AIM:To investigate the clinicopathological characteristics of late-stage lung cancer patients with gastrointestinal(GI)-tract metastases,focusing on therapeutic options and outcomes.METHODS:Our institution(the Nationa...AIM:To investigate the clinicopathological characteristics of late-stage lung cancer patients with gastrointestinal(GI)-tract metastases,focusing on therapeutic options and outcomes.METHODS:Our institution(the National Taiwan University Hospital) diagnosed 8159 patients with lung cancer between 1987 and 2008,of which 21 developed symptomatic GI metastases.This study reviewed all of the patients' information,including survival data,pathological reports,and surgical notes.RESULTS:The most common histological type of lung cancer was adenocarcinoma,and 0.26% of patients with lung cancer developed GI metastases.The median duration from lung cancer diagnosis to GI metastases was three months(range,0-108 mo),and the average time from diagnosis of GI metastasis to death was 2.8 mo.Most patients with symptomatic gastric and/or duodenal metastases exhibited GI bleeding and were diagnosed by panendoscopy.In contrast,small bowel metastases typically presented as an acute abdomen and were not diagnosed until laparotomy.All patients with small bowel or colonic metastases underwent surgical intervention,and their perioperative mortality was 22%.Our data revealed a therapeutic effect in patients with solitary GI metastasis and a favorable palliative effect on survival when metastases were diagnosed preoperatively.In patients with multiple GI metastases,the presentation varied according to the locations of the metastases.CONCLUSION:Surgical treatment is worthwhile in a select group of patients with bowel perforation or obstruction.Physicians should be more alert to symptoms or signs indicating GI metastases.展开更多
Objective To investigate the clinical outcomes of children with congenital heart disease （CHD） requiring extracorporeal membrane oxygenation （ECMO） and left ventricular assist device （LVAD） support after cardiac...Objective To investigate the clinical outcomes of children with congenital heart disease （CHD） requiring extracorporeal membrane oxygenation （ECMO） and left ventricular assist device （LVAD） support after cardiac surgery. Methods A total of 22 patients with CHD who required postcardiotomy mechanical circulatory support between March 2004 and March 2011 （85 months ） were analyzed retrospectively. Median age of the patients was 420 d （ 15 d - 4 years） and median weight was 3.4 kg （ 2 - 14. 5 kg ）. Eight patients were put on ECMO, while 14 patients were placed on LVAD. Results Thirteen （59%） patients died and 9 （41% ） survived to discharge. In survivals, the duration of LVAD and the duration of ECMO were both shorter than those of nonsurvivals （P 〈 O. 05）. The main complication was bleeding. Conclusion The earlier treatment and application of more advanced cardiac support devices for CHD patients are key factors for reducing complications.展开更多
文摘AIM:To investigate the clinicopathological characteristics of late-stage lung cancer patients with gastrointestinal(GI)-tract metastases,focusing on therapeutic options and outcomes.METHODS:Our institution(the National Taiwan University Hospital) diagnosed 8159 patients with lung cancer between 1987 and 2008,of which 21 developed symptomatic GI metastases.This study reviewed all of the patients' information,including survival data,pathological reports,and surgical notes.RESULTS:The most common histological type of lung cancer was adenocarcinoma,and 0.26% of patients with lung cancer developed GI metastases.The median duration from lung cancer diagnosis to GI metastases was three months(range,0-108 mo),and the average time from diagnosis of GI metastasis to death was 2.8 mo.Most patients with symptomatic gastric and/or duodenal metastases exhibited GI bleeding and were diagnosed by panendoscopy.In contrast,small bowel metastases typically presented as an acute abdomen and were not diagnosed until laparotomy.All patients with small bowel or colonic metastases underwent surgical intervention,and their perioperative mortality was 22%.Our data revealed a therapeutic effect in patients with solitary GI metastasis and a favorable palliative effect on survival when metastases were diagnosed preoperatively.In patients with multiple GI metastases,the presentation varied according to the locations of the metastases.CONCLUSION:Surgical treatment is worthwhile in a select group of patients with bowel perforation or obstruction.Physicians should be more alert to symptoms or signs indicating GI metastases.
文摘Objective To investigate the clinical outcomes of children with congenital heart disease （CHD） requiring extracorporeal membrane oxygenation （ECMO） and left ventricular assist device （LVAD） support after cardiac surgery. Methods A total of 22 patients with CHD who required postcardiotomy mechanical circulatory support between March 2004 and March 2011 （85 months ） were analyzed retrospectively. Median age of the patients was 420 d （ 15 d - 4 years） and median weight was 3.4 kg （ 2 - 14. 5 kg ）. Eight patients were put on ECMO, while 14 patients were placed on LVAD. Results Thirteen （59%） patients died and 9 （41% ） survived to discharge. In survivals, the duration of LVAD and the duration of ECMO were both shorter than those of nonsurvivals （P 〈 O. 05）. The main complication was bleeding. Conclusion The earlier treatment and application of more advanced cardiac support devices for CHD patients are key factors for reducing complications.
