Clinical experience of double sleeve lobectomy of the bronchus and the pulmonary artery in patients with central lung cancer

Objective： The aim of our study was to introduce the surgical method and evaluate the efficacy of double sleeve Iobectomy of the bronchus and the pulmonary artery in treatment for the central lung cancer. Method： From March 1995 to October 2010, double sleeve Iobectomy of the bronchus and the pulmonary artery was performed in 45 cases with central lung cancer that involved the bronchial opening of an upper lobe of the lungs or the main bronchus and＇pulmonary artery but didn＇t involve any lower lobes. Among them, left upper Iobectomy was performed in 37 cases, right medium-upper Iobectomy was performed in 6 cases and right upper Iobectomy was performed in 2 cases. Results： Postoperative complications were found in 12 cases. Among them, 3 cases were arrhythmia, 1 case was acute heart failure, 6 cases were obstructive pneumo-nia and pulmonary atelectasis, 2 cases were bronchial anastomotic fistula. Two cases died of cerebral infarction and massive hemoptysis respectively. Thirty-one cases were squamous carcinoma, 7 cases were adenocarcinoma, 4 cases were small cell lung cancer, 1 case was adenosquamous carcinoma, 1 case was sarcomatoid carcinomas, 1 case was mucinous adeno- carcinoma. Ten cases were T3NOM0, 11 cases were T3N 1M0, 17 cases were T3N2M0, 2 cases were T4N 1M0, 5 cases were T4N2M0. The 1-year, 3-year, 5-year survival rates were 84.4% （38/45）, 51.7% （15/29）, 53.8% （7/13） respectively. Conclu-sion： The double sleeve Iobectomy of the bronchus and the pulmonary artery can maximumly reserve the normal lung tissues while removing tumors, and avoid pneumonectomy. The surgery was safe and effective, while it required a high technique.

Comparison of laparoscopic vs open liver lobectomy(segmentectomy) for hepatocellular carcinoma

AIM:To investigate the effects of laparoscopic hepatectomy for the treatment of hepatocellular carcinoma(HCC) .METHODS:From 2006 to January 2011,laparoscopic hepatectomies were performed on 30 cases of HCC at Northern Jiangsu People's Hospital. During this sametime period,30 patients elected to undergo conventional open hepatectomy over laparoscopic hepatectomy at the time of informed consent. The degree of invasiveness and outcomes of laparoscopic hepatectomy compared to open hepatectomy for HCC were evaluated.RESULTS:Both groups presented with similar bloodloss amounts,operating times and complications. Patients in the laparoscopic hepatectomy group started walking and eating significantly earlier than those inthe open hepatectomy group,and these more rapid recoveries allowed for shorter hospitalizations. There were no significant differences between procedures insurvival rate.CONCLUSION:Laparoscopic hepatectomy is beneficial for patient quality of life if the indications are appropriately based on preoperative liver function and the location and size of the HCC.

Laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct and traditional open operation

AIM: To investigate the possibilities and advantages of laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct compaired with traditional open operation.METHODS: Laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct and traditional open operation were performed in two groups of patients who had gallstones in the left lobe of liver and in the common bile duct. The hospitalization time, hospitalization costs, operation time, operative complications and post-operative liver functions of the two groups of patients were studied.RESULTS: The operation time and post-operative liver functions of the two groups of patients had no significant differences, while the hospitalization time, hospitalization costs and operative complications of the laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration in the common bile duct group were significantly lower than those in the traditional open operation group.CONCLUSION: For patients with gallstones in the left lobe of liver and in the common bile duct, laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct can significantly shorten the hospitalization time, reduce the hospitalization costs and the post-operative complications,without prolonging the operation time and bringing about more liver function damages compared with traditional open operation. This kind of operation has more advantages than traditional open operation.