ObjectiveTo analyze the surgical techniques and perioperative patient management of bronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplasty in the treatment of locally advanced central type of lung cancer and summarize the experiences. MethodsWe retrospectively analyzed the clinical data of 21 locally advanced central type of lung cancer patients with bronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplast in our hospital from December 2011 through November 2014. There were 17 males and 3 females with a mean age of 63.2±6.2 years. All operations were successful. The time of operation was 3.29±0.75 h. The hospitalization time was 25.48±22.31 days. No death ocurred during perioperative period. Postoperative complications were found in 3 patients, including 2 patients with atelectasis and 1 patient with bronchopleural fistula. ConclusionBronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplasty apply to treat locally advanced central type of lung cancer not only maximally remove the lung cancer tissue, but also maximally reserve the healthy lung tissue.
ObjectiveTo evaluate effect and safety of a novel conservative therapy for post-lobectomy bronchopleural fistula. MethodsWe retrospectively analyzed the clinical data of 20 patients with post-lobectomy bronchopleural fistula in our hospital between 2000 and 2013 year. There were 12 males and 8 females at average age of 67.7±8.7 years. Endobronchial naso-bronchial lavage (ENBL) was used for 10 patients (an ENBL group). Traditional method-thoracostomy drainage tube (TDT) was used for the other 10 patients (a TDT group). ResultsCompared with the TDT group, shorter hospital day was found in the ENBL group (49.7±9.6 d versus 68.3±9.8 d, P < 0.001). Fistula healing time was also shorter in the ENBL group than that in the TDT group (43.7±9.7 d versus 62.6±8.8 d, P < 0.001). There were lower complication rate, less inflammatory reaction, and better recovery in the ENBL group than those in the TDT group. ConclusionENBL may be a promising procedure for post-lobectomy bronchopleural fistula.
ObjectiveTo evaluate the efficiency and clinical outcomes of endoscopic thoracic sympathectomy (ETS) with flexible thoracoscopy under local anesthesia with monitored anesthesia care in primary palmar hyperhidrosis. MethodsFrom March 2011 to March 2013, we performed ETS with flexible thoracoscopy under local anesthesia with monitored anesthesia in 23 patients with primary palmar hyperhidrosis (PH), including 10 males and 13 females with their age of 25.6±7.2 years (range, 17-32 years). T3 sympathectomy was performed with flexible endoscopy under local anesthesia with monitored anesthesia care. All patients were followed up until May 2014. ResultsDuring surgery, the vital signs of the patients remained stable. Operation time was 30-40 minites. The symptom of PH disappeared right in the surgery. All patients were discharged from the hospital on the 2nd postoperative day. One patient received unilateral sympathectomy because of pleural adhesion. Other 22 patients received follow-up to May 2014 and no reoccurrence was reported. ConclusionETS with flexible thoracoscopy under local anesthesia with monitored anesthesia is a safe, microinvasive and effective method.
The precise resection and suture of bronchia, vascular and pulmonary tissue are the key techniques in thoracic surgery. Mechanical suture technique has gradually become a routine operation in thoracic surgery. However, at present, there is still a lack of consensus and guidelines on the application of this technique in thoracic surgery, neither strong evidence-based medical support. In this study, we discuss the application standard of mechanical suture technique in thoracoscopic surgery, irregular treatment techniques, intraoperative complications, and management principles to promote the standardized application of mechanical suture technique. We also explain the shortcomings of the technique in order to promote the further improvement and perfection.
The quality control of lung transplantation involves many aspects, such as team building, selection of recipients, preoperative diagnosis and evaluation of recipients, maintenance of brain-dead donors, evaluation and acquisition of donors, surgical operation, postoperative management and postoperative follow-up. Precision management is the core concept of operation quality control. Only by normalizing the operation quality control of lung transplantation to provide basic guarantee for multi-team cooperation and development of lung transplantation management in the future, building a complete lung transplantation database to excavate data resources and improve the quality of transplantation, and comprehensively building a Chinese lung transplantation quality control system with multi-team participation and cooperation, can we improve the overall level of surgical diagnosis and treatment of lung transplantation in China.