Prevention and treatment of postoperative complications of esophageal cancer / 中华胃肠外科杂志

Surgery is the primary treatment for esophageal cancer, but the postoperative complication rate remains high. Therefore, it is important to prevent and manage postoperative complications to improve prognosis. Common perioperative complications of esophageal cancer include anastomotic leakage, gastrointestinal tracheal fistula, chylothorax, and recurrent laryngeal nerve injury. Respiratory and circulatory system complications, such as pulmonary infection, are also quite common. These surgery-related complications are independent risk factors for cardiopulmonary complications. Complications, such as long-term anastomotic stenosis, gastroesophageal reflux, and malnutrition are also common after esophageal cancer surgery. By effectively reducing postoperative complications, the morbidity and mortality of patients can be reduced, and their quality of life can be improved.

Thoracoscopic cardiac surgical procedures: a report of 674 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of thoracoscopic cardiac surgical procedures under extracorporeal circulation.</p><p><b>METHODS</b>From May 2000 to May 2006, 674 patients received thoracoscopic cardiac surgery under extracorporeal circulation. These procedures included atrial septal defect occlusion for 238 patients, ventricular septal defect occlusion for 380 patients and mitral valve replacement for 56 patients. Thirty degree thoracoscopes and femoral extracorporeal circulation were used. The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold crystal or blood cardioplegia.</p><p><b>RESULTS</b>The operation succeed in 645 patients (96%, 645/674). Enlarging the incision was performed in 28 patients. Operation time was from 1.8 h to 5.6 h with the mean of (2.8 +/- 1.2) h. Cardiopulmonary bypass time was from 56 min to 198 min with the mean of (78 +/- 2.3) min. Aortic cross-clamp time was from 8 min to 96 min with the mean of (31 +/- 19) min. The volume of chest drainage was (140 +/- 46) ml. None but one postoperative death occurred, the mortality was 0.15%. Postoperative complications occurred in 48 cases (7%), including bleeding in 8 patients, leakage in 5 patients (reoperation in 2 patients) and hemo-pneumothorax in 33 patients. One patient died postoperatively from cerebral hemorrhage (0.15%, 1/647).</p><p><b>CONCLUSION</b>Thoracoscopic cardiac surgical procedures for atrial septal defect occlusion, ventricular septal defect occlusion and mitral valve replacement is feasible and safe.</p>