BACKGROUND: Currently, there are many reports on the advantages of three portal video-assisted thoracic surgery (VATS) in the treatment of lung cancer, but there are few reports on the comparison between uniportal and three portal video-assisted thoracic surgery. In this study, we aimed to evaluate the recent curative effect of the postoperative short-term quality of life between uniportal and three portal video-assisted thoracic surgery for non-small cell lung cancer. METHODS: We retrospectively evaluated 266 patients with NSCLC who underwent intended VATS lobectomy by a single surgical team in our ward between January 2016 and August 2017. The general clinical date, perioperative data and short-term life quality were individually compared and analyzed between the two groups. RESULTS: The two groups were similar in terms of clinicopathological features, total number of dissected lymph nodes and nodal stations, postoperative complications and pulmonary complications (P>0.05). Compared with three portal VATS, the intraoperative blood loss, chest tube duration, postoperative thoracic drainage, length of stay and NRS score were significantly decreased in uniportal VATS, with significant differences (P<0.05). CONCLUSIONS As a more minimally invasive surgery, uniportal VATS can be safely and effectively performed for resectable lung cancer, which would achieve even better operation curative effect than three portal VATS.
Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Humans ; Lung ; pathology ; surgery ; Lung Neoplasms ; pathology ; surgery ; Middle Aged ; Operative Time ; Postoperative Complications ; etiology ; Quality of Life ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; adverse effects ; methods ; Treatment Outcome

BACKGROUND: The morbidity of lung cancer has long been the highest in cancer. Stage I, stage II and partly of stage III non-small cell lung cancer (NSCLC) are mainly treated by surgery. Lobectomy and segmentectomy both are common lung resection methods. Video-assisted thoracoscopic surgery (VATS) has been widely used in clinical, and the application of single-portvideo-assisted thoracoscopic surgery (SP VATS) has gradually been recognized and accepted by professors. With increasing degree of eldly in society, eldly patients already have become inceasingly difficulties in the diagnosis and treatment of NSCLC. The aim of this study is to explore and analyze clinical value of SP VATS lobectomy and segmentectomy in elderly patients with NSCLC. METHODS: In this retrospective observational study, the outcomes of 417 consecutive patients who had undergone SP VATS anatomic segmentectomy or lobectomy for NSCLC from May 2014 to December 2016 on department of thoracic surgery in Fujian Medical University Affiliated Union Hospital were examined, including 139 elderly-case (lobectomy vs segmentectomy: 124 vs 15) and 278 nonelderly-case (lobectomy vs segmentectomy: 248 vs 30). The condition of perioperative period and postoperative short-time recovery could be compared with lobectomy and segmentectomy between elderly and nonelderly cases and lobectomy and segmentectomy in elderly cases. RESULTS: The morbidty of preoperative complications was significant difference (P<0.05) in comparing with elderly and non-elderly patients with NSCLC either in SP VATS anatomic segmentectomy orlobectomy, except others is no significant difference (P>0.05). Numbers of dissected lymph nodes and mediastinal nodal stations of SP VATS lobectomy in elderly patients with NSCLC were more than segmentectomy (P<0.05), which were (7.61±0.21) vs (20.39±0.97) and (5.60±0.35) vs (15.40±2.64). But there was not significant difference between two elderly groups of SP VATS lobectomy and anatomic segmentectomy in age, morbidty of preoperative complications, average operation time and intraoperative blood loss (P>0.05). Postoperative drainage volume [(1,150.15±140.02) mL vs (853.53±177.04) mL] and duration [(7.00±1.31) d vs (5.00±0.74) d], duration of postoperative hospital stay [(3.18±1.32) d vs (5.04±1.30) d], costs [(70.06±5.23) thousands yuan vs (61.20±5.22) thousands yuan ] or postoperative complications (5.97% vs 20.00%)(P>0.05). Notwithstanding, group of SP VATS anatomic segmentectomy found more postoperative atrialfibrillation and the vein thrombosis of lower limbs (P<0.05). CONCLUSIONS Elderly patients having more basic diseases and taking increasely risk of postoperative complications. SP VATS anatomic segmentectomy andlobectomy do not increase the risk of elderly patients with surgery. SP VATS segmentectomy is as safe and effective as SP VATS lobectomy in elderly patients, who fit to undergo SP VATS segmentectomy seem to get as same short-time effect as SP VATS lobectomy.
Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Humans ; Length of Stay ; Lung Neoplasms ; pathology ; surgery ; Lymph Node Excision ; Male ; Mastectomy, Segmental ; methods ; Middle Aged ; Pneumonectomy ; methods ; Postoperative Complications ; etiology ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; methods

