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@#Objective To evaluate the learning curve of CT-guided medical glue localization for pulmonary nodule before video-assisted thoracic surgery (VATS). Methods The clinical data of the patients with pulmonary nodules who underwent CT-guided medical glue localization before VATS in our hospital from July 2018 to March 2021 were retrospectively analyzed. The patients were divided into 3 groups: a group A (from July 2018 to August 2019), a group B (from September 2019 to June 2020) and a group C (from July 2020 to March 2021). The localization time, morbidity, complete resection rate and other indexes were compared among the three groups. Results A total of 77 patients were enrolled, including 24 males and 53 females aged 57.4±10.1 years. There were 25 patients in the group A, 21 patients in the group B, and 31 patients in the group C. 77 pulmonary nodules were localized. There was no significant difference among the groups in the basic data (P>0.05). The localization time in the group C was 10.6±2.0 min, which was statistically shorter than that in the group A (15.4±4.4 min) and group B (12.9±4.3 min) (P<0.01). The incidence of complications in the group C was lower than that in the group A and group B (25.8% vs. 52.0% vs. 47.6%, P=0.04). The success rate of localization of the three groups was not statistically different (P=0.12). Conclusion There is a learning curve in CT-guided medical glue localization for single pulmonary nodule before VATS. After the first 46 cases, the operation time can be shortened, and the incidence of complications can be decreased.
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BACKGROUND@#The localization of pulmonary nodules is related to whether the lesions can be found and removed accurately and quickly. It is an important link for the success of minimally invasive video-assisted thoracic surgery (VATS). This study investigated the feasibility of medical glue localization under VATS video-assisted thoracoscopic computed tomography (CT) guidance for single pulmonary nodule and more than two pulmonary nodules, and compared with the accuracy and safety of single nodule localization.@*METHODS@#A retrospective analysis of the clinical data of patients who underwent unilateral CT-guided medical glue localization before VATS from November 2018 to March 2021 were performed, the patients was divided into multiple pulmonary nodules group (localized nodules ≥2) and single pulmonary nodule group according to the number of localized nodules. The localization time, success rate and complication rate of the two groups were compared.@*RESULTS@#There were 126 nodules in the two groups, including 62 in single pulmonary nodule group and 64 in multiple pulmonary nodules group. The average single nodule localization time was (13.23±4.5) min in single pulmonary nodule group and (10.52±2.8) min in multiple pulmonary nodules group, the difference between the two groups is statistically significant (P<0.05). The localization success rate of single pulmonary nodule group and multiple pulmonary nodules group were 100% and 98.4% separately, the difference between the two groups was not statistically significant (P>0.05). All VATS were successfully completed after localization. The incidence of pneumothorax was higher in multiple pulmonary nodules group than in single pulmonary nodule group (P=0.07).@*CONCLUSIONS@#Compared with localization of single lung nodule, unilateral CT-guided medical glue localization for multiple pulmonary nodules before VATS is also feasible and accuracy, it is worthy of clinical application. But the higher rate of pneumothorax should be paid attention to.
Subject(s)
Humans , Lung Neoplasms/surgery , Multiple Pulmonary Nodules/surgery , Pneumothorax , Retrospective Studies , Solitary Pulmonary Nodule/surgery , Thoracic Surgery, Video-Assisted , Tomography, X-Ray ComputedABSTRACT
BACKGROUND@#With the wide application of computed tomography (CT) in the screening of early lung cancer, more and more ground glass nodules (GGNs) have been found. Early intervention is helpful to improve the survival rate of lung cancer patients. Radiofrequency ablation (RFA) is an alternative option to manage primary or metastatic lung malignancies. The purpose of this study is to review the safety and clinical efficacy for lung GGN treated by RFA.@*METHODS@#From June 2016 to March 2021, 24 patients with a total of 28 lung GGNs in our hospital underwent 28 sessions of RFA. There were 13 males and 11 females with an average age of (69.4±11.1) years. The size of GGN receiving RFA was (1.30±0.56) cm; The ablation range was (2.50±0.63) cm and ablation time was (15.00±8.68) min.@*RESULTS@#The procedure of all RFAs went smoothly, no perioperative deaths occurred and no serious complications during the operation. The median follow-up was 25 months. One case died of myocardial infarction 2 months after operation. All 28 GGNs showed no evidence of local progression and the local control rate was 100.0%. Kaplan-Meier analysis showed that the 1-year and 2-year overall survival rates were 95.8% and 95.8%; the tumor specific survival rates were 100.0% and 100.0%, respectively.@*CONCLUSIONS@#RFA is a safe, effective and minimally invasive technique for the treatment of lung GGNs.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Lung , Lung Neoplasms/surgery , Radiofrequency Ablation/adverse effects , Tomography, X-Ray ComputedABSTRACT
