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Chinese Journal of Lung Cancer ; (12): 756-763, 2021.
Article in Chinese | WPRIM | ID: wpr-922143


BACKGROUND@#Segmentectomy has gradually become one of the standard surgical methods for small pulmonary nodules with early lung cancer on imaging. This study aimed to investigate the perioperative outcomes of patients who underwent uniport video-assisted thoracoscopic surgery (VATS) segmentectomy for identifying the intersegmental boundary line (IBL) by the near-infrared fluorescence imaging with intravenous indocyanine green (ICG) method or the modified inflation-deflation (MID) method and assess the feasibility and effectiveness of the ICG fluorescence (ICGF)-based method.@*METHODS@#We retrospectively analyzed the perioperative data in total 198 consecutive patients who underwent uniport VATS segmentectomy between February 2018 and August 2020. With the guidance of preoperative intelligent/interactive qualitative and quantitative analysis-three dimensional (IQQA-3D), the targeted segment structures could be precisely identified and dissected, and then the IBL was confirmed by ICGF-based method or MID method. Clinical effectiveness and postoperative complications of the two methods were evaluated.@*RESULTS@#An IBL was visible in 98% of patients by the ICGF-based group, even with the low-doses of ICG. The ICGF-based group was significantly associated with the shorter IBL clear presentation time [(23.59±4.47) s vs (1,026.80±318.34) s] (P0.05).@*CONCLUSIONS@#The ICGF-based method could highly accurately identify the IBL and make anatomical segmentectomy easier and faster, and therefore has the potential to be a feasible and effective technique to facilitate the quality of uniport VATS segmentectomy.

Feasibility Studies , Humans , Indocyanine Green , Ion Transport , Lung Neoplasms/surgery , Pneumonectomy , Postoperative Complications , Retrospective Studies , Thoracic Surgery, Video-Assisted
Article in Chinese | WPRIM | ID: wpr-618169


Objective To evaluate the effect of video- assisted thoracoscopic pulmonary segmentectomy in patients with isolated pulmonary arteriovenous fistula (PAVF). Methods A retrospective analysis was performed on 10 patients with PAVF in the department of thoracic surgery of the first affiliated hospital of Nanjing Medical University between January 2010 and December 2016. Computed tomography angiography (CTA) and three-dimensional reconstruction were performed before operation, and all patients accepted video-assisted thoracoscopic pulmonary segmentectomy. Results The diagnosis of PAVF was identified by CTA, with maximum diameter of tumor of 3.0- 5.0 cm. No perioperative mortality or postoperative complications were observed including bleeding, hemoptysis, serious air leakage, and bronchopleural fistula. The lesions were completely removed in all 10 patients, and no patients converted to open surgery intraoperatively. Blood gas analysis showed that oxygen partial pressure before operation, in the first day after operation and the third month after operation was (62.5 ± 6.7), (70.2 ± 4.8) and (75.4 ± 4.8) mmHg (1 mmHg = 0.133kPa) respectively; which was significantly increased successively (P<0.05). After a follow-up time of 3-30 months, no recurrences were observed. Conclusions Video- assisted thoracoscopic pulmonary segmentectomy guided by preoperative CTA and three-dimensional reconstruction is a very effective method for the treatment of isolated PAVF.

Article in Chinese | WPRIM | ID: wpr-608501


Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.

Article in Chinese | WPRIM | ID: wpr-482849


Objective To evaluate the association between iodine intake and treatment outcomes of radioiodine remnant ablation in patients with papillary thyroid cancer (PTC),and to investigate the determinants related to the ablation efficacy.Methods A total of 95 PTC patients (28 males,67 females;average age 39.8 years) without distant metastases from January 2013 to May 2014 were enrolled in this retrospective study.All patients underwent total thyroidectomy and 2-4 weeks of low iodine diet (LID) before initial 131I therapy.Patients were divided into 3 groups according to urinary iodine excretion (UIE):moderate-severe iodine deficiency group (0<UIE<50 μg/L,n =30),mild iodine deficiency group (50 μg/L≤UIE<100 μg/L,n =26),adequate iodine group (100 μg/L ≤ UIE < 300 μg/L,n =39).Patients were followed up for 3-6 months after radioiodine ablation,successful ablation was defined as no visible uptake in the thyroid bed on diagnostic 131I whole body scan and Tg level <2 μg/L (with negative TgAb),or no visible uptake in thyroid bed on posttreatment 131I whole body scan.x2 test,two-sample t test,Mann-Whitney u test and logistic regression analysis were performed.Results In all,84.2% (80/95)of patients were successfully ablated.The successful rates in the three iodine intake groups were 96.7% (29/30),84.6% (22/26) and 74.4% (29/39),respectively,with significant difference (x2=7.374,P<0.05).Univariate analysis revealed that UIE,pre-treatment TSH,pre-treatment Tg and the amount of remnant thyroid tissue at ablation affected ablation efficacy (x2 =7.374,t =2.037,z =-2.966,x2 =4.144,all P<0.05).Logistic regression showed that the level of pre-treatment Tg (P < 0.05) and iodine intake (P < 0.05) were independent factors of ablation efficacy.Conclusion Iodine intake before 131I remnant ablation is one of the important factors affecting treatment outcomes.Thyroid remnant could be more successfully ablated if reasonable LID protocols be adopted according to the iodine nutritional status before treatment.

Article in Chinese | WPRIM | ID: wpr-333633


<p><b>OBJECTIVE</b>To test the efficiency of transfecting (99)Tc(m)-labeled anti-miR208b oligonucleotide into early hypertrophic cardiac myocytes in vitro.</p><p><b>METHODS</b>The anti-oligonucleotide targeting miR208b (AMO) was synthesized and modified with LNA followed by conjugation with N-hydroxysuccinimidyl S-acetyl-meraptoacetyl triglycine (NHS-MAG3) and radiolabeling with (99)Tc(m). NHS-MAG3-LNA-AMO and labeled AMO were purified with Sep-Pak C18 column chromatography, and the former was examined for UV absorption at the 260 nm using Gene Quant DNA/RNA calculator. The labeling efficiency, radiochemical purity, stability and molecular hybridization activity were analyzed. An angiotensin II-induced cell model of hypertrophic cardiac myocytes was transfected with (99)Tc(m)-NHS-MAG3-LNA-AMO via liposome, and the relative expression of miRNA208b and retention ratio of the labeled AMO in early hypertrophic cells were determined.</p><p><b>RESULTS</b>The labeling efficiency and radiochemical purity of the labeled AMO after purification exceeded 84% and 86%, respectively. The radio- chemical purities of the labeled AMO incubated in serum and normal saline for 12 h were both higher than 80%, and the labeled AMO showed a capacity to hybridize with the target gene. In the hypertrophic model of cardiac myocytes, the retention ratio of labeled AMO at 6 h was higher than 20%.</p><p><b>CONCLUSION</b>The (99)Tc(m)-labeled antisense probe can be efficiently transfected into hypertrophic cardiac myocytes in vitro, which provides an experimental basis for subsequent radionuclide imaging studies.</p>

Humans , Isotope Labeling , Liposomes , MicroRNAs , Genetics , Myocytes, Cardiac , Oligonucleotides , Oligonucleotides, Antisense , Oligopeptides , Radiopharmaceuticals , Silicon Dioxide , Succinimides , Transfection