No abstract available.
Adult ; Biopsy ; Disease Progression ; Fatal Outcome ; Humans ; Lung Neoplasms/*complications/diagnostic imaging/secondary/surgery ; Lymphatic Metastasis ; Male ; Pleural Effusion, Malignant/diagnostic imaging/*etiology/therapy ; Pneumothorax/diagnostic imaging/*etiology/therapy ; Sarcoma/*complications/diagnostic imaging/secondary/surgery ; Soft Tissue Neoplasms/*pathology ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: To investigate associations between dyspnea and clinical outcomes in patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: From 2001 to 2014, we retrospectively reviewed the prospective lung cancer database of St. Paul's Hospital at the Catholic University of Korea. We enrolled patients with NSCLC and evaluated symptoms of dyspnea using modified Medical Research Council (mMRC) scores. Also, we estimated pulmonary functions and analyzed survival data. RESULTS: In total, 457 NSCLC patients were enrolled, and 259 (56.7%) had dyspnea. Among those with dyspnea and whose mMRC scores were available (109 patients had no mMRC score), 85 (56.6%) patients had an mMRC score <2, while 65 (43.3%) had an mMRC score ≥2. Significant decreased pulmonary functions were observed in patients with dyspnea. In multivariate analysis, aging, poor performance status, advanced stage, low forced expiratory volume in 1 second (%), and an mMRC score ≥2 were found to be significant prognostic factors for patient survival. CONCLUSION: Dyspnea could be a significant prognostic factor in patients with NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung/complications/pathology/*physiopathology ; Dyspnea/*etiology/*physiopathology ; Female ; Forced Expiratory Volume ; Humans ; Lung Neoplasms/complications/pathology/*physiopathology ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Severity of Illness Index

Herein, we report a rare case of concurrent gastric and pulmonary mucosa-associated lymphoid tissue (MALT) lymphomas. A 65-year-old man who had been diagnosed with Helicobacter pylori-positive gastric MALT lymphoma received eradication therapy and achieved complete remission. During follow-up, he developed de novo pulmonary MALT lymphoma as a sequela of pulmonary tuberculosis, accompanied by recurrent gastric MALT lymphoma. Polymerase chain reaction (PCR) products of the CDR3 region of the immunoglobulin heavy chain gene showed an overall polyclonal pattern with bands at 400 base pairs (bp) and 200 bp predominant in the pulmonary tissue, as well as two distinctive bands in the gastric tissue at 400 bp and 200 bp. This case suggests that multiorgan lymphomas are more likely to be independent from each other when they are far apart, involve different organ systems, and have independent precipitating factors.
Aged ; Gastric Mucosa/pathology ; Humans ; Inflammation/pathology ; Lung Neoplasms/etiology/*pathology ; Lymphoma, B-Cell, Marginal Zone/etiology/*pathology ; Male ; Respiratory Mucosa/pathology ; Stomach Neoplasms/etiology/*pathology ; Tuberculosis, Pulmonary/complications

Herein, we report a rare case of concurrent gastric and pulmonary mucosa-associated lymphoid tissue (MALT) lymphomas. A 65-year-old man who had been diagnosed with Helicobacter pylori-positive gastric MALT lymphoma received eradication therapy and achieved complete remission. During follow-up, he developed de novo pulmonary MALT lymphoma as a sequela of pulmonary tuberculosis, accompanied by recurrent gastric MALT lymphoma. Polymerase chain reaction (PCR) products of the CDR3 region of the immunoglobulin heavy chain gene showed an overall polyclonal pattern with bands at 400 base pairs (bp) and 200 bp predominant in the pulmonary tissue, as well as two distinctive bands in the gastric tissue at 400 bp and 200 bp. This case suggests that multiorgan lymphomas are more likely to be independent from each other when they are far apart, involve different organ systems, and have independent precipitating factors.
Aged ; Gastric Mucosa/pathology ; Humans ; Inflammation/pathology ; Lung Neoplasms/etiology/*pathology ; Lymphoma, B-Cell, Marginal Zone/etiology/*pathology ; Male ; Respiratory Mucosa/pathology ; Stomach Neoplasms/etiology/*pathology ; Tuberculosis, Pulmonary/complications

Abdominal Neoplasms ; complications ; secondary ; therapy ; Acute Lung Injury ; diagnostic imaging ; etiology ; Anemia ; complications ; therapy ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child, Preschool ; Etoposide ; administration & dosage ; Fluoroscopy ; Humans ; Ifosfamide ; administration & dosage ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; complications ; secondary ; therapy ; Male ; Postoperative Complications ; diagnostic imaging ; etiology ; Prosthesis Implantation ; Radiography, Thoracic ; Radiotherapy ; Respiratory Distress Syndrome, Adult ; diagnostic imaging ; etiology ; Transfusion Reaction ; Vascular Access Devices

