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Objective To introduct the experience of anesthesia and operation of complicated resection of the trachea,and promote techniques of anesthesia and operation of the tracheal resection and reconstruction. Methods Reviewing the anesthetic and operative process of 5 cases of tracheal resection and reconstruction,dis-close difficulties with corresponding methods,postoperative follow-up,summarizing suitable measures for succeed of large-segment resection and reconstruction of the trachea. Results In 4 cases of patients with benign stricture of the trachea,3 cured with good quality of life in 2 - 5 years follow-up, 1 case of resection of 6 cm trachea with one-stage reconstruction dead from anastomotic fistula and infection of mediastinum. One case with malignancy re-section of 8 cm trachea and reconstructed with Zhao's artificial trachea dead from remote metastasis one and a half year later. Conclusion The complexity of tracheal operation is with big different from case to case,therefore, preoperative precisely evaluation with careful individually protocol of anesthesia and operation,and good coopera-tion between surgeon and anesthesiologist are critical.
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Objective To evaluate the application of Sigma stent in treatment for esophagn-tracheal fistula. Methods Clinical data of 22 cases of esophago-tracheal fistula treated with Sigma stent were retrospectively analyzed, including 17 cases of esophageal cancer and 5 cases of benign esophageal diseases, with length of 4 days to 2 months. One single stent was placed in 5 cases, two stents ( both in trachea and esophagus each) in 15 cases, and three stents in 2 cases, and 18 eases with tube-type trachea stent, 3 with obtuse angle L-type and 1 with Y-type. Placement of stent was by interventional method or/and endoscopy. Results Forty-one stents were successfully placed in 22 patients with no death in the procedure. And, all patients with fistula were healed successfully and could have normal eating 2 to 4 days after operation, except 1 patient who received a tracheal stent inserted first, but an esophageal stent inserted again due to incomplete seal of the fistula and another benign case who received surgical operation 1 year after stent placement due to protracted unsealed fistula, with an overall cure rate of 91% (20/22). Conclusions Placement of Sigma stent in the esophagus or/and trachea could effectively heal esophago-tracheal fistula. All the patients can eat normally after the procedure. Stent can be recycled and formation of secondary esophago-traeheal fistula can be prevented effectively with such procedure.
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Objective To explore the CT manifestations of non-functional islet cell tumor(NFICT)Methods The findings of plain and enhancement CT scanning from 17 cases with NFICT,which were confirmed by the surgeries and pathological sections,were analyzed retrospectively.Ninty ml of non-ioniodine contrast reagent with 3ml/s injection flow rate was employed as the enhancer for measuring the arteriovenous double phase CT value of the pancreas and tumor.Results Tumors were found in all the cases who received CT scan.Compared with pancreatic substance in the CT plain scan,tumors with low density were found in 2 cases,tumors with mixed low density in 11 cases and tumors with isodensity in 4 cases.Local calcification in tumor was found in 5 cases.Various degrees of strengthening were showed in 17 cases with enhancement scanning.Obvious enhancement in arterial phase presented in 5 cases,moderate enhancement in 6 cases and slight enhancement in 6 cases.Conclusions CT plain scan of NFICT shows that the tumor margins are clear and some tumors have calcification.All tumors in the CT enhancement scanning show various degrees of enhancement,the persistent enhancement from arterial phase to portal vein phase is the characteristic manifestation of NFICT.