Video assisted surgery has been applied to many fields of thoracic surgery including esophagectomy. At first radical video assisted esophagectomy (RVAE) for malignant esophageal tumors faced intense criticism, but almost all recent reports confirm its feasibility, safety. This article reviews the recent research of RVAE.

Objective To investigate the factors associated with contralateral recurrence of primary spontaneous pneumothorax And prosvide referencee for how to prevent primary spontaneous Pneumothrorax with Contralateral recurrence.Methods From January 2006 to December 2011,the clinical follow-up data of 203 patients with primary spontaneous pneumothorax were reviewed.The median follow-up time was 43 months.Results Two hundred and three patients developed 241 recurrences,among which 27 patients had contralateral recurrences.The average time of contralateral recurrence was 20.19 months.Patients with contralateral recurrence of primary spontaneous pneumothorax had smaller age(P ＜ 0.05),lower body weight (P ＜ 0.05) and lower body mass index (P ＜0.01).All patients with contralateral recurrence of primary spontaneous pneumothorax received surgical treatment and were found bullae during surgery.Three patients had unilateral recurrences of pneumothorax during follow up,with single-stage bilateral video-assisted thoracoscopic surgery for bilateral primary spontaneous pneumothorax.Conclusions Contralateral recurrence of primary spontaneous pneumothorax is more common in patients with small age,low body weight and low body mass index.These patients could perform high-resolution computerized tomographic scan of the lung before surgery.Single-stage bilateral video-assisted thoracoscopic surgery may be considered for these patients with contralateral bullae on high-resolution computerized tomographic scan of the lung to prevent contralateral recurrence of primary spontaneous pneumuothorax.

Objective:To evaluate the effect of autologous hematopoietic stem cell transplantation (ASCT) on the treatment of relapsed/refractory multiple myeloma (RRMM) with chimeric antigen receptor T cell (CAR-T) therapy.Methods:A retrospective cohort study. The clinical data of 168 patients with RRMM who underwent CAR-T therapy at the Department of Hematology, Xuzhou Medical University Hospital from 3 January 2020 to 13 September 2022 were analyzed. Patients were classified into a transplantation group (TG; n=47) and non-transplantation group (NTG; n=121) based on whether or not they had undergone ASCT previously. The objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and the levels of CD3, CD4, CD8, CD19, CD56 and natural killer (NK) cells before CAR-T infusion were analyzed by χ2 test, Kaplan-Meier method and independent sample t-test. Results:Among 168 patients with RRMM, 98 (58.3%) were male. The median age of onset was 57 (range 30-70) years. After CAR-T therapy, the ORR of patients was 89.3% (92/103) in the NTG and 72.9% (27/73) in the TG. The ORR of the NTG was better than that of the TG ( χ2=5.71, P=0.017). After 1 year of CAR-T therapy, the ORR of the NTG was 78.1% (75/96), and that of the TG was 59.4% (19/32). The ORR of the NTG was better than that of the TG ( χ2=4.32, P=0.038). The median OS and PFS in the NTG were significantly longer than those in the TG (OS, 30 vs. 20 months; PFS, 26 vs. 12 months; both P<0.05). The CD4 level before CAR-T infusion in the TG was significantly lower than that in the NTG (25.65±13.56 vs. 32.64±17.21; t=-2.15, P=0.034), and there were no significant differences in the counts of CD3, CD8, CD19, CD56, and NK cells between the TG and NTG (all P>0.05). Conclusion:Among patients suffering from RRMM who received CAR-T therapy, patients who did not receive ASCT had significantly better outcomes than those who had received ASCT previously, which may have been related to the CD4 level before receiving CAR-T therapy.

Objective    To analyze the effect of 3D simulation technique in thoracoscopic lobectomy. Methods    From June 2015 to January 2018, 124 patients with left lower lobe resection underwent thoracoscopy with single-port thoracoscopic surgery, including 64 males and 60 females, aged 42–83 years. They were randomly divided into two groups including an experimental group (preoperatively given 3D simulation surgery in 59 patients) and a control group (preoperatively not given 3D simulation surgery in 65 patients). The clinical effect between the two groups was compared. Results    All patients recovered without any death during hospitalization. In the experimental group, the operation time, intraoperative blood loss and postoperative hospital stay were significantly less than those in the control group (P<0.05). There was no significant difference in postoperative drainage volume, and duration of drainage tube retention and analgesic drug usage between the two groups (P>0.05). Conclusion    3D simulation technique for thoracoscopic lobectomy has advantage in short operation time, minor trauma and quick recovery. It has a guiding role in the preoperative planning of lung cancer surgery and is worthy of popularization and application.