-795, 2001. 39.Rusch V.W., Difusse malignant mesothelioma. În General Thoracic Surgery, Shields T.W. (editor) 5th edition, Lippincot Williams &Wilkins, Philadelphia, vol 1, 65: 767-782, 2000. 40.Rusch V., Saltz

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
mesothelioma. În General Thoracic Surgery, Shields T.W. (editor) 5th edition, Lippincot Williams &Wilkins, Philadelphia, vol 1, 65: 767-782, 2000. 40.Rusch V., Saltz L., A phase II trial of pleurectomy / decortication followed by intrapleural and systemic chemotherapy for malignant pleural mesothelioma. Journal of Clinical Oncology, 12:1156-1163, 2004. 41.Scagliotti G.V., Novello S., State of the art in mesothelioma. Annals of Oncology, 16 (Supplement 2):ii240-ii245; 2005. 42.Schouwink H., Rutgers E.T., Intraoperative photo-dynamic therapy after pleuropneumonectomy in patients with

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
Journal of Clinical Oncology, 12:1156-1163, 2004. 41.Scagliotti G.V., Novello S., State of the art in mesothelioma. Annals of Oncology, 16 (Supplement 2):ii240-ii245; 2005. 42.Schouwink H., Rutgers E.T., Intraoperative photo-dynamic therapy after pleuropneumonectomy in patients with malignant pleural mesothelioma: Dose finding and toxicity results. Chest, 120, 4:1167-1174, 2001. 43.Schouwink J.H., Kool L.S., The value of CT and cervical mediastinoscopy in the preoperative assessment of patients with malignant pleural mesothelioma. Annals of Thoracic Surgery, 75, 6:1715-1718

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
photo-dynamic therapy after pleuropneumonectomy in patients with malignant pleural mesothelioma: Dose finding and toxicity results. Chest, 120, 4:1167-1174, 2001. 43.Schouwink J.H., Kool L.S., The value of CT and cervical mediastinoscopy in the preoperative assessment of patients with malignant pleural mesothelioma. Annals of Thoracic Surgery, 75, 6:1715-1718, 2003. 44.Sterman D.H., Advances in the treatment of malignant pleural mesothelioma. Chest, 116:504-520, 1999. 45.Sugarbaker D.J., Jaklitsch M.T., Prevention, early detection and management of complications after 328 consecutive EPPS

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
2001. 43.Schouwink J.H., Kool L.S., The value of CT and cervical mediastinoscopy in the preoperative assessment of patients with malignant pleural mesothelioma. Annals of Thoracic Surgery, 75, 6:1715-1718, 2003. 44.Sterman D.H., Advances in the treatment of malignant pleural mesothelioma. Chest, 116:504-520, 1999. 45.Sugarbaker D.J., Jaklitsch M.T., Prevention, early detection and management of complications after 328 consecutive EPPS. The Journal of Thoracic and Cardiovascular Surgery, 128:138-146, 2004. 46.Sugarbaker D.J., Norberto J.J., Current Therapy for mesothelioma

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
4:326-334, 1997. 47.Sugarbaker D.J., Strauss G.M. Node status has prognostic significance in the multimodality therapy of diffuse malignant mesothelioma. Journal of Clinical Oncology, 11, 6:1172-1178, 1993. 48.Tammilehto L., Maasilta P.L., Diagnosis and prognostic factors in malignant pleural mesothelioma: a prospective analysis of 65 patients. Respiration, 59:129-135, 1992. 49.Truong M., Marom E., Preoperative evaluation of patients with malignant pleural mesothelioma: Role of Integrated CT-PET Imaging. Journal of Thoracic Imaging, 21, 2:146-153, 2006. 50.Tug E.

