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@#Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients' quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.
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Objective The aim of this study was to investigate the effect of complete lung cancer resection on the balance of Th17/Treg cells in the peripheral blood of lung cancer patients. Methods Flow cytometry was used to detect the percentage of Th17 and Treg cells in the peripheral blood of 21 patients with lung cancer before and after operation and 21 healthy controls. RT-PCR was used to detect the expression of fork-head/winged helix transcription factor( Foxp3) and retinoic acid-related orphan receptor γt ( RORγt)in PBMC. The plasma levels of interleukin(IL) -17 and transforming growth factor(TGF) -β1 were detected by enzyme-linked immunosorbent assay(ELISA). Results After surgery,the percentage of Th17 cells in the peripheral blood decreased and the percentage of Treg cells increased in patients when compared to the pre -operation ( P <0. 01). After surgery,the expression of RORγt was decreased and the expression of Foxp3 was increased in the CD4 +T cells of patients in comparison with the pre-opera-tion(P<0. 01). After surgery,the expression of IL-17 was decreased and the expression of TGF-β1 was increased in the plasma of patients in comparison with the pre -operation( P <0. 01). In addition,the percentage of Th17 and Treg cells,the expression of RORγt and Foxp3,and the expression of IL-17 and TGF-β in the peripheral blood were increased in preoperative lung cancer pa-tients when compared to healthy controls. Conclusion There is a Th17/Treg imbalance in the peripheral blood of lung cancer pa-tients after complete resection of lung cancer.
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Objective To evaluate the clinical effect of Uniportal video -assisted thoracoscopic surgery and single utility port video-assisted thoracoscopic surgery for ⅠA stage non-small cell lung cancer .Methods A total of 81 patients with ⅠA stage non-small cell lung cancer was admitted to our hospital from January 2015 to November 2015 .The patients were divided into control group and observation group .51 patients of control group received single utility port video -assisted thoracoscopic surgery , while other 30 patients of observation group received Uniportal video -assisted thoracoscopic surgery .Results The incision length of observation group was(4.27 ±0.29) cm,operative time was (208.80 ±61.12) mins.The volume of blood intra -operation was (92.33 ±73.75)mL;the number of lymph nodes dissection was (15.62 ±5.12),post-operative drainage within 24 hours was(401.70 ±53.31)mL;drainage tube retention was (6.30 ±3.01)days;postoperative hospitalization time was(19.03 ±5.85)days.The incidence rate of postoperative complications was 13.33%.The incision length of control group was(3.86 ±0.23)cm.The operative time was(184.30 ±51.36)mins;The volume of blood intra-operation was(84.90 ±80.98)mL,the number of lymph nodes dissection was (15.84 ±5.66),post-operative drainage within 24 hours was(398.00 ±52.73)mL;drainage tube retention was(6.10 ±3.25)days;postoperative hospitalization time was(18.69 ±6.81) days;The incidence rate of postoperative complications was 25.49%, there were no significant difference between the two groups (P>0.05).VAS pain score of the observation group was(2.32 ±0.94)and it was(4.18 ±0.95)in control group,and observation group was significantly better than the control group(P<0.05).Conclusion Uniportal video -assisted thoracoscopic surgery has the benefit of less trauma and pain ,and it is worth using widely .
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Objective The aim of this study is to evaluate whether video -assisted thoracoscopic surgi-cal( VATS) lobectomy is as effective as open thoracotomy lobectomy for complete dissection of the mediastinal lymph node(MLN).Methods Patients with clinical stage N0 lung cancer who underwent lobectomy between January 2008 and June 2013were retrospectively evaluated based on the LN station resected and lobectomy proce -dure used,and a resection ratio was calculated .Nodal stage and the proportion of patients ,from whom at least three MLNs and station 7were dissected and compared by lobectomy type .Results Of the 201 patients enrolled in the study,84 and 117 underwent VATS and open thoracotomy lobectomies ,respectively.The mean number of LNs dissected at station 3a was similar in the two groups (1.34 ±2.58 vs.1.52 ±1.78;P>0.05),but the re-section ratio differed(39%sv .63%;P 0.05).There were no differences in the number of LNs dissected or resection ratio between the two groups for stations 4 L,5 L6, L,7 L, and9 L for the left-sided approaches .Only station 8L showed significant differences between the VATS and open thoracotomy groups in the number of LNs dissected (0.12 ±0.44 vs.0.46 ±0.71;P0.05). The Kaplan-Meier 5-year survival was also similar between the two groups (log-rank test,P>0.05).Con-clusion VATS lobectomy is as effective as open thoracotomy lobectomy for the dissection of MLNs .Thus,VATS lobotomy resection will continue to be offered as the best choice for patients with clinical stage N0.
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Objective Two-incision video-assisted thoracic surger relieved post operative pain when compared with open thoractomy ,while it is rarely reported worldwide ,most thoracic surgeons think it is hard to finish the complicated operation and it is not safe .We compared the safety between open and two -incision VATS.Methods Bwteen Febrary 2009 to December 2011 ,a total of 334 cases with clinical early -staged lung cancer of open thoracotomy were performed ,66 cases were completely performed with 2-incision VATS,17 cases were transferred to open thoracotomy defined as two -incision VATS assisted thoracotomy .We compared and ana-lyzed open thoracotomy with two -incision VATS in operating time ,and pre,post and total period of hospitaliza-tion,postoperative chest tube removal time ,postoperative complications .Results Operating time in the left lower lobe of both traditional open thoracotomy and two -incision VATS was 162.5 ±6.5 and 185.8 ±12.8 minutes re-spectively(P=0.1228),there was no statistical significance for the remaining parts of the lobectomy ,the operat-ing time of open thoracotomy was shorter than two -incision VATS.The overall complication and perioperative mortality rate of open thoracotomy and two -incision VATS were 10.2% and 15.0%(P=0.238),and 2.0%and 0.0%(P=1.000)respectively,there was no statistical significance.Conclusion The lobectomy and lymph node dissections for 2-incision VATS in treating clinical stage I lung cancer is feasible and safe .