Clinical value of indocyanine green fluorescence navigation combined with carbon nanoparticles in sentinel lymph node biopsy for patients with early breast cancer / 天津医药

Objective To explore the clinical value of indocyanine green (ICG) fluorescence navigation combined with carbon nanoparticles (CNP) in sentinel lymph node biopsy (SLNB) for patients with early breast cancer. Methods A total of 294 early breast cancer patients with axillary node negative in Department of Breast Surgery, Foshan Hospital Affiliated to Sun Yat-Sen University from June 2013 to April 2016 were retrospectively analyzed. Of the patients, 149 cases underwent SLNB with ICG combined with CNP (combination group), while 145 cases underwent SLNB with methylene blue alone (MB group). If the intraoperative pathology results of sentinel lymph nodes (SLNs) were negative, axillary lymph node dissection (ALND) was avoided. The SLNs detection rate, detection number, metastatic SLNs detection rate in SLNB were compared between two groups. The influence of age and body mass index (BMI) on SLNs detection rate was also analyzed. Results In the combination group, subcutaneous lymphatic channels were successfully visualized in 145 patients, and the detection rate was 97.3％(145/149). The fluorescence of SLNs was successfully detected in 143 patients, and the detection rate was 95.9％(143/149). The detection rate of SLNs was higher in the combination group than that of methylene dye alone group (97.9％vs. 91.0％,χ2=6.902,P<0.05). The average number of detected SLNs was higher in the combination group than that of methylene dye alone group (4.5±1.6 vs. 3.2±1.5,t=4.476,P<0.05). Fifty-eight metastatic SLNs were found in 715 SLNs in the combination group (8.1％), and 26 in 544 SLNs in MB group (4.7％). The detection rate was significantly higher in the combination group than that of methylene dye alone group (χ2=13.714,P<0.01). Age and BMI showed no influence on the detection rate and accuracy of SLNB in two groups (P>0.05). Conclusion The combined tracing of ICG fluorescence and carbon nanoparticles for SLNB has showed a better stability and operability in patients with early breast cancer, which is recommended to be a new SLNB method.

Intercostal video-mediastinoscopy: a report of 701 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of intercostal video-mediastinoscopy (VMS) in treatment for mediastinal masses, malignant pleural effusion and palmar hyperhidrosis.</p><p><b>METHODS</b>The clinical data of 701 patients received intercostal VMS from November 2001 to June 2007 were summarized retrospectively. Forty-eight patients with mediastinal masses and 46 patients with suspected malignant pleural effusion underwent intercostal VMS pleural biopsy (39 cases with talc pleurodesis) and 607 patients with palmar hyperhidrosis underwent bilateral intercostals VMS thoracic sympathectomy.</p><p><b>RESULTS</b>No mortality and morbidity were reported in this group. Definitive pathologic diagnosis had been made through VMS mediastinal masses biopsy in mediastinal masses and pleural biopsy in pleura effusion. The efficiency of talc pleurodesis was 100% for 39 cases. The symptoms of sweating of hands in 607 patients with palmar hyperhidrosis disappeared completely, all patients' hands became dry with a 1.5 degrees C to 3.0 degrees C increase of the skin temperature immediately after operation. No recurrence occurred during the follow-up.</p><p><b>CONCLUSION</b>VMS is a simple, convenient and alternative procedure for the treatment of mediastinal masses, malignant pleural effusion and palmar hyperhidrosis.</p>

T3/T4 thoracic sympathictomy and compensatory sweating in treatment of palmar hyperhidrosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Compensatory sweating (CS) is one of the most common postoperative complications after thoracic sympathectomy, sympathicotomy or endoscopic sympathetic block (ESB) for palmar hyperhidrosis. This study was conducted to examine the relevance between CS and the sympathetic segment being transected in the surgical treatment of palmar hyperhidrosis, and thus to detect the potential mechanism of the occurrence of CS.</p><p><b>METHODS</b>Between October 2004 and June 2006, 163 patients with primary hyperhidrosis were randomly divided into two groups, T(3) sympathicotomy (78 patients) and T(4) sympathicotomy (85), who were operated upon under general anesthesia via single lumen intubation and intercostal video-mediastinoscopy (VM).</p><p><b>RESULTS</b>No morbidity or mortality occurred. Palmar hyperhidrosis was cured in all patients. Follow-up (mean (13.8 +/- 6.2) months) showed no recurrence of palmar hyperhidrosis. The difference of rates of mild CS in groups T(3) and T(4) was of no statistical significance. The rate of moderate CS was significantly lower in group T(4) than in group T(3). No severe CS occurred.</p><p><b>CONCLUSION</b>The rates of occurrence and severity of CS are lowered with the lower sympathetic chain being transected.</p>