Deruo Liu

The Common Causes of Conversion of VATS during Operation for 248 Non-small Cell Lung Cancers

BACKGROUND AND OBJECTIVE VATS-lobectomy has been used as regular surgical procedure clinically for non-small cell lung cancer. The aim of this study is to evaluate the surgical emergencies during VATS and the related factors postoperatively. METHODS Clinical data were reviewed for patients who were performed with pulmonary related surgery between January 2006 and July 2008 in our department. RESULTS 248 (117 CVATS and 131 AVATS) VATS lobectomy were performed, including 13 cases that were transferred into AVATS or OPEN. The common related reasons were bleeding of pulmonary branches, adhesion, anatomic deformity, bleeding of azygos and bleeding of middle-lobe-vein. 129 thoracotomy cases were enrolled. Compared with OPEN surgery, VATS got the merits of short in-hospital duration (20 days vs 27 days, P=0.015), less bleeding (197 mL vs 250 mL, P=0.005) and less pain (4.6 vs 6.2, P=0.003). CONCLUSION VATS is a safe surgical procedure for early stage NSCLC with merits of lower morbidity and sooner recovery. So it could be concluded that in some circumstances, VATS could be chosen as an alternate of thoractomy.

Preferred surgical procedure for posterior mediastinal neurogenic tumor

Aim:  To compare the outcomes of video‐assisted thoracoscopic surgery (VATS) with those of thoracotomy for the removal of posterior mediastinal neurogenic tumors.

Tracheal carina reconstruction and bronchoplasty in the treatment of 94 central type bronchogenic carcinomas

BACKGROUND To analyze the short-term effects and long term survival of patients with lung cancer underwent tracheal carina reconstruction and bronchoplasty. METHODS From April 1985 to May 1999, 94 patients with lung cancer underwent tracheal carina reconstruction and bronchoplasty, 14 for carinal resection and reconstruction and 80 for bronchial sleeves. RESULTS Postoperative complications were atelectasis ( 19 cases) , arrthymia ( 2 cases) and anastomotic leakage ( 1 case) . There was no operative death in this series. The 1-, 3- and 5-year survival rates were 83. 1%( 74/ 89) , 58. 3%( 35/ 56) and 34. 0%( 18/ 53) respectively for the entire group. The 5-year survival rate was 66. 7%( 6/ 9) in stage Ñ B disease, 40%( 6/ 15) in Ò B disease and 21. 1%( 4/ 19) in Ó A disease. The indication of these procedures and the methods of lymph node dissection, bronchoplasty and pulmonary artery reconstruction, and superior vena cava reconstruction have been discussed. CONCLUSIONS Bronchoplasty for lung cancer is a safe and effective therapy. The long term survival depends on the stage of lung cancer , proper selection of surgical indication, clearance of lymph nodes in operation and multiple modality therpay after operation.