Robotic lobectomy versus thoracoscopic lobectomy in treatment for clinical N0 lung malignant tumor≥3 cm: A propensity score matching study / 中国胸心血管外科临床杂志

@#Objective    To investigate the effectiveness and safety of robotic lobectomy in clinical N0 lung malignant tumor≥3 cm. Methods    We retrospectively analyzed the clinical data of 182 patients with lung malignant tumor≥3 cm receiving robotic or thoracoscopic lobectomy at Shanghai Chest Hospital in 2019. The patients were divided into a robotic surgery group (RATS group) and a thoracoscopic surgery group (VATS group). There were 39 males and 38 females with an average age of 60.55±8.59 years in the RATS group, and 51 males and 54 females with an average age of 61.58±9.30 years in the VATS group. A propensity score matching analysis was applied to compare the operative data between the two groups. Results    A total of 57 patients were included in each group after the propensity score matching analysis. Patients in the RATS group had more groups of N1 lymph node dissected (2.53±0.83 groups vs. 2.07±0.88 groups, P=0.005) in comparison with the VATS group. No statistical difference was found in operation time, blood loss, postoperative hospital stay, number of N1 and N2 lymph nodes dissected, groups of N2 lymph node dissected, lymph node upstage rate or postoperative complications. The hospitalization cost of RATS was higher than that of VATS (P<0.001). Conclusion    In contrast with thoracoscopic lobectomy, robotic lobectomy has similar operative safety, and a thorough N1 lymphadenectomy in patients with clinical N0 lung malignant tumor≥3 cm.

Application of lymphography in the location and treatment decision of chyle leakage: an analysis of 177 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To identify the value of lymphography in the location and treatment decision of chyle leakage.</p><p><b>METHODS</b>The clinic data of 177 patients suffered from chyle leakage admitted in 6 medical centers in Shanghai from February 1998 to December 2014 was analyzed retrospectively. There were 94 male and 83 female patients aging from 9 to 84 years with a mean of 49 years, including 128 cases of chyluria, 34 cases of primary chylothorax and 15 cases of other chyle leakage. All patients had failed to conservative treatment more than 2 weeks. Pedal lymphography was performed in every patient to investigate the site and range of chyle leakage. Effect of surgical or conservative management was compared according to the different results of lymphography.</p><p><b>RESULTS</b>No serious complication was noticed. For all 177 patients, lymphography showed localized lymphatic diseases in 148 cases (83.6%), including 125 cases of lymphatic renal pelvic leaks, 14 cases of unilateral identified leak within thorax and 9 cases of chyle leakage in neck, heart, abdomen or scrotum. Among these patients, surgical treatment cured 129 and improved 3 patients but failed in 2 patients, while the remaining 14 cases had their leaks decreased after lymphography and cured by conservative management. For those 15 patients having disseminated lymphatic diseases or 14 with no abnormality under lymphography, surgery only cured 2 and improved 1 patient but failed in 8 patients (with 3 death), whereas continuous conservative treatment cured 11 patients, improved 5 patients but only failed in 2 patients (with one death). For localized leakage, surgical treatment showed better efficacy (98.5% vs. 3/11), whereas conservative treatment had significantly higher successful rate than surgical interventions in patients with disseminated lymphatic diseases or no abnormality under lymphography (16/18 vs. 3/11).</p><p><b>CONCLUSIONS</b>Lymphography could identify the location and range of complicate chyle leakage failed to primary conservative management. Patients with disseminated lymphatic diseases or no abnormality under lymphography would be better managed by continuous non-operative treatment partly due to therapeutic effect of lymphography, while surgical intervention could be a good option for patients having localized lymphatic etiology.</p>

Study of treatment of cesarean section on pregnancy associated with hysteromyoma / 中国现代医生

Objective To discuss the processing method of cesarean section in pregnant women with uterine fibroids. Methods A total of 162 cases of pregnant women with uterine fibroids cesarean section from June 2010 to June 2013 were selected in our hospital, 123 cases undergoing myomectomy were chosen as excluded group, 39 cases not undergoing myomectomy were chosen as no excluded group; 100 normal cesarean patients without other complications were chosen as control group, operative time, intraoperative and postoperative bleeding of the three groups were compared;The adverse reactions, recurrence rates of excluded group and no excluded group were analyzed;Hemoglobin difference of excluded group and control group before and after surgery were analyzed. Results The operative time, intraoperative and postoperative bleeding had no significant difference among three groups (P>0.05); The incidence of adverse reactions, reoperation rate had no significant difference between excluded group and no excluded group (P<0.05);The difference of hemoglobin approximation before and after surgery in excluded group and control group was not statistically significant (P>0.05). Conclusion In patients with uterine fibroids during pregnancy cesarean, myomectomy surgery is simultaneously safe and reliable and can reduce adverse reactions, recurrence rate and surgical trauma again, so it is worthy of popularization and application.

Clinial implication of tThe expression of Aurora B in normal endometrium and endometrial carcinoma / 华中科技大学学报（医学）（英德文版）

The expression of Aurora B in normal endometria and endometrial carcinomas and its relation with clinicopathologic parameters of endometrial carcinomas were investigated. Streptavidin-biotin peroxidase (SP) immunohistochemical technique was used to detect the expression of Aurora B in 10 cases of normal proliferative phase endometria, 10 cases of normal secretory phase endometria and 72 cases of endometrial carcinomas respectively. According to the 1988 International Federation of Gynecology and Obstetrics (FIGO) grade, there were 37 patients in grade 1, 23 in grade 2 and 12 in grade 3 respectively. According to the FIGO stage, there were 59 patients in stage I-II and 13 patients in stage III-IV. Aurora B was expressed in both normal proliferative phase endometria, secretory phase endometria and endometrial carcinomas, but its positive labeling index (PLI) in proliferative phase endometria was significantly higher than that in secretory phase endometria (P1/2 myometrial invasion (all P<0.01). Aurora B exerts its functions in the replication of normal endometrial glandular cells; Expression of Aurora B is significantly correlated with biologic behavior of endometrial carcinoma, indicating that Aurora B may be a promising prognostic factor in endometrial carcinoma.

Video-assited thoracoscopic lobectomy in the treatment of clinical stage I lung cancer / 中国微创外科杂志

Objective To evaluate the outcomes of video-assisted thoracoscopic(VATS)lobectomy for patients with clinical stage I lung cancer. Methods 30 patients with clinical stage I lung cancer underwent VATS lobectomy with complete mediastinal lymphadenectomy from November 1997 to October 2000.Male 19, female 11 ranged in age from 36 to 78 years with a mean of 63 1 years. Results No perioperative death occurred .Two cases(6 67%) were given blood fransfusion and complications were found in 4 coses(13 3%).During the follow-up period lasting 12 months to 45 months with a mean of 28 7 months the overall survival rate,when all stages were calculated,was 83 3%(25/30).For stage I survival rete was 90 9%(20/22). Conclusions VATS lobectomy with systemic lymphadenectomy is a safe and reliable approach for stage I lung cancer,by which an excellent long-term outcome can be achieved.