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Objective To explore the clinical characteristics of bronchial carcinoma in elder patients and determine the operative indication, surgical technique, and management in the perioperative period. Methods 16 patients with bronchial carcinoma aged 80 and over received major pulmonary resection through muscle sparing mini-thoracotomy. The operative procedures were lobectomy(8 cases), bilobectomy (3 cases), sleeve lobectomy (2 cases), pneumonectomy (1 case), and lobectomy plus wedge resection (2 cases). Clinical data were analyzed retrospectively. Results Of the 16 patients, 6 with stage Ⅰ disease, 3 with stage Ⅱ and 7 with stage Ⅲdisease. There were no perioperative death occurred. The most popular postoperative complications were cardiac arrhythmia, pulmonary infection and hypoxemia. Conclusion Major pulmonary resection is a rational choice for part of the octogenarian patients with lung cancer.
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<p><b>BACKGROUND AND OBJECTIVE</b>Positron emission tomography (PET) is used increasingly in staging of non-small cell lung cancer (NSCLC) as a non-invasive tool. However, the role of PET in mediastinal lymphatic staging of NSCLC is not clear. The aim of this study was to demonstrate the efficacy of mediastinoscopy in determining mediastinal lymphatic metastasis in cases of positive PET finding.</p><p><b>METHODS</b>We performed PET preoperatively in 68 patients with clinically operable NSCLC between 2003 and 2008. Mediastinal lymphatic defined as metastasis by PET (SUV(max) > 2.5) was recorded. Mediastinoscopy being performed initially in all patients. Involvement of mediastinal lymph nodes was verified to compare the sensitivity and specificity of mediastinoscopy and the related PET results.</p><p><b>RESULTS</b>From 2003 to 2008, 61 mediastinoscopy were performed. There were 38 men and 23 women, aged from 41 to 81 years (mean 60 years). Localization of the tumor was right lung in 41 patients and left lung in 20 patients. After the operation, 45 patients were demonstrated to have N2 or N3 disease. Ten patients with N3 mediastinal metastasis for chemotherapy, 38 patients with N2 mediastinal metastasis for neuadjuvant chemotherapy while lung resection and systemic mediastinal lymphatic dissection through thoracotomy was performed in the remaining 16 patients with no mediastinal metastasis. The positive prediction value of PET scan was 73.8% (45/61). The sensitivity, specificity, accuracy, positive prediction value and negative prediction value in diagnosis of metastasis of mediastinal lymph nodes were 93.8% (45/48), 100% (13/13), 95.1% (58/61), 100% (45/45), 81.3% (13/16) for mediastinoscopy, respectively.</p><p><b>CONCLUSION</b>PET results do not provide acceptable accuracy rates. Mediastinoscopy still remains the gold standard for mediastinal staging of NSCLC.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Lung Neoplasms , Pathology , Lymph Nodes , Pathology , Lymphatic Metastasis , Pathology , Mediastinoscopy , Positron-Emission TomographyABSTRACT
Objective Under the guidance of CT and three dimensional reconstruction, we made therapeutic plan for lung cancer by radiofrequency ablation (RFA) and observed its effect. Methods From February 2007 to January 2009, we used RITA radiofrequency therapeutic equipment to treat lung cancer under the guidance of 64-slice spiral CT (Siemens) and three dimensional reconstruction of the image. The target temperature is 90℃. Results We performed 29 RFA on 25 patients. In the follow-up, 10 of them showed tumor shrinkage by CT scan. 23 showed lack of tumor-uptake value by SPECT scan and 2 showed lower tumor-uptake value. Conclusion CT-guided percutaneous RFA is safe and practical for lung cancer. It has satisfactory short-term effect to reduce tumor burden.
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To Further Strengthen the humanities education in medical universities and colleges,we investigated four medical universities and colleges in Yunnan Province,and came up with relevant countermeasures from the following aspects including curriculum setting,teaching content,teaching methods,construction of teaching staff,social practice,and supervision mechanism.