Experiences and benefits of positron emitted tomography-computed tomography （PET-CT） combined with video-assisted thoracoscopic surgery （VATS） in the diagnosis of Stage 1 sarcoidosis

Background： The purpose of this study was to describe our experiences and analyze the benefits of video-assisted thoracoscopic surgery （VATS） combined with positron emitted tomography （PET）-computed tomography （CT） in the diagnosis of patients with early （Stage 1） sarcoidosis. Methods： From 1995 to 2006, seven patients （two males, five females）, with ages ranging from 26 to 58 years, were impressed with Stage 1 sarcoidosis （mediastinal or hilar lymph nodes involvements without lung involvement） by histological examination of intrathoracic lymph nodes （LNs） and/or lung parenchyma taken＇from VATS biopsy. Three of them received PET or PET-CT evaluation. VATS was approached from the right and left side in one and six patients, respectively, according to the locations of their lesions. Results： All the VATS biopsied LNs or lung specimens were adequate for establishing diagnosis. Mediastinal LNs were taken from Groups 3, 4 in four, Group 7 in two, and Groups 5, 6 in one of them. Hilar LNs biopsies were performed in four cases. Lung biopsy was performed in all but two cases. All of them were expressed pathologically or radiologically as Stage 1 sarcoidosis. PET-CT revealed high emission signals over these affected LNs. These patients received oral steroid treatment or follow up only. All of them were followed up from 5 months to 11 years with satisfactory results. Conclusion： VATS biopsy is a minimally invasive, safe and effective procedure. It can be used as a diagnostic altermative of transbronchial lung biopsy （TBLB）, and can harvest larger and more areas of specimens than mediastinoscopy for staging patients with sarcoidosis. PET-CT can provide us more accurate information about the characteristics and localization of these lesions before biopsy. VATS combined with PET-CT can provide more accurate and earlier diagnosis of patients with unknown intrathoracic lesions, including the sarcoidosis.     

超级无敌狗（下）

上期中,达克斯猎犬兰斯椎间盘突出压迫脊髓,经过一番手术治疗,医生仍宣布其永久瘫痪。坚强勇敢乐观的兰斯,能否重新站起来？它的命运又将迎来怎样的转机？本期故事进入高潮部分,精彩不容错过!     

成年骶尾部畸胎瘤的诊治:单中心8年经验回顾（英文）

目的:探讨成人骶尾部畸胎瘤的临床表现、影像学特点、组织学特征、手术方式及预后.方法:回顾分析2010年8月至2018年8月在我院收治经组织病理学诊断为骶尾部畸胎瘤患者的临床资料.结果:本组患者病例8例(男2例,女6例),中位年龄34岁.6例患者表现为骶尾部疼痛,4例表现为骶尾部肿块和溃疡.采用计算机断层扫描(CT)和磁共振成像(MRI)相结合的方法进行评估,所有患者均进行手术治疗.7例经病理诊断为良性畸胎瘤,术后无复发.1例为恶性畸胎瘤,术后84个月复发,二次手术后随访6月无复发.结论:(1)由于缺乏典型的临床表现,成人骶尾部畸胎瘤难以诊断;(2)CT和MRI检查相结合有利于术前诊断;(3)手术入路和手术切除方式的选择取决于肿瘤的大小、位置和组成,可以通过术前的CT和MRI来确定;(4)大多数成年骶尾部畸胎瘤是良性的,恶性畸胎瘤手术切除效果良好.即使对于复发性恶性畸胎瘤,再次手术效果良好.     

Value of video-assisted thoracoscopic surgery in the diagnosis and treatment of pulmonary tuberculoma: 53 cases analysis and review of literature

Tuberculoma of the lung is one of manifestations in tuberculosis and usually presents as a solitary pulmonary nodule (SPN). It is difficult to differentiate tuberculoma from SPN by other benign or malignant diseases. At present, the crucial role of video-assisted thoracoscopic surgery (VATS) in diagnosis and treatment of pulmonary diseases has been well acknowledged. Here, we reported 53 patients undergoing VATS resection for tuberculomas in our series. No postoperative mortality was found and only two patients experienced prolonged air-leakage (>7 d) and two had minor wound infections that were recovered after anti-tuberculosis or antibiotic treatment. Anti-tuberculosis chemotherapy from 6 to 12 months was routinely used postoperatively. We conclude that VATS is a satisfactory tool for the diagnosis and treatment of tuberculoma and can also establish a reliable diagnosis for all patients with SPNs.     

Pulmonary actinomycosis: a case undergoing resection through video-assisted thoracic surgery (VATS)

Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection and related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing due to its variable presentation and the similarity in appearance to other intrapulmonary diseases. Here we report an 80-year-old man with a solitary pulmonary nodule over the left upper lobe. Pulmonary neoplasm was highly suspected in this patient and thus resection of the mass was undertaken through video-assisted thoracic surgery (VATS). Histopathological examination demonstrated this patient had an Actinomyeces infection. While the application of VATS in patients with pulmonary actinomycosis has rarely been reported in literature, we conclude that VATS is valuable for the diagnosis and treatment of patients with undetermined pulmonary nodule(s).      

Video-assisted thoracic surgery——the past, present status and the future

Video-assisted thoracic surgery （VATS） has developed very rapidly in these two decades, and has replaced conventional open thoracotomy as a standard procedure for some simple thoracic operations as well as an option or a complementary procedure for some other more complex operations. In this paper we will review its development history, the present status and the future perspectives.     

Video-assisted thoracic surgery―the past, present status and the future

VATS,THE PAST Historical perspective The application of thoracoscopy can be traced back to nearly one hundred years ago,when Dr.Jacobaeus(1910)first reported his experiences in the diagnosis and treatment of pleural effusions by tho-racoscope in1909.Most patients who needed to un-dergo thoracoscopy at that time suffered from pul-monary tuberculosis(TB)(“the era of enthusiasm”)(Cutler,1933),and was rarely performed after the development of chemotherapy for patients with TB after the195…     

Diagnosis and treatment of primary spontaneous pneumothorax

Primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder. Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography (CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies. The development of video-assisted thoracoscopic surgery (VATS) has changed the profiles of management strategies of PSP due to its minimal invasiveness and high effectiveness for patients with these diseases.     

基于工作流的SP管理系统的设计及实现

在介绍SP管理系统基本架构的基础上,详细阐述了其特点和实施步骤,并对其实现过程进行了说明。