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Fibrin sealant for esophageal anastomosis:A phase II study

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World Journal of Gastrointestinal oncology 2020年第6期12卷 651-662页

作者： Yao-Bin Lin Jian-Hua Fu Yan Huang Yi-Huai Hu Kong-Jia Luo Ke-Xi Wang AmosÉla Bella Dong-Rong Situ Ji-Yang Chen Ting Lin Xavier B D’Journo Nuria M Novoa Alessandro Brunelli Hiran C Fernando Robert J Cerfolio Mahmoud Ismail Hong Yang 无 department of thoracic surgery State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Esophageal Cancer InstituteSun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina department of thoracic surgery Avicenne HospitalBobigny 93000France department of surgery and Specialties Faculty of Medicine and Biomedical SciencesUniversity of YaoundéIYaoundéCameroon department of surgery Royal Darwin HospitalNorthern Territory 0811Australia department of thoracic surgery and Diseases of Esophagus Aix-Marseille UniversityHôpital NordMarseille 13915France thoracic surgery Service University Hospital of SalamancaSalamanca 37007Spain department of thoracic surgery St James's University HospitalLeeds LS97TFUnited Kingdom Section of thoracic surgery Inova Fairfax Medical CenterInova Schar Cancer InstituteFalls ChurchVA 22042United States department of Cardiothoracic surgery New York University Langone HealthNew YorkNY 10016United States department of thoracic surgery Academic Hospital of the Charité–UniversitätsmedizinHumboldt University BerlinBerlin 10117Germany the AME thoracic surgery Collaborative Group

BACKGROUND Esophagectomy is a pivotal curative modality for localized esophageal or esophagogastric junction cancer(EC or EJC).Postoperative anastomotic leakage(AL)remains *** use of fibrin sealant(FS)may improve the strength of esophageal anastomosis and reduce the incidence of *** To assess the efficacy and safety of applying FS to prevent AL in patients with EC or *** In this single-arm,phase II trial(*** identifier:NCT03529266),we recruited patients aged 18-80 years with resectable EC or EJC clinically staged as *** open or minimally invasive McKeown esophagectomy was performed with a circular stapled *** performing the anastomosis,2.5 mL of porcine FS was applied *** primary endpoint was the proportion of patients with AL within 3 *** From June 4,2018,to December 29,2018,57 patients were *** the data cutoff date(June 30,2019),three(5.3%)of the 57 patients had developed AL,including two(3.5%)with esophagogastric AL and one(1.8%)with gastric *** incidence of anastomotic stricture and other major postoperative complications was 1.8%and 17.5%,*** median time needed to resume oral feeding after operation was 8 d(Interquartile range:7.0-9.0 d).No adverse events related to FS were *** deaths occurred within 90 d after *** Perioperative sealing with porcine FS appears safe and may prevent AL after esophagectomy in patients with resectable EC or *** phase III studies are warranted.

关键词： Esophageal cancer McKeown esophagectomy Fibrin sealant Anastomotic leakage Postoperative complications Prevention

Uniportal video-assisted thoracoscopic surgery for complex mediastinal mature teratoma:A case report

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World Journal of Clinical Cases 2021年第26期9卷 7870-7875页

作者： Xue-Lei Hu Dong Zhang Wen-Yong Zhu department of thoracic surgery Qilu Hospital(Qingdao)Qingdao 266035Shandong ProvinceChina department of thoracic surgery Pingdu People's HospitalPingdu 266770Shandong ProvinceChina department of thoracic surgery Qilu Hospital(Qingdao)Cheeloo College of MedicineShandong UniversityQingdao 266035Shandong ProvinceChina

BACKGROUND Mediastinal mature teratoma is the most common histological type of primary extragonadal germ cell *** this report,we describe a rare case of giant mature teratoma located primarily in the anterior mediastinum and causing partial atelectasis of the upper and middle lobes of the right lung,as well as extrinsic compression of the right *** SUMMARY A 31-year-old male with a giant mediastinal mature teratoma presented with progressive exertional dyspnea and chest pain for 1 *** tomography of the chest indicated the diagnosis of anterior mediastinal *** patient underwent right uniportal anterior approach video-assisted thoracoscopic surgery(VATS).En bloc resection of the giant teratoma,wedge resection of the upper and middle lobes of the right lung,resection of the thymus and partial excision of the pericardium were successfully *** pathological diagnosis revealed a mature cystic teratoma with foreign-body reaction that was closely related to the right lung,atrium dextrum,superior vena cava and ascending *** atrophic thymic tissue was also discovered at the external teratoma *** patient was discharged on postoperative day *** This is the first report of the use of uniportal VATS for complete resection of a teratoma in combination with wedge resection of the right upper and middle lung lobes and partial resection of the pericardium.

