Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma...Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma in our hospital from January 2003 to March 2011 were retrospectively analyzed. Results A total of 36 patients were included, in whom 13 developed cervical anastomotic leak, 18 had intra-thoracic anastomotic leak, and 5 had intra-thoracic gastric necrosis. Of these patients, 7 were treated with resurgery, 6 with esophageal stent implantation, and 23 with conservative treatment. Treatment lasted for 5 to 181 days, averagely 47.0±31.9 days. After management, 9 patients died (25.0%). Among seven patients with resurgery, four had deceased, two were cured, and one developed leak again and was switched to conservative treatment until discharged. All the 6 patients treated with stent implantation were cured. Of the 24 patients receiving conservative treatment (including one switched from resurgery), 18 (75.0%) were cured and 1 was not cured but survived. Conclusions Anastomotic leak following surgery for esophageal carcinoma should be treated individually based on the onset time, location, size, and extent of the leakage. Conservative treatment is still a safe and effective method.The efficacy of stent implantation needs further investigation to confirm.展开更多
Lung resection following pneumonectomy for recurrent lung cancer is a challenging scenario.Peri-operative airway management and choice of surgical procedure are issues to be addressed by both the anesthesiologists and...Lung resection following pneumonectomy for recurrent lung cancer is a challenging scenario.Peri-operative airway management and choice of surgical procedure are issues to be addressed by both the anesthesiologists and thoracic surgeons.We hereby report a case of anterior segmentectomy of the right upper for recurrent lung cancer,in a patient who had previously underwent pneumonectomy for primary lung cancer one year earlier.A modified conventional tracheal intubation and unique surgical techniques were applied for video-assisted thoracoscopic surgery(VATS)anterior segmentectomy of the right upper lobe in a patient with a notable mediastinal shift(following contralateral pneumonectomy),resulting in a good recovery and clinical outcome.The clinical experience is summarized in detail in this article.展开更多
文摘Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma in our hospital from January 2003 to March 2011 were retrospectively analyzed. Results A total of 36 patients were included, in whom 13 developed cervical anastomotic leak, 18 had intra-thoracic anastomotic leak, and 5 had intra-thoracic gastric necrosis. Of these patients, 7 were treated with resurgery, 6 with esophageal stent implantation, and 23 with conservative treatment. Treatment lasted for 5 to 181 days, averagely 47.0±31.9 days. After management, 9 patients died (25.0%). Among seven patients with resurgery, four had deceased, two were cured, and one developed leak again and was switched to conservative treatment until discharged. All the 6 patients treated with stent implantation were cured. Of the 24 patients receiving conservative treatment (including one switched from resurgery), 18 (75.0%) were cured and 1 was not cured but survived. Conclusions Anastomotic leak following surgery for esophageal carcinoma should be treated individually based on the onset time, location, size, and extent of the leakage. Conservative treatment is still a safe and effective method.The efficacy of stent implantation needs further investigation to confirm.
文摘Lung resection following pneumonectomy for recurrent lung cancer is a challenging scenario.Peri-operative airway management and choice of surgical procedure are issues to be addressed by both the anesthesiologists and thoracic surgeons.We hereby report a case of anterior segmentectomy of the right upper for recurrent lung cancer,in a patient who had previously underwent pneumonectomy for primary lung cancer one year earlier.A modified conventional tracheal intubation and unique surgical techniques were applied for video-assisted thoracoscopic surgery(VATS)anterior segmentectomy of the right upper lobe in a patient with a notable mediastinal shift(following contralateral pneumonectomy),resulting in a good recovery and clinical outcome.The clinical experience is summarized in detail in this article.
