Chinese Journal of Thoracic and Cardiovaescular Surgery最新文献

{"title":"Risk factors and prevention strategies of spinal cord ischemic injury after thoracoabdominal aortic aneurysm repair","authors":"Yusong Wang, Guanglang Zhu, Ziyang Sun, Lei Zhang","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.012","url":null,"abstract":"Thoracic and abdominal aortic aneurysm repair has always been a challenging procedure in cardiovascular surgery due to its high mortality and complication rate. At present, there are traditional open surgery, hybrid surgery and intracavitary repair for thoracic and abdominal aortic aneurysms. The main postoperative complication of spinal cord ischemia injury is paraplegia, which seriously affects the long-term survival rate and quality of life of patients. This paper summarized and considered the pathogenesis, risk factors and prevention measures of spinal cord ischemia injury after thoracic and abdominal aortic aneurysm repair.","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75272598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the accuracy of the frozen section (FS) identification for early-stage lung adenocarcinoma","authors":"Xiaofan Wang, Donglai Chen, E. Zhu, Chang Chen, Yong-sheng Zhang, Yongbing Chen","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.013","url":null,"abstract":"The frozen section (FS) technology has been widely used in the process of surgical pathology since its time-saving nature exhibited superiority over traditional paraffin method. Therefore FS, of great value in providing preliminary pathological diagnosis, offers guidance in the extension of surgical resection. However, it remains controversial whether the early-stage lung adenocarcinoma could be accurately identified in FS. This review aims to generalize the studies concerning the accuracy of FS in identifying early-stage lung adenocarcinoma, analyzing the interference factors, comparing the similarities and differences between frozen sections and traditional paraffin sections. It also gives insight into whether FS can provide significant guidance for surgeons to perform resection on early-stage lung adenocarcinoma.","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85980741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of 10 cases of right heart system uterine venous leiomyomatosis treated by one-stage operation","authors":"Gaojun Xu, Shuai Hu, Baoen Wang, Jun-jie Sun, Dao-Kuo Zheng, Z. Ge","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.011","url":null,"abstract":"回顾性分析2015年4月至2018年12月收治的10例右心系统子宫静脉平滑肌瘤病女性患者的临床资料，年龄35～53岁，平均(45±6)岁。全组均联合妇科医师，在全麻下行一期肿瘤完整切除，其中6例取体外循环下胸腹联合切口，4例取非体外循环下单纯腹部切口。术后1例出现急性肾衰、肺部感染等并发症，家属拒绝继续治疗，术后第9天自动出院。余9例患者均康复出院。电话或门诊随访3～47个月，平均(29±13)个月，1例术后2月余因肠梗阻再次住院，予保守对症治疗后好转出院。子宫静脉平滑肌瘤病的诊断较困难，一期手术可取得较好的中长期生存率和生存质量，术后复发率较低。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78113110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To evaluate the extravascular lung water in patients of bilateral lung transplantation with lung ultrasonography and SDC-1","authors":"Song Gao, Ding-ye Wu, Gen-Hui Chen, K. Jin, Feng Zhang, Hong-yang Xu","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.006","url":null,"abstract":"Objective \u0000The purpose of this study was to explore new method for evaluating the severity of extravascular lung water in patients after bilateral lung transplantation. \u0000 \u0000 \u0000Methods \u0000The study was performed in 50 patients after bilateral lung transplantation in our hospital from 2017 to 2018. Picco were implanted during the operation .Two hours after the operation, a doctor monitored the index of EVLWI and PVPI.At the same time, another doctor carried out examination of lung ultrasonography and Calculated the numbers of B line. After ultrasonography, the doctor used ELISA to determine the level of SDC-1. \u0000 \u0000 \u0000Results \u0000EVLWI were significantly correlated with the number of B-line and the level of SDC-1 (RS=0.833, RS=0.747, P<0.05), PVPI were significantly correlated with the number of B-line and the level of SDC-1 (RS=0.738, RS=0.626, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The number of B-line and the level of SDC-1 have a good correlation with extravascular lung water. The combination of the two indicators might be used as a reliable index for evaluating the degree of extravascular lung water after bilateral lung transplantation. \u0000 \u0000 \u0000Key words: \u0000Bilateral lung transplantation; EVLWI; Lung ultrasonography; SCD-1","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79475813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of Patient-level Prediction Model for In-hospital Mortality in Congenital Heart Disease Surgery: Regression and Machine Learning analysis","authors":"X. Song, Xinwei Du, Shun-min Wang, Zhiwei Xu, Zhaohui Lu","doi":"10.21203/rs.3.rs-35146/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-35146/v1","url":null,"abstract":"\u0000 Background: Prediction of in-hospital death is important for patient management as well as risk-adjusted evaluation of Congenital heart disease (CHD) surgery performance. Using a large database containing CHD surgery records of 12 years, we aim to establish patient-level in-hospital mortality prediction models.Methods: Patients with congenital heart disease who underwent surgery at Shanghai Children’s Medical Center from January 1, 2006, to December 31, 2017 were included in the study. Each procedure was assigned a complexity score based on Aristotle Score with