ObjectiveTo evaluate the safety, feasibility and short-term outcomes of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer.MethodsFrom February 2018 to December 2019, 118 consecutive patients who underwent minimally invasive McKeown esophagectomy for esophageal squamous cell carcinoma in our hospital were included. There were 94 males and 24 females with an average age of 53.7 (41–77) years. They were divided into two groups based on the methods of gastric mobilization: a traditional dissociation (TD) group (n=55) and a single-direction mobilization (MD) group (n=63). The clinical data of the two groups were compared.ResultsEnbloc resection and a negative resection margin were obtained in all patients. There was no postoperative mortality or incision complication. The rate of postoperative complications was 22.9%. There was no significant difference in the spleen injury, gastric injury, conversion to open surgery, abdominal reoperation as well as cervical anastomotic leakage between the two groups (P>0.05). It took significantly less time in the MD group compared with the TD group (P<0.05). There was an obvious statistical difference in the incidence of gastric mobilization related complications between the MD group (1.6%, 1/63) and TD group (12.7%, 7/55, P<0.05).ConclusionApplication of single-direction gastric mobilization under 3D-laparoscopy in minimally invasive esophagectomy for the treatment of esophageal cancer is safe and easy to perform with a satisfactory short-term outcome.
ObjectiveTo summarize the experience of colon interposition for esophageal replacement. MethodThe clinical data of 108 consecutive patients underwent colon interposition for esophageal replacement in our hospital between January 2005 and March 2013 were reviewed for benign and malignant lesions. Their ages ranged from 2 to 71 years (mean age at 34.3 years). There were 81 males and 27 females. ResultThere was no surgical death. Esophago-colic anastomotic insufficiency occurred in 7 patients. One case of graft necrosis was observed. Injury of recurrent laryngeal nerve occurred in 8 patients, incomplete intestinal obstruction in 2 patients, and wound infection of the abdominal wall in 1 patient, and deep venous thrombosis in 1 patient. In-hospital mortality was 15.7% (17/108). The postoperative follow-up was made for 12 months in 97 patients (91.5%) and all of them were alive. The patients' body weight and appetite improved. ConclusionColon interposition is a valuable alternative with a good long-term function.
Objective To investigate the changes of serum cardiac-specific troponin I (cTnI) level in patients after lung transplantation. Methods Clinical data of patients undergoing lung transplantation in our hospital from December 2016 to December 2022 were retrospectively analyzed. The relationship between postoperative serum cTnI level and clinical characteristics were explored. Results Finally 20 patients were collected, including 15 males and 5 females with an average age of 51.65±12.79 years. The serum cTnI level was significantly increased after lung transplantation. The serum cTnI reached the highest level on the first day after transplantation, and significantly decreased from the third day after transplantation. The serum cTnI levels in patients with obstructive pulmonary disease and bilateral lung transplantation were significantly higher than those in patients with restrictive pulmonary disease and unilateral lung transplantation on the day after surgery and on the first day after transplantation. Conclusion Transient myocardial injury can occur after lung transplantation, which is characterized by an abnormal increase in serum cTnI level.