ABSTRACT
Objective To evaluate the effect of mechanical dilation on cardia achalasia under an endoscope.Methods A total of 62 patients with cardia achalasia were treated with mechanical dilation by using a self-designed dilator under a gastroscope.Of the cases,one had experienced a failure of heller surgery,and four had received ballon dilation before the gastroscopy.Results Among the cases,2 were convered to open thoracic surgery becaues of rupture of the esophagus,1 patient could not tolerate the operation,1 received a second dilation because of unsatisfied outcome of the first attempt.In the other 58 patients,the surgery was completed in the first attempt.The mean dilation time was 3.5 minutes(ranged from 2 to 5 minutes).Slight mucosal hemorrhage was observed during the operation,while no continuous bleeding occurred.Cold liquid diet was given to the patients 2 hours after the dilation,and then semiliquid diet was prescribed in 6 hours,after that the patients began to take normal diet gradually.The patients were followed up for 2 to 11 years with a mean of 7.5.All of them were cured without recurrence.Conclusions Endoscopic mechanical dilation is microinvasive,safe,and effective for cardia achalasia.It is worth being widely used because of a low cost and reliable long-term outcomes.
ABSTRACT
Objective To investigate the therapeutic effect of a new surgical procudure for intractable pnumothorax.Methods Subaxillary mini-incision and folding ligation of bullae of lung were conducted without suture if possible.Parietal pleura was rubbed with a dry gauze roll and irrigated with hydrogen peroxide solution.The corresponding pulmonary segments were suspended on the parietal pleura to keep the lung tissues in inflation state and to avoid over compression of the lungs.Pleural cavity was irrigated with 5-10 ml lidocaine for 3 days after the surgery.Results The operation was successfully conducted in 21 cases(including 1 case of bilateral surgery).The average operation time was 45 min(range:30-60 min);and the average blood loss was 70 ml(range:50-100 ml).No complications occurred.The follow-up time was 6-72 months,25 months in average,and no recurrence of pneumothorax occurred.Conclusions This therapeutic method combining subaxillary mini-incision,suspension of pulmonary lobe,folding ligation and general adhesion is effective,minimally invasive,safe and inexpensive for treating intractable pnumothorax.