关键词： Uniportal video-assisted thoracoscopic surgery Mediastinal mature teratoma Complex adhesions and infiltration Video-assisted thoracoscopic surgery Case report

Therapeutic approaches for portal biliopathy: A systematic review

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World Journal of Gastroenterology 2016年第45期22卷 9909-9920页

作者： Irene Franceschet Alberto Zanetto Alberto Ferrarese Patrizia Burra Marco Senzolo Gastroenterology Unit Department of Surgery Oncology and Gastroenterology University Hospital of Padua Multivisceral Transplant Unit Department of Surgery Oncology and Gastroenterology University Hospital of Padua

Portal biliopathy(PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/nonneoplastic extrahepatic portal vein obstruction(EHPVO) and portal cavernoma(PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC(77%-100%), only a part of these(5%-38%) are symptomatic. Clinical presentation includes jaundice, cholangitis, cholecystitis, abdominal pain, and cholelithiasis. In this subset of patients is required a specific treatment. Different therapeutic approaches aimed to diminish portal hypertension and treat biliary strictures are available. In order to decompress PC, surgical porto-systemic shunt or transjugular intrahepatic porto-systemic shunt can be performed, and treatment on the biliary stenosis includes endoscopic(Endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy, balloon dilation, stone extraction, stent placement) and surgical(bilioenteric anastomosis, cholecystectomy) approaches. Definitive treatment of PB often requires multiple and combined interventions both on vascular and biliary system. Liver transplantation can be considered in patients with secondary biliary cirrhosis, recurrent cholangitis or unsuccessful control of portal hypertension.

关键词： Portal biliopathy Portal cavernoma Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiopancreatography Porto-systemic shunt

Effects and translatomics characteristics of a small-molecule inhibitor of METTL3 against non-small cell lung cancer

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Journal of Pharmaceutical Analysis 2023年第6期13卷 625-639页

作者： Han Xiao Rong Zhao Wangyang Meng Yongde Liao department of thoracic surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China department of thoracic surgery Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China

In non-small cell lung cancer(NSCLC),the heterogeneity promotes drug resistance,and the restricted expression of programmed death-ligand 1(PD-L1)limits the immunotherapy *** on the mechanisms related to translation regulation and the association with PD-L1 of methyltransferaselike 3(METTL3),the novel small-molecule inhibitor STM2457 is assumed to be useful for the treatment of *** evaluated the efficacy of STM2457 in vivo and in vitro and confirmed the effects of its inhibition on disease ***,we explored the effect of STM2457 on METTL3 and revealed its effects on the inhibition of catalytic activity and upregulation of METTL3 protein ***,we described the genome-wide characteristics of multiple omics data acquired from RNA sequencing,ribosome profiling,and methylated RNA immunoprecipitation sequencing data under STM2457 treatment or METTL3 *** also constructed a model for the regulation of the translation of METTL3 and ***,we found PD-L1 upregulation by STM2457 in vivo and in *** conclusion,STM2457 is a potential novel suppressor based on its inhibitory effect on tumor progression and may be able to overcome the heterogeneity based on its impact on the ***,it can improve the immunotherapy outcomes based on PDL1 upregulation in NSCLC.

关键词： STM2457 METTL3 Translatomics Non-small cell lung cancer PD-L1

Development of a prognostic signature for esophageal cancer based on a novel 7-DNA damage repair genes signature

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BIOCELL 2022年第12期46卷 2601-2613页

作者： JIAMING ZHAN WEIHUA WANG YANLEI TANG NING ZHOU DAOWEN JIANG department of thoracic surgery Minhang HospitalFudan UniversityShanghai201199China

