Objective The aim of this study is to evaluate the efficacy and safety of preoperative CT-guided hardening agent localization.Methods From December 2010 to January 2012,27 patients with 29 solitary pulmonary nodules who had undergone CT-guided hardening agent localization and video-assisted thoracoscopic surgery (VATS) were studied.Results All cases were underwent CT-guided hardening agent localization successfully,and no patient had serious complication that required any intervention.The diameter of nodules ranged from 3 to 21 mm as measured by CT[mean (11.27 ± 6.32) mm].The distance between the center of nodule and visceral pleural ranged from 4 to 38 mm[mean (14.45 ± 4.32) mm].Conversion from VATS to thoracotomies was not necessary during the diagnostic resection procedure nodules.29 solitary pulmonary nodules underwent thoracoscopic wedge resection,and no intra-or postoperative mortality or morbidity was recorded.Conclusion CT-guided hardening agent localization before video-assisted thoracoscopic solitary pulmonary nodule resection is a safe and effective procedure for accurate diagnosis and resection of indeterminate solitary pulmonary nodules.

Objective To report a multi-center series of 600 consecutive cases of completely video-assisted thoracoscopic lobectomy with 3-year follow-up results. Methods Data from 600 consecutive patients who underwent attempts for thoracoscopic lobectomy between September 2006 and August 2010 in Peking University People's Hospital, Jiangsu Cancer Hospital and Beijing Haidian Hospital were collected. Of these, 315 males (52.5%) and 285 females (47.5%), the average age was ( 59.1 ± 12.6 ) years( 15 - 86 years). Perioperative variables were assessed using standard descriptive statistics and 3-year survival was estimated by Kaplan-Meier analyses. Results One hundred and nineteen cases were diagnosed as benign disease and 481 cases were malignancy. 68.9% (82/119) of the benign cases were chronic infectious disease and the majority of the malignancy was non-small cell lung cancer, especially adenocarcinomas which comprised 65.9% (317/481) of all malignancies.Fifty-four cases required conversion to thoracotomy with a conversion rate of 9%. Of the VATS accomplished group, the median operation time was 180 min(30 -40 min), median blood loss 200 ml( 10 - 1500 ml) . Benign surgery took significantly less time, had shorter drainage time and hospitalization time, and lower morbidity than that for malignancies ( P = 0.001, P ＜0.01, P = 0.004, P = 0.020, respectively). Non-small cell lung cancer patients had a 3 -year survival of 85.4%, and pathologic stage Ⅰ patients 91.2%. Conclusion This largest case series and the first report 3-year survival in China confirms that completely thoracoscopic lobectomy surgery we performed have reached short- and middle-term standards compared with that of the western country.

BACKGROUNDCarinal resection and reconstruction is an emphasis in surgical treatment of carinal tumor and bronchogenic carcinoma involving carina. The aim of this study is to discuss the clinical value of carinoplasty in lung cancer surgery.

METHODSFrom 1982 to 2004, 41 cases of central bronchogenic carcinoma that invaded the carina accepted carinal resection and reconstruction in this hospital. Of the 41 patients, 25 patients underwent simutaneously additional cardiovascular plasty operation besides carinoplasty. There were 12 different types of carinal resection and reconstruction in this series.

RESULTSThere was 1 perioperative death (because of anastomotic leakage) in this group. Arrhythmia occured in 12 patients, atelectasis in 6 patient and pneumonia in 5 patients. Five patients were assisted ventilation through breathing machine because of pulmonary function failure. The 1-, 3-, and 5-year survival rates were 76.21%, 47.23% and 26.83% respectively.

CONCLUSIONSThe carinoplasty is a good method to treat central bronchogenic carcinoma which invaded the carina. With this method lung cancer tissue can be resected maximally, meanwhile, it can save pulmonary function of patient maximally. Postoperative multi-modality therapy is helpful to increase postoperative survival rate and improve quality of life.

BACKGROUNDTo summarize the surgical treatment for locally advanced lung cancer invading heart and great vessels.

METHODSOne hundred and eighteen cases of lung cancer accepting cardiovascular plasty operation from 1980 to 2001 were reviewed.

RESULTSThe operations included partial resection of left atrium in 38 cases, pulmonary artery resection and restruction in 48 cases, replacement or partial resection of superior vena cava in 25 cases, partial resection of pulmonary conus in 3 cases, and lober replantation in 4 cases respectively. There was no perioperative death, and the 1-, 3-, 5- and 10 year survival rate was 72.68%, 55.20%, 28.62% and 20.36% respectively.

CONCLUSIONSCardiovascular plasty in the surgical treatment of locally advanced lung cancer invading heart or great vessels can remarkably increase the long-term survival and improve the life quality of the patients.