To the Editor：We read with tremendous interest the paper by Del Fabbroet al. [1]. In this thorough article, the authors meticulously underlinethe advantages of a modified j-shaped incision for the simultaneoustreatme...To the Editor：We read with tremendous interest the paper by Del Fabbroet al. [1]. In this thorough article, the authors meticulously underlinethe advantages of a modified j-shaped incision for the simultaneoustreatment of difficult liver colorectal metastases （CRM） and right-lung CRM, reporting their experience in a cohort of 11 patients.展开更多
The Author Reply：We thank Dr. Sucameli et al. for the interest toward our article[1] and for the opportunity for further discussing on this issue,providing a case report of single metastastic fore sites in the livera...The Author Reply：We thank Dr. Sucameli et al. for the interest toward our article[1] and for the opportunity for further discussing on this issue,providing a case report of single metastastic fore sites in the liverand lung both treated in a minimal access fashion. However, giventhe interest of the authors insight, it appears misleading when related to that discussed in our report which was clearly referred toother patients＇ profiles. Indeed, they described a case with a singleperipheral nodule in the right lung and a single liver metastasesin segment 5. This uncommon situation （less than 2% of patientsaccording to the LiverMetSurvey registry [2]）, is obviouslya more than reasonable indication for a mini-invasive approach.However, our patients received surgery for complex oncological involvementof the liver： as described, this means large and/or multiplelesions, in contact or invading the hepatic veins at caval confluence.For such conditions we have introduced original surgicalapproaches [3,4]： in such conditions we would select a J-shapedthoracophrenolaparotomy for the liver per se [5]. This incision forsuch complex conditions other than allowing the liver clearance in a single operation rather than in staged approach [6], allows justin case the removal of lung nodules. Therefore, we thank again theauthors for their interest to our report, and furthermore we congratulatefor the original management of the shared clinical case.However, the condition recalled by the authors is related to a scenariooncologically and surgically at the opposite side of that discussedin our paper and for that somehow suggesting a comparisonis misleading.展开更多
Liver fire invading the lung (also called wood-fire torturing metal) is widely seen in various respiratory diseases.In order to understand this pattern well,from the perspective of the five elements theory and zang-fu...Liver fire invading the lung (also called wood-fire torturing metal) is widely seen in various respiratory diseases.In order to understand this pattern well,from the perspective of the five elements theory and zang-fu theory in Chinese Medicine,we systematically reviewed and discussed the physiological and functional characteristics of the liver and lung,the liver -lung relationship,the pathogenesis and identification of the pattern,as well as the commonly used basic formulas for the treatment of this pattern,including White-Draining Powder (Xiè Bái Sǎn,泻白散),Liver Heat-Dissolving Decoction (Huà Gān Jiān,化肝煎),Indigo and Clam Shell Powder (Dài Ge Sǎn,黛蛤散)and Hemoptysis-Relieving Formula(KéXuè Fāng,咳血方).Two examples of clinical modifications of these formulas in the treatment of hemoptysis and asthma are provided in this article.It should be noted that in the treatment of pulmonary diseases,these formulas should be used flexibly,and modified in accordance to the condition of the patient.展开更多
文摘To the Editor：We read with tremendous interest the paper by Del Fabbroet al. [1]. In this thorough article, the authors meticulously underlinethe advantages of a modified j-shaped incision for the simultaneoustreatment of difficult liver colorectal metastases （CRM） and right-lung CRM, reporting their experience in a cohort of 11 patients.
文摘The Author Reply：We thank Dr. Sucameli et al. for the interest toward our article[1] and for the opportunity for further discussing on this issue,providing a case report of single metastastic fore sites in the liverand lung both treated in a minimal access fashion. However, giventhe interest of the authors insight, it appears misleading when related to that discussed in our report which was clearly referred toother patients＇ profiles. Indeed, they described a case with a singleperipheral nodule in the right lung and a single liver metastasesin segment 5. This uncommon situation （less than 2% of patientsaccording to the LiverMetSurvey registry [2]）, is obviouslya more than reasonable indication for a mini-invasive approach.However, our patients received surgery for complex oncological involvementof the liver： as described, this means large and/or multiplelesions, in contact or invading the hepatic veins at caval confluence.For such conditions we have introduced original surgicalapproaches [3,4]： in such conditions we would select a J-shapedthoracophrenolaparotomy for the liver per se [5]. This incision forsuch complex conditions other than allowing the liver clearance in a single operation rather than in staged approach [6], allows justin case the removal of lung nodules. Therefore, we thank again theauthors for their interest to our report, and furthermore we congratulatefor the original management of the shared clinical case.However, the condition recalled by the authors is related to a scenariooncologically and surgically at the opposite side of that discussedin our paper and for that somehow suggesting a comparisonis misleading.
文摘Liver fire invading the lung (also called wood-fire torturing metal) is widely seen in various respiratory diseases.In order to understand this pattern well,from the perspective of the five elements theory and zang-fu theory in Chinese Medicine,we systematically reviewed and discussed the physiological and functional characteristics of the liver and lung,the liver -lung relationship,the pathogenesis and identification of the pattern,as well as the commonly used basic formulas for the treatment of this pattern,including White-Draining Powder (Xiè Bái Sǎn,泻白散),Liver Heat-Dissolving Decoction (Huà Gān Jiān,化肝煎),Indigo and Clam Shell Powder (Dài Ge Sǎn,黛蛤散)and Hemoptysis-Relieving Formula(KéXuè Fāng,咳血方).Two examples of clinical modifications of these formulas in the treatment of hemoptysis and asthma are provided in this article.It should be noted that in the treatment of pulmonary diseases,these formulas should be used flexibly,and modified in accordance to the condition of the patient.
