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@#With the change of coronavirus disease 2019 (COVID-19) prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.
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With the change of COVID-19 prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.
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Objective To develop an easy-to-use nomogram to assist clinicians in predicting major postoperative morbidity in those non-small-cell lung canccr patients who underwent VATS lobectomy.Methods A perspective multi-center study was developed to analyze the major postoperative complications of 612 non-small-cell lung cancer patients who underwent VATS lobectomy.Muhivariable logistic regression was used to model postoperative morbidity and built the nomogram to accurately predict the major complications.Results There were 606 (99％) survivors and 6 (1％) mortality.A total of 32 patients suffered from major complications.Using logistic regression to predict major complications,preoperative model for ASA score,age ≥70 years and operation time ＞ 150 nin were found to be the significant predictors(P ＜ 0.05) of morbidity and were included in our model.Conclusion We propose a nomogram to enable clinicians to better estimate morbidity in patients with VATS lobectomy.
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Objective To assess the safety of combined lung resection and cardiac surgery in patients with synchronously occurring lung tumor and heart disease. Methods Fourteen patients with synchronously lung tumor and heart disease received lung resection combined with open heart surgery between 2003 and 2008 in our hospital. There were 11 men and 3 women with a mean age of 64 years. Lung resection consisted of lobectomy in 8 patients, sleeve lobectomy in 1, and wedge resection in 5.Pulmonary tumor pathology was squamous cell in 4 patients, adenocarcinoma in 6, undifferentiated carcinoma in 1, hamartoma in 2 and sclerosing hemangioma in 1. Cardiac procedure included coronary artery bypass grafting (off-pump) in 12 cases, mitral valve replacement in 1 and valve repair in 1. Results No patient died or needed to do re-exploration for bleeding. One patient developed atrial fibrillation postoperatively and recovered soon. One patient developed pneumonia and ARDS who bad to receive tracheostomy but finally he discharged from hospital one month later after the operation. Conclusion Combined lung tumor resection and cardiac surgery are relatively safe in selected patients, especially concomitantly with off pump coronary artery bypass grafting. Lung resection and system medinstinal lymph node dissection for lung canner through second incision had low and acceptable operative morbidity.