modification. In-hospital mortalities for various surgery procedures were estimated. In-hospital death prediction models including a procedure complexity score and patient-level risk factors were constructed using logistic regression analysis and machine learning methods. The predictive values of the models were tested. Results: Among 24,684 patients underwent CHD operations, there were 595 (2.4%) in-hospital deaths. The results showed that AUC of the prediction model based on logistic regression is 0.864 (95% CI: 0.833-0.895, P <0.001), the sensitivity is 0.831 and the specificity is 0.786. The AUC of the Gradient boosting model is 0.884 (95 %% CI: 0.858-0.909, P <0.001), the sensitivity and specificity were 0.838 and 0.785 respectively. The feature importance analysis found that the variable (average score) that had the greatest impact on the model's prediction performance was operation score (95.6), and other variables (average scores) were Age (days) (95.5), Ultrasound MV （54.6）, Ultrasound atrial level （54.5）, Palliative operation (45.8), Operation history (38.8), Ultrasound TV2 (32.1), Urgent operation (30.8), Ultrasound ventricular level (30.5), and Spo2 ≤ 90% (30.3).Conclusions: Model constructed using machine learning method and logistic regression containing procedure complexity score and pre-operative patient-level factors had high accuracy in in-hospital mortality prediction. Operation score and age have the greatest impact on model prediction performance.","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87714412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the short-term and long-term outcomes between minimally invaisive Ivor-Lewis and minimally invaisive McKeown esophagectomy for middle or lower esophageal squamous cell carcinoma after propensity score matching analysis","authors":"Xiaodong Zhu, Hanran Wu, Guang-Wen Xu, Chang-qing Liu, X. Mei","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.007","url":null,"abstract":"Objective \u0000The aim of our study was to compare the short-term and long-term outcomes between minimally invaisive Ivor-Lewis esophagectomy(MIILE)and minimally invasive McKeown esophagectomy(MIME) for squamous cell carcinoma of middle and lower esophagus. \u0000 \u0000 \u0000Methods \u0000The data of 268 patients diagnosed with middle and lower esophageal spuamous cell carcinoma who had received MIILE or MIME between August 2010 and March 2014 at department of thoracic surgery, The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital), was analyzed retrospectively. We divided the subjects into two groups according to the mode of the operation, each group was identified 81 patients after propensity score matching. We were using t test, χ2 test, Kaplan-Meier curve and Log-rank test to compare preoperative data and overall survival of the two groups. \u0000 \u0000 \u0000Results \u0000Compared with MIME, MIILE had lower complication in pulmonary infection and anastomotic fistula, also had less operating time, whereas MIME had an advantage in the number of lymph nodes dissection adjacent to recurrent laryngeal nerve(P<0.05). The 1-year、3-year、5-year survival rate of MIILE were 87.7%、59.2%、45.9%, and the 1-year、3-year、5-year survival rate of MIME were 86.4%、58.7%、42.8%.There were no significant difference between two groups in 5-year survival rate. \u0000 \u0000 \u0000Conclusion \u0000For squamous cell carcinoma of middle and lower esophagus, minimally invasive Ivor-Lewis esophagectomy and minimally invasive McKeown have no significant difference in long-term survival, but minimally invasive Ivor-Lewis esophagectomy has advantages in reduce the operating time, decrease pulmonary infection and anastomotic fistula during perioperative period.Nevertheless minimally invasive McKeown has an advantage in dissection of the lymph nodes adjacent to recurrent laryngeal nerve. \u0000 \u0000 \u0000Key words: \u0000Esophageal cancer; Minimally invasive esophagectomy; Survival","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83390255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancein surgicaltreatment of congenital tracheal stenosis in children","authors":"X. Song, Zhaohui Lu, Shun-min Wang","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.015","url":null,"abstract":"Congenital tracheal stenosis is a rarebut life-threatening disorder. In recent years, the improvement of surgical skills has significantly reduced the incidence of postoperative complications and mortality in children. Through researching the relevant published articles and books, this review introduces the pathology, types, commonsurgical methods of congenital tracheal stenosis, summarizes the surgical indications for tracheoplasty, and prospects for providing some suggestions for thetreatment of congenital tracheal stenosis.","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74642260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of influencing factors for rapid postoperative recovery of young lung cancer patients","authors":"Ya-Nan Song, Y. Qi, Chunyang Zhang, Sheng Yinliang, Song Zhao","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.005","url":null,"abstract":"Objective \u0000To explore the influencing factors of rapid postoperative recovery in young(≤40 years old) lung cancer patients. