ABSTRACT
Lung transplantation is the ultimate treatment of end-stage lung disease. After transplantation, the 1-year survival rate is 80%, while the 5-year survival rates remaines at around 50% mainly due to bronchiolitis obliterans syndrome (BOS). BOS is regarded as a fibrosing process in the small airways leading to irreversible airway obstruction. A lot of factors are involved in the development of BOS, such as Ischemia/reperfusion injury, infections, oxidative stress, and acute rejection, etc. Studies have shown that early diagnosis of BOS may improve outcome. It is valuable for the long-term survival of lung transplantation to find out several predictors for the BOS. This article reviews the current state of knowledge on predictors for BOS.
ABSTRACT
Objective To evaluate the advantages of minimally invasive technique for treatment of progressive hemothorax.Methods The study enrolled 62 patients with progressive hemothorax treated by minimally invasive surgery between October 2009 and March 2012.According to the treatment methods,the patients were classified to thoracoscope group (n =47) and urethral catheter balloon blockage group (n =15).Postoperative drainage volume and recovery were detected in both groups.Results All patients in thoracoscope group were healed with the mean operation time of 54 minutes (range,30-120 minutes).Mean effusion removed within thoracic cavity was 1 260 ml (range,700-2 000 ml).Postoperative bedside chest radiography revealed good pulmonary reexpansion without effusion or pneumatosis within thoracic cavity.All patients in urethral catheter balloon blockage group were healed.Chest drainage within postoperative 3 hours was mean 260 ml of fresh blood (range,100-500 ml) and thereafter no more massive bloody fluid discharge occurred.Meanwhile,chest CT reexamination revealed no increase of chest effusion.Conclusion Minimally invasive technique in treatment of progressive hemothorax patients with moderate or less effusion provides accurate effect,minor trauma,rapid recovery,and few complications and hence deserves clinical application.