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
Clinical Oncology, 11, 6:1172-1178, 1993. 48.Tammilehto L., Maasilta P.L., Diagnosis and prognostic factors in malignant pleural mesothelioma: a prospective analysis of 65 patients. Respiration, 59:129-135, 1992. 49.Truong M., Marom E., Preoperative evaluation of patients with malignant pleural mesothelioma: Role of Integrated CT-PET Imaging. Journal of Thoracic Imaging, 21, 2:146-153, 2006. 50.Tug E., Tug T., Tumor suppressor gene alterations in patients with malignant mesothelioma due to environmental asbestos exposure in Turkey: Journal of Carcinogenesis, 5:23

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
environmental asbestos exposure in Turkey: Journal of Carcinogenesis, 5:23, 2006. 51.Vachani C., Mesothelioma: The basics. www.oncolink.com/types/article.cfm accesat în data de 15 februarie 2007. 52.van Ruth S., Baas P., Surgical treatment of malignant pleural mesothelioma. Chest, 123:551-561, Feb.2003. 53.van Ruth S., Baas P., Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy for stage I malignant pleural mesothelioma. Annals of Surgical Oncology, 10, 2:176-182, 2003. 54.Vogelzang N.J., ASCO reports on

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
data de 15 februarie 2007. 52.van Ruth S., Baas P., Surgical treatment of malignant pleural mesothelioma. Chest, 123:551-561, Feb.2003. 53.van Ruth S., Baas P., Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy for stage I malignant pleural mesothelioma. Annals of Surgical Oncology, 10, 2:176-182, 2003. 54.Vogelzang N.J., ASCO reports on intracavitary hyperthermic chemo, FDG-PET scan prognostication and Alimta/Cisplatin quality of life. Medscape Hemathology-Oncology, 6, 1, 2003. 55.Wang Z.J., Reddy G.P., Malignant pleural

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
pleural mesothelioma. Annals of Surgical Oncology, 10, 2:176-182, 2003. 54.Vogelzang N.J., ASCO reports on intracavitary hyperthermic chemo, FDG-PET scan prognostication and Alimta/Cisplatin quality of life. Medscape Hemathology-Oncology, 6, 1, 2003. 55.Wang Z.J., Reddy G.P., Malignant pleural mesothelioma: Evaluation with CT, MR Imaging and PET. Radiographics, 24:105-119, 2004. 56.Watanabe N., Shimizu M., Thallium-201 scintigraphy in malignant mesothelioma. The British Journal of Radiology, 72:308-310, 1999. 57.Whitley C., Mesothelioma cancer: early warning signs and causes

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
British Journal of Radiology, 72:308-310, 1999. 57.Whitley C., Mesothelioma cancer: early warning signs and causes. www.ezinearticles.com accesat în data de 22 februarie 2007. 58.Yilmaz U., Polat G., CT in differential diagnosis of benign and malignant pleural disease. Monaldi Archives for Chest Disease, 63,1:17-22, 2005. 59.Yoshida S., Fukumoto M., Ga-67 tumor scan in malignant diffuse mesothelioma-Comparison with CT and pathological findings. Annals of Nuclear Medicine, 13, 1: 49-54, 1999. 60.Zellos l.S., Sugarbaker D.J.

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
Disease, 63,1:17-22, 2005. 59.Yoshida S., Fukumoto M., Ga-67 tumor scan in malignant diffuse mesothelioma-Comparison with CT and pathological findings. Annals of Nuclear Medicine, 13, 1: 49-54, 1999. 60.Zellos l.S., Sugarbaker D.J., Multimodality treatment of diffuse malignant pleural mesothelioma. Semin Oncol, 29, 1:41-50, 2002. 61.***, Natural history of malignant mesothelioma http://medicineworld.org/cancer/mesothelioma/natural-history-of-malignant-mesothelioma.html accesat în data de 23 Februarie 2007. 62.***, Prevention, http://www.asbestosnews.com/html/ prevention.html accesat în data de

