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1.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 522-527, 2020.
Article in Chinese | WPRIM | ID: wpr-871656

ABSTRACT

Objective:To investigate different incidences of recent complications after thoracoscopic lobectomy at different operation schedules in patients with early stage non-small cell lung cancer(NSCLC).Methods:A total of 730 patients with early stage NSCLC who underwent thoracoscopic lobectomies in the Department of Thoracic Surgery, Peking University People's Hospital from June 2013 to October 2017 were enrolled. Clinical data were collected retrospectively to calculate the incidence of postoperative complications. Meanwhile, the effects of different operation time periods(before 4pm or after 4pm, working day or weekend) on complications were compared, and the propensity score matching method was used to eliminate the confusion factors that may cause result bias. Univariate and multivariate logistic regression methods were used to analyze the independent risk factors of postoperative complications.Results:162 patients(22.2%) had complications within one month after thoracoscopic surgeries, and 53(7.3%) of them were major complications. After the propensity scores of the preoperative clinical factors were matched, there was no significant difference in the incidence of complications between weekdays and weekends(18.7% vs 23.9%, P=0.267). There was also no significant difference in the effect of complications between the group before 4pm and group after 4pm on surgery(22.1% vs 27.9%, P=0.337). Conclusion:The incidence of recent complications in patients with early stage NSCLC after thoracoscopic lobectomy was as acceptable as 22.2%. The choice of operation schedules did not affect the postoperative complications.

2.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 93-95, 2015.
Article in Chinese | WPRIM | ID: wpr-469381

ABSTRACT

Objective To summarize and analyze the clinical features of familial spontaneous pneumothorax.Methods During April 2001 to March 2013,the clinical data of 65 familial spontaneous pneumothorax from 21 families were retrospected and summarized.Contrasting with previous literature,the clinical features of familial spontaneous pneumothorax were analyzed.Results Patients in one family vary from 2 to 6,average 3.1.Families in which patients distribute in one generation,two generations and three generations were 19.0%,61.9% and 19.0% respectively.Male/female ratio of patients was.Mean onset age was 36.2 ± 12.2 ; Body mass index (BMI) of male and female patients were 24.0 ± 2.6 and 22.6 ± 3.0.32.7% patients suffered bilateral pneumothorax.The recurrence rate after non-operative treatment was 50.0%.Conclusion Compared with sporadic spontaneous pneumothorax,Familial spontaneous pneumothorax has the following features:The incidence in man and woman was more similar; The onset age was older; Lanky body is less common; More were bilateral pneumothorax; Multiple pulmonary bullae are more common; Patients with non-surgical treatment have a higher recurrence rate.

3.
Chinese Journal of Surgery ; (12): 731-736, 2015.
Article in Chinese | WPRIM | ID: wpr-308490

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the clinical characteristics and follow up record of patients with synchronous multiple lung cancers (SMLC).</p><p><b>METHODS</b>The medical records of 1 868 lung cancer patients who underwent surgical treatments From January 2007 to December 2014 were reviewed, in which 103 patients were diagnosed SMLC by Martini and American College of Chest Physicians modified guideline. The average age was 60.5 years, including 34 male and 69 female patients. According to consolidation/tumor ratio (CTR) on thin-section computed tomography, 103 cases were classified into three groups: group A (multiple ground-glass opacities, CTR ≤ 50%), group B (with one solid dominant nodules, CTR > 50%), group C (with two solid dominant nodules). The surgical procedure was determined according to CT findings and respiratory function. The Kaplan-Meier method was used to analyze the duration of recurrence-free survival (RFS) and over-all survival (OS), and differences were assessed using the Log-rank test. Multivariate analysis using the Cox proportional hazards models was used to assess the potential independent effects on RFS or OS.</p><p><b>RESULTS</b>There were 38 patients in group A (36.9%), 40 patients in group B (38.8%) and 25 patients (24.3%) in group C. More female (73.7% vs. 48.0%, χ² = 4.291, P = 0.038), less smoker (21.1% vs. 44.0%, 2 = 3.770, P = 0.052), younger (56.2 years old vs. 65.9 years old, t = -4.172, P = 0.000) and less tumor size (1.24 cm vs. 2.31 cm, t = -4.573, P = 0.000) patients in group A than in group C. The 3, 5-year RFS were 80.3% and 64.9% for all patients, respectively. The 3, 5-year OS were 87.3% and 68.6% for all patients, respectively. The 3, 5-year RFS were 100% and 100% in group A, 77.7% and 51.8% in group B, 59.6% and 44.7% in group C (P = 0.029). No significance were found in OS between the three groups (P = 0.214). Multivariate Cox analysis demonstrated that size of dominant nodule larger than 2 cm (HR = 4.475, 95% CI: 1.138 to 17.604, P = 0.032) is associated with poor prognosis, whereas postoperative chemotherapy did not affect RFS.</p><p><b>CONCLUSIONS</b>Multifocal ground-glass opacities and multiple solid lung cancers are different in nature. RFS of patients with SMLC is strongly affected tumor size. Surgical resection is effective and should be performed specifically to patients.</p>