Esophageal cancer(EC)was an aggressive malignant neoplasm characterized by high morbidity and poor *** the changes in DNA damage repair genes helps to better understand the mechanisms of carcinoma *** this study,by comparing EC samples and normal samples,we found a total of 132 DDR expression with a significant ***,we revealed higher expression of POLN,PALB2,ATM,PER1,TOP3B and lower expression of HMGB1,UBE2B were correlated to longer OS in *** addition,a prognostic risk score based on 7 DDR gene expression(POLN,HMGB1,TOP3B,PER1,UBE2B,ATM,PALB2)was constructed for the prognosis of ***,EC cancer samples were divided into 3 subtypes based on 132 DDR genes *** profile analysis showed cluster C1 and C2 showed a similar frequency of T2,which was remarked higher than that in cluster ***,we found the immune cell inflation levels were significantly changed in different subtypes of *** infiltration levels of T cell CD8+,B cell and NK cells were greatly higher in cluster 2 than that in cluster 1 and cluster *** results showed T cell CD4+infiltration levels were dramatically higher in cluster 1 than that in cluster 2 and cluster ***,we perform bioinformatics analysis of DEGs among 3 subtypes of EC and found DDR genes may be related to multiple signaling,such as Base excision repair,Cell cycle,Hedgehog signaling pathway,and Glycolysis/*** results showed DDR genes may serve as new target for the prognosis of EC and prediction of the potential response of immune therapy in EC.

关键词： Esophageal cancer DNA damage repair genes Signature Tumor immune infiltration

CARDIAC　ARRHYTHMIA　AFTER　LUNG　CANCER　surgery　－－ANALYSIS　OF　140　PNEUMONECTTOMY　CASES

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Chinese Journal of Cancer Research 1995年第4期7卷 272-274页

作者：吴怀申周允中张良平张新民陈文虎郑敏 department of thoracic surgery Shanghai Chest Hospital Shanghai

Among 808 surgically resected lung cancer cases at Shanghai Chest Hospital during 1991 to 1992, 140 of them (17.3%) underwent Pneumonectomy. Of the 140 cases:124 male, 16 female; aged 27-74 yrs, 35.7% elder (60 and over), preoperative abnormal EKG was found in 38 cases, operative mortality was 4.3%. The histopathological diagnosis were: squamous 43.6%, adeno. 36.4%, small cell 8.6%, mixed type 11.4%. The pTNM stages: stage I 2.9%, II 17.1%, IIIa 55.0%, IIIb 21.4%, IV 3.6%.Postoperatively, arrhythmia occuried in 76 cases, with an incidence of 54.3%. Of the 76 arrhythmias, atrial fibrillation was seen in 7 patients, atrial premature beats in 2, supraventricular tachycardia in 1, and sinus tachycardia in 66. The incidences of cadiac arrhythmia during the postoperative day (DO), first day (D1), D2, D3,and D4 were 48.7%, 35.5%, 7.9%, 4.0%and 2.6%respectively. Conclusion: the cardiac arrhythmia is the most common complication after pneumonectomy for lung cancer surgery. The major causes were incisional pain, hypovolemia due to blood loss and respirative insufficiency due to anomia. The perioperative prevention and treatment for arrhythmia were also discussed.

关键词： Lung cancer Pneumonectomy Cardiac arrhythmia,Complication,Morbidity.

Circulating tumor cells with epithelial-mesenchymal transition markers as potential biomarkers for the diagnosis of lung cancer

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World Journal of Clinical Cases 2021年第12期9卷 2721-2730页

作者： Sha-Sha Jiang Chun-Guo Mao Yong-Geng Feng Bin Jiang Shao-Lin Tao Qun-You Tan Bo Deng department of thoracic surgery Institute of Surgery ResearchDaping HospitalArmy Medical UniversityChongqing 400042China