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
sau de la distanță [3, 4, 10, 13, 14, 16]. Interesul chirurgilor de chirurgie toracică generală arătat cavității pericardice se explică prin necesitatea zilnică de a trece peste „granița pericardică”, când efectuează operații majore, cât și prin asocierea revărsatelor lichidiene maligne pleurale și pericardice, având aceeași cauză, care necesită rezolvare în aceeași ședința chirurgicală sub o singură anestezie. Dar nu numai revarsatele pericardice asociate, ci și cele solitare au la origine maladii maligne, ce constituie în majoritate, sfera de preocupare a chirurgiei

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
pericardice asociate, ci și cele solitare au la origine maladii maligne, ce constituie în majoritate, sfera de preocupare a chirurgiei toracice. Se poate spune, fără a greși, că un chirurg toracic „accesează” cavitatea pericardică mai frecvent decât este abordată cavitatea pleurala de către un chirurg cardiac. Epanșamentele lichidiene pericarice maligne adevărate apar la un pacient cu cancer cunoscut sau necunoscut (formă primă de manifestare clinică - revărsat pericardic) și se caracterizează prin prezența celulelor maligne în revărsat și prin țesut malign pericardic. Absența

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
se instalează tamponada cardiacă, tensiunea arterială se prăbușește - pericolul de moarte este iminent. TABLOUL CLINIC Un bolnav cu pericardită malignă poate fi asimptomatic sau simptomele sunt comune sau estompate de tumora primară ce poate avea asociat și un revărsat malign pleural uni sau bilateral [4]. Dispneea este simptomul cel mai frecvent întâlnit, la început de efort, dar progresiv și în repaus. Tusea severă, durerea precordială sau doar o senzație de greutate sau disconfort toracic sunt alte simptome pe care le poate

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
13, 14]. TABLOUL PARACLINIC Radiografia toracică Radiografia toracică de față relevă mărirea opacității cardiace și dispariția arcurilor sale, iar din profil se poate observa pensarea spațiului transparent retrocardiac [4]. Tot prin examenul radiologic clasic se pot pune în evidență epanșament pleural asociat uni- sau bilateral, opacitate sau opacități pulmonare parenchimatoase, mărirea opacității mediastinale. Aceste aspecte pot sugera cauza revărsatului pericardic: cancer bronho-pulmonar, tumoră de mediastin (limfom) etc. [14] (fig. 5.56). Figura 5.56. Radiografie toracica postero-anterioară. Revărsat lichidian pleural la

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
epanșament pleural asociat uni- sau bilateral, opacitate sau opacități pulmonare parenchimatoase, mărirea opacității mediastinale. Aceste aspecte pot sugera cauza revărsatului pericardic: cancer bronho-pulmonar, tumoră de mediastin (limfom) etc. [14] (fig. 5.56). Figura 5.56. Radiografie toracica postero-anterioară. Revărsat lichidian pleural la baza stângă. cu extensie în planul scizural, opacitate difuz conturată de intensitate subcostală, intercleidohilar stâng, cord etalat pe diafragm cu arcul inferior drept mult proeminent. Radioscopia toracică Examenul radioscopic, pe lângă semnele de mai sus, relevă estomparea mișcărilor cordului. Electrocardiograma

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]
foarte bine revărsatul pericardic, topografia și grosimea „cămășii” lichidiene care înconjoară inima [3, 18]. Nu oferă date despre funcția cordului, dar permite chirurgului să se orienteze asupra „punctului de atac” pentru a obține decomprimarea cordului. Figura 5.57. Revărsat lichidian pleural drept în cantitate mare, revărsat lichidian pericardic; tumoră bronhopulmonară lob inferior drept. Rezonanța magnetică Rezonanța magnetică este superioară CT în aprecierea invadării vaselor intrapericardice și a miocardului de către procesul tumoral. Face distincție mai bună între tumoră și mușchiul cardiac, prin

Tratat de chirurgie vol. IV. Chirurgie toracică. by CLAUDIU NISTOR, ADRIAN CIUCHE, TEODOR HORVAT (2008) [Corola-publishinghouse/Science/92103_a_92598]