Subject(s)
Female , Humans , Male , Middle Aged , Lung , Pathology , General Surgery , Lung Neoplasms , Diagnosis , Pathology , General Surgery , Multivariate Analysis , Proportional Hazards Models , Tomography, X-Ray Computed , Treatment Outcome
4.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 230-232, 2012.
Article in Chinese | WPRIM | ID: wpr-428660

ABSTRACT

Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of intrapulmonary tumors located adjacent to the central airway.MethodsThe study was retrospective,from September 2009 to September 2011,33 patients with pulmonary masses located close to the central airways suspected to be lung cancer were accessed by EBUS-TBNA.Conventional bronchoscopic biopsy before EBUSTBNA was nondiagnostic in all cases.If EBUS-TBNA did not result in a formal pathological diagnosis of malignancy,patients were subsequently referred for a surgical procedure.ResultsOf the 33 patients,EBUS-TBNA confirmed lung cancer in 29 cases (4 small cell lung cancer,25 non-small cell lung cancer).Four patients were not confirmed by EBUS-TBNA,3 cases were diagnosed as squamous cell carcinoma by thoracoscoopy or thoracotomy,the other one was a pulmonary inflammatory lesion diagnosed by thoracoscopy.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of EBUS-TBNA for the diagnosis of intrapulmonary lesions was 90.2%,100%,90.9%,25%,and 100%,respectively.The procedure was uneventful,and there were no complications.ConclusionEBUS-TBNA is an effective tool with a high yield for the diagnosis of intrapulmonary lesions located adjacent to the central airway.

5.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 241-244, 2012.
Article in Chinese | WPRIM | ID: wpr-428642

ABSTRACT

ObjectiveTo evaluate thd cell biologic changes in thd non-small-cell lung cancer(NSCLC) which PTEN gene were activated by double-stranded RNA(dsRNA).MethodsSpecific dsRNA was designed.First,the promoter region of PTEN gene was determined by Promoter 2.0 program,then the CpG island in the promoter was found by CpGisland searcher software and the possible target non-CpG sequence that dsRNA might activate were defined by SiRNA Target Finder software.dsRNA were synthesized at Genechem Company( Shanghai,China).Then the specific dsRNA was transfected into A549 and H292 cells which were stored in our laboratory using Lipofectamine 2000 ( Invitrogen,USA) according to manufacture's instruction.Total celluar RNA was isolated.The expression of PTEN mRNA in transfected,control and mock group were determined by real-time quantitative polymerase chain reaction.Cell profiferation was investigated on days 1 to 5 by using Cell Counting Kit-8 according to the manufature's technical manual.Cell invasion ability was assessed by Transwell method that transmembrane cells were counted,and cell bycle distribution were studied by flow cytometer(FCM) using CycleTESTTM PLUS DNA Reagent Kit.ResultsAfter the introduction of dsRNA into the A549 cells,the PTEN mRNA expressin was upregulated to (4.35 ±0.42) folds compared with the mock and control cells.And in H292 cells,the mRNA expression of PTEN was upregulated to (3.92 ± 0.20) folds.It confirmed the RNA activation phenomenon in the PTEN gene in NSCLC cells.Compared with the control group,the number of alive transfected cells did not decreased in the cell proliferation assay.In the cell invasion test we found that the transmembrane A549 cells were 122.4 ±11.2 vs.150.7 ±13.1 in transfected group and control group respectively.In the cell cycle distribution we found dsRNA in duced part ofthe transfected cells arrested in G1 phase and a corresponding decrease in S-phase population was observed,though this change was not statistically significant.Conclusion The expression of PTEN mRNA could by enhanced by inducing the specific dsRNA into the A549 and H292 cells,though no evidence was found that after the activation of silenced PTEN,the cell proliferation and invasion ability were significantly changed.

