Early results of thoracic remodeling for patients with bar removal after pectus excavatum correction in minimal-procedure / 中华胸心血管外科杂志

Objective To study thoracic re-remodeling and therapeutic effect after the bar removal for pectus excavatum corrected by minimal-invasive technique.Methods 145 cases with pectus excavatum,male 115,femal 30;adults in 59,children 86;corrected by minimal-invasive technique improved and performed by the same group surgeon.Bar removed 12-82 months after the procedure,appraising index of curative effects include in chest appearance,thoracic index,thoracic computer tomography(CT) and the distance between the behind of sternum to the anterior border of thoracic spine in the sagittal view.Results The chest shape was good.Thoracic index:before bar removal 2.36 ± 0.32 in children,2.60 ± 0.45 in adults;after that,2.77 ± 0.44 in children,3.04 ± 0.56 in adults.There was all subsidence on the each point of the sternum,descent the maximum at the inferior end of the midsternum,(15.18 ±7.95)mm in children,(14.93 ± 8.81) mm in adults,comparing with bar removal before and after.There was statistical significance.Not the signs of compressing the heart on the CT view.The time interval of the bar removed 3-year in children,5-year in adults without affecting the development of the patients' thorax.Conclusion The sternum descended slightly after bar removal when pectus excavatum corrected to expecting effects.After that,thoracic remodeling again,the chest shape well.

Effect of the simultaneous correction of pectus excavatum and scoliosis on the thoracic deformity / 中国组织工程研究

BACKGROUND: Studies on the biomechanical properties in NUSS procedure have obtained some achievements, but the effect of scoliosis surgical correction of scoliosis on thoracic deformity remains unclear.OBJECTIVE: To explore the effect of simultaneous correction of pectus excavatum and scoliosis on thoracic deformity so as to provide reference for designing a rational orthopedic scheme.METHODS: The three-dimensional reconstruction model of the chest was established based on the CT data of the patients with pectus excavatum and scoliosis. The surgical correction of pectus excavatum and scoliosis was simulated by numerical simulation method.RESULTS AND CONCLUSION: (1) Results after correction showed that the bilateral spinous processes at T3-5 segments displaced to the left (X direction) about 1 mm, suggesting that the simultaneous correction is favorable for the correction of scoliosis. (2) Compared with the single NUSS procedure, the displacement at Y direction was increased by 13.358 mm in the simultaneous correction; meanwhile, there was significant difference in the shortest displacement between two methods.(3) In views of Von Mises stress distribution, the stress in the simultaneous correction was decreased by 24.6 MPa compared with the single Nuss procedure, indicating that the simultaneous correction can significantly reduce the Von Mises stress on the chest, which contributes to alleviate the postoperative pain. (4) Our results show that the simultaneous correction cannot only improve scoliosis, but also improve the symptoms of pectus excavatum.

Surgical treatment for patients with chest cancers invading the superior vena cava / 中国医师进修杂志

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

Relationship between Suspended Particles in Air and Respiratory Diseases / 环境与健康杂志

To discuss the relationship between suspend particles in the air and respiratory diseases. After the fine particle in the air inhaled into the lung, they retained mainly alveolar ducts and alveoli. They induced inflammatory reactive process and produced inflammatory cytokines in the respiratory tract and epithelial hyperplasia, increased the morbidity of respiratory diseases. The polycyclic aromatic hydrocarbons (PAHs) in the air pollutants had carcinogenesis, the mucosa was irritated by it for long-term and might result in canceration and it increased morbidity and mortality of lung cancer.

Early Efficacy of Minimally Invasive Correction of Pectus Excavatum in Adult Patients / 中国微创外科杂志

Objective To study the feasibility and efficacy of minimally invasive repair for pectus excavatum in adult patients. Methods A total of 23 patients with pectus excavatum aged 18-38 years(mean 24.1?6.6) were treated in our hospital from June 2006 to June 2008.On admission,21 of patients had never been treated,and 2 patients were recurrent cases after Ravitch surgery;the Haller index of the cases ranged from 3.2 to 7.5(mean 4.38?1.16);type I pectus excavatum was diagnosed in 14 of the patients(60.9%) and type II in the other 9(39.1%).Under general anaesthesia with the patients at supine position,two 3-cm incisions were made along the bilateral mid-axillary line at the level of the most pronounced sternal depression.Then,a conductor was penetrated into the mediastinum from the right to the left at almost the same level.After establishing artificial pneumothorax by CO2 gas,a pectus bar(Lorenz) was placed through the mediastinum under the guidance of thoracoscopy.Afterwards,a stabilizer was used to fix the bar at the right side.Both the stabilizer and the bar were fixed to the muscle layer.Chest X-ray was performed to observe the stabilizer and the bar after the operation. Results Among the cases,the procedure was successfully completed in 22 patients.In the other patient,the pericardium and the right atrial appendage were injured,and we had to enlarge the incision for haemostasis.All of the patients were uneventful after the operation.No incisional infection or bar displacement occurred during the perioperative period.During a mean of 16-month follow-up(range 3-24 months),the symptom of chest distress was significant improved,and the cosmetic results were satisfying in 87% of the patients(20/23).Conclusions Minimally invasive repair is feasible and effective for adult patients with pectus excavatum.

CLINICAL EFFECT ANALYSIS OF THE BRONCHUS CUT OUT AND BRONCHOPLASTY FOR LUNG CANCER / 解放军医学杂志

Objective To investigate value and effect of the bronchus was cut out and bronchoplasty for lung cancer. Methods Twenty-one patients with lung cancer which all invased out one bronchial orifice and precluded standard lobectomy. The present of endobronchial tumor was cut out according to the lesion region during operation, the bronchoplasty performed by health bronchial wall. Results There were squamous carcinoma in 15 patients; adenocarcinoma in 4; small cell lung cancer and carcinoid each one patient. Staging: stage Ⅰ in 3 patients; stage Ⅱ in 12, stage Ⅲa in 6. The 19 patients were uneventful after operation. The 2 cases died from acute pulmonary embolism or gastric irritable ulcer with large bleeding in perioperation. Respiratory failure in all patients had not occurred. Bronchoscopy performed immediately after operation in 16 patients and in the period of following up 6-36 months in 12 patients, the mucosa of bronchoplastic sites was smooth, no bronchial stenosis and no tumoral relapse.The period of following-up was 4-72 months, median survival 42 months after operation. Five patients died from the metastases or relapse. Life time in survival patients was well. Conclusion The bronchial resection by cut out and bronchoplasty for lung cancer had a good results in near future and long period, and proved individualized and adapted selective type of resection for bronchoplasty of lung cancer.