BACKGROUND@#As a new technique developed in recent years, endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has the advantages of simple operation, minimal invasive, high accuracy, safety and repeatability. It has become a new standard for lung cancer diagnosis and mediastinal staging. Because small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) have different biological characteristics and treatment methods, it is very important to diagnose and differentiate the types of lung cancer in the early stage of lung cancer for the staging, treatment and prognosis of lung cancer. This article evaluated the accuracy and sensitivity of EBUS-TBNA in the diagnosis of SCLC and NSCLC.@*METHODS@#From January 2012 to December 2018, the clinical data of 85 patients with SCLC and NSCLC who performed EBUS-TBNA in Xuan Wu Hospital CMU were retrospectively analyzed and the differences between the two groups were compared.@*RESULTS@#45 cases of SCLC were confirmed by immunohistochemistry and pathology. 42 cases of SCLC were diagnosed by EBUS-TBNA. The accuracy and sensitivity of diagnosis were 93.3% (42/45) and 100.0% (42/42), respectively. The positive rate of diagnosis was 48.9% (22/45) in 22 cases diagnosed by cytology, and 40 cases diagnosed by pathology, including 35 cases diagnosed by EBUS-TBNA. The accuracy and sensitivity of diagnosis were 87.5% (35/40) and 100.0% (35/35), respectively. The positive rate of diagnosis was 27.5% (11/40) in 11 cases diagnosed by cytology. The diagnostic sensitivity of EBUS-TBNA in SCLC group was significantly higher than that in NSCLC group (P<0.05).@*CONCLUSIONS@#EBUS-TBNA is more sensitive in the diagnosis of SCLC than NSCLC. As a minimally invasive technique, EBUS-TBNA can assist SCLC in early diagnosis and timely treatment.
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Objective To study the diagnostic values of salivary and plasma microRNA‐21 for e early esophageal cancer . Methods Totally 112 patients with early esophageal cancer in Nanyang Municipal Central Hospital from February 2011 to Febru‐ary 2014 were selected as the observation group and contemporaneous 100 healthy people of physical examination were selected as the contract group .The salivary and plasma microRNA‐21 expression levels were compared between the two groups ;the diagnostic values of salivary versus plasma microRNA‐21 for the early esophageal cancer were also compared;the correlation between the miR‐NA‐21 level with the stage ,pathogenic type and differentiation of early esophageal cancer .Results The salivary microRNA‐21 level (6 .08 ± 2 .22) in the observation group and (0 .64 ± 0 .09) in the control group ,the difference had statistical significance (P0 .05) . The salivary and plasma microRNA‐21 levels had no obvious correlation with the stage and pathogenic type of early esophageal cancer(P>0 .05) ,while had strong correlation with the differentiation degree(P<0 .05) .Conclusion Salivary and plasma microR‐NA‐21 has higher diagnostic value in for early esophageal cancer ,and saliva may supplant plasma in the diagnosis of early esophage‐al cancer .
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Objective To explore influence factors of gerontal patients with lung squamous carcinoma after surgical therapy . Methods 210 gerontal patients with lung squamous carcinoma were accepted surgical therapy and adjuvant therapy ,and were fol-lowed up .The survival rates of 1 ,3 and 5 years after the surgery were evaluated by Kaplan-Meier ,and influence factors were ana-lyzed by Cox regression .Results The 1 ,3 and 5 years survival rates were 89 .0% ,68 .6% and 56 .2% ,respectively .The survival rates were significantly influenced by the smoking history ,the abnormal degree of mediastinal lymph node ,TNM stage ,the class number of lymph node dissection ,and the class number of mediastinal lymph node dissection(P<0 .05) .The smoking history(χ2 =16 .198 ,P=0 .000) ,the abnormal degree of mediastinal lymph node(χ2 =8 .873 ,P=0 .003) ,TNM stage(χ2 =18 .718 ,P=0 .000) , and the class number of mediastinal lymph node dissection (χ2 =4 .897 ,P=0 .027) were the influence factors of prognostic .Conclu-sion The accurate TNM staging and mediastinal lymph node with image examination could be more appropriate to operative indica-tions ,meanwhile ,if smoking was controlled ,the class number of mediastinal lymph node dissection was more .These could be bene-ficial to the survival .