6.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 529-531,538, 2011.
Article in Chinese | WPRIM | ID: wpr-597925

ABSTRACT

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of thoracic sarcoidosis.Methods The study was retrospective,from September 2009 to June 2011,35 patients with suspected sarcoidosis,with enlarged hilar or mediastinal lymph nodes on computed tomography ( ≥1.0 cm),underwent EBUS-TBNA.Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up.Results EBUS-TBNA was performed on a total of 87 lymph node stations in 35 patients.Of the enlarged lymph nodes,64 (73.6%) were located in the mediastinal region and the remaining 23 ( 26.4% ) around the hilar or interlobar area.A final diagnosis of sarcoidosis was made for 28 (80%) of the patients.In patients with a final diagnosis of sarcoidosis,EBUS-TBNA demonstrated noncaseating epithelioid cell granulomas in 25 ( 89.3% ) of the patients.EBUS was well tolerated by all of the patients with no complications.Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic sarcoidosis of stage Ⅰ or Ⅱ.

7.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 735-737, 2011.
Article in Chinese | WPRIM | ID: wpr-428304

ABSTRACT

Objective To evaluate the feasibility of lobectomy by completely Video-Assisted Thoracoscopic Surgery (cVATS) in the management of bronchiectasis.Methods Between June 2001 and October 2010,a total of 60 major lobectomies were performed in our single center on 32 female and 28 male patients of bronchiectasis,with a mean age of 43.4( range 17 to 69)years.All lobectomies were carried out anatomically and divided into thoracotomy group and cVATS group.Pulmonary vessels and bronchus were dissected by endo-cutters.Conversion to a thoracotomy took place if severe adhesion or bleeding was encountered.Results The operations included 5 lobectomies of right upper lobe,3 of middle lobe,6 of right lowerlobe,3 of left upper lobe,26 of left lower lobe,10 of left lower lobe plus lingular segment,4 of left pneumonectomy,1 of bi-lobectomy,1 of right middle lobe plus wedge resection of lower lobe and 1 of left lower lobe plus right middle lobe.There were 25 patients in the thoracotomy group and 35 patients in the cVATS group,in which 2 operations (5.7%) converted due to severe adhesion,poor differentiation of the fissure and/or the proliferation of tortuous vessels at hilus In thoracotomy and cVATS groups,the operative time were ( 207.6 ± 88.5 ) vs.( 168.7 ± 55.9 ) min ( P =0.041 ),the blood loss were ( 522.0 ±644.2) vs.(210.1 ± 213.1 ) ml ( P =0.009),the mean chest tube duration were ( 5.4 ± 4.4) vs.(6.3 ± 3.4 ) days ( P >0.05 ) and the mean length of hospitalization were ( 10.2 ±4.7 ) vs.( 8.5 ± 3.5 ) days ( P > 0.05 ).No mortality or severe complication occurred in both groups.The morbidity was 25.7% (9/25)vs.17.1% (6/35) in thoracotomy and cVATS group,with no significant difference statistically (P =0.133 ) . There were 52% vs.62.9% patients achieved symptomatic completely relief and significant improvement was obtained in 40.0% vs.31.4% patients in thoracotomy and cVATS group separately.Conclusion cVATS lobectomy is safe and effective in the management of bronchiectasis.

8.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 521-525, 2011.
Article in Chinese | WPRIM | ID: wpr-419932

