Discussion about cervical incision of goiter in mediastinum posterior and its indications / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the feasibility of cervical approach for goiter in posterior mediastinum.@*METHOD@#According to the mechanism that goiter filed into posterior mediastinum and the dissection of thyroid gland and mediastinum, we designed the following surgery principles (1) From top to bottom. (2) Find out recurrent nerve at the place where it enters larynx, then dissect recurrent nerve as long as possible and protect it carefully, meanwhile, search thyroid vessels along recurrent nerve. (3) To avoid and uncontrollable serious hemorrhage in the operation, all normal and aberrant blood vessels must be ligated cautiously, and avoid pulling great vessels in the thoracic part. (4) Separating tumor of hemorrhage under surgical capsule. Bluntly, it can avoid damage important structure in most occasions. (5) If the tumor of hemorrhage was difficult to be separated from the surrounding structure, ask thoracic surgeon for cooperation.@*RESULT@#Two operations case were operated under the above guideline successfully, and the operations were performed with satisfactory effect, minimal invasion, rapid recovery and low medical cost.@*CONCLUSION@#Cervical approach for goiter in mediastinum posterior is an ideal method of surgery, but it has following operative indication. (1) imaging date indicate that tumor of posterior septum is not connected to the surrounding structure. (2) It is not accompanied with superior vena cava syndrome. (3) The size of large thyroid tumor of posterior septum could be decreased by taking out the center part of tumor, and it is suitable for liquidized center tissue especially, then take out the tumor from neck. If it is hard to be taken out, you can ask thoracic surgeon for help.

Percutaneous microwave coagulation therapy for lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effect, CT image changes and side-effects of percutaneous microwave coagulation therapy for lung cancer.</p><p><b>METHODS</b>CT-guided percutaneous puncture was performed using a needle mono-pole microwave antenna with 65W, 2 450 MHz microwave delivered in 60 seconds to 20 peripheral lung cancer patients, including 8 suffering from primary lung cancer and 12 metastatic lung cancer (totally 28 lesions).</p><p><b>RESULTS</b>Sixteen patients were alive after having been followed-up for 3 approximately 24 months. All patients showed nodules decreased in size. Diminution of over 50% was observed in 13 nodules and 3, completely disappeared. The overall response rate was 57.1%. Ellipsoid shadow 3.5 cm x 2.5 cm across was observed by CT in lesions immediately after coagulation. Gasification within the coagulated area was observed in a week with a high density in the peripheral region. Consolidation was observed in 3 months and the lesion disappeared 1 year later. Complete tumor necrosis was proved by biopsy. No side-effects or complications were observed.</p><p><b>CONCLUSION</b>Percutaneous microwave coagulation therapy is a new safe treatment for lung cancer, giving marked effect but minimum trauma.</p>