ABSTRACT
Objective To investigate the application value of closed single-port thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer.Methods The retrospective and descriptive study was conducted.The clinical data of a 49-year-old male patient with esophageal cancer who was admitted to the Fujian Medical University Union Hospital in November 2018 were collected.The patient underwent closed single-port thoracoscopic and laparoscopic radical esophagectomy and three-field lymph node dissection.In the thoracic part,esophageal separation and thoracic lymph node dissection were performed with closed pneumothorax,semi-lateral position and multi suspension methods.In the abdominal part,gastric separation and lymph node dissection were accomplished with lifting of liver lobe and respective separation of greater curvature and lesser curvature of stomach.The operation time,volume of intraoperative blood loss,time for out-of-bed activities,time of postoperative drainage tube removal,volume of thoracic drainage fluid,postoperative complications,postoperative pathological examination results,time for discharge from hospital and results of follow-up were observed.Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence and metastasis of patients after operation up to February 2019.Count data were described as absolute number.Results The patient underwent successfully closed single-port thoracoscopic and laparoscopic radical esophagectomy and three-field lymph node dissection.The operation time and volume of intraoperative blood loss was 310 minutes and 120 mL.The patient resumed out-of-bed activities at 2 days after operation.The abdominal drainage tube,thoracic closed drainage tube and right cervical drainage tube were removed at 2 days after operation with fasting,acid suppression,nutritional support.The thoracic Abel drainage tube and the left cervical drainage tube were removed at 5 days after operation.The volume of thoracic drainage fluid was 550 mL.No obvious sign of anastomotic leakage was found on esophageal angiography at 5 days after operation.The patient recovered well after operation without hoarseness,pulmonary infection and chylothorax.The postoperative examination result of the patient showed midthoracic esophageal squamous cell carcinoma (pT3N1M0G3 ⅢB stage).The patient was discharged at 8 days after operation.The patient was followed up for 3 months,and was able to engage in light physical activity.CT reexamination showed no sign of local recurrence or distant metastasis of the tumor.Conclusion Closed singleport thoracoscopic and laparoscopic radical esopahgectomy for esophageal cancer is safe and feasible,with good short-term efficacy.
ABSTRACT
Objective To compare the ultrafine chest drainage tube with traditional thick hose as lower tube after uniport thoracoscope pulmonary nodules resection(segmentectomy,lobectomy) and evaluate its efficacy and safety.Methods Ultrafine chest drainage tube was applied in 55 patients underwent uniport thoracoscopy pulmonary resection,and traditional thick closed drainage hose was applied in another 55 patients in the same period as the control group.Postoperative drainage quantity,drainage time,pain score and incision healing between two group were compared.Results No statistically difference was found in two groups at thoracic drainage quantity on 1 day,2 days postoperative and total drainage time.But statistically difference was found in thoracic drainage quantity on 3 days postoperative,pain score and incision healing(P ＜0.05).Conclusion Ultrafine chest drainage tube has little trauma,definite clinical effect and can be easily accepted by patients.
ABSTRACT
Objective The incidence of complications after esophageal cancer surgery is relatively high.The purpose of this paper was to explore the feasibility of combined thoraco-laparoscopy surgical treatment for senile esophageal cancer(over 70 years old).Methods A total of 526 esophageal cancer cases were retrospectively analyzed in this study.The operative procedures was esophageal carcinoma resection surgery and thoracic and abdominal lymphadenectomy which were operated through video-assisted by thoracoscope and laparoscopic From January 2010 to June 2014 in the Union Hospital of Fujian Medical University,divided into aged groups(≥70 years old,n =132) and non-aged group(＜ 70 years old,n =394).Statistical analysis was carried on the rate of two groups of preoperative risk factors(hypertension,diabetes,cardiac insufficiency,pulmonary insufficiency,cerebral infarction),surgical trauma and the number of lymph node dissection (laryngeal recurrent nerve injury,operation time,intraoperative blood loss),postoperative complications(cardiac complications,chylothorax,pulmonary complications,anastomotic fistula,poor healing of the incision,intrathoracic stomach atony),postoperative recovery and early postoperative mortality.Results Preoperative risk factors:the prevalence of the aged group with hypertension,cerebral infarction,cardiac insufficiency,and pulmonary insufficiency was significantly higher than the non-aged group (P ＜ 0.05) but diabetes (P ＞ 0.05).Surgical trauma and the number of lymph node dissection:no significant difference (P ＞ 0.05).Postoperative complications:the aged group was higher in the incidence of pulmonary complications and cardiac complications than the other (P ＜ 0.05) ; but the chylothorax,anastomotic fistula and poor healing of incision,intrathoracic stomach atony in the two groups seemed no significant difference(P ＞ 0.05).Furthermore,pulmonary complications were highest in the all complications,significantly higher than the others in both groups.Postoperative recovery:significant difference existed in postoperative hospitalization days,the aged group was obviously longer than the non-age groups.Early postoperative mortality rates in the two groups had no significant difference.Conclusion The aged patiences had a higher prevalence in the preoperative risk factors and so was the cardiac complications as well as pulmonary complications among the postoperative complications.However the combined thoraco-laparoscopy in the surgical treatment of elderly patients with esophageal cancer is safe and feasible.