ABSTRACT

Objective To review the experience d EBUS-TBNA for staging of lung cancer and the value in diagnosing thoracic diseases in our single center.Methods The data of 343 patients who underwent EBUS-TBNA from September 2009 to August 2011 in our institution were retrospectively reviewed.There were 219 males and 124 females with an average age of (59.4 ± 13.6 ) years.Based on their primary indication,patyients were divided into three categories:group A:with known or strongly suspected lung cancer and enlarged mediastinal lymph nodes on chest radiographic examination ( short axis ≥ 1.0cm) ; group B:with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin; and group C:with pulmonary parenchymal mass located close to the central airways.Results The average short axis diameter of the thoracic lesions was ( 1.94 ± 1.01 ) cm ( range from 0.5 to 8.0cm),and 2.66 punctures were performed per lesion.In group A ( n =208 ),151 patients were confirmed to have mediestinal lymph nodes metastasis while 51 showed negative results.Four patients were diagnosed as tuberculosis and two were confirmed to be stage Ⅱ sarcoidosis.37 in the 51 patients with negative EBUS-TBNA underwent thoracoscopic or thoracotomy for pulmonary resection and mediastinal lymph node dissection.Postoperative pathology confirmed that 32 patients did not have lymph nodes metastases.The diagnostic sensitivity,specificity,accuracy,positive predictive and negative predictive of EBUS-TBNA for the mediastiral staging of lung cancer were 96.8% (151/156),100.0% (32/32),97.3% ( 183/188 ),100% ( 151/151 ) and 86.5% (32/37),respectively.In group B ( n =94),22 patients had malignancy and 72 had benign diseases.Thirteen patients received operative validation in the 23 cases which were diagnosed as proliferative lymph nodes by EBUS-TBNA,and by further operation two and three patients were confirmed as malignancy and other benign diseases respectively.The sensitivity,negative predictive value ( NPV ) and accuracy of EBUS-TBNA in distinguishing malignant mediastinal diseases was 88.0% (22/25)、100% (73/73) 、95.9% (70/73)and 97.9% (92/94),respectively.In group C( n =41 ),malignant diagnosis was achieved in 33 patients,while 4 patients confirmed as malignancy by further operations in the other 8 negative cases.The diagnostic sensitivity and accuracy of EBUS-TBNA for the diagnosis of unknown pulmonary parenchymal mass were 89.2% (33/37) and 90.2% (37/41),respectively.All the procedures were uneventful and no complication occurred.Conclusion EBUS-TBNA is a highly effective and safe procedure in the diagnosis of thoracic diseases and staging.of lung cancer.

9.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 474-476, 2011.
Article in Chinese | WPRIM | ID: wpr-419784

ABSTRACT

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal lesions around the trachea.MethodsThe study was retrospective, between September 2009 to July 2010, 34 consecutive patients with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin underwent EBUS-TBNA.Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up.ResultsOf the 34 patients, EBUS-TBNA achieved definitive diagnosis in 28 patients (82.4%), 10 were diagnosed as malignancies, 18 were diagnosed as benign.The sensitivity, specificity,and accuracy of EBUS-TBNA in distinguishing benign from malignant mediastinal lesions were 90.9%, 100%, and 97.1%,respectively.EBUS was well tolerated by all of the patients with no complications.ConclusionEBUS-TBNA of mediastinal lesions around the trachea is a minimally invasive safe diagnostic technique with high yield.

10.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 17-19, 2011.
Article in Chinese | WPRIM | ID: wpr-382658

ABSTRACT

Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010 ,29 patients ( 23 men , 6 women , median age 62.2 years , range from 34 to 81 years) underwent AFB procedure. There were 3 lesions located at trachea, 1 at right main bronchus, 9 at right upper lobe, 1 at right median bronchus, 1 at right middle lobe, 4 at right lower lobe, 1 at left main bronchus, 9 at left upper lobe.There were 21 preliminary diagnostic cases and 8 postoperative surveillance cases. All procedure was performed under combination of local anaesthesia and general anaesthesia. All patients underwent white light bronchoscopy followed by AFB procedure.All of the suspicious abnormal sites were recorded and biopsied for pathological examination. Results All procedures were safely performed without death or serious complications. 100 specimens were obtained for pathologic examination. Malignant lesion was diagnosed in 39 and non-malignancy in61. All malignant sites were detected by AFB, however WLB missed 12 sites.The sensitivity of AFB and WLB for malignancy were 100% and 69.2%, respectively. In 21 preliminary diagnostic cases,AFB detected all malignancy sites, but WLB missed 23 sites, in which 9 were malignant sites. In 8 rechecked patients, AFB detected all malignancy sites, but WLB missed 7 sites, in which 3 were malignant sites. Conclusion Autofluorescence bronchoscopy could be more accurate in judging the extent of the tumor invasion, more sensitive in finding multiple lesions in airway, more sensitive in detecting early cancer recurrence in postoperative surveillance patients.

