romana english

Original Papers

Determination of safe margin in the surgical pathologic specimens of non-small cell carcinoma of the lung

Iraj Feizi1, Mohsen Sokouti2, Samad EJ Golzari3,4, Morteza Gojazadeh5, Mohammad Reza Farahnak6, Shahriar Hashemzadeh2, Mohammad Hossein Rahimi-Rad7
1. Department of Surgery, Ardabil University of Medical Sciences, Ardabil, Iran, 2. Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran, 3. Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, 4. Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran, 5. Department of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran, 6. Department of Cardiothoracic Surgery, Ahwaz University of Medical sciences, Ahwaz, Iran, 7. Department of pulmonary Medicine, school of Medicine, Urmia University of Medical Sciences, Urmia, Iran

Background and Aim: Local recurrences of the tumor at the surgical margin are serious problems in pulmonary resections for lung cancer. The aim of this study is to determine the involved margins and safe distances of the resection sites from tumor for prevention of local recurrences. Material and Methods: In this prospective study, 66 patients operated for non-small cell lung carcinoma (NSCLC) from Jan 2006 to Sep 2008 were evaluated. After performing pulmonary resections, multiple biopsies were taken up from 5 mm (A), 10 mm (B), 15 mm (C), and 20 mm (D) distance from tumor. The specimens were studied histopathologically. Results: From a total of 66 patients with NSCLC admitted to our referral hospital, 25 (38%) had adenocarcinoma, 18 (27.3%) squamous cell carcinoma, 5 (7.5%) large cell carcinoma, 4 (6%) bronchoalveolar cell carcinoma, 4 (6%) adenoid cystic carcinoma, 3 (4.6%) malignant carcinoid tumor and 7 (10.6%) had metastasis. The most common symptoms were dyspnea and cough. Histopathologically tumor positive margins were found in 84.8% (A), 10.6% (B), 4.5% (C), and 0% (D). There was a significant statistically difference between tumor involvement at distances 5 mm (A) versus 10-20 mm (B-D) (P <0.001). Conclusion: A 20 mm distance from the gross tumor is considered as a safe surgical margin in any type of malignant pulmonary resections for prevention of local surgical recurrences if there was no pathologic examination before surgery.

Keywords: lung, safe margin, surgery, tumor

Non-invasive ventilation in Romania – results of an inquiry among lung physicians

Fl. Mihălţan, Mirela Ciontu, Oana Deleanu, Ioana Munteanu
Institutul de Pneumologie „Marius Nasta“, Bucureşti

Non-invasive ventilation in Romania - results of an inquiry among lung physicians. Non-invasive ventilation (VNI), although it is a validated strategy for many years with serious scientific studies, remains a matter of acceptance by Romanian colleagues. In this investigation on 140 valid questionnaires we found that VNI was used by 22.1% of lung physicians, with the highest percentage of those under 40 years (30.8%); the home ventilation was indicated by 35.7% of colleagues, but actually only very few of them (5.2%) have experience which enables them to assert that they have a current practice.

The major part of indications are related to COPD, chronic hypercapnic respiratory failure. Shortages in this field are manifold: from lack of knowledge concerning the VNI benefits who generates uncertainty in guidance and monitoring, to zero home insurance coverage and shortage of equipment in hospitals and ambulatory services.

Keywords: non-invasive ventilation, inquiry Romania, lung physicians