1.The surgical safety analysis of elderly patients with thoracic esophageal squamous cell carcinoma
Gao WU ; Dazhong WEI ; Mingran XIE ; Jieyong TIAN ; Dongchun MA
China Oncology 2014;(2):151-156
Background and purpose: The incidence rate of elderly esophageal carcinoma patients is increasing year by year. In this study, the clinicopathologic factors, operational factors and postoperative complications were compared between the older and the younger elderly patients with thoracic esophageal squamous cell carcinoma (ESCC), and the influence of different surgical approaches to older elderly patients were analyzed. Methods: A retrospective review of 371 cases of elderly patients with thoracic esophageal squamous cell carcinoma (≥60 years) between Jan. 2006 and Dec. 2008 were performed. The patients were divided into two age groups. The patients over 75 years old named the older elderly group including 53 patients, and the patients between 60-74 years named the younger elderly group including 318 patients, the clinicopathological factors, operational factors, postoperative hospital mortality and average length of stay were compared. Meanwhile, according to different surgical approaches, the comparison of the left chest and right chest approach of operative time, blood loss and postoperative complication rate, and so on and so forth. Results: The older elderly group compared with the younger elderly group had more preoperative complications. Preoperative ASA classiifcation and postoperative complications, length of stay and hospital mortality rates were signiifcantly higher. The older elderly group over the right chest approach had less postoperative complications, especially pulmonary complications, the results were statistically signiifcant.(13.0%vs 40.0%,P<0.05) Conclusion: The patients over 75 years old with thoracic esophageal squamous cell carcinoma have a higher risk during the operation, we can choose relatively simpler operation approach to reduce the incidence of postoperative complications, especially pulmonary complications.
2.Video-assisted thoracoscopic surgery and conventional radical operation on stage Ⅰ , Ⅱ esophageal cancer
Baochuan XU ; Meiqing XU ; Dazhong WEI ; Dongchun MA ; Mingfa GUO ; Baolin RONG ; Xinyu MEI ; Shibin XU
Chinese Journal of Postgraduates of Medicine 2010;33(14):13-15
Objective To compare the results and safety between video-assisted thoracoscopic surgery ( VATS ) and conventional radical operation in patients with stage Ⅰ , Ⅱ esophageal cancer. Methods Retrospectively reviewed 43 patients with stage Ⅰ , Ⅱ esophageal cancer,underwent either VATS radical operation (VATS group,16 cases) or conventional radical operation (control group,27 cases ) from September 2007 to September 2009. Patient's operative characteristics and postoperative courses were compared between two groups. Results In VATS group the operation time was ( 115.6 ± 48.0) min,the peri-operative blood loss was ( 131 ± 71 ) ml,the first postoperative day chest lead quantity was (331 ± 170)ml, the time of postoperative chest tube was (7.25 ± 2.35) d,the postoperative 36 h visual analogue scale (VAS) was (3.4 ± 1.2) scores,the postoperative drainage of chest was ( 1281 ± 534) ml,the 72 h postoperative locomotor activity of right upper extremity was (5.1 ± 1.5) cm. While in control group was ( 145.6 ± 20.6)min, (292 ± 111 ) ml, (494 ± 194) ml, ( 10.00 ± 2.79 )d, (7.3 ± 1.4) scores, ( 1780 ± 731 ) ml, ( 15.6 ± 3.1 )cm respectively (P < 0.01 or < 0.05 ). The lymph node dissection number,the total cost of hospital between were no statistically significant differences in two groups (P >0.05). Conclusion Comparing with conventional radical operation, VATS radical operation for patients with stage Ⅰ , Ⅱ esophageal cancer appears to be as effective but less morbid.
4.Super-minimally invasive bilateral thoracoscopic extended thymectomy
Wei WANG ; Dazhong LIU ; Hao XU ; Yi LI ; Lei YANG ; Linyou ZHANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(3):135-136
Objective To present the technique of super-minimally invasive bilateral thoracoscopic extended thymectomy,and evaluate the early clinical results by using of this technique.Methods Twenty-three patients with myasthenia gravis (MG) with thymoma underwent with super-minimally invasive bilateral thoracoscopic extended thymectomy in our institution between July 2014 and January 2016.Two operate-poles are 5mm trocar,one is three intercostal space at the anterior axillary line,and the other is four intercostal space at the midclavicular line.A 10 mm trocar is inserted through the 6th intercostal space in the mid axillary line.The perioperative variables and outcomes were collected and analysed retrospectively.Results In the 23 patients who underwent Super-Minimally invasive bilateral thoracoscopic extended thymectomy,the mean operation time was (163.2 ± 14.4) min and the average blood loss was (148.2 ± 39.5) ml.The chest tube duration was (4.14 ± 0.27) days.There were no mortalities.Conclusion Our preliminary report showed that Super-Minimally invasive bilateral thoracoscopic extended thymectomy for mediastinal tumour resection was a promising and safe technique with regard to short-term clinical outcome.
5.Application of new ERCC1 antibody for molecular diagnosis of platinum chemotherapy in non-small cell lung cancer
Jing LUO ; Meiqing XU ; Mingfa GUO ; Dazhong WEI ; Changqing LIU ; Xiangxiang SUN
China Oncology 2014;(2):135-138
Background and purpose:High expression of excision repair cross-complementing 1 (ERCC1) is related to resistance in patients treated with platinum-containing regimens. The ERCC1 antibody 8F1 was usually used in past studies, but it was found to have no-speciifcity recently. This study aimed to investigate the predictive role of a new ERCC1 antibody 4F9 to platinum chemotherapy in non-small cell lung cancer (NSCLC) patients. Methods:Expression of ERCC1 was detected using antibody 4F9 by immunohistochemistry (IHC) in 72 NSCLC tissues. The relationship between the expression of ERCCl and the clinical pathological parameters, the efficacy of platinum chemotherapy and overall survival of patients were explored by statistical analysis. Results: The high expression of ERCCl protein was 55.5%in 72 cases. There was no signiifcant correlation between the ERCC1 expression with gender, age, pathological type, clinical stage and lymphatic metastasis (P>0.05). Patients with low expression of ERCC1 had signiifcantly higher response rates to platinum chemotherapy, longer median survival time and 2-years survival rate comparing with those with high expression of ERCC1 (62.5%vs 37.5%;22.9 vs 18.4 month;46.9%vs 37.5%), respectively (P<0.05). Conclusion:The expression analysis of ERCC1 using new ERCC1 antibody 4F9 by IHC method is helpful to assign chemotherapeutic regimen, and guide individual platinum chemotherapy for post-operation patients.