ABSTRACT
Objective:To investigate the safety and feasibility of Ivor-Lewis procedure under uniportal video-assisted thoracoscopy(VATS) for esophageal cancer and Siewert type I esophago-gastric junction carcinoma.Methods:The patients with middle-lower segment esophageal cancer or Siewert type I esophago-gastric junction carcinoma received minimally invasive esophagectomy between October 2020 and June 2021, and the clinical data was collected and analyzed.Results:26 patients received Ivor-Lewis procedure underwent uniportal VATS, while 45 patients underwent McKeown surgery under multiport VATS. The average operation time of patients in the two groups were(265±110)min and (235±94)min, and the average intraoperative blood loss were(80±57)ml and(105±60)ml. The mean number of lymph nodes removed in the surgery were (19.3±2.9) and 18.6±2.7 respectively in two groups, and the mean length of hospital stay was(7.5±3.5)days and(8.3±2.7)days. The incidence of perioperative complications were not significantly different in two groups. The VAS score of patients received Ivor-Lewis procedure underwent uniportal VATS was lower than that of patients received McKeown surgery in ostoperative day 1, day 3, day 7 and 1 month. The difference was statistically significant in two groups( P<0.05). Conclusion:The Ivor-Lewis procedure under uniportal VATS for esophageal cancer and Siewert type I esophago-gastric junction carcinoma has the advantage of less postoperative pain, and the procedure is feasible in clinical practice.
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Objective:To explore the efficacy of total sternotomy or partial sternotomy for the treatment of isolated plasmacytoma of the sternum, and the feasibility of the chest wall reconstruction using 3D printed polyether ether ketone(PEEK) implants.Methods:In this study, a total of 6 patients with isolated plasmacytoma of sternum was enrolled, including 5 males and 1 female, aged (57.7±9.4) years old (42-71 years old). All patients received total sternotomy or partial sternotomy, and the chest wall was reconstructed using 3D-printed PEEK implant. The perioperative data and demographic characteristics of the patients were collected for statistical analysis.Results:All patients in this study had isolated plasmacytoma of sternum. Chest wall defects with mean area of (102.7±18.8)cm 2 were anatomically repaired using 3D-printed PEEK implants. No postoperative complications such as abnormal respiration was found. All 6 patients were discharged from hospital successfully, and no complications during the perioperative period were found. During the average follow-up period of(31.2±15.4)months, no implant fracture, displacement, rejection and other phenomena occurred, and no recurrence, metastasis or death occurred in postoperative patients. Conclusion:Total or partial sternotomy was an effective treatment for isolated sternum plasmocytoma . The chest wall reconstruction using 3D-printed PEEK implant was a reliable clinical treatment method.
ABSTRACT
@#Objective To explore the safety and effectiveness of a precise marking method based on body surface mesh and three-dimensional (3D) image reconstruction. Methods We retrospectively analyzed the clinical data of 22 patients in our hospital from October 2018 to October 2019. There were 13 males and 9 females aged 58.5 (37-72) years. All patients underwent a precise marking of pulmonary nodules based on body surface mesh and 3D image reconstruction. Then, video-assisted thoracoscopic surgery (VATS) was performed to resect the nodules. The clinical data, including positioning success rate and operation time were analyzed. Results A total of 22 small pulmonary nodules were removed. The average diameter of small nodules was 12±3 mm, and the average distance from the visceral pleura was 17±6 mm. The localization success rate was 86.4%. The operation time was 110±43 min, and there was no surgery-related complication. Conclusion The method of marking pulmonary nodules based on body surface mesh and 3D image reconstruction is a safe and reliable technology, which reduces the risk of hemopneumothorax caused by CT-guided lung puncture.