2017年 · 第33卷第07期

On July 22nd, 2017, it is the birthday of Professor Sun Yanqing, a medical giant in China, honorary president of Beijing Anzhen Hospital, chief expert of Beijing High-tech Research Laboratory of Cardiopulmonary Vascular Diseases, honorary chairman of Chinese Society of Thoracic and Cardiovascular Surgery, and honorary chairman of Beijing Society of Biomedical Engineering. I would like to wish Professor Sun a happy birthday and good health!

Esophageal cancer is one of the most common malignant tumors of the digestive tract. About 300,000 people die of esophageal cancer every year, which has seriously threatened human health. Surgery is still the first choice for the treatment of early and middle stage esophageal cancer. There are three main approaches in radical surgery of esophageal cancer: left thoracotomy, right thoracotomy and no thoracotomy. The transcervical and trans-diaphragmatic non-thoracotomy approach is currently limited to some early patients with high surgical risk. There has been a lot of controversy about the surgical approach of left and right chest in esophageal cancer surgery, and the main focus of controversy is whether upper mediastinal lymph node dissection can be achieved. At present, the left thoracic approach is still the main approach in China. How to find an effective method of superior mediastinal lymph node dissection is imperative. The application of video mediastinoscopy can reveal the upper mediastinal anatomy well and resect the upper mediastinal lymph nodes. In order to provide a new technical method for exploring the surgical treatment of esophageal cancer, we proposed transcervical mediastinoscopic lymph node dissection (VAMLA) combined with left thoracic radical esophagectomy, and compared the advantages and disadvantages of right thoracic radical esophagectomy.

Esophageal foreign body is a common emergency, most of which can be removed under direct endoscopic vision, and the prognosis is good. However, if an esophageal foreign body pierces the esophagus and causes esophageal perforation, even if the foreign body is removed, it may still cause mediastinal infection or even mediastinal abscess, which seriously threatens the patient's life and needs to be paid great attention by clinicians^[1]。 The clinical data of patients with esophageal perforation and mediastinal abscess caused by esophageal foreign body admitted to our department are summarized, and the etiology, clinical characteristics and treatment principles of this disease are analyzed in combination with the literature, so as to provide reference for clinical diagnosis and treatment.

pulmonary primary leiomyoma (PPL) is a rare benign tumor derived from smooth muscle cells in the bronchi, blood vessels or pulmonary interstitium. From January 2006 to October 2015, we treated a total of 18 patients with PPL. Now we summarize and analyze the clinical data and follow-up results to raise awareness.

In recent years, many centers at home and abroad have reported the carrying out of thoracoscopic broncholobar sleeve resection^[1,2,3]So far, we have performed a total of 5 cases of single operating hole broncholobectomy, which are summarized and reported below.

Surgery is the first choice of treatment for early and middle stage esophageal cancer. With the development of laparoscopic technology and laparoscopic instruments, thoracoscopic radical esophagectomy has been widely carried out and recognized^[1,2]。 During the operation, due to the small tissue space around the esophagus and poor exposure of important tissues and organs, it is difficult to dissociate and remove esophageal tumors. In order to better expose and remove esophageal tumors, artificial pneumothorax has attracted more and more attention of surgeons. The method of establishing artificial pneumothorax is to use a sealed poke card to continuously blow carbon dioxide gas into the chest cavity during the operation, control the flow rate, form a stable positive pressure in the pleural cavity, make the lung collapse, and form mild mediastinal emphysema at the same time, so as to achieve better surgical field exposure. This study evaluated the safety and feasibility of artificial pneumothorax in thoracic and laparoscopic radical esophagectomy by retrospectively analyzing the relevant indexes of patients undergoing thoracoscopic radical esophagectomy in non-artificial pneumothorax group and artificial pneumothorax group.

PatientMale, 51 years old. Sudden hematemesis accompanied by dull pain in chest and back was admitted to hospital for 1 day. CT scan of chest and abdomen + enhancement showed thoracic aortic dissection, and the rupture was located in the descending part of the aortic arch, 0.3 cm away from the left subclavian artery; The left renal artery opened in the true lumen and the inferior mesenteric artery opened in the false lumen; Aortic dissection involved celiac trunk, hepatic artery, left renal artery, bilateral common iliac artery and right external iliac artery; Multiple rupture of abdominal aorta (Figure 1)。