11.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 105-107, 2011.
Article in Chinese | WPRIM | ID: wpr-382651

ABSTRACT

Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for staging of lung cancer. Methods The study was retrospective, a total of 52 patients underwent EBUSTBNA for known or suspected lung cancer. All patients were detected enlarged mediastinal lymph nodes on CT scan ( ≥ 1.0cm). Results Of the 52 patients, 41 patients were found with N2 or N3 disease on EBUS-TBNA. 11 patients with negative EBUS-TBNA underwent thoracoscopy or thoracotomy for pulmonary resection and mediastinal lymph node dissection, 9 patients were confirmed N0 by pathology, whereas 2 patients had metastatic lymph node. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of EBUS-TBNA for the mediastinal staging of lung cancer were 95.3%, 100%, 96.2%, 100%, and 81.8%, respectively. The procedure was uneventful, and there were no postoperative complications. Conclusion EBUS-TBNA is an effective and safe technique for mediastinal staging in lung cancer patients.

12.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 120-122, 2010.
Article in Chinese | WPRIM | ID: wpr-379905

ABSTRACT

Objective To evaluate the impact of 1125 seeds para-tracheal braehytherapy on regional tissue injury in rab-bit models. Methods 42 rabbits were randomized into 7 groups. Group 1 to 6 belong to study groups (in which 1,4,5 and 6 belong to "dose gradient" subgroup, while 2,3 and 4 to "chronologic" subgroup) , while the last group acts as negative con-trol. The activity of seeds in study group were 0.3 mCi in group 1, 0.5 mCi in group 2 to 5, 0.7 mCi in group 5, and 0.9mCi in group 6. False seeds (0 mCi) were used for the negative control. 4 seeds with equal dosage were implanted between trachea and esophagus in each rabbit under general anesthesia. Seeds arrangement was made according to Paris principle. For the tissue injury evaluation, group 2 was sacrificed by the end of first month post-operatively, group 3 at the end of the second month, and group 4 end of the third month. The rest of rabbits were also sacrificed at the end of the third month. Pieces of adjacent e-sophagus and trachea were sampled from each rabbit. Tissue injury features such as inflammation, edema, congestion or fibrosis as evaluated histologically. Results All rabbits were healthy during study period except 5. Histological analysis revealed that trachea samples from all groups had lymphocytas and plasma cells infiltration as signs of chronic inflammation, hut fibrosis was nut clearly visible. There were no differences between study and control groups with respect to inflammation, edema and con-gestion scores. But in groups which received the highest doses of radiation or sacrificed at 60 d showed more eosinophil infiltra-tion and epithelum degeneration, and statistical significance was reached between these groups and control. Esophageal samples had less histological changes compared with trachea. Conclusion Para-tracheal implantation of ~(125)Ⅰ seeds with therapeutic or higher dosage only induce minor and reversible damage to the regional tissue. This implies that ~(125)Ⅰ implants adjacent to trachea or esophagus are clinically safe.

13.
Chinese Journal of Lung Cancer ; (12): 607-611, 2010.
Article in Chinese | WPRIM | ID: wpr-323819

ABSTRACT

<p><b>BACKGROUND AND OBJECTIVE</b>Solitary pulmonary nodules (SPN) is a knotty problem in clinical work. The clinical manifestation and pathological features of SPN in sizes may be obviously different. The aim of this study is to analyze the relationship between the diameters and clinicopathologic characteristics of SPN.</p><p><b>METHODS</b>390 patients (212 male, 178 female, ranging from 17 years to 86 years, median age 57.1 years) with SPN who were postoperatively diagnosed by pathology between Jan. 2000 and Jun. 2009 are enrolled to this study. In these cases, the number of SPN diameters which are smaller than 0.5 cm (including 0.5 cm) (group A) is 16, between 0.5 cm and 1 cm (including 1 cm, not including 0.5 cm) (group B) is 58, between 1 cm and 2 cm (group C) is 163, and between 2 cm and 3 cm (group D) is 153. The clinical manifestation, and postoperative pathological characters are analyzed in various diameter ranges.</p><p><b>RESULTS</b>All procedures were carried out securely, including tumor enucleation (n = 20), wedge resection (n = 153), lobectomy (n = 217). There are 130 benign cases (33.3%) and 260 malignant cases (66.7%). 58.5% SPN are detected incidently with no symptoms. There is an increasing incidence of clinical symptoms as the increasing diameter of SPN. All the cases are divided into 4 groups, the prevalence of malignant are separated 43.7% (group A), 50.0% (group B), 63.2% (group C), 79.1% (group D). The diameter of SPN is positively correlated with incidence of malignancy (chi2 = 22.535, P < 0.001). Single factor analysis and Logistic regression analysis show the diameter of SPN is an independent risk factor of malignant pathology (OR = 1.922, P < 0.001). Fourteen patients in all of the SPN were followed up by 2 years or more before operation, and 10 of them turn out to be malignant at last. In the 14 patients, 7 cases were found not enlarged by CT scan, and 3 of them (42.9%) were malignant.</p><p><b>CONCLUSION</b>The diameter of SPN is highly associated with clinical symptoms, and is a significant risk factor to predict pathology. Early diagnosis and treatment is so important for patients with SPN.</p>


