ABSTRACT
AIM: To justify and develop the indications for thoracoscopic procedures in patients with complications after advanced cardiothoracic surgery including combined and simultaneous operations. MATERIAL AND METHODS: From 2013 to 2017 was performed treatment of complication in 27 patients undergoing various cardiothoracic intervention with the use of thoracoscopic technology. RESULTS: We have analyzed immediate results of thoracoscopic operations in 27 patients with various intrapleural complications after advanced cardiothoracic surgery. Satisfactory results of these interventions confirm safety of thoracoscopic technologies and serve as an argument in favor of this direction in thoracic surgery.
Subject(s)
Cardiac Surgical Procedures/adverse effects , Pleural Diseases , Postoperative Complications , Thoracic Surgery, Video-Assisted/methods , Cardiac Surgical Procedures/methods , Female , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Pleural Diseases/diagnosis , Pleural Diseases/etiology , Pleural Diseases/surgery , Postoperative Complications/diagnosis , Postoperative Complications/surgery , Reoperation/methods , Russia , Tomography, Spiral Computed/methodsSubject(s)
Intra-Aortic Balloon Pumping/methods , Intraoperative Complications/prevention & control , Lung Neoplasms , Myocardial Ischemia , Pneumonectomy , Aged , Counterpulsation/methods , Female , Humans , Lung/diagnostic imaging , Lung/surgery , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Myocardial Ischemia/complications , Myocardial Ischemia/diagnosis , Myocardial Ischemia/physiopathology , Myocardial Ischemia/therapy , Neoplasm Staging , Pneumonectomy/adverse effects , Pneumonectomy/methods , Risk Adjustment/methods , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
AIM: To analyze advisability of cardiopulmonary bypass in thoracic surgery. MATERIAL AND METHODS: We estimated early and long-term results of CPB-assisted thoracic interventions in 31 patients with malignant and benign thoracic diseases and invasion into vital mediastinal structures or with concomitant cardiovascular pathology. RESULTS: Acceptable rates of mortality and morbidity confirm safety of CPB in thoracic surgery while satisfactory long-term outcomes are arguments in favor of this direction of thoracic oncology.
Subject(s)
Cardiopulmonary Bypass , Long Term Adverse Effects , Postoperative Complications/epidemiology , Thoracic Neoplasms , Thoracic Surgical Procedures/methods , Cardiopulmonary Bypass/adverse effects , Cardiopulmonary Bypass/methods , Cardiopulmonary Bypass/mortality , Female , Humans , Long Term Adverse Effects/epidemiology , Long Term Adverse Effects/etiology , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Outcome and Process Assessment, Health Care , Russia , Thoracic Diseases/diagnosis , Thoracic Neoplasms/pathology , Thoracic Neoplasms/surgeryABSTRACT
We performed a parallel evaluation of the status of epidermal growth factor receptors EGFR and HER-2 in tumor samples from 31 patients with squamous cell carcinoma of the esophagus. Hyperexpression of proteins was detected by immunohistochemical methods and gene amplification and other chromosome abnormalities were studied using FISH reaction. Evaluation of EGFR status showed that amplification of EGFR gene was present in 25% cases and chromosome 7 polysomy was detected in 29.2% cases positive by protein expression (2+/3+). Immunohistochemically positive EGFR status was confirmed by the results of FISH reaction for gene amplification and chromosome 7 polysomy in 54.2% cases (p=0.002). During evaluation of HER-2 status in the tumor, hyperexpression of the protein detected histochemically was not confirmed by FISH reaction for detection of amplification of the corresponding gene in 16.1% cases. In 22.6% patients, chromosome 7 polysomy was detected; it was not accompanied by amplification of HER-2 gene, but was related to immunohistochemically positive status of the tumor. Hyperexpression of EGFR protein significantly correlated with the presence of intravascular invasion (p=0.006) and increased depth of invasion (p=0.044), while amplification of EGFR gene (≥2.2) correlated with low differentiation degree of the tumor (p=0.006). The outcome of the disease was not associated with EGFR status at the gene and protein levels, whereas clinical course of the disease in patients with immunohistochemically negative expression of HER-2 protein was more favorable than in patients with positive expression (p=0.004). The results of this study suggest that hyperexpression/amplification of EGFR and hyperexpression of HER-2 are important clinical markers for evaluation of disease prognosis and development of new regimens of targeted therapy for patients with squamous cells carcinoma of the esophagus.
Subject(s)
Carcinoma, Squamous Cell/genetics , ErbB Receptors/biosynthesis , Esophageal Neoplasms/genetics , Receptor, ErbB-2/biosynthesis , Adult , Aged , Aneuploidy , Carcinoma, Squamous Cell/pathology , Chromosomes, Human, Pair 7/genetics , Esophageal Neoplasms/pathology , Female , Humans , Immunohistochemistry , In Situ Hybridization, Fluorescence , Male , Middle Aged , PrognosisABSTRACT
Immunohistochemical study of marker expression in primary tumors of patients with esophageal squamous-cell carcinoma was carried out in order to evaluate prognostic significance of EGFR and HER-2 levels in the tumors. Hyperexpression of EGFR and HER-2 in the tumors is an important marker for the analysis of prognosis and clinical course of the disease. A relationship between high levels of EGFR and HER-2 in the tumors of patients with esophageal squamous-cell carcinoma and intravascular tumor invasion (p=0.038) and poor outcome of the disease (p=0.019) was detected. The results indicate that evaluation of changes in the expression of EGFR and HER-2 in tumors is essential for individual prediction of the disease course and development of new approaches to the treatment of these tumors, including target therapy aimed at these tyrosine kinase receptors.
