Objective To study the reconstruction method and effectiveness of titanium plate and Teflon patch for the chest wall after resection of sternal tumors. Methods Between October 2006 and November 2009, 4 patients with sternal tumors were treated and the thoracic cages were reconstructed. There were 2 males and 2 females, aged 30-55 years. The patientswere admitted because of chest lump or pain. The sizes of palpable lump ranged from 4 cm × 3 cm to 10 cm × 8 cm. CT examination showed bone destruction. After sternal tumor resection, defect size ranged from 10 cm × 8 cm to 18 cm × 14 cm, and titanium plate and Teflon patch were used to repair and reconstruct the chest wall defect. Results The operations of the tumor resection and reconstruction of chest wall defect were successfully performed in 4 cases. Incisions healed by first intention with no abnormal breath, subcutaneous emphysema, pneumothorax, and infection. One case failed to be followed up after 6 months; 1 case died of intracranial hemorrhage; and 2 cases were followed up 1 and 4 years respectively without tumor recurrence. The chest wall had good remodel ing. No loosening and exposure of titanium plate, difficulty in breathing, chest distress, and chest pain were observed during followup. Conclusion Surgical resection of sternal tumors will cause large chest wall defect which can be repaired by titanium plate and Teflon patch because it had the advantages of easy operation, satisfactory remodel ing, and less compl ication.
ObjectiveTo investigate the safety and effectiveness of near-infrared fluorescence imaging of the thoracic duct (NFITD) using indocyanine green (ICG) during inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) for esophageal cancer. MethodsA retrospective analysis was conducted on patients with esophageal cancer who underwent IVMTE at the Department of Thoracic Surgery, the First Affiliated Hospital of University of Science and Technology of China, from January 2024 to October 2024. Patients were divided into two groups based on whether they underwent NFITD: an ICG NFITD group (ITD group) and a non-ICG NFITD group (NITD group). Propensity score matching was used to balance confounding factors, and perioperative data and short-term follow-up results (within 6 months) of the two groups were compared. ResultsA total of 66 patients were included, of which 51 were males and 15 were females, with an average age of (70.9±7.2) years. In the comparison of general information between the two groups, the proportion of patients in the ITD group with preoperative chronic obstructive pulmonary disease was higher than that in the NITD group (P=0.044), and the proportion of patients with preoperative bronchiectasis was lower than that in the NITD group (P=0.035). After propensity score matching at a 1:1 ratio, a total of 15 pairs of patients were successfully matched. There was no statistically significant difference between the two groups in terms of intraoperative blood loss, postoperative hospital stay, complications, maximum tumor diameter, pT stage, pN stage, and pTNM stage (P>0.05). The 6-month postoperative follow-up results showed no statistically significant difference between the two groups in terms of anastomotic stricture, hoarseness, gastric paralysis, anastomotic leakage, and postoperative adjuvant treatment (P>0.05). ConclusionThe application of NFITD in IVMTE is safe and effective, with a thoracic duct visualization rate of 100.0%. Compared with NITD, ITD prolonged the operation time but increased the number and stations of lymph node dissection without increasing perioperative and short-term postoperative complications (within 6 months), making it worthy of further clinical promotion.
ObjectiveTo investigate the feasibility, safety, and effectivity of the application of systematic lymph node dissection (SLND) in inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE). MethodsThe clinical data of the patients who underwent IVMTE for esophageal cancer in the First Affiliated Hospital of University of Science and Technology of China From January to October 2024 were restrospectively analyzed. They were divided into a SLND group and an elective lymph node dissection (ELND) group according to intraoperative lymph node resection. clinical characteristics and perioperative outcomes were compared between the two groups. Results A total of 66 patients were enrolled, including 51 males and 15 females, with a mean age of (70.13 ± 8.49) years. There were 12 patients in the selective lymph node dissection (SLND) group and 54 patients in the extended lymph node dissection (ELND) group. There were no statistical differences between the two groups in terms of age, sex, cT stage, tumor location, differentiation grade, pT stage, pN stage, and preoperative comorbidities (P>0.05). statistical differences were observed between the two groups in terms of receiving preoperative neoadjuvant therapy and pTNM staging (P<0.05). There were no statistical differences between the two groups in postoperative complications, operative time, intraoperative blood loss, postoperative hospital stay, and left recurrent laryngeal nerve paratracheal lymph node dissection (P>0.05). The SLND group had a higher average number of lymph nodes dissected, number of stations, number of mediastinal lymph nodes, and number of mediastinal stations than the ELND group. statistical differences were observed between the two groups in the dissection of paraesophageal, right recurrent laryngeal nerve, subcarinal, and diaphragmatic lymph nodes (P<0.05). There were no statistical differences between the two groups in mediastinal lymph node metastasis and cervical lymph node metastasis (P>0.05). The SLND group had more abdominal lymph node metastasis than the ELND group, and the difference was statistically significant (P=0.034). Univariate and multivariate logistic regression analysis showed that cervical lymph node dissection was a risk factor for postoperative complications (P=0.023). Conclusion SLND is safe and effective in IVMTE. Compared with the ELND group, it increased the number of lymph nodes and stations dissected in the mediastinum, and improved the accuracy of postoperative staging. Meanwhile, it did not prolong operative time or hospital stay, nor did it increase the risk of postoperative complications or non-surgical complications.
Objective To analyze the risk factors for chronic cough following pulmonary surgery in patients with non-small cell lung cancer (NSCLC).Methods A retrospective analysis was conducted on 427 NSCLC patients who underwent pulmonary surgery in the Department of Thoracic Surgery, The First Affiliated Hospital of the University of Science and Technology of China, between January 2021 and June 2023. Patients were categorized into a chronic cough (103 patients) and a non-chronic cough groups (324 patients) based on the presence of cough at 8 weeks post-surgery. A comparative analysis was performed between the two groups, considering gender, age, smoking history, comorbidities, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration. Factors showing statistical significance in univariate analysis underwent multivariate logistic regression analysis. Results Among the 427 patients undergoing pulmonary surgery, there were 165 males and 262 females, with an average age of 59.93±12.11 years. The incidence of chronic cough was 24.12%. Univariate analysis revealed significant differences in smoking history, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration ≥135.5 minutes, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration (P<0.05). Multivariate logistic regression analysis indicated that the surgical site (right upper lung), operative techniques (lobectomy), lymph node dissection, and anesthesia time ≥135.5 min were independent risk factors for chronic cough following pulmonary surgery. ConclusionPatients undergoing right upper lung surgery, lobectomy, lymph node dissection, and experiencing anesthesia duration ≥135.5 minutes are at a higher risk of developing chronic cough post-pulmonary surgery.