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Lung Neoplasms , Pathology , General Surgery , Solitary Pulmonary Nodule , Pathology , General Surgery
14.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 300-306, 2010.
Article in Chinese | WPRIM | ID: wpr-383204

ABSTRACT

Objective To optimize operative techniques of completely video-assisted thoracoscopic lobectomy by reviewing the experience of Peking University People's Hospital. Methods From September 2006 to August 2010, 408 patients (214 males,194 females) with median age of 58.6 years (range from 15 to 86 years) underwent completely thoracoscopic lobectomy. All procedures were conducted under general anesthesia with double lumen intubation. The thoracoscope was introduced through 7th or 8th intercostals space on the mid-axillaries line. The 4 cm long utility incision was made on the 4th or 5th intercostals space anterior axillary's line without rib-spreading. A third retraction incision located on the 7th or 8th intercostals space sub-scapular line. The surgeon stands on the ventral side of patient using an electrocautery hook and a suction device through the utility incision. Anatomic lobectomy was performed with systemic mediastinal lymph node dissection for lung cancer patients. Results All procedures were carried out smoothly with no case of serious complication. There was 1 case death because of respiratory failure of pulmonary fungal infection during the operative period. The average surgical duration was 195 minutes, and average blood loss was 249 ml with no blood transfusion required. There were 35 cases (8.6%) of conversion to open thoracotomy, including interference by lymph nodes, bleeding, inflammatory adhesion of Artery and large size tumors.The results of pathology show 322 cases of malignant disease and 86 cases of benign disease. Conclusion To grasp the core technique of completely thoracoscopic lobotomy may make the procedure undergone smoothly, and may shorten the learning curve.

15.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 337-339, 2010.
Article in Chinese | WPRIM | ID: wpr-383200

ABSTRACT

Objective To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for CT-positive mediastinal lymph nodes. Methods From September 2009 to December 2009, 28 patients with confirmed or suspected non-small-cell lung cancer with CT scan demonstrating enlarged ( ≥ 1 cm) mediastinal lymph nodes underwent EBUS-TBNA. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Results 28 patients with 40 lymph nodes were studied. 27 patients had been performed successfully with enough specimens. No complications happened in the group. Mediastinal metastases were confirmed by EBUS-TBNA in 20 patients. 8 patients with benign mediastinal nodes as detected by EBUS-TBNA underwent surgery and mediastinal lymph node dissection, which confirmed N2 disease in 2 patients. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA in the detection of mediastinal metastasis were 92.9%, 90.9%,100%, 100%, 75% respectively. Conclusion EBUS-TBNA is a safe and effective technique for CT-positive mediastinal lymph nodes on CT scan.

16.
Chinese Journal of Lung Cancer ; (12): 376-380, 2007.
Article in Chinese | WPRIM | ID: wpr-358423

ABSTRACT

<p><b>BACKGROUND</b>The activation of epidermal growth factor receptor (EGFR) downstream molecule Akt plays an important role in lung carcinogenesis and tumor progression. The aim of this study is to evaluate the association of phosphorylated Akt (p-Akt) expression with EGFR expression and survival in non-small cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>p-Akt and EGFR expressions were detected by immunohistochemistry in 167 NSCLC samples constructed into tissue microarray.</p><p><b>RESULTS</b>p-Akt protein positively expressed in 52.1% (87/167) samples. There were no statistically significant association between p-Akt protein expression and gender, age, smoking status, histology, differentiation or pathological stage (P > 0.05). Spearman correlation anylasis failed to show association of positive p-Akt with EGFR protein expression (P=0.122). Kaplan-Meier survival analysis showed both of the positive p-Akt expression and p-Akt/EGFR co-expression had no impact on the patients' survival (P=0.903 and P=0.894 respectively). Cox regression anylasis indicated that survival time correlated with tumor differentiation and pathological stage (P=0.034 and P=0.003 respectively).</p><p><b>CONCLUSIONS</b>In NSCLC patients, positive p-Akt expression does not correlate with any clinicopathological features and has no impact on survival.</p>

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