scholarly journals Simultaneous Bilateral Thoracoscopic Pneumonectomy for Early Multiple Primary Lung Cancer Feasibility Analysis

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Zhonglong Zheng ◽  
Tao Li ◽  
Yang Chen ◽  
Yang Zhang ◽  
Pan Zhang

Objective: To analyze the feasibility of simultaneous bilateral thoracoscopic lung resection in the treatment of multiple primary lung cancers in the early stage. Methods: The study time range is between March 2019 and March 2021. A sample of 30 patients with early multiple primary lung cancer admitted to this hospital were included, and they were divided into a study group, a control group, and samples within the group using a random number table scheme n=15, patients in the control group underwent staged bilateral thoracoscopic pneumonectomy, and patients in the study group underwent bilateral thoracoscopic pneumonectomy at the same time. The indicators of the two groups were compared and analyzed. Results: There was no significant difference in the operation time and intraoperative blood loss between the two groups (P>0.05). There were significant differences in the VAS score, total length of hospital stay, and total surgical costs on the first day after surgery (P<0.05); there was no significant difference in the two groups' postoperative recovery indicators and the incidence of complications (P>0.05). Conclusion: It is safe and feasible to treat patients with multiple primary lung cancer in both lungs at the same time with simultaneous bilateral thoracoscopic surgery, and is suitable for promotion.

2021 ◽  
Vol 5 (4) ◽  
pp. 220-224
Author(s):  
Chengxi Chi ◽  
Mengmeng Zhao ◽  
Jiajing He ◽  
Yanli Wang

Objective: To investigate and analyze the anesthetic effect of compound artevacaine hydrochloride in patients undergoing oral implantation. Methods: In this study, 60 patients receiving oral implant surgery in our hospital were selected as the research subjects, and the operation time was from July 2019 to March 2021. Patients were randomly selected and divided into groups for the study. 30 patients receiving lidocaine hydrochloride anesthesia were used as the control group, and 30 patients receiving compound artevacaine hydrochloride anesthesia were used as the research group. The anesthetic effect and safety of the two groups were compared and analyzed. Results: The anesthetic effect of the study group was significantly better than that of the control group (P < 0.05). The blood pressure and heart rate in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups before anesthesia (P > 0.05). There was no significant difference in the incidence of ADR between the two groups (P > 0.05). Conclusions: For patients undergoing oral implant surgery, choosing compound artevacaine hydrochloride as anesthetic drug has obvious anesthetic effect and can stabilize patients' life indexes. The anesthetic effect is obvious, and there is no obvious adverse reaction, and the clinical value is obvious.


2021 ◽  
Vol 11 ◽  
Author(s):  
Guotian Pei ◽  
Mingwei Li ◽  
Xianjun Min ◽  
Qiang Liu ◽  
Dasheng Li ◽  
...  

ObjectiveThe incidence of early stage multiple primary lung cancer (MPLC) has been increasing in recent years, while the ideal strategy for its diagnosis and treatment remains controversial. The present study conducted genomic analysis to identify a new molecular classification method for accurately predicting the diagnosis and therapy for patients with early stage MPLC.MethodsA total of 240 tissue samples from 203 patients with multiple-non-small-cell lung cancers (NSCLCs) (n = 30), early stage single-NSCLC (Group A, n = 94), and advanced-stage NSCLC (Group B, n = 79) were subjected to targeted multigene panel sequencing.ResultsThirty patients for whom next-generation sequencing was performed on &gt;1 tumor were identified, yielding 45 tumor pairs. The frequencies of EGFR, TP53, RBM10, ERBB2, and CDKN2A mutations exhibited significant differences between early and advanced-stage NSCLCs. The prevalence of the EGFR L858R mutation in early stage NSCLC was remarkably higher than that in advanced-stage NSCLC (P = 0.047). The molecular method classified tumor pairs into 26 definite MPLC tumors and four intrapulmonary metastasis (IM) tumors. A high rate of discordance in driver genetic alterations was found in the different tumor lesions of MPLC patients. The prospective Martini histologic prediction of MPLC was discordant with the molecular method for three patients (16.7%), particularly in the prediction of IM (91.7% discordant).ConclusionsComprehensive molecular evaluation allows the unambiguous delineation of clonal relationships among tumors. In comparison, the Martini and Melamed criteria have notable limitations in the recognition of IM. Our results support the adoption of a large panel to supplement histology for strongly discriminating NSCLC clonal relationships in clinical practice.


BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ting-Fei Chen ◽  
Chun-Ying Xie ◽  
Bing-Yu Rao ◽  
Shi-Chao Shan ◽  
Xin Zhang ◽  
...  

Abstract Background As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and meta-analysis. Methods Relevant literature was obtained from three databases including PubMed, Embase and Web of Science. Inclusion and exclusion criteria were set for the screening of articles to be selected for further conduction of systemic review and meta-analysis. The HRs of OS of the sublobar group compared with standard resection group were extracted directly or calculated indirectly from included researches. Results Ten researches published from 2000 to 2017 were included in this study, with 468 and 445 MPLC cases for the standard resection group and sublobar resection group respectively. The result suggested that OS of MPLC patients underwent sublobar resection (segmentectomy or wedge resection for at least one lesion) was comparable with those underwent standard resection approach (lobectomy or pneumonectomy for all lesions), with HR 1.07, 95% CI 0.67–1.71, p = 0.784. Further analysis found no difference in subgroups of synchronous and metachronous (from second metachronous lesion), different population region and dominant sex type. Conclusions This study may reveal that sublobar resection is acceptable for patients with MPLC at an early stage, because of the equivalent prognosis to the standard resection and better pulmonary function preservation. Further research is needed to validate these findings.


2021 ◽  
Author(s):  
Panpan Zhang ◽  
Dan Liu ◽  
Dong Luo ◽  
Fuli Pang

Abstract Background To investigate the effects of modified subxiphoid thoracoscopic surgery and traditional surgery on pain mediators and pain stress levels in patients with anterior mediastinal teratoma. Method Eighty patients with anterior mediastinal teratoma who underwent surgery in our hospital from May 2019 to May 2021 were selected as the subjects of this prospective study. According to the random residue grouping method, they were divided into a control group and observation group with 40 cases each. Among them, the control group underwent traditional surgery, and the observation group underwent modified subxiphoid thoracoscopic surgery. Observe and compare the surgical indicators, pain-causing mediators, and pain stress levels of the two groups of patients. Result The intraoperative blood loss, postoperative extubation time, and total drainage volume of the observation group were significantly lower than those of the control group, while the operation time was significantly higher than that of the control group, which was statistically significant (P < 0.05). There was no statistically significant difference in the pain-causing mediators of the two groups before surgery (P > 0.05), while the NPY, PGE2 and 5-HT at 1 day after surgery were significantly different, and the observation group was better than the control group. The comparison was statistically significant. Significance (P < 0.05). There was no statistically significant difference in pain stress levels between the two groups before surgery (P > 0.05), while NO, IL-6, and IL-β 1 day after surgery were significantly different, and the observation group was better than the control group. Statistically significant (P < 0.05). Conclusion The modified subxiphoid thoracoscopic surgery has a significant effect, reduces the level of peripheral blood pain-causing factors, relieves the pain of the patient, and promotes the recovery of the patient. It provides a certain reference for the mediastinal teratoma before the clinical operation.


2019 ◽  
Author(s):  
Ting-Fei Chen ◽  
Chun-Ying Xie ◽  
Bing-Yu Rao ◽  
Shi-Chao Shan ◽  
Xin Zhang ◽  
...  

Abstract Background As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and meta-analysis. Methods Relevant literature was obtained from three databases including PubMed, Embase and Web of Science. Inclusion and exclusion criteria were set for the screening of articles to be selected for further conduction of systemic review and meta-analysis. The HRs of OS of the sublobar group compared with standard resection group were extracted directly or calculated indirectly from included researches. Result s: Ten researches published from 2000 to 2017 were included in this study, with 468 and 445 MPLC cases for the standard resection group and sublobar resection group respectively. The result suggested that OS of MPLC patients underwent sublobar resection (segmentectomy or wedge resection for at least one lesion) was comparable with those underwent standard resection approach (lobectomy or pneumonectomy for all lesions), with HR 1.07, 95% CI 0.67 - 1.71, p = 0.784. Further analysis found no difference in subgroups of synchronous and metachronous (from second metachronous lesion), different population region and dominant sex type. Conclusions This study may reveal that sublobar resection is acceptable for patients with MPLC at an early stage, because of the equivalent prognosis to the standard resection and better pulmonary function preservation. Further research is needed to validate these findings.


