Objective To evaluate the advantages of minimally invasive technique for treatment of progressive hemothorax.Methods The study enrolled 62 patients with progressive hemothorax treated by minimally invasive surgery between October 2009 and March 2012.According to the treatment methods,the patients were classified to thoracoscope group (n =47) and urethral catheter balloon blockage group (n =15).Postoperative drainage volume and recovery were detected in both groups.Results All patients in thoracoscope group were healed with the mean operation time of 54 minutes (range,30-120 minutes).Mean effusion removed within thoracic cavity was 1 260 ml (range,700-2 000 ml).Postoperative bedside chest radiography revealed good pulmonary reexpansion without effusion or pneumatosis within thoracic cavity.All patients in urethral catheter balloon blockage group were healed.Chest drainage within postoperative 3 hours was mean 260 ml of fresh blood (range,100-500 ml) and thereafter no more massive bloody fluid discharge occurred.Meanwhile,chest CT reexamination revealed no increase of chest effusion.Conclusion Minimally invasive technique in treatment of progressive hemothorax patients with moderate or less effusion provides accurate effect,minor trauma,rapid recovery,and few complications and hence deserves clinical application.

Lung transplantation is the ultimate treatment of end-stage lung disease. After transplantation, the 1-year survival rate is 80%, while the 5-year survival rates remaines at around 50% mainly due to bronchiolitis obliterans syndrome (BOS). BOS is regarded as a fibrosing process in the small airways leading to irreversible airway obstruction. A lot of factors are involved in the development of BOS, such as Ischemia/reperfusion injury, infections, oxidative stress, and acute rejection, etc. Studies have shown that early diagnosis of BOS may improve outcome. It is valuable for the long-term survival of lung transplantation to find out several predictors for the BOS. This article reviews the current state of knowledge on predictors for BOS.

Objective    To assess the outcome of harmonic scalpel (HS) in esophageal cancer surgery and to provide evidence for the role of HS in the enhanced recovery after surgery (ERAS) and short-term prognosis after esophageal cancer surgery. Methods    We collected the clinical data of 81 esophageal cancer patients receiving surgery by HS between January 1 and December 31, 2016 and successfully followed up in our department. There were 67 males and 14 females with an average age of 64.07±7.52 years. Sweet approach was adopted in 16 patients, Ivor-Lewis approach in 23 and McKeown approach in 40. Intrathoracic anastomosis was completed in 41 patients and cervical anastomosis in 40. The length of total hospital stay and postoperative hospital stay, operation time, intraoperative blood loss, duration and volume of thoracic drainage and perioperative complications were recorded and compared in patients with different surgical approaches and anastomosis sites. Results    For these 81 patients, the operation time was 276.7±70.4 min, and the intraoperative blood loss was 115.9±69.7 ml. The postoperative duration of thoracic drainage, postoperative complication rate and the drainage volume were 12.3±5.3 d, 35.80% and 1 411.9±1 199.5 ml, respectively. During the follow-up, 15 patients died and the cumulative survival rate was 81.48%. There was no obvious HS-related complication. The operation time of Sweet approach was shorter than that of Ivor-Lewis or McKeown approach (P=0.012) and the dissected lymph nodes were less in Sweet approach (P=0.035). There was no significant difference in perioperative indexes and postoperative short-term prognosis between intrathoracic anastomosis and cervical anastomosis. Conclusion    HS is widely used in the surgery for esophageal cancer with safety and effectiveness, which is worthy of clinical application.