Objective To investigate the effect of surgical treatment of patients with esophageal foreign bodies (EFBs), in order to provide a reference for its prevention. Methods We retrospectively analyzed the clinical records of 18 patients with EFBs treated in West China Hospital from June 2005 to December 2010. There were 13 males and 5 females with an average age of 57.50±15.28 years (30 to 82 years). All the 18 patients had a history of ingesting EFBs which were mainly animal bones (10/18). The EFBs were mostly in the upper segments of the esophagus (12/18). Sixteen patients had complications like perforations and severe mucosal injuries, while complications were not detected in the other 2 patients. Fifteen patients received surgical treatment, while the other 3 patients didn’t. Results As for the 15 patients with surgical treatment, the operative time was 136.33±92.86 minutes (50 to 410 minutes), and the hospital stay was 16.35±15.8 days (4.00 to 69.92 days). Three patients (of which,one aged at 78 years and one 82 years) died, among whom two died of multiorgan failure, and 1 died of respiratory failure. All the other 12 patients were discharged from the hospital. For the 3 patients without surgical treatment, the hospital stay time was 5.06±1.47 days ranged from 3.71 to 6.63 days. They were cured and left the hospital. Conclusion EFBs should be treated as early as possible to reduce severe complications. Surgery is still one of the mostly used treatments for EFBs. Senility and complications are the major causes of death. It should be comprehensively assessed whether the EFBs patients should receive operations and which operative procedures should be performed.
Abstract: Objective To evaluate the impact of shortterm preoperative pulmonary rehabilitation (PR) on the exercise capacity of lung cancer patients with moderate to severe chronic obstructive pulmonary disease（COPD）. Methods Between March 2009 and August 2010, 30 lung cancer patients with moderate or severe COPD were treated with preoperative comprehensive PR for two weeks in Department of Thoracic Surgery, West China Hospital. The sample was comprised of 18 males and 12 females with an average age of 62.5±7.7 years. Twelve of the patients had moderate COPD, while 18 had severe COPD. We collected information on the length of postoperative hospital stay for each patient,as well as any pulmonary complications. Results (1) The forced expiratory volume in one second (FEV1), forced expiratory volume in one second % (FEV1%), forced expiratory volume in/ forced vital capacity (FEV1/FVC),and maximal ventilatory volume (MVV) (1.30±0.30 L, 59.19±18.00 L, 47.74±1200 L, 56.63±13.00 L) values after PR were slightly better than those before PR(1.24±0.40 L, 51.89±14.00 L, 46.59±10.00 L, 49.67±13.00 L), but not significantly so(Pgt;0.05). The results for carbon monoxide diffusion capacity were similar. (2) The sixminute walking distance (before: 502.67±157.00 m, after: 594.87±116.00 m), peak expiratory flow (before: 209.33±66.00 L/min, after: 255.33±70.00 L/min), dyspnea index (Borg index) (before: 0.26±0.20, after: 0.12±0.10), and fatigue index (before:0.24±0.20, after: 0.12±0.10) all improved significantly aftercomprehensive PR (Plt;0.05). (3) All 30 patients underwent surgery, and none died during the perioperative period. Eight patients experienced cardiopulmonary complications. The average hospitalization time after surgery was 8.0±2.4 days. Conclusion Preoperative comprehensive PR appears to significantly improve exercise capacity and reduce the rate of postoperative lung complications in lung cancer, patients with lower cardiopulmonary function.