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BACKGROUND@#Bronchial tuberculosis is a common complication of pulmonary tuberculosis. The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis, when the drug and endoscopic treatment were no effect.@*METHODS@#Reviewed the clinical-pathological records documenting the surgical outcomes in 36 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 2000 and February 2016. Pneumonectomy in 8 cases, lobectomy in 23 cases, sleeve resection in 5 cases.@*RESULTS@#No intraoperative or early postoperative death occurred. Six patients developed complications. All 6 cases recovered well after treatment.@*CONCLUSIONS@#Surgical treatment is still the recommended treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its good results. It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Bronchi , General Surgery , Bronchoscopy , Pneumonectomy , Retrospective Studies , Tuberculosis, Pulmonary , General SurgeryABSTRACT
<p><b>BACKGROUND</b>With the development of social industrialization and aging of the population, patients with lung cancer have the tendency of becoming youthful and elderly, therefore the way of treatment should be also changed. In resent years, lung cancer in young and elderly patients have been reported respectively, but simultaneous contrast analysis of clinical feature and prognosis in elderly, normal and youthful patients have been rarely reported. Based on the clinic data in the patients, the clinical feature and prognosis of patients with non-small cell lung cancer at different ages were analyzed.</p><p><b>METHODS</b>From January 1996 to January 2003, 1380 patients with NSCLC were treated surgically in thoracic department in our hospital, the patients were divided into three group based on their age, group 1 (G1) (range ≤40), group 2 (G2) (range 41-69), group 3 (G3) (range ≥70). The clinical feature and prognosis were analyzed in each group.</p><p><b>RESULTS</b>The mean age in the whole group was 58.16±0.26, and 35.76±0.57 (range 12-40) in G1, 58.00±0.22 (range 41-69) in G2, 72.30±0.21 (range 70-80) in G3. The ratio of lung cancer in female between G1 and G3 was significant different (P=0.024). The coexisting diseases in G3 were more common than those of other groups (P=0.000). Squamous cell carcinoma was the main type in histology, accounting for 41.79% (28/67), 54.12% (644/1190) and 58.54% (72/123) in each group respectively (P=0.080), but the ratio of adenocarcinoma, higher than that of other groups, were 43.28% (29/67), 29.50% (351/1190) and 26.82% (33/123) (P=0.036). Lobectomy and pneumonectomy were the main surgical procedures, accounting for 58.21%, 65.29%, 78.86% (P=0.004) and 34.33%, 26.22%, 12.20% (P=0.001), respectively. The ratio of stage III were 43.28% (29/67), 38.82% (462/1190), and 26.02% (32/123) in each groups (P=0.015). 55.22% (37/67) in G1 received adjuvant chemotherapy, 47.48% (565/1190) in G2, and 29.27% (36/123) in G3 (P=0.000). 5-year survival rate was 38.96% in the whole group, 29.99% in G1, 39.61% in G2, and 37.99% in G3 (P=0.494).</p><p><b>CONCLUSIONS</b>In young patients with non-small cell lung cancer, female and adenocarcinoma make up the majority of the number, and a lot of patients are in advanced stage and likely to adopt adjuvant chemotherapy. While in elderly, squamous cell carcinoma accounts for the majority of the number, and more coexisting diseases are accompanied, much more complications occur after surgical procedure. Nevertheless, their prognosis has no significant difference.</p>
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<p><b>BACKGROUND</b>There are many factors that affect the prognosis of non-small cell lung cancer (NSCLC). This study aims to analyze the influential factors and prognosis in patients with NSCLC following operation.</p><p><b>METHODS</b>From January 1996 to January 2003, 1380 patients with NSCLC treated surgically were retrospectively studied. The correlation between clinicopathological characteristics and prognosis was evaluated by univariate and multivariate analyses.</p><p><b>RESULTS</b>In the whole group, 1-, 3- and 5-year survival rate was 78.85%, 49.78% and 38.96% respectively, and median survival time (MST) was 38.77 months. According to univariate analysis, tumor size, pathologic type, clinical type (central or peripheral), TNM stages, lymph node involvement, surgical procedure, postoperative chemotherapy, and cycles of chemotherapy were significantly related to the survival of patients. By multivariate analysis, tumor size, TNM stages, lymph node status and postoperative chemotherapy were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Tumor size, TNM stages, lymph node involvement and postoperative chemotherapy are independent prognostic factors for NSCLC following the surgical procedure.</p>
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<p><b>BACKGROUND</b>The influence of tumor size on prognosis has been determined in different stages of lung cancer, but it is not clear yet within the same stage of lung cancer, especially for those less than 3cm in diameter. The aim of this study is to explore the impact of tumor size on prognosis in stage IA non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 142 consecutive, surgically treated patients with pathologic stage IA NSCLC were analysed retrospectively. Kaplan-Meier survival curve was performed to estimate the survival of patients with different tumor size. And a COX proportional hazard regression model was used to make multivariate analysis about age, gender, pathologic type, tumor size and chemoradiotherapy or not.</p><p><b>RESULTS</b>There were 60 patients with tumor diameter less than 2.0cm, and 82 between 2.1 to 3.0cm. The overall 3-and 5-year survival rate was 84.41% and 70.89% respectively, in which tumor diameter less than 2.0cm group was 94.91% and 81.40%, tumor diameter between 2.1 to 3.0cm group was 82.18% and 64.91% (P=0.0353), respectively. In both univariate and multivariate analyses, the tumor size was an independent prognostic factor for survival.</p><p><b>CONCLUSIONS</b>Since the tumor size is an independent prognostic factor for NSCLC, it is necessary to improve the level of imageological diagnosis so as to treat the patients much earlier.</p>
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<p><b>BACKGROUND</b>To summarize the operative indication, surgical technique and perioperative ma-nagement of resection and reconstruction of carina for advanced lung cancer involving the carina.</p><p><b>METHODS</b>There were 67 patients with lung cancer invaded the carina, right central lung cancer in 46 cases, peripheral lung cancer in 4 cases, involved superior vena cava (SVC) or with bilateral anonymous veins in 11 cases, left central lung cancer in 17 cases, respectively. Surgical procedure included carinal right pneumonectomy or lobectomy in 50 cases, concomitant replacement of SVC or with bilateral anonymous veins with vascular prosthesis in 11 cases, carinal left pneumonectomy in 17 cases. Follow-up was performed in long-term.</p><p><b>RESULTS</b>Perioperative death occured in 8 cases (11.94%), circulatory failure in 6 cases (8.96%), and respiratory failure in 2 cases (2.99%). The overall 1-, 3- and 5-survival rate was 77.21%, 48.23% and 32.54% respectively.</p><p><b>CONCLUSIONS</b>Complete resection and reconstruction of carina, SVC or bilateral anonymous veins combined with postoperatively multiple modality therapy can get good prognosis for the patients with advanced lung cancer.</p>