Lymph node metastasis is the main and frequent metastatic way of lung cancer, it is also the reason of postoperative carcinoma residue which results in relapse and metastasis. It is vital to clean mediastinal lymph nodes and hilar lymph nodes in lung cancer operation. However, the patterns of lymphadenectomy are not yet uniform. There are complete mediastinal lymph node dissection(CMLND), radical lymph node dissection(RLND), lymph node sampling(LS), systematic lymph node sampling(SS) and sentinel lymph node navigation(SLN). And with the development of minimal invasive surgery, the thoracoscopic lymphadenectomy gets mature day by day. It is very necessary to find a more standardized and perfect patten of lymphadenectomy. This paper reviews the clinical significance, the pattens and the extent of mediastinal lymph node dissection and hilar lymph node dissection, and also reviews the current status and prospect of thoracoscopic lymphadenectomy
Abstract： Currently, there are two significant tendencies in the advancement and progress of video-assisted thoracoscopic surgery（VATS）, firstly, the widening surgical indications for VATS techniques, and secondly, the use of single-port VATS which is less invasive and more cosmetic. This article focuses in particular on four aspects of single-port VATS, including；（1）the individualized incision approach and its characteristics of single-port VATS；（2）single-port VATS for the treatment of pneumothorax and the development of related techniques and equipment；（3）single-port VATS for the diagnosis and treatment of thoracic diseases such as lung lobectomy；（4）the advantages and disadvantages of single-port VATS in clinical practice.
Abstract: Although lung transplantation has been established as the only valid therapeutic approach for endstage pulmonary disease, several related problems remain to be solved. In addition to the serious problem in donor lung shortage, primary graft dysfunction caused by lung ischemia-reperfusion injury is one of the most common reason of early mortality. Optimal preservation of lung is essential to reduce ischemic organ dysfunction after lung transplantation. The development of a highly reliable lung preservation solution that reduces ischemia-reperfusion injury will improve the functioning of transplanted lungs. The progress of the type, perfusing technique or strategies and modified methods of lung preservation solution are reviewed in this article.
The TNM staging of lung cancer which is now widely used in clinic was formally proposed in 1997. It has played quite an important role in directing the diagnosis and treatment of lung cancer as well as the clinical research in the past decade. However, at the same time, there are some insufficiencies which are emerging gradually. By collecting the clinical information from 100 869 patients, in 2007, International Association for the Study of Lung Cancer(IASLC) made a deep analysis on the relativity between TNM staging and prognosis, and put forward the suggestions to revise the Seventh Edition of the TNM staging of lung cancer: (1) According to the size of tumor, the primary T staging is divide into T1a (the maximum tumor diameter≤2 cm), T1b (3 cm≥the maximum tumor diameter＞2 cm), T2a (5 cm≥the maximum tumor diameter＞3 cm) and T2b (7 cm≥the maximum tumor diameter＞5 cm); (2) T 2c (the maximum tumor diameter gt;7 cm) and additional nodules in the same lobe are classified as T3, while nodules in the ipsilateral nonprimary lobe are classified as T4;(3) Cancerous hydrothorax, pericardial effusion and the additional nodules in the contralateral lung are classified as M1a, while the extrapulmonary metastases are classified as M1b. It is believed that the new revised edition will has higher international authority and identification degree, and it will play a more meticulous and accurate guiding role in the treatment of lung cancer and its predicting prognosis in the future. At the same time, it will provide a new starting point to the research of lung cancer.
Foreign body ingestion is common in emergency. The vast majority of foreign body ingestion occurs in the pediatric population as well as mentally impaired and edentulous adults. The typical clinical manifestation of foreign body ingestion includes acute onset of dysphagia and chest pain. Most of the ingested foreign bodies pass without the need of intervention; however, about 20% of esophageal foreign body ingestion requires endoscopic removal. While less than 1% will need surgery for foreign body extraction. Timely diagnosis and proper treatment are associated with low mortality and morbidity rate, while delayed diagnosis and improper treatment always lead to severe complications such as esophageal perforation and death. This article reviews the diagnosis and treatment of adult esophageal foreign body ingestion.