2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Xi Zhang

Objective: To analysis of the effect of video-assisted thoracoscopic surgery on immune function and survival in patients with early stage lung cancer undergoing radical operation. Methods From August 2009 to May 2011, 96 cases of early stage lung cancer undergoing radical operation patients were studied in our hospital.According to the simple random method were divided into control group and observatio n group, each group of 48 patients. The control group underwent thoracotomy and resection of lung cancer and the observation group underwent endoscopic resection of lung cancer. Comparison of the two groups of patients with surgery, immune parameters, quality of life and prognosis. Results The operation situation of the two groups were compared, found no significant difference between the two groups of patients with operation time (P>0.05), but the amount of intraoperative bleeding, postoperative drainage, extubation time and postoperative ambulation time were significantly lower than the control group (P<0.05); two groups of patients before and after surgery, IgA IgM had no significant difference (P>0.05), and IgG patients aftersurgery is higher than the level before surgery, andCD3+,CD4+,CD8+T cell fraction less than before the surgery, compared with statistical significance (P<0.05); the patients in the observation group 1 days after IgG was significantly higher than control group, and CD3+,CD4+,CD8+T cell fraction in 1 days after surgery was lower than that of control group, compared with statistical significance (P<0.05); the control group of patients with 5 year survival rate was 43.75% and the observation group patients 5 year survival rate was 56.25%. Two groups of patients with 5 year survival rate, recurrence rate and distant metastasis showed no significant difference (p>0.05). But the recurrence time of the observation group was significantly higher than the control group (P<0.05); the two groups of patients after treatment, the physiological status, social / family status, emotional status, functional status, additional lung cancer status was better than that before treatment (P<0.05), and the observation group of patients with physiological status, social / family, emotional status, functional status, additional lung cancer status was significantly better than the control group (P<0.05). Conclusion Compared with thoracotomy, video assisted thoracoscopic surgery for early lung cancer resection, with small trauma, short recovery time of patients with, and has little effect on the immune function of patients, prolong the recurrence time of patients, improve the quality of life of patients.


Cancers ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 242
Author(s):  
Chi-Lu Chiang ◽  
Ping-Chung Tsai ◽  
Yi-Chen Yeh ◽  
Yuan-Hung Wu ◽  
Han-Shui Hsu ◽  
...  

With the wide application of computed tomography in lung cancer screening, the incidence of multiple primary lung cancer (MPLC) has been increasingly reported. Despite the established criteria, the differentiation between MPLC and intrapulmonary metastasis remains challenging. Although histologic features are helpful in some circumstances, a molecular analysis is often needed. The application of next-generation sequencing could aid in distinguishing MPLCs from intrapulmonary metastasis, decreasing ambiguity. For MPLC management, surgery with lobectomy is the main operation method. Limited resection does not appear to negatively affect survival, and it is a reasonable alternative. Stereotactic ablative radiotherapy (SABR) has become a standard of care for patients refusing surgery or for those with medically inoperable early-stage lung cancer. However, the efficacy of SABR in MPLC management could only be found in retrospective series. Other local ablation techniques are an emerging alternative for the control of residual lesions. Furthermore, systemic therapies, such as targeted therapy for oncogene-addicted patients, and immunotherapy have shown promising results in MPLC management after resection. In this paper, the recent advances in the diagnosis and management of MPLC are reviewed.


2019 ◽  
Author(s):  
Ting-Fei Chen ◽  
Chun-Ying Xie ◽  
Bing-Yu Rao ◽  
Shi-Chao Shan ◽  
Xin Zhang ◽  
...  

Abstract Background As there is no consensus on the optimal surgery strategy for multiple primary lung cancer (MPLC), we conducted this study to address this issue by comparing the prognosis of MPLC patients underwent different surgical strategies including sublobar resection and the standard resection through a systemic review and meta-analysis. Methods Relevant literature was obtained from three databases including PubMed, Embase and Web of Science. Inclusion and exclusion criteria were set for the screening of articles to be selected for further conduction of systemic review and meta-analysis. The HRs of OS of the sublobar group compared with standard resection group were extracted directly or calculated indirectly from included researches. Result s: Ten researches published from 2000 to 2017 were included in this study, with 468 and 445 MPLC cases for the standard resection group and sublobar resection group respectively. The result suggested that OS of MPLC patients underwent sublobar resection (segmentectomy or wedge resection for at least one lesion) was comparable with those underwent standard resection approach (lobectomy or pneumonectomy for all lesions), with HR 1.07, 95% CI 0.67 - 1.71, p = 0.784. Further analysis found no difference in subgroups of synchronous and metachronous (from second metachronous lesion), different population region and dominant sex type. Conclusions This study may reveal that sublobar resection is acceptable for patients with MPLC at an early stage, because of the equivalent prognosis to the standard resection and better pulmonary function preservation. Further research is needed to validate these findings.


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