Combined lung tumor resection and heart surgery / 中华胸心血管外科杂志

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.

Imitating the ischemic preconditionging in lung preservation / 中华器官移植杂志

ObjectiveTo investigate the preventive effect of drugs imitating the ischemic preconditio ning to the donor lung.MethodsAdenosine was used to imitate the early protection of ischemic preconditioning, SOD to imitate the delayed protection and both of them to imitate the integral p rocess of ischemic preconditioning. At the same time, a control group was set up . The rabbits' lungs were flushed, the heart-lung blocs harvested, and adenosin e, SOD, both or none of them wadded respectively. After preservation for 6 h, th e lungs were reperfused for 1 h with the isolated rabbit lung reperfusion model. The PaO 2, airway pressure, pulmonary compliance, wet/dry ratio and content of NOS were measured. The microscopic and electron microscopic examinations were c arried out.ResultsPaO 2 values were the highest in the control group, followed by the SOD group, the adenosine group, the combined use group. The differences among the groups we re significant. The wet/dry ratio was the highest in the control group, followed by the adenosine group, the SOD group, the combined use group with the differen ces among the groups being significant. The airway pressure and NOS content in t he imitating ischemic preconditioning groups was lower than that of the control group. The pulmonary compliance of the imitating ischemic preconditioning groups was higher than that of the control group. However, the differences were not si gnificant. The microscopic and electron microscopic examination revealed that th e pathological changes in the imitating ischemic preconditioning groups was obvi ously lightened as compared with those in the control group.ConclusionsAdministration of the drugs imitating ischemic preconditioning could improve pul monary oxygenation function and ameliorate pulmonary edema. Although the drugs s howed less effect in ameliorating airway pressure, pulmonary compliance and NOS activity, the imitating ischemic preconditioning could protect the donor lung.