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was performed on 82 young patients with lung cancer diagnosed by postoperative pathology admitted to the department of thoracic surgery of the first affiliated hospital of Zhengzhou University from March 2013 to March 2019, the patients were divided into two groups according to their postoperative hospitalization time(hospitalization time≤7d, hospitalization time >7d). The preoperative medical history and examination data, intraoperative(operative method, embedding materials), postoperative complications and postoperative treatment and other data of the enrolled patients were collected to analyze the relationship between various factors and postoperative hospitalization time.Univariate analysis used t test or Fisher exact probability method, multivariate analysis used logistic regression model to analyze the data . \u0000 \u0000 \u0000Results \u0000All 82 patients successfully completed the operation, and no death occurred during the perioperative period. There were no significant differences(P>0.05)according to the two groups of patients in the preoperative pulmonary function(FEV1) operation history, history of hypertension, diabetes, history of preoperative chemotherapy and surgery in the patients' position, blood transfusion, pleural adhesion, Czech, nai d, the use of xanthan gum, operation time, the maximum diameter and postoperative tumor thermal perfusion, fever, vomiting, choking cough, abdominal distension, etc.And it has significant differences(P<0.05). In the preoperative antibiotic use(P=0.002), the improvement of lung function(P=0.018), smoking history(P=0.024), medical reasons(P=0.011) and the operation(P<0.001), the lymph node excision scope(P<0.001), the lymph node dissection(P=0.017), hemostatic material use(P=0.023), blood loss(P=0.001) and postoperative average white blood cell count(P=0.033). \u0000 \u0000 \u0000Conclusion \u0000Preoperative and postoperative prophylactic use of antibiotics and drugs to improve pulmonary function were beneficial to postoperative recovery.Smoking was an independent risk factor for prolonged postoperative hospital stay.Minimally invasive operation and application of hemostatic materials can effectively shorten the postoperative hospitalization time of patients. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, non-small-cell lung; Youth; Postoperative recovery; Influence factors","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80083732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and midterm results of the Rastelli operation in Fuwai hospital","authors":"Xiaodong Lyu, Ke-ming Yang, Shoujun Li, Hongyang Fan","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.002","url":null,"abstract":"Objective \u0000To describe eraly and midterm outcome of the Rastelli repair in Fuwai hospital Patients. \u0000 \u0000 \u0000Methods \u0000From May 2010 to March 2017, 71 patients with transposition of the great arteries(TGA)with ventricular septal defect(VSD)and right ventricular outflow tract obstruction(RVOTO) or double outlet right ventricle(DORV)with VSD and RVOTO underwent Rastelli repair. 48 cases male , 23 cases female . Age at operation is(4.7±2.7) years. There are 10 TGA cases, 27 DORV cases, 34 CTGA cases in this group. 30 patients(42.3% , 30/71)received palliative operation prior to the Rastelli procedure, including 13 BT shunt and 17 bi-Glenn operation. 31 patients(43.7%, 31/71 )underwent the Rastelli procedure with VSD enlargement. Right ventricle-to-pulmonary artery connection were created with the use of 9 homografts, 56 valved bovine jugular vein, 6 man-made valved Gore-Tex conduit. The overall mean right ventricle-to-pulmonary artery conduit size was(17.9±3.3)mm. \u0000 \u0000 \u0000Results \u0000CPB time was(209.0±83.4)minutes, aortic crossclamping time was(132.0±71.1)minutes, mechanical ventilation time was(102.6±81.7)h. Early mortality was 1.4%(1/71). morbidity in hospital was 16.9%, 4 patients with Ⅲ AVB implanted permanent pacemaker, Subxiphoid pericardial window drainage in 3 cases, delayed sternal closure in 3 and re-thoratomy for hemaostsis in 2.Follow up is from 4 months to 6.8 years. Overall survival was 97.2% and 97.2% at 1 and 5 years, respectively. Freedom from RVOTO was 98.6% and 84.1% at 1 and 5 years, respectively. Freedom from reintervention was 98.6% and 90.0% at 1 and 5years, respectively. 1 patients performed a conduit replacement. Seven patients performed 10 times balloon dilatation . Time-related freedom from recurrent LVOTO on echocardiogram in all patients, and the pressure gradient of the LV to the aorta was(10.5±8.8 )mmHg at the most recent follow-up. \u0000 \u0000 \u0000Conclusion \u0000The Rastelli operation remains the preferred procedure for part of the DORV , CTGA , TGA with VSD and severe fixed valvular or subvalvular PS. The Rastelli procedure can be performed with low early mortality. There is frequent need for late reoperation, especially for conduit replacement. \u0000 \u0000 \u0000Key words: \u0000Heart diseases, congenital; Rastelli procedure; Transposition of the great arteries; Duble outlet right ventricle","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78323590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis of the incidence of acute aortic disection with lower limb malperfusion","authors":"Zengkai Xu, Bin Li, Haisheng Chen","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.010","url":null,"abstract":"近年来，国内外学者对急性主动脉夹层合并器官灌注不良越来越重视，但缺乏相关的流行病学数据。为明确下肢缺血在急性主动脉夹层的发病率，通过meta分析合成后，统计出下肢缺血在急性A型主动脉夹层(TAAD)和急性B型主动脉夹层(TBAD)的发病率分别为11%和10%；TAAD和TBAD合并下肢缺血的患者中男性分别占77.17%和84.35%。下肢缺血在急性主动脉夹层中占一定的比例，不论A型夹层还是B型夹层，男性患者发病率均高于女性。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83300217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}