Primary bronchopulmonary carcinoma occurs in the bronchial mucosa epithelium, also called lung cancer (LC), and has currently become the first cause of death of malignant tumors in China. With constant efforts of Chinese physicians, the diagnosis and management of LC has made certain progress, but standardized surgery for LC still varies to a great extent due to difference regions, nature of medical centers, and technical levels. Complete and standardized surgical resection can provide good long-term survival for patients with stageⅠ, Ⅱand partly ⅢA LC, and cannot be a substitute for other treatment, which shows the importance of standardized surgery. As the most solid member, surgery plays a decisive role in comprehensive multidisciplinary treatment of LC. Today's medical development requires thoracic surgeons to provide most standardized and individualized treatment with principles of evidence-based medicine. This review focuses on progress of standardized surgery for stage Ⅰto ⅢA LC.
【Abstract】Objective To study the surgical therapy and staging investigation about stage Ⅳ breast carcinoma. Methods The clinical data of 38 patients with stage Ⅳ breast carcinoma were summarized, and the patients were followed up. Results The stage Ⅳ patients who had isolated metastasis and removable primary tumor were treated by radical surgery with good effect. On the other hand, the stage Ⅳ patients who had extensive metastasis and primary tumor unresectable were treated by palliative operation with the living quality of patients becoming better and chemotherapy load cutting down. Conclusion The stage Ⅳ patients should be divided into stage Ⅳa and stage Ⅳb. And the stage Ⅳa patients should be treated by radical operation, and the stage Ⅳb by palliative operation.
目的 评价不同外科手术治疗肝脏囊性占位的临床疗效以及不同外科治疗策略的优缺点。 方法 对1998年1月－2011年12月收治的肝囊性占位患者的临床资料进行回顾性分析。共纳入148例患者，其中单纯性肝囊肿患者86例（单发35例，多发51例），多囊肝病患者62例。43.9%（65/148）患者行腹腔镜囊肿开窗治疗，27.0%（40/148）患者行开腹囊肿开窗术，21.6%（32/148）的患者行经皮囊肿穿刺及硬化剂注入术，另有7.4%（11/148）患者行开腹肝部分切除联合囊肿开窗术。 结果 经过手术治疗后，患者症状缓解率高达100.0%；术中患者出血量以经皮囊肿穿刺及硬化剂注入术最少，而以开腹肝部分切除联合囊肿开窗术最多。对于单纯性肝囊肿单发患者，不同手术治疗后均未出现症状复发；对于单纯性肝囊肿多发患者，肝部分切除联合囊肿开窗术治疗未出现症状复发，而经皮囊肿穿刺及硬化剂注入、腹腔镜囊肿开窗和开腹囊肿开窗治疗则分别有3、4、2例患者发生症状或影像学复发，总复发率为17.6%(9/51)；对于多囊肝病患者，经皮囊肿穿刺及硬化剂注入、腹腔镜囊肿开窗、开腹开窗和肝部分切除联合囊肿开窗治疗则分别有2、7、3和2例患者发生症状或影像学复发，总复发率为22.6%（14/62）。 结论 目前常用治疗方式对于单纯性肝囊肿单发患者疗效均理想，但对于单纯性多发肝囊肿和多囊肝病患者远期效果均尚不理想。
目的 探讨嵌顿性食管旁疝的诊断和外科治疗。方法 对我院手术治疗的4例嵌顿性食管旁疝患者的临床资料进行分析。结果 2例急诊剖腹探查确诊，2例经胸部X线平片和CT检查确诊； 4例均行经腹Hill胃背侧固定术，术后均无并发症，无疝复发。结论 胸部X线平片及CT检查是诊断本病的主要手段； 一旦获得诊断或高度怀疑，应及早手术治疗； 经腹Hill胃背侧固定术式简单、可靠、复发率低，适合基层医院医生掌握。
Objective To explore the diagnostic methods, therapy and the prognostic factors for the ruptured abdominal aortic aneurysm (RAAA). Methods The clinical data of 23 patients (males 15, females 8, age range 35-78, mean age 65) with RAAA below the level of renal arteries, who were treated with surgery, were collected from April 1999 to December 2005 and were analyzed retrospectively. Seven cases had a history of RAAA, 6 cases had pulsating abdominal masses; 15 cases were diagnosed by emergency Doppler ultrasonic examination or CT. All of the patients underwent emergency surgical operation: The ruptures of the abdominal aorta below the level of renal arteries were obstructed by using clamp ring or using transluminal ballon according to conditions of each patient. The aritficial vascular graft was then taken after the control of hemorrhage. Results There were 9 (39%) patients died within 30 d after the emergency operation. The causes of death included acute renal failure because of hemorrhagic shock (4 cases), multiple organ failure (3 cases), and respiratory-circulatory failure (2 cases).Conclusion Surgery may be an effective treatment for RAAA. The critical step of the operation was to control hemorrhage by obstructing the proximal end of the aortic rupture according to the conditions of each patient. The main postoperative complications and causes of death include acute cardiovascular and cerebrovascular diseases, renal failure and pneumonia.