1.Surgical management of complex malignant tumors of the inferior vena cava
Zhen LI ; Zhonggao WANG ; Xiaosen HUO ; Leiyong WANG ; Feng JI ; Ce BIAN ; Gaofeng HOU
Chinese Journal of General Surgery 2011;26(4):312-315
Objective To explore the surgical strategy and effects for treating complex malignant tumors of the inferior vena cava (IVC) or/and the tumors extending into right atrium/ventricle.Methods Between Dec 2004 and Jul 2008, eight patients underwent surgical resections, among those seven patients with tumors of IVC or the tumors extending into right atrium/ventricle were operated on under deep hypothermia with cardiopulmonary bypass( CPB), and one patient with recurrence of leiomyosarcoma of the IVC successfully underwent en bloc resection and caval reconstruction. The prosthetic graft was used for IVC reconstruction in two patients and vascular patch in the other two patients. Preoperative chest roentgenography, computed tomography, ultrasonography, or magnetic resonance imaging was used to exclude the presence of metastatic disease, to assess local resectability of the tumour and the extent of involvement and obstruction of the IVC. Results One patient died of liver failure postoperatively. The postoperative course was uneventful in other 7 patients. On follow-up two patients died 2 and 5 months later due to functional disorder of the liver. Three patients have been followed up for 14 - 24 months and were
2.A Case of Multidomain Integrated Treatment Strategy for Complex Primary Pulmonary Sarcomatoid Carcinoma
HUO XIAOSEN ; ZOU HANG ; DONG YANYAN ; LI YUAN ; BIAN LINGJIE ; LI LEI ; WANG HONGWU
Chinese Journal of Lung Cancer 2024;27(2):157-160
Pulmonary sarcomatoid carcinoma(PSC)is a rare and highly malignant tumor,which includes the follow-ing five pathologic types:pleomorphic carcinoma,spindle cell carcinoma,giant cell carcinoma,carcinosarcoma and pulmonary blastoma.The onset of PSC is occult with non-specific clinical symptoms and signs.The clinical manifestations include irritat-ing cough,bloody sputum,dyspnea,chest pain and so on,which are closely related to the growth and invasion site of the tumor.PSC tends to metastasize early,so most patients are already in local advanced stage or advanced stage with a median survival of 9 months at the time of hospital visit.A patient with primary PSC which led to 90%stenosis in central airway was treated by com-bined method of vascular and tracheoscopic intervention in our respiratory center.This treatment prolonged the patient's survival time and got a satisfactory effect at 19-month follow-up after surgery.Herein we report the case for clinical reference.
3.Retrospective Study of Bronchoscopic Intervention Therapy for Bronchopleural Fistula Induced by Pulmonary Surgery
HUO XIAOSEN ; LI YUAN ; DONG YANYAN ; BIAN LINGJIE ; AN PENG ; ZOU HANG ; LI LEI ; WANG HONGWU
Chinese Journal of Lung Cancer 2024;27(3):187-192
Background and objective As a new technique developed in recent years,bronchoscopic interven-tion therapy has the advantages of minimal invasion,high safety and repeatability.The aim of this study is to investigate the clinical characteristics of bronchopleural fistula(BPF)induced by surgeries for lung malignancies or benign diseases and the effect of bronchoscopic intervention therapy for BPF,so as to provide support for prevention and treatment of BPF.Methods Data 64 patients with BPF who were treated by bronchoscopic intervention in Respiratory Disease Cen-ter of Dongzhimen Hospital,Beijing University of Chinese Medicine from June 2020 to September 2023 were collected.Patients with fistula diameter ≤5 mm were underwent submucous injection of macrogol,combined with blocking therapy with N-butyl cyanoacrylate,medical bioprotein glue or silicone prosthesis.Patients with fistula diameter>5 mm were im-planted with different stents and cardiac occluders.Locations and characteristics of fistulas were summarized,meanwhile,data including Karnofsky performance status(KPS),shortbreath scale(SS),body temperature,pleural drainage volume and white blood cell count before and after operation were observed.Results For all 64 patients,96 anatomic lung resections in-cluding pneumonectomy,lobectomy and segmentectomy were executed and 74 fistulas occurred in 65 fistula locations.The proportion of fistula in the right lung(63.5%)was significantly higher than that in the left(36.5%).Besides,the right inferior lobar bronchial fistula was the most common(40.5%).After operation,KPS was significantly increased,while SS,body tem-perature,pleural drainage volume and white blood cell count were significantly decreased compared to the preoperative values(P<0.05).By telephone follow-up or readmission during 1 month to 38 months after treament,median survival time was 21 months.33 patients(51.6%)showed complete response,7 patients(10.9%)showed complete clinical response,18 patients(28.1%)showed partial response,and 6 patients(9.4%)showed no response.As a whole,the total effective rate of broncho-scopic intervention for BPF was 90.6%.Conclusion BPF induced by pulmonary surgery can lead to severe symptoms and it is usually life-threating.Bronchoscopic intervention therapy is one of the fast and effective therapeutic methods for BPF.
4.Bronchoscopic Interventional Treatment of Mixed Squamous Cell and Glandular Papilloma of Diffuse Trachea:A Case Report and Literature Review
HUO XIAOSEN ; ZHANG YAO ; DONG YANYAN ; LI LEI ; ZOU HENG ; AN PENG ; BIAN LINGJIE ; LI YUAN ; WANG HONGWU
Chinese Journal of Lung Cancer 2024;27(9):711-716
Pulmonary mixed squamous cell and glandular papilloma(MSCGP)is a subtype of pulmonary papil-loma,which can be classified as central type and peripheral type based on its site of development.The central type is the most common.The clinical manifestations of pulmonary MSCGP are mainly related to the location of the tumor.Surgery is the main treatment for this disease.Bronchoscopic interventional treatment for the MSCGP in the central trachea could receive satis-factory effect.We reported a patient suffered from diffuse tracheal MSCGP who was treated by bronchoscopic interventional treatment in Respiratory Disease Center,Dongzhimen Hospital of Beijing University of Chinese Medicine,aiming to enhance the recognition of the clinical features and provide clinical references for the diagnosis and treatment of such disease.