ABSTRACT
Objective To evaluate the clinical efficacy of video-assisted thoracoscopic lobectomy in the treatment of primary lung cancer in elderly patients.Methods Clinical data of 50 elderly patients with primary non-small cell lung cancer undergoing lobectomy at our hospital from July 2016 to July 2017 were retrospectively analyzed.The patients were divided into video-assisted thoracoscopic surgery(VATS) group(n =30) and conventional thoracotomy group (n =20).General data of surgery including operating time,intraoperative bleeding volume,the total volume of intraoperative drainage,the group number of lymph node dissection and the number of dissected lymph nodes,and postoperative data including duration of chest tube drainage,the first 24 h post-operative pain numeric rating scale(NRS)score,postoperative hospitalization time and 30-day postoperative complication were analyzed and compared between the two groups.Results All operations were successfully completed in all patients of both groups,and no patient died during the perioperative period.The differences were statistically significant between VATS and traditional thoracotomy groups in operating time[(96.8 ± 10.2)min vs.(126.3±16.1)min,t =6.211,P=0.036],in transoperative bleeding[(101.3±12.7)ml vs.(128.3±14.6)ml,t =4.310,P =0.027]and in total volume of intraoperative draining[(231.7±31.6)ml vs.(295.6 ± 39.8) ml,t =5.610,P =0.018].VATS showed superiority over traditional thoracotomy.In VATS groups vs.the traditional thoracotomy group,the duration of chest tube drainage was[(3.0±0.6)d vs.(3.9±0.8)d,t =5.317,P=0.022],postoperative pain NRS score was [(3.61± 1.09)vs.(5.3 ± 1.3) score,t =6.290,P =0.016]and postoperative hospitalization time was [(5.9 ±1.6) d vs.(8.9 ± 1.9) d,t =3.069,P =0.031].In addition,the incidences of postoperative complications were lower in the VATS group than in the traditional thoracotomy group(1/30 or 3.3 ％ vs.5/20 or 25.0％,x2 =5.335,P=0.021).Conclusions Video-assisted thoracoscopic lobectomy is safe and effective in treating primary lung cancer in elderly patients and can promote postoperative recovery,which is more suitable for elderly patients with primary lung cancer.
ABSTRACT
Objective To analyze the value of conventional T2WI combining with breath-hold Cartesian VIBE sequence, and compared with Blade combining with breath-free radial VIBE sequences in pre-operative T staging of potentiallly resectable esophageal carcinoma. Methods Sixty-five cases of esophageal carcinoma were concluded prospectively. All patients had received pathological examination of gastroscope biopsy before MRI. Patients received MR examination, including T2WI, breath-hold VIBE, Blade, and breath-free radial VIBE sequences. Two radiologists with more than five years experiences in the diagnosis of chest, performed T staging in MRIby referring to the the 7th edition of UICC-AJCC TNM classification. The results of MRI T staging and the postoperative pathological T staging were analyzed byχ2 test. Results Sixty-five patients were included. Diagnostic coincidence rates of the preoperative T staging by using conventional T2WI combining with breath-hold Cartesian VIBE sequences and Blade combining with breath-free radial VIBE sequences were 51%(33/65) and 88%(57/65) ,with 32 and 8 cases overstaging or understaging respectively, and the statistical differences were significant(χ2=20.80, P<0.05). The former diagnostic accuracy of esophageal carcinoma in situ, muscularis violation and esophageal fiber membrane were 42%(8/19), 54%(14/26), 55%(11/20), and the latter were 89%(17/19), 88%(23/26), and 85%(17/20). Conclusions Diagnostic coincidence rate of the preoperative T staging by using Blade combining with breath-free radial VIBE sequences is much higher than conventional T2WI combining with breath-hold Cartesian VIBE sequences. Blade combining with breath-free radial VIBE sequences could be used as non-invasive imaging method in preoperative T staging of potentially resectable esophageal carcinoma.