Objective To investigate the effects of inflammatory reaction of thymomas with myasthenia gravis (MG) treated by traditional thoracotomy and minimally invasive surgery. Methods A total of 40 thymomas patients (Mssaoka Ⅰ or Ⅱ) with myasthenia gravis from August 2014 to June 2015 were treated by traditional thoracotomy (n=20) or video-assisted thoracoscopic surgery (n=20). The serum levels of IL-6, IL-8, TNF-α, CRP and CORT were measured by enzyme-linked immunosorbent assay (ELISA) methods at before anesthesia (T1), after anesthesia (T2), 2 h after skin cut (T3), 24 h post-operation (T4), 48 h post-operation (T5) and 72 h post-operation (T6) respectively. Perioperative parameters were also reported. The statistics analysis was performed by SPSS 17.0 software. Results The serum levels of IL-6, IL-8, TNF-α, CRP and CORT had no significant difference between T1 and T2, T2 and T3 (allP value>0.05) in both groups. But the serum levels of these factors after operation were obviously higher than that of before operation, commonly the highest level was reached at T4 (allP value>0.01), and also was higher at T6 than that of before the operation (allP value<0.01), except the level of TNF-α recovered rapidly to the level of before operation (allP value>0.05) in the VATS group. The operation time, postoperative drainage tube indwelling time and incision healing time in the VATS were lower than that in the control group (allP value<0.05). Conclusion VATS could be widely applied in clinical practice with lowering operative trauma and reducing the degree of inflammatory reaction.
Objective To compare the distribution of drug concentration in lymph nodes and blood between lymphatic chemotherapy and single drug chemotherapy and to study if nano carbon can enhance the number of lymph node dissection. Methods From June 2015 to February 2016, 80 patients with esophageal cancer in the Department of Thoracic Surgery, West China Hospital were enrolled and they were divided into two groups: a lymphatic chemotherapy with paclitaxel (LCP) group and a paclitaxel alone (PTX) group. There were 35 males and 5 females with an average age of 60.63±8.78 years in the LCP group, and 30 males and 10 females with an average age of 62.13±7.89 years in the the PTX group. We observed the incidence rate of complications after operation, the number of lymph node dissection and the rate of lymph node metastasis. The drug concentration in the blood and lymph nodes between the two groups was compared. Results The postoperative morbidity did not increase in the both groups, which did not have adverse drug reactions such as bone marrow suppression, gastrointestinal reaction and so on. The concentration of chemotherapy drug in lymph nodes in the LCP group was higher than that in the PTX group. The LCP group collected 771 lymph nodes, and the average number was 19.27±7.77 for each patient; the PTX group collected 658 lymph nodes, and the average number was 16.45±7.12 for each patient; but the difference between two groups was not statistically significant (P>0.05). Conclusion Nano carbon carriers can effectively improve the drug concentration in lymph nodes after the local injection of chemotherapy drugs. The use of nano carbon tracer in the operation to improve lymph node dissection may not have significance.