BACKGROUND:Although thoracoscopy with pleurodesis is regarded as a positive and effective way for the treatment of malignant pleural effusion, the merit and demerit of sclerosants are directly related to postoperative recovery and the success of pleurodesis. OBJECTIVE:To evaluate the therapeutic effect of talc pleurodesisvia thoracoscopy in the treatment of refractory malignant pleural effusions METHODS:There were 14 male and 15 female patients in this study, age ranging from 38 to 79 years. Al patients with refractory malignant pleural effusion underwent talc pleurodesis under thoracoscopy. The postoperative adverse reactions, chest CT scan 1 month after operation and the fluid drainage were observed. RESULTS AND CONCLUSION:Twenty-nine patients with chest pain were observed in this study. Eighteen patients could relieve the pain itself without medications, eight patients required oral Tramadol and three patients took Demerol or morphine oraly to ease the pain. Fever occurred in three cases at 3 days after operation. Neither pneumonedema, acute respiratory failure, nor death ocurred postoperatively. One month later, complete successful pleurodesis was achieved in 24 cases, and partial successful in 3 cases, and unsuccessful in 2 cases. The results indicate that thoracoscopy with talc pleurodesis can be regarded as a positive and effective way for the treatment of malignant pleural effusion.

BACKGROUND:Some scholars believe that for primary spontaneous pneumothorax thoracoscopic surgery and intraoperative pleurodesis can effectively reduce the recurrence rate. ＜br> OBJECTIVE:To study the reliability and validity of video-assisted thoracoscopic entoiodine pleurodesis for treatment of primary spontaneous pneumothorax. ＜br> METHODS:Videothoracoscopy procedures were performed on 64 patients with primary spontaneous pneumothorax, including 46 males and 18 females, with an age ranging from 15 to 30 years. According to the use of pleurodesis, the patients were randomly divided into two groups:experimental group and control group. In the control group, no entoiodine was used;while in the experimental group, entoiodine dipped gauze was used on the visceral pleura. The operation time, intraoperative bleeding, postoperative drainage, postoperative leakage time, postoperative extubation time, postoperative complications and the recurrence rate of pneumothorax within 1 year after operation were compared between two groups. ＜br> RESULTS AND CONCLUSION:No significance was found in the operation time, intraoperative bleeding, postoperative leakage time, postoperative extubation time and postoperative complications between the two groups (P>0.05). Although the experimental group had significantly more postoperative drainage volume than the control group (P＜0.05), there were no consequences of medical intervention. Video-assisted thoracoscopic entoiodine pleurodesis could significantly reduce the recurrence rate of pneumothorax in 1 year after operation (P＜0.05). The results show that video-assisted thoracoscopic operation with entoiodine is a reliable and effective method to reduce the recurrence of pneumothorax after operation in patients with primary spontaneous pneumothorax.

Objective To compare short-term clinical effect according to the extent of lymphadenectomy.To identify the rational lymph node dissection in patients with esophageal squamous cell carcinoma(ESCC).Methods Between January 2010 and December 2013,160 patients with ESCC received video-assisted laparothoracoscopy esophagectomy plus three-field lymphadenectomy(3FL) (86 cases)or two-field lymphadenectomy(2FL) (74 cases).Retrospectively analyzed the lymph node metastasis, postoperative complications and short-term survival rates between 3FL and 2FL.Results There was significantly differences in the number of lymph node between 3 FL(28.60 ± 3.30) and 2 FL(14.54 ± 5.59) (P ＜ 0.05) , but no significantly differences in postoperative complications between 3FL(22.09％) and 2FL(14.86％) (P ＞ 0.05).There was significantly differences in half-year survival rates between 3FL(93.02％) and 2FL(83.78％) (P ＜ 0.05).Conclusion Three field lymph oode dissection can reduce local recurrence, improve survival rate of some patients with ESCC.We suggest that esophagectomy plus three-field lymphadenectomy should be conventional.

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