Comparison of short-term and long-term outcomes between thoracoscopic pneumonectomy and open pneumonectomy for non-small cell lung cancer: a study based on propensity score matching / 中华外科杂志

To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer. The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using test, χ(2) test, Kaplan-Meier curve and Log-rank test, respectively. Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes . (171.3±43.5) minutes, 2.50, 0.02), more mediastinal lymph node dissection ((): 17(9) . 11(10), =388, 0.02) and shorter postoperative hospital stay (7.0(3.5) . 9.0(3.0), =285, 0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% . 48.1%, 0.10) and 3-year disease-free survival (67.4% . 47.2%, 0.13) between the two groups. Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.

Single lung transplantation with concomitant contralateral lung volume reduction for end- stage emphysema / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of single lung transplantation with concomitant contralateral lung volume reduction surgery (LVRS) for the management of end-stage emphysema.</p><p><b>METHODS</b>A 46 year-old patient with end-stage emphysema received right lung transplantation and LVRS through the bilateral anterior-lateral intercostal incisions simultaneously.</p><p><b>RESULTS</b>Hyperinflation of the native lung or mediastinal shift did not occur after the operation, and the transplanted right lung dilated well without suppression. Acute rejection was not observed and the patient weaned from tracheal intubation 60 h after operation and from ventilator 108 h postoperatively. Persistent air leak occurred after LVRS but closed after instillation of hyperosmotic glucose. The patient was discharged 45 days after operation with significantly improved pulmonary function and normal life.</p><p><b>CONCLUSION</b>Single lung transplantation with concomitant contralateral lung volume reduction for emphysema eliminates such complications of single lung transplantation as native lung hyperinflation, mediastinal shift, excessive suppression of the transplanted lung and hemodynamics instability, and can improve the success rate of the operation.</p>