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@#Objective To evaluate the feasibility and safety of da Vinci robotic surgery for elderly patients with radical surgery of lung cancer. Methods We retrospectively analyzed the clinical data of 59 patients aged over 70 years who underwent radical surgery of lung cancer in our hospital between 2016 and 2019. These patients were divided into two groups including a da Vinci robot group and a single-utility port video-assisted thoracoscopic surgery (VATS) group according to the patients’ selection of the treatments. There were 32 patients with 20 males and 12 females aged 73.1±2.3 years in the da Vinci robot group and 27 patients with 16 males and 11 females aged 71.2±1.3 years in the VATS group. The clinical data of the two groups were compared. Results There was no statistical difference in surgery time between the two groups (t=–0.341, P=0.484). Compared with the VATS group, the da Vinci robot group had more number of lymph nodes dissected (t=1.635, P=0.015), less intraoperative blood loss (t=–2.569, P <0.001), less postoperative drainage amount within 3 days after surgery (t=–6.325, P=0.045), lower visual analogue scale (VAS) scores at postoperative 3rd day (t=–7.214, P=0.021). Conclusion The da Vinci robot system is safe and efficient in the treatment for elderly patients with radical surgery of lung cancer with less trauma.
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In December 2019, a new type of coronavirus pneumonia emerged and spread rapidly, but there is no specific antiviral vaccine or drug. At present, traditional Chinese Medicine (TCM) prevention and treatment programs have been introduced in many places in China. This paper systematically reviews and summarizes the etiology and pathogenesis of novel coronavirus pneumonia 2019 (COVID-19), the prevention programs for different populations in different regions and the treatment programs by stages. We analyzed the TCM prevention and treatment programs of COVID-19 in various regions and the clinical characteristics of the first-line patients. It is verified that the disease belongs to the category of "wet poison epidemic" according to TCM, and the disease is located in the lung and the spleen. The core pathogenesis of the disease is "dampness, heat, poison, blood stasis and deficiency" because of the rage of the disease. According to the relevant plan, TCM prevention should adopt different prescriptions according to the constitution of different populations and pay attention to comprehensive prevention according to different climates, regions and populations. Treatment should focus on eliminating filth and resolving turbidity, with clearing dampness as the key point. The corresponding treatment plan should be made according to the development of the disease, and the treatment should be divided into five stages (observation stage, initial stage, middle stage, severe stage and convalescence stage) according to the rules of syndrome development. Through the systematic analysis of the progress of TCM applied in various regions during the epidemic period, this paper hopes to provide useful help and guidance for the prevention and control of the epidemic and rational application and further research on the clinical treatment with TCM.
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BACKGROUND@#Surgical site infection is one of the common postoperative complications of thoracic surgery, and its harm is related to infection degree and location. Light causes local pain, prolonged hospitalization and increased cost. Severe infection can lead to severe infection, even septic shock and life-threatening. Therefore, proper treatment of incision infection can help to promote recovery, reduce the burden of disease and lay a good foundation for further treatment. The traditional surgical treatment of wound infection includes thorough drainage, intensive dressing change and antibiotic use. There are many shortcomings such as long treatment process, ineffective treatment effect and so on. The experience of using vacuum sealing drainage (VSD) in 6 cases of postoperative infection patients in our department is summarized in order to improve the traditional treatment of postoperative infection in patients after thoracic surgery.@*METHODS@#The clinical data of patients with postoperative incision infection or fistula after thoracic surgery in our department were reviewed and summarized. 6 patients treated with VSD material for postoperative infection. The process and final clinical results of them were summarized and discussed.@*RESULTS@#In this study, fever and wound exudation disappeared within 6 h-10 h after VSD use, 5 cases of wound infection were obviously improved, the secretion disappeared and the granulation tissue grew well at the cutting edge of the operation, the second stage operation was performed to close the chest and skin. One patient was seriously infected, and the secretion was still more after VSD removal, reposition VSD device next time, the VSD device was removed 7 d later. The wound infection were obviously improved, the secretion disappeared and the granulation tissue grew well, close the chest and skin second stage. In all 6 patients, the symptoms were relieved, the symptoms improved and the surgical incision healed well. In 2 patients with esophageal cancer, the average operation time was 427.5 min, the average hospitalization time was 40 d, the average number of times of dressing change was 8.5, the average total cost during hospitalization was 111,893.47 yuan patients with chronic empyema, the average operation time was 192.5 min. The average hospital stay was 27.75 days, the average number of times of dressing change was 5.5, and the average total expenditure during hospitalization was 48,237.71 yuan.@*CONCLUSIONS@#VSD has a good effect on the treatment of postoperative incision infection patients in thoracic surgery. It can reduce the pain and burden of patients and ensure the quality of life of postoperative infected patients.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Drainage , Methods , Esophageal Neoplasms , General Surgery , Lung Neoplasms , Postoperative Complications , General Surgery , Retrospective Studies , Thoracic Diseases , General SurgeryABSTRACT
AIM: In vitro isolation and culture of esophageal epithelial cells are basic component of tissue-engineered esophagus. This study explored the method to culture esophageal epithelial cells for research on tissue-engineered esophagus. METHODS: The experiment was performed at experimental center of Lanzhou University from May to November 2007. Normal esophagus tissues, 2.0-3.0 cm, were harvested from patient with esophagus cancer by surgery. The informed consent was obtained from the patient. Esophageal epithelial cells for tissue engineering were obtained and passaged. The cells cultured by DMEM+F12 (1∶1) after 20 minutes, 1-4 days were observed by immunohistochemistry staining and inverted phase contrast microscope. The growth curve of cells was drawn by MTT method. RESULTS: The immunohistochemistry staining results showed that 90% of the cells were positive, which indicated the cultured cells were esophageal epithelial cells. Normal cells were big and globular, floating in the culture-medium. Cells began to adhere after 20 minutes, and most cells were polygon-like or irregular globular and adherent after 1 day; the cells began to cluster after 2 days; the cells grew at peak after about 3-4 days with abundant endochylema and large and spherical nuclear. Cells growth reached the peak after about 3 days of culture and its absorbance was significantly different compared with that on the 1st, 2nd, 5th, and 6th days (P