ABSTRACT
Objective: To explore the relationship between slow coronary lfow (SCF) and characteristics of coronary lumen condition in relevant patients. Methods: We retrospectively summarized 2117 patients who received coronary angiography (CAG) in Weifang people’s hospital from 2012-08 to 2014-04 and 2 groups of patients were enrolled in our study. SCF group, according to TIMI frame count, the patients had coronary stenosis Results: The ratios of dLADp/dLADm, dLCXp/dLCXm, dRCAp/dRCAm were similar between 2 groups,P>0.05. Compared with Control group, SCF group had increased dLM, increased dLADp and dLADm, dLCXp and dLCXm, dRCAp and dRCAm, allP Conclusion: Elevated coronary TIMI frame count was related to increased vessel diameter, the expended diameter of left and right coronary arteries may promote SCF development in relevant patients.
ABSTRACT
Objective To study the postoperative survival rate of elderly patients with hip fracture at different time and its related factors.Methods We conducted the follow-up studies of 255 elderly hip fracture patients from June 2008 to June 2011 in our hospital.The survival rates of patients at 6 months,1,2 and 3 years after operation and their related factors were studied.Results The survival rate was 96.5％,89.8％,78.0％ and 69.4％ at 6 months,1,2 and 3 years after operation respectively in 255 elderly hip fracture patients.Survival analysis showed that many kinds of preoperative comorbidities,low albumin level,old age and severe anemia were the risk factors for survival.Good activity of daily living before injury was a protective factor for survival.Gender,fracture type,the American Society of Anesthesiologists (ASA) classification,time from injury to surgery,anesthesia type,surgical approach,operative time,blood loss and hospital stay periods had no effect on survival after operation.Conclusions The survival rate in elderly patients with hip fracture after surgery is affected by many factors.Preoperative comorbidities,anemia and hypoalbuminemia should be actively treated,the activity of daily living should be improved by the directed therapy and rehabilitation,in order to improve the survival rate in elderly patients with hip fracture.
ABSTRACT
Objective The new lung cancer TNM staging for T staging the new grading.The aim of this study was to investigate the relationship between the T staging and grading of the Seventh Edition and lymph node metastasis of lung cancer.Methods In 513 cases of non-small cell lung cancer primary tumor size and lymph node metastasis were analyzed,and explore the situation of different size,lymph node metastasis in primary tumors.To analyse the collected data with SPSS software.Results The total lymph node metastatic rates in tumor diameter biggest ≤2 cm(T1a) 、2 cm ＜ ～ ≤3 cm(T1b) 、3 cm ＜ ～ ≤5 cm (T2a) 、5 cm ＜ ～ ≤7 cm(T2b) 、＞ 7 cm(T3) were 14.47％ 、28.89％ 、37.59％ 、36.37％ 、37.89％.The lymph node metastatic rate of T1a was significantly different,compared with T1b 、T2a 、T2b and T3,respectively.There were no differences between every two groups of T1b,T2a,T2b and T3.The N1 metastaic rates of T1a 、T1b 、T2a 、T2b 、T3 were compared by chi-square(P ＜0.05),The lymph node metastatic rates of T1a and T2a (P =0.001),T1a and T2b (P =0.024).The N2 metastaic rates of T1a 、T1b 、T2a 、T2b 、T3 were compared by chi-square(P ＜0.05),The lymph node metastatic rate of T 1 a was significantly different,compared with T1b 、T2a and T2b,respectively.The lymph node metastatic rate of T1 b was significantly different,compared with T2a 、T2b and T3,respectively.Conclusion The new T staging of tumor the size of the new classification is associated with lymph node metastasis rate,especially in N2.low T la lymph node metastasis rate.