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Objective To investigate the application value of the Perclose Proglide vascular devices in the thoracic endovascular aortic repair (TEVAR) of aortic dissection.Methods Retrospective analysis of 106 patients who underwent TEVAR for Standford B type aortic dissection were performed.The femoral lumen was measured by CTA be fore,1 month and 1 year after TEVAR.Results A total of 223 Perclose Proglide vascular closure devices were used in the 106 patients,including 97 patients with 2 devices,7 patients with 3 devices,2 patients with 4 devices.The puncture femoral artery diameters had no significant differences between before and 1 month,1 year after TEVAR (all P ＞0.05).Conclusion Per close Proglide vascular closure devices can be effectively and safely used in the TEVAR,which has little influence on the femoral artery diameter,and is worth to be applied in the clinics extensively.
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Objective To evaluate the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) in treating Standford type B thoracic aortic dissection complicated by type A intramural hematoma.Methods From October 2015 to January 2017,a total of 3 patients with Standford type B thoracic aortic dissection complicated by type A intramural hematoma were admitted to authors' hospital to receive treatment.After admission,conservative treatment such as stabilizing blood pressure and heart rate,symptomatic medication,etc.were carried out for 14 days,then,TEVAR was performed.Results Successful TEVAR was accomplished in all 3 patients,no serious complications,such as reverse tear,occurred.One month after TEVAR,reexamination of total aortic CT angiography revealed that the rupture of dissection was completely closed with no internal leakage,the blood flow in the true lumen was obviously improved,the intramural hematoma was remarkably absorbed and faded away,and the wall thickness of ascending aorta returned to normal range.The clinical symptoms were greatly improved,no serious complications such as paraplegia or death occurred.Conclusion For the treatment of Standford type B thoracic aortic dissection complicated by type A intramural hematoma,TEVAR performed at 14 days after the onset of disease is safe and effective if the ascending aorta intima is intact and the clinical symptoms are relived after medication of lowering blood pressure and heart rate.
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Objective To discuss the clinical application of ultrasound-CT double-guided radiofre-quency ablation(RFA) in treating hepatic tumors. Methods Fifteen patients with 20 liver tumor lesions were included in this study. Ultrasound-CT double-guided radiofrequency ablation was employed in all patients. First, under ultrasound guidance the electrode of RFA was inserted to the site close to the lesion, then, guided by CT scanning the accurate positioning of the electrode was accomplished and RFA procedure was completed. Results The accurate puncturing of the electrode was achieved in all 20 hepatic lesions, and the RFA procedure was successfully performed in a short time. Follow-up examination showed that there was no obvious residual tumor tissue, and no RFA-related complications occurred in all the 15 patients. Conclusion Under ultrasound-CT double-guidance, the percutaneous transhepatic puncturing can be more accurately accomplished, which can ensure a successful RFA procedure. This technique is especially useful when the hepatic tumor is incomplete or unclear on ultrasonograph, and it can improve the puncturing accuracy and reduce the complications as well.
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Objective: To discuss the clinical features of basaloid squamous carcinoma(BSC)and the factors relating to its prognosis and to compare patient survival between poorly differentiated squamous cell carcinoma(PDSC)and BSC. Methods: Clinical and pathological data of BSC and PDSC cases seen in our hospital between January 2004 and December 2008 were reviewed. Results: There were no statistical differences in demographic and clinical features between PDSC and BSC patients,with the exception that a larger proportion of BSC patients were female(P=-0.001).Additionally,higher tobacco consumption was observed among BSC male patients (P=0.003).There were no significant differences in survival rate between BSC and PDSC groups(X2=0.03,P=0.5470).The median survival time of BSC and PDSC patients was 19 months and 30 months，respectively.The 4-year survival rate was 22.4%and 36.1%，respectively(u=0.740,P=0.230).No significant difference was found in survival rate between stage Ⅰ and stage Ⅱ patients(X~2=0.109，P=0.2974).The median survival time of stage Ⅰ and stage Ⅱ patients was 19 months and 46 months，respectively；and the 4-year survival rate of stage Ⅰ and stage Ⅱ patients was 47.3% and 45.2%，respectively(u=0.122，P=0.450).Using Cox proportional hazard model，we found that surgical types and clinical stages of BSC were correlated with its prognosis.Compared with that of patients who received lobectomy,the postoperative mortality hazard of patients who received pneumonectomy and segmentectomy was increased by 1.379 times(P=0.031)and 1.634 times(P=0.061)，respectively.A more advanced clinical stage was associated with an increase in the postoperative morta,ty hazard ratio(X~2=14.12,P=0.000).The postoperative mortality hazard of patients of stage Ⅲ and stage Ⅳ was 2.437 times higher than that of stage Ⅰ patients(P=0.018).There were no statistical differences in postoperative mortality risk between stage Ⅰ patients and stage Ⅱ patients(P=0.057). Conclusion: Compared with that of PDSC,the incidence of BSC is higher among females.However,there is no difference in the prognosis between BSC and PDSC.BSC can be treated with the same therapies as those for other types of non-small cell lung cancer(NSCLC).
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<p><b>BACKGROUND</b>Sleeve recestion for lung cancer can get similar tumor and lymph node resection rate as pneumonectomy, with less influence on pulmonary function and much improvement of quality of life. The aim of this study is to compare the 5-year survival and complications of sleeve resection and pneumonectomy for lung cancer.</p><p><b>METHODS</b>Survival analysis was used to investigate the 5-year survival of 173 patients undergoing sleeve resection and 435 patients undergoing pneumonectomy from January 1990 to December 2000. Their complication and perioperative motality were also analyzed.</p><p><b>RESULTS</b>The overall 5-year survival for sleeve resection and pneumonectomy was 42.3% and 30.9%, respectively (P=0.007). 5-year survival of right lung sleeve resection was better than that of left lung [P=0.004 (N0), 0.025 (N1), 0.042 (N2)]. In left lung cancer patients without nodal involvement, the survival after sleeve resection was better than that after pneumonectomy. There was no survival difference between N1 and N2 lung cancer patients. Survival was not significantly different for bronchoplasty and pulmonary arterioplasty and pneumonectomy. The incidence rate of pneumonia and arrhythmia for sleeve resection was less than those for pneumonectomy (P=0.0019), and no significant difference of mortality was observed between the two groups.</p><p><b>CONCLUSIONS</b>In lung cancer patients suitable for sleeve resection or pneumonectomy, sleeve resection should be performed for right lung cancer and left lung cancer of stage I. Bronchoplasty and pulmonary arterioplasty don't prolong the survival of lung cancer patients compared with pneumonectomy.</p>