3.Mediastinoscopy for the diagnosis and differential diagnosis of undifferentiated mediastinal diseases.
Chinese Journal of Minimally Invasive Surgery 2001;0(05):-
Objective To evaluate the value of mediastinoscopy in the diagnosis of undifferentiated mediastinal diseases. Methods A total of 35 mediastinoscopies were performed for patients with undifferentiated mediastinal disease from November 1999 to February 2002 and suspicious tissues at peritracheal,retrosternal,subcarinal,or bilateral hilar areas were obtaiued for pathological examination. Results Thirty four of 35 patients with undetermined mediastinal diseases had definite pathologic diagnosis.The diagnosis accuracy was 97%(34/35).Of the 34 patients,18 were diagnosed as malignant accounting for 52.9%.Sixteen of the 34 were diagnosed as benign,accounting for 47.1%.The diagnostic consistency of preoperation and postoperation was 47.1%(16/34).The misdiagnosis of preoperation was 52.9%(18/34).In this series,the benigns were apt to lead to misdiagnosis.10 of 16 patients with benign disease were diagnoscd as initially malignancies,representing 62.5%.In the entire group one patient had complications (2.9%).Yet no perioperative death occurred. Conclusions Mediastinoscopy is a valuable procedure which helps mede a correct diagnosis of mediastinal diseases.Given its safety and usefulness It is suggested that mediastinoscopy should be used routinely in the diagnosis of undifferentiated mediastinal diseases.
4.Video-mediastinoscopy in the diagnosis of mediastinal tumor and the staging of lung cancer
Chinese Journal of Minimally Invasive Surgery 2001;0(01):-
1.0 cm) by radiographic examinations, video-mediastinoscopy showed positive results in 30 cases, and negative in 14 cases, in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes. No postoperative complications and mortality were observed. Conclusions Video-mediastinoscopy offers clear operation field, high resolution, convenient application, safety and reliability. We suggest that it be adopted as a routine method in the diagnosis of mediastinal tumor and the staging of lung cancer.
5.Mediastinoscopy with biopsy on R4 lymph node in lung cancer patients
Chinese Journal of Thoracic and Cardiovascular Surgery 2003;0(06):-
Objective To evaluate the role of mediastinoscopy with biopsy on right trachea-bronchial lymph node (R4) in the diagnosis and pathologic staging of lung cancer. Methods From November 1999 to May 2004, sixty-six patients with lung cancer (47 right and 19 left) received mediastinoscopic biopsy on R4 lymph node. 17 patients were preoperative diagnosed and 49 suspected have lung cancer. The approach included cervical mediastinoscopy in 62 cases, parasternal mediastinoscopy in 1 and cervical combined with parasternal mediastinoscopy in 3. Results In total 66 patients, R4 lymph node positive was found in 49 cases, including 38 patients with right lung cancer and 11 with left lung cancer. The metastasis rate in small cell lung cancer, adenocarcinoma and squamous cell carcinoma were 100%, 82.2% and 52%, respectively. For 49 preoperatively suspected lung cancer patients, malignant tumor was confirmed by mediastinoscopy with biopsy in 40 and open thoracic surgery in 9. All the operations were successful and the patients recovered smoothly without severe postoperative complications. Conclusion R4 lymph node is one of the most common and important site for the tumor metastasis in lung cancer. Mediastinoscopy with biopsy on R4 lymph node has incomparable advantages in diagnosis and staging lung cancer over other examinations and biopsy on other sites of lymph nodes.
6.Video-mediastinoscopy vs. standard mediastinoscopy in clinical application
Chinese Journal of Thoracic and Cardiovascular Surgery 2003;0(03):-
Objective: To compare the clinical value of video-mediastinoscopy (VM) and standard mediastinoscopy(SM) in diagnosis of thoracic diseases. Methods: The clinical data of 100 patients with mediastinoscopy were studied retrospectively. Of them, 54 patients underwent VM, and 46 patients underwent SM. The operative parameters including operating time, complications and post-operative hospital stay, the diagnosis accuracy of undifferentiated mediastinal diseases and the accuracy of perioperative staging of lung cancer were compared. Results: The average operating time in VM group was (53.9?17.2) mins, which was less than that in SM group (69.4?24.7)mins (t=2.05,P
9.Clinical significance of serum hyaluronic acid,procollagen type Ⅲ, collagen type Ⅳ and laminin in patients with chronic renal failure
Jun CHEN ; Lan ZHAO ; Songjiao WANG
Chinese Journal of Postgraduates of Medicine 2014;37(10):39-40
Objective To investigate the chronic renal failure (CRF) patients with serum hyaluronic acid (HA),procollagen type Ⅲ (PC-Ⅲ),collagen type Ⅳ (C-Ⅳ) and laminin (LN) joint detection of clinical significance.Methods Using chemiluminescence method in 80 cases of CRF patients (CRF group) and 60 healthy (control group) serum HA,PC-Ⅲ,C-Ⅳ and LN for joint detection and comparison.Results The serum HA,PC-Ⅲ,C-Ⅳ in CRF group was significantly higher than that in control group [(305.37 ± 41.28) μ g/L vs.(73.26 ± 21.21) μ g/L,(236.39 ± 56.63) μ g/L vs.(68.46 ± 32.55) μtg/L,(112.54 ±26.73) μg/L vs.(55.36 ± 18.44) μg/L] (P <0.01).The LN there was no statistically significant difference between two groups (P > 0.05).Conclusion Detecting HA,PC-Ⅲ,C-Ⅳ for the early diagnosis and therapeutic efficacy observation of patients with CRF has important clinical significance.
10.Lobectomy by video-assisted thoracoscopic surgery versus thoracotomy for clinical stage Ⅰ / Ⅱ non-small cell lung cancer: a multi-center comparative study
Xin ZANG ; Hui ZHAO ; Jun WANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2014;30(5):285-289
Objective To compare safety,completeness and long-term results between lobectomy by video-assisted thoracoscopic surgery(VATS) and thoracotomy for clinical stage Ⅰ / Ⅱ non-small cell lung cancer(NSCLC).Methods Between July 2010 and December 2011,673 patients with clinical stage Ⅰ / Ⅱ NSCLC from 11 hospitals underwent pulmonary lobectomy(425 VATS,248 thoracotomy).Patients were matched by propensity score matoh method to create two comparable groups,402 patients remained eligible for analysis,with 201 patients in each group.Perioperative variables and follow-up results were compared between the two groups.Results Patients characteristics were comparable between the two groups,except for a slight lower preoperative FEV1,FEV1% and FEV1/FVC in the VATS group (P < 0.05).There was one postoperative death in each group.There was no significant difference in operative time,mediastinal lymph nodes stations/numbers dissected and postoperative drainage time between the two groups.The operative blood loss was lower in the VATS group(P < 0.001),the mean hospital stay was shorter in the VATS group(P < 0.001).Postoperative pneumonia/pulmonary atelectasis rate was lower in the VATS group than in the thoracotomy group (5.1% vs.10.4%,P < 0.05).Median follow-up time was 20 months in both groups.One-year and two-year recurrence-free survival was 90% vs.88% and 80% vs.70%,respectively(P =0.163).One-year and two-year overall survival were 96% vs.95% and 88% vs.85%,respectively(P =0.226).Conclusion For clinical stage Ⅰ / Ⅱ NSCLC,VATS lobectomy is a feasible procedure with shorter hospital stay and less complications,while its surgical and oncologic outcome is comparable to that of thoracotomy lobectomy.