Malignant airway obstruction and hemoptysis are common in lung cancer patients. Recently, airway stent is commonly used to preserve airway in malignant airway obstruction. Hemoptysis can be managed through various methods including conservative treatment, endobronchial tamponade, bronchoscopic intervention, embolization and surgery. In our case studies, we sought to investigate the effectiveness of airway stents for re-opening the airway as well as tamponade effects in four patients with malignant airway obstruction and bleeding caused by tumors or lymph node invasions.
Aged ; Airway Obstruction/*etiology/pathology/*therapy ; Alloys ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung/*complications ; Fatal Outcome ; Fluoroscopy ; Hemoptysis/*etiology/pathology/*therapy ; Humans ; Lung Neoplasms/*complications ; Male ; Middle Aged ; *Stents

OBJECTIVETo investigate the clinicopathologic features of pulmonary capillary hemangiomatosis (PCH).

METHODSThe clinical and pathologic profiles of 2 PCH cases were evaluated. Immunohistochemical study (EnVision method) was performed on fixed tissues. The biologic behavior was analyzed with follow-up data.

RESULTSThe main presenting symptom was dyspnea. Chest radiography of the two cases depicted diffuse, ground-glass nodules, accompanied by enlarged central pulmonary arteries. Microscopically, the most distinctive feature was proliferation of capillary channels within pulmonary interstitium and alveolar walls, accompanied by muscularization of arterioles. Immunohistochemical study showed an abundance of mast cells in the lesion, and staining for platelet-derived growth factor receptor-beta (PDGFR-β) localized to vascular smooth muscles surrounding the proliferating capillaries and the mast cells. The index of Ki-67 was less than 1 percent and the p53 was negative.

CONCLUSIONSPCH is a rare vascular proliferative disease of yang patients. Increased number of mast cell and the up-regulation of PDGFR-β may suggest mechanism for PCH. The clinical and radiologic diagnosis of PCH can be very difficult, and the histological examination is regarded as the most reliable means to establish the diagnosis. Pathologists should improve their knowledge on PCH.

Adult ; Female ; Follow-Up Studies ; Hemangioma, Capillary ; complications ; diagnostic imaging ; metabolism ; pathology ; Humans ; Hypertension, Pulmonary ; etiology ; Lung Neoplasms ; complications ; diagnostic imaging ; metabolism ; pathology ; Male ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Proto-Oncogene Proteins c-kit ; metabolism ; Receptor, Platelet-Derived Growth Factor beta ; metabolism ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo compare the short-term outcomes of surgical treatment for non-small cell lung cancer (NSCLC) by video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT).

METHODSData of 737 consecutive NSCLC patients who underwent surgical treatment for non-small cell lung cancer by video-assisted thoracoscopic surgery and 630 patients who underwent pulmonary resection via open thoracotomy (as controls) in Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and August 2011 were retrospectively reviewed. The risk factors after lobectomy were also analyzed.

RESULTSIn the 506 NSCLC patients who received VATS lobectomy, postoperative complications occurred in 13 patients (2.6%) and one patient died of acute respiratory distress syndrome (0.2%). In the 521 patients who received open thoracotomy (OT) lobectomy, postoperative complications occurred in 21 patients (4.0%) and one patient died of pulmonary infection (0.2%). There was no significant difference in the morbidity rate (P > 0.05) and mortality rate (P > 0.05) between the VATS group and OT group. In the 190 patients who received VATS wedge resections, postoperative complications occurred in 3 patients (1.6%). One hundred and nine patients received OT wedge resections. Postoperative complications occurred in 4 patients (3.7%). There were no significant differences for morbidity rate (P = 0.262) between these two groups, and there was no perioperative death in these two groups. Univariate and multivariate analyses demonstrated that age (OR = 1.047, 95%CI: 1.004 - 1.091), history of smoking (OR = 6.374, 95%CI: 2.588 - 15.695) and operation time (OR = 1.418, 95%CI: 1.075 - 1.871) were independent risk factors of postoperative complications.

CONCLUSIONSTo compare with the NSCLC patients who should undergo lobectomy or wedge resection via open thoracotomy, a similar short-term outcome can be achieved via VATS approach.

Age Factors ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Female ; Humans ; Length of Stay ; Lung Neoplasms ; mortality ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Operative Time ; Pneumonectomy ; adverse effects ; classification ; methods ; Postoperative Complications ; etiology ; Respiratory Distress Syndrome, Adult ; etiology ; Retrospective Studies ; Smoking ; Thoracic Surgery, Video-Assisted ; adverse effects ; Thoracotomy ; adverse effects ; methods