BACKGROUND Circulating tumor cells(CTCs) can be clustered into three subtypes according to epithelial-mesenchymal transition(EMT) markers: CTCs with epithelial markers(E-CTCs), CTCs with mesenchymal markers(M-CTCs), and CTCs with both markers(E&M-CTCs). CTC detection has clinical implications in the diagnosis of lung cancer(LC).AIM To clarify the diagnostic value of CTCs categorized by EMT markers in *** The study included 106 patients with lung adenocarcinoma, including 42 groundglass opacities(GGO) and 64 solid lesions, who underwent surgery between July 2015 and December 2019. Eleven patients with benign tumors and seventeen healthy controls were included. CTCs in peripheral blood and associated EMT markers were detected preoperatively using the CanPatrol TM technique. The diagnostic power of CTCs for discriminating LC cases from controls was analyzed by the receiver operating characteristic(ROC) curve. The CytoploRare technique was used in 20 cases and 18 controls for validation, and Kappa values were calculated to evaluate consistency between *** Of the 106 LC cases, 94(89.6%) had at least one CTC. CTCs were detectable in 35(83.3%) of 42 GGO cases. Total CTCs and E&M-CTCs were significantly more frequent in LC cases than in benign or healthy controls. The proportion of MCTCs plus E&M-CTCs increased gradually from healthy controls, to benign controls, to LC cases. The area under the ROC curve of total CTCs and E&M-CTCs was > 0.8 and > 10.75, respectively. The combined sensitivity of total-CTCs and E&M-CTCs was 85.85% for LC patients(80.95% for GGO patients) and the specificity was 78.57%.The Kappa value was 0.415,indicating relative consistency between CanPatrol TM and *** CTC detection is valuable for distinguishing LC from controls,and particularly E&M-CTC detection warrants further study.

关键词： Circulating tumor cells Epithelial-to-mesenchymal transition Diagnosis Lung cancer Ground-glass opacities CanPatrol

The impact of postoperative EGFR-TKIs treatment on residual GGO lesions after resection for lung cancer

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Signal Transduction and Targeted Therapy 2021年第3期6卷 599-601页

作者： Bo Cheng Caichen Li Yi Zhao Jianfu Li Shan Xiong Hengrui Liang Zhichao Liu Wenchuang Zeng Wenhua Liang Jianxing He department of thoracic surgery and oncology the First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease&National Clinical Research Center for Respiratory DiseaseGuangzhou 510120China department of thoracic surgery Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiChina

Dear Editor,In recent years,the incidence of multifocal lung cancer is increasing,called multiple primary lung cancer(MPLC).Synchronous MPLC(sMPLC)is defined by multiple malignant lesions occurring at the same time.1 In clinical practice,it was always extremely difficult to remove all lesions simultaneously for sMPLC ***,unresected GGO lesions after primary surgery frequently caught the risk of progression.

关键词： lesions lung cancer

Gasless Laparoscopic surgery plus Abdominal Wall Lifting for Giant Hiatal Hernia——Our Single-center Experience

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第6期36卷 923-926页

作者： Jiang-hong YU Ji-xiang WU Lei YU Jian-ye LI department of General surgery department of thoracic surgery Beijing Tongren Hospital Capital Medical University Beijing 100730 China

Giant hiatal hernia（GHH） comprises 5% of hiatal hernia and is associated with significant *** traditional operative procedure,no matter transthoracic or transabdomen repair of giant hiatal hernia,is characteristic of more invasion and more *** laparoscopic repair as a minimally invasive surgery is accepted,a part of patients can not tolerate pneumoperitoneum because of combination with cardiopulmonary diseases or severe posterior mediastinal and neck emphesema during *** aim of this article was to analyze our experience in gasless laparoscopic repair with abdominal wall lifting to treat the giant hiatal *** performed a retrospective review of patients undergoing gasless laparoscopic repair of GHH with abdominal wall lifting from 2012 to 2015 at our *** GHH was defined as greater than one-third of the stomach in the *** laparoscopic repair of GHH with abdominal wall lifting was attempted in 27 *** age was 67 *** results showed that there were no conversions to open surgery and no intraoperative *** mean duration of operation was 100 min（range：90–130 min）.One-side pleura was injured in 4 cases（14.8%）.The mean postoperative length of stay was 4 days（range：3–7 days）.Median follow-up was 26 months（range：6–38 months）.Transient dysphagia for solid food occurred in three patients（11.1%）,and this symptom disappeared within three *** was one patient with recurrent hiatal hernia who was reoperated *** patients still complained of heartburn three months after *** reoperation nor endoscopic treatment due to signs of postoperative esophageal stenosis was required in any ***,satisfactory outcome was reported in 88.9% *** was concluded that the gasless laparoscopic approach with abdominal wall lifting to the repair of GHH is feasible,safe,and effective for the patients who cannot tolerate the pneumoperitoneum.

关键词： gasless laparoscopy abdominal wall lifting giant hiatal